Pre-Surgery appointment with the surgeon.

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Hockey Heart

Well-known member
Joined
Mar 1, 2011
Messages
82
Location
Evanston, IL
I am getting ready for this appointment and compiling my list of questions to ask him (thanks for that sticky post).

I just wanted to ask all of you what your experiences were in this appointment? What did you learn that you didn't know going in? What would you have done differently or made sure you asked more questions about if you could go back? And if you have any advice for someone like me who is going into this appointment who is feeling a little overwhelmed by it all.

Thanks,
Scott
 
Hi Scott

I too felt overwellmed by EVERYTHING by the time I met the surgeon. I first received the news of valve replacement and surgery at the end of Sept, and the surgeon appointment was late Oct of 2010. Things were moving too fast for me, no time to process the feelings I was living with and felt that I wasn't in control but decided to surrender to the experts. I detatched from my emotions by the time I got into his office, and listened intently to the things he said. He gave me the choice of tissue valve or mechanical, going over the pros and cons of both. I knew at this time I wasn't going to tell him his job after he had assured me he had done the proceedure-"I'm doing a Bentall..." many,many,many times. His team knows what they are good at. The only choice I had in the meeting was what kind of valve did I want. I had did a little research - nasty scary stuff on the internet ( I hadn't found this site). For some reason I blurted out Pig...he said good and that was the end of that.

That's when the vascilation started. Did I say the right thing? Can I change my mind? I knew do it or die, but what was life going to be like afterwards? I stuck with the pig as having been on cumadin for a brief period and didn't like the blood testing, but not really content with the replacement factor - 15 years and counting - for the pig. The seesaw continued to my surgery date November 26th 2010. In the waiting area before I went into the OR just before they put the IV in I felt like saying "change it to mechanical". I didn't say it, as I felt when I blurted out pig in the surgeon meeting it was a gut reaction which for me tend to work out the best.

When I woke up in ICU the initial thoughts were - hey!! its working!!! and did I make the right decision on going with the pig, really feeling like I don't wanna go through this again.

It was my 10th week post op that the ups and downs stopped and I decided the pig IS right for me....not that I could do anything about it anyway,lol!!!!

Hang in there, Its all good!

Bob
 
You're talking about the first time you meet the surgeon and not right before surgery when you are doing all your pre-op testing and talking with the team correct?

We have alot of experience with talking to surgeons before surgery..and i think that list is a good list of questions in genral but like others mentioned in that thread, some of thse questions, about the hospital stay in general, wifi who can visit type questions, should be answerred by someone else on the "team" depending on how that hospital is set up, usually there is a contact person, maybe a nurse or PA, that can answer all the questions about the hospital stay.
We like to focus JUST on the actual questions about the surgery itself when we're talking to the surgeon. Questions about what his plan would be, what valve or other material he recomends and why, how long the surgery SHOULD last and how long on the heart lung machine, also how long do most people having the same surgery in the same age group/health usually have to stay in the hospital I also would ask how they plan on closing you. Some people just use glue or steri strip (tape) for the top/skin closing and others use staples that have to be removed. Also depending on what you need done, this is the time to discuss incisions and how big or little and if it will be down the sternum or between ribs and why he thinks that would be best for the surgery you need. Also depending what you know about the surgeon, ask how many of this surgery does he do and the success rate etc.

Then if there are any concerns we might have based on past experience or even if any other medical issue someone might have could play any part in the descions or the surgery or recovery.


Most surgeons will answer anything you ask, but most surgeons, especially in busy centers don't really have alot of time, inbetween doing surgeries, checking post op patients, meetings reports- so I try to respect that and rather focus on things about the surgery itself. I've also noticed surgeons are pretty good at knowing what people want to know and even tho I have a list of questions, I usually let them speak first and explain everything they are planning, and answer any questions the surgeon asks us and THEN I ask my questions he might not have answerred, usually tho most things were answerred before we've had to ask.
I think the more you can understand about your surgery and how hearts work as well as any choices you might have to make before you meet with the surgeon the better. Alot of the questions I had were mostly follow up type questions, depending on what answers he gave to the other questions, or when he was describing his plan, so the more I understood going in the better I could think of follow up questions about Justin's surgery and his unique set of concerns.

Also remember make sure you do understand what he is saying, If you're a little confused ask again or ask him to explain it alittle differently until you do understand. IF possible I think it is could to have someone with you during the meeting, sometimes it gets a little over whelming so it's good to have another person listening that you can talk with after the appt to make sure you both heard the same thing. But don't be worried you have to get every questions answerred right then, alot of time you don't think of more questions until your home and thinking about or talking to someone about what was discussed, you can always call the person they give you the contact info for to ask any questions.

Then when we go in for the pre-op day usually a day or so before surgery, thats when we meet the anesthia and discuss any questions or concerns about drugs before, during and after the surgery, as well as either the surgeon or sometimes a surgical fellow and other members of your team. It can be a very long day.
 
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Scott, the best questions to ask are ANY QUESTIONS AT ALL..............leave no stone unturned or in this case no questions unasked no matter how trivial it may seem it is in your mind ....you want a puerfectly clear and relaxed state of mind
 
Thank you all for the excellent feedback! I am meeting with the surgeon this Wednesday and will ask all my questions that are relevant for him that he doesn't answer on his own when he is explaining things to us. I'll let you all know how it went!
 
Scott -

One thing I did was was to lay out all my medical issues/conditions/concerns, and then ask my surgeon, "If I were your sister, what kind of valve would you recommend?"

BTW, I see you're in Evanston. Mind if I ask where you're having surgery?
 
I am most likely going to have my surgery at Northwestern. There is an outside chance I will opt to have it at Evanston Hospital. Where did you have yours?
 
Quick Update: Met with two surgeons (Pat McCarthy from Northwestern and John Alexander from Evanston Hospital). I am choosing to have it done by McCarthy. I was really impressed with McCarthy and the facilities over at Northwestern. My surgery date is April 28, 2011. A little nervous here but also looking forward to getting it over with.
 
Scott -

One thing I did was was to lay out all my medical issues/conditions/concerns, and then ask my surgeon, "If I were your sister, what kind of valve would you recommend?"

BTW, I see you're in Evanston. Mind if I ask where you're having surgery?

I asked the same question to my surgeon before my first surgery (except I said brother) and without hesitation his response was "I don't like my brother". That was priceless lol. I am sure that is his automatic response to all of his patients to let them know that he doesn't want to influence their decision. I am sure if a patient has a certain condition that should rule out a certain type of valve he would say so.

Scott...I think you made an excellent choice picking Dr. McCarthy at Northwestern (he used to be at Cleveland Clinic). I live 30 minutes from Duke Medical Center in Durham, NC so I have had both of my surgeries there, but there have been many members here that have had Dr. McCarthy as their surgeon and they have nothing but great things to say about him. Good luck with your surgery. I think Lyn covered everything great although you have already had your meeting. One other thing I want to mention, and you can still talk to your surgeon about it when you meet the day before surgery, is to be brutally honest about everything in your life that affects your lifestyle. Me and my surgeon had originally agreed on implanting an On-X valve. The evening before surgery we sat down and talked and i was "brutally honest" about my lifestyle. I said that I have had periods where I have (i hate saying this but you never know if it will help someone) quit drinking for long periods of time (7 years two different times) but when a life crisis came up I always went back to drinking (more than the average person). At that point we decided that a tissue valve was the best decision for me even if it meant another surgery down the road. He felt confident that if this valve lasted me as long as he thinks it will that catheter based valve replacement would be a viable option for me. This issue might not affect you but it may be of some help to someone else. And it could be an issue that is not alcohol related but the surgeon needs to know everything that might affect your valve choice.
 
Very good point, Bryan. This is not a circumstance when you want to be less than fully honest with your surgeon and all your care providers. They need to know this information to give you the best care possible.
 
Thank you, Bryan. For me, it was always a tissue valve mostly due to my age (36) and active lifestyle. Throw in the fact that you really can't ever get rip-roaring drunk when you are on Coumadin, which I like to do a few times a year, and the choice for me is a no-brainer.
 
Agree with Greg, I recently met with a pre-op patient whose wife asked Dr Pettersson at the Cleveland Clinic if he was ecperienced with AVR. Well he is, but if you do not know, then you better ask the question.

I found that meeting with Dr Pettersson myself to just give the comfort level that he was as good as I had been told he was. It also helped me to make my Valve choice. Had my wife not stated the he needed to fix me so that I (most like she) would never need to go through this again, I might not have really considered a mechanical valve.

I also like to state my opinion that you should rely on your Cardio a lot as well. I see them as a team and that the Cardio is really the goto person who will be well versed in all the options and what they will mean to you long term.

Scott
 

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