Choice of Doctor/Hospital

[mar-kadam]

Hello all. My wife and I are trying to understand what all is involved here. She has severe arotic stenosis. We're not thrilled with the cardiolgists in town, and thought we'd set up a 2nd appointment at the Cleveleand Clinic. It appears to be one of the best, if not the best, and certainly seems to be better than what's here in central PA.

1) Are we wrong to go there for a 2nd? Any opinins/advice is helpful.

2)In the process of seeing a cardiologist, is the process to see the echo guys/evaluation first, and later if/when necessary use the surgeon? Can we pick both, or does the first one (echo/eval) pick the surgeon, or is it just based on rotation, or...

I guess what I'm asking is how much control do we have in selecting who does what. Because right now my wife is scared to death, so much so that I can't get her to input, or even read these wonderful threads. So I'm trying to find out.

Thanks so much. Bob

 

[bvdr]

Second Opinion.

Second Opinion.

Hi,

First of all, your wife is very fortunate to have you there at her side. You are truly being a caring husband.

I have not yet had valve surgery but have heard absolutely wonderful things about Cleveland Clinic. Many members on this board have had work done there. If you feel like you need a second opinion please don't hesitate. It is truly amazing what is being done in heart valve surgery today. Things that were unheard of just a decade ago are now commonplace.

Being fearful is pretty natural because it is a major operation and because of that you both need to have confidence in who will do your surgery. Some of the others here will have a better idea as to with whom you should try to get an appointment. You certainly do have some control in these matters.

There are some good valve centers in Pennslyvania but I would probably be tempted to get that second opinion at Cleveland Clinic.

Please let us know how things are going. Tell your wife that we would love for her to spend some time here and ask her questions. God Bless.

Betty(bvdr)

 

[Ross]

Bob if you feel a second opinion is needed, by all means get one. If you don't think the second is correct, get a third.

The Cleveland Clinic is the #1 rated heart surgery hospital in the nation. It's hard to say who to consult with but I can tell you to try for Dr. Cosgrove. If that's not appropriate for him, they can recommend someone there.

Bare in mind that if you go to Cleveland, take all tests that have already been done with you. If there are things yet undone, they will do them there. It's like a one stop shop. I spent a full day doing testing and then surgery another day. They are VERY thorough. I had Dr. Patrick McCarthy. He's my guardian angel. Here is a link to the entire staff of Cardiothoracic surgery at CCF
http://www.clevelandclinic.org/staf...acic+Surgery&LName=&Sinterests=&CCFDir=Search
As for your choices or control- You can select anyone that you want. That is your right. The only draw back or limitations are who you have for Insurance. It's usually the insurer that gets most of the control as far as who you see and what gets done.

Please tell your wife not to go bonzo. This stuff has become such a fine science now, that there are very few complications and most people are back in business in as little as 6 weeks and out of the hospital in 5 to 7 days.

Keep in touch.

 

[mar-kadam]

choice

choice

Thanks everyone. More later, since finding time to reply is difficult.

 

[Nancy]

Hi Bob-

Welcome to this terrific site. You'll find loads of support and information here. I am also the spouse of a heart surgery patient. My husband has no interest in computers, so I do all his research on the various conditions.

You were mentioning that you weren't too pleased with the cardiologists close by. It's always a good idea to get a second opinion under those circumstances. But I urge you to try to eventually locate a cardiologist fairly close by that you can have a good relationship with. Your wife will have numerous appointments, and a local heart doctor is almost a necessity, especially for visits to the ER. If you have a family doctor that you trust, try to get a recommendation for a good cardiologist. Also ask around with your friends and family for recommendations. Cleveland Clinic is fantastic and can do it all, but you will still need that close by care, after all is said and done.

Years ago, after my husband had his aortic valve replaced (25 years ago), his cardiologist was located in Boston at Lahey Cinic. He was an excellent doctor and Joe went there for cardiology appointments. Lahey Clinic is about 3 and a half hours away from us. As time went on, it became more and more difficult to keep this relationship as a working arrangement. It was just too far away, and Joe's local doctor (several years ago) was not in good communication with the cardiologist. Things eventually fell apart, and we were forced to seek local care.

For subsequent surgeries, we have a local cardio-thoracic surgeon who is excellent. It was so very easy to have the surgeries done here with the after-surgery "hand-off" to the local cards.

As far as surgery, if it turns out that your wife is in need of that, there are several things that you could tell her.

First of all, it is very normal to be frightened. It's major surgery and not like any other.

The surgery is highly perfected and the mortality rate is low.

This surgery is done to save your life.

The surgeons who do this are very, very expert at what they do. They operate on hearts all the time, sometimes, more than once a day. Everything that is inside your wife's heart, they have seen before and wiill know how to take care of.

The care in the hospital will be the best that hospital can offer. All of the nurses and Physician's Assistants are excellent.Pain management is of the utmost importance, and your wife will be made as comfortable as possible.

The hospital stay is remarkably short. Many people can go back home in 5-7 days. Some have gone home sooner.

She will be up and walking by about day 2 after surgery.

Please do what you can to read as many posts here as possble. It might be hard at first, but it really does help to ameliorate the angst associated with heart surgery.

Above all, we will be here for you to offer support, and for your wife, if she decides to come here.

Take care,

 

[mar-kadam]

Thank you Nancy,

Our first thought is to go to the best (Cleveland), and then do follow-up eventually with our local cadiologist(s).

We are a bit in flux right now. I start a new job teaching in the Fall, and next Fall our youngest son goes to college. Our second son is getting his degree from New Hampshire (and then Grad school), so the point is that to a large extent we will become mobile travelling around to sons/my college job/etc. etc.

That's why the CCF is first, the rest comes later.

Thank you for your kkind words, they are much appreciated.

Bob

 

[Kevin M]

A second opinion is a good idea. Even if the conclusions match exactly, at least it will give you comfort.

Let's not forget that some doctors may be brilliant, but have the personality of a Yeti. One should feel comfortable talking to their doctors. I've had both - the most personable and caring individual you could want and the most stonefaced cyborg imaginable.

It's great that you are supporting your loved one. I know when I was going through this stage, I felt weak and confused and my wife stood up and put her foot down and got the answers we needed to make our decisions.

Best of luck to you both.
Kev

 

[David by Philly]

In Philadelphia

In Philadelphia

Hi Bob,

If you are looking to go east, I can recommend Dr. Joseph Bavaria, Director of Cardiothoracic Aortic Surgery at Universty of PA Hosp. (HUP).

He is probabably the best in the Phila area and the top 10 in the US. Does over 200 valves a year.

Initially, we were looking to do a aortic resection and avr with a stentless porcine root. During surgery, he felt my aorta only needed minor repair and implanted a bovine pericardial valve. After surgery he spent 20 min talking with my family, and explained one of the reasons he chose the bovine valve was the ease for the surgeon to reimplant a new valve 15-20 years down the line.

The man is not just looking at todays surgery but my life in the future. See why I recommend him???

Best of luck with your choice, and feel free to pick my brain.

 

[Gail in Ca]

My biggest advice is she must feel comfortable with the cardiologist and especially the surgeon. If the surgeon comes highly recommended for the type of surgery she needs and she meets him and likes him, I say, he's the one! I have felt so comfortable with my surgeons that I knew I would survive, and that's the key,
Gail

 

[EVELYN]

Hello Bob

I don't think Gail could have said it any better......it doesn't matter whether you consult with one, two, or three cardio-thoracic surgeons, you will DEFINITELY KNOW the one who is right for you. I once had a friend who told me.....finding a surgeon is like buying a horse.......you can buy one who is absolutely sound or one who is lame, blind, and mean.....doesn't matter, it's your choice and your money.......find the right one for you, no matter what it takes.

Evelyn

 

[mar-kadam]

Surgeon

Surgeon

Thank you everyone. We'll go to visit Dr. Rimmerman at Cleveland on Tuesday. I'm sure that will open our eyes, since no one here in town has been much help. I even had to fight to get her medical records (videos, test results) to take out for this 2nd opinion. One thing we found is that in December '01 the blood work-up showed triglycerides of 256, and nothing was said! We now know that that number is too high. Anyway, by Wednesday we'll know alot more. Thank you. Bob