Saw a surgeon yesterday

[Ross]

Well the surgeon visit is over for the time being. I'm now awaiting a call for scheduling of a CATSCAN and TEE. I should get that today sometime.

I discussed most of my fears with the surgeon and he agrees that the stakes are high, but I really don't have any choice. He advised getting any dental work taken care of and getting the dental clearance to him a.s.a.p.

When I asked about the valve that he likes to use, he said that prefered would be the "Gold Standard St. Jude Mechanical" but it would depend on what may be found once he's inside. I may have to go for a homograft or other tissue valve.

I asked how long I could wait. He said, 1 month yes, 2 months probably, but with each passing month I'm growing closer to becoming inoperable, so I should not wait any longer then necessary.

As far as where and when, it appears to be up to me.
This is where I'm now torn. I can stay here or he'll send me to The Cleveland Clinic. Now, I wonder if the insurance company will play ball. The local hosptial is rating close to Cleveland Clinic as far as mortality rates go, but those are numbers. We all know that numbers don't necessarily reflect the care given and received. I'm tired of driving myself nuts over the decision and feel like flipping a coin and going with whatever comes up. I'll have to rely on God for the guidance here, because I just don't know.

Anyone out here ever had any experience with Aultman Hospital in Canton, Ohio when it comes to heart surgery? I'd sure love to have some feedback.

 

[RobThatsMe]

Hi Ross,

You may want to send Ben Smith a private message or e-mail. He lives up near Lima, OH and had AVR. He had his done at the Cleveland Clinic, but may be able to share some information with you.

Wishing you good health,

Rob

 

[JenniferO]

Ross:

At least things are moving finally.

I think more than the mortality rates, the important thing is volume. Cleveland Clinic does such high volume of these procedures that you know there is nothing they can find in your chest that they haven't seen before and dealt with many times over. That for me was the big reassurance.

Have you actually talked to anyone at Cleveland as to which surgeons there would be appropriate for what you need done?

I believe Cleveland can move quickly if your condition is termed an "emergency" since obviously if you had to wait 3-4 months for a surgery date there, it might put you at too much risk to be worth it. In that case, the local hospital might be the better call, assuming you have a good gut feel about the surgeon there.

I recently talked to a client here in Utah who is headed to Cleveland for surgery with Cosgrove on an expedited basis since he just found out a couple weeks ago that he needs mitral and aortic repair in addition to a double bypass.

If the insurance company won't "play ball" that may be your answer. Believe me, you don't want to be looking at the kinds of bills I'm seeing without insurance cooperation. My bottom line is still uncertain and it definitely keeps me awake nights.

 

[Bill Hall]

Ross - I had my heart surgery done in Cleveland, even though I am from Virginia. My cardiologist told me to have it done local or at Cleveland or Houston since they are large, high volume. I chose Cleveland because I figured this was a one time deal with a lot on the line. I checked my insurance to make sure they would cover. That is important. Also wanted to comment about the urgency. I know you would like to weigh the pros and cons, but you are much better off picking and getting this scheduled.

 

[Ross]

Thanks Rob, I'll do that.

Jennifer, The surgeon I saw was Dr. Roberto Novoa and he at one time, was a surgeon at The Cleveland Clinic.
I haven't yet talked to anyone at Cleveland, but if I go back there, Dr. Novoa would send me to Dr. McCarthy. From there, who knows what would come about.

I'm very familiar with Cleveland, more so then I'd like to be anyway. The problems come in with (get this) transportation.
I don't own a vehicle that is capable of multiple trips to Cleveland and I'd certainly hate to see my wife and family make the track everyday. Aultman is 10 miles from the house, Cleveland is 65. Quality of the surgeon is comparable and I do have a good feeling about him, but I question the hospital all around. It's not my first encounter with Aultman. In fact, that place has a mailbox set up for me in the ICU or at least it once did. I know they have a "Owners Manual" ( I kid you not. The files they have on me are 4 to 5 inches thick!) on me there, but then again, so does Cleveland.

Dr. Novoa's office just called with Next Thursday, April 11th, for the Catscan, Carotid Echo, and April 17th for the TEE. I guess I'll partially use how I'm treated through these proceedures to make my decision. I've had both, good and bad from both places, so this is really a tough choice to make.

 

[Nancy]

Hi Ross-

So glad that things are starting to move for you. Tell them to fix your alien when they get in there. LOL

Joe opted to have his surgery in the local hospital. We are blessed with a fantastic surgeon and the quality of care in the cardiac surgery unit is superb. Plus the hospital is high volume for heart surgery and in the top 100 hospitals.

The good thing was that I was able to take care of the house and still spend many hours with Joe. I made sure that his care was good, and for the most part, didn't have to get on my broom and fly around too much.

The other good thing is that the "hand-off" to the local cardiologist is pretty much seamless.

So we were pleased all around. But every hospital is different, and even the big ones have some glitches. It sounds as if no matter what you choose, the surgery will be top notch. So that's a big part of decision making.

Good luck with your choice.

 

[JenniferO]

My experience with care at Cleveland as far as the surgery and the ICU was excellent. However, I felt they really fell down on quality in the pre-op testing and consultations and on the regular cardiac nursing floor after I was moved from the ICU. The whole experience at Cleveland was very impersonal and I knew I was just a number in the crowd.

I got much better care at my local hospital as far as nursing and the attitude of staff administering tests when I was hospitalized at University of Utah for the suspected TIA.

If you feel good about the surgeon at the local hospital, that sounds like a reasonable way to go.

You know I'm praying for the best for you whatever your decision.

 

[Christina]

Hi Ross,

I had no intensions of leaving my hometown because I wanted my family to be with me. If I would've chosen to go out of town they wouldn't have been able to come every day because of distance.
I think I was blessed with a terrific surgeon. I did not know him at all but later learned that he has been on the heart/lung transplant team with the famous Dr. Jack Copeland here in Tucson. Also I liked his eyes and he touched my hand real gently when he spoke to me.
I thought that was real personal. I had had the cath that day and was real scared. He tried to put my mind at ease and took time out.

Christina
Congenital Aortic Stenosis
AVR's 8/7/00 & 8/18/00
St. Jude's Mechanical

 

[Mara]

Ross,
By now I am sure everyone is sick of hearing my 2 cents on this. I had my surgery done locally, too. I felt comfortable with my surgeon and the hospital. I wanted my family to be close by and did not want to travel.

It's a tough choice. But, the sooner you decide the better off you'll be.

good luck
-Mara

 

[Ross]

Thanks for your input everyone.

I still have sometime to think this through (Not likely to change my mind any) but I'm thinking that I'm staying at home this time around.

I know Doctors are supposed to seperate themselves from feelings, but I do think Dr. Novoa is a caring type individual, even though he has a tough case load. I should have looked at this a little more thoroughly when he was 2 hours late for my appointment. Of course, there were others in the office that had waited 5 hours. It was going on 6:15 p.m. and he still took his time with me to explain and answer questions, also try to order more tests. Not that I like tests, but I can't say he isn't being thorough!

 

[Zazzy]

Hi Ross... I have waited for four hours for my heart surgeon. He was called away on an emergency and since I live 1-1/2 hours away it was more convenient for me to wait.

I feel that it is very important to like and respect your surgeon. My care that I received was excellent... by the end of December (my surgery was in October) everyone on the cardiac floor knew me... even the maintenance people!!! lol You KNOW that you've been there too many times when they ask why you are back!!! lol

Good luck and keep us posted!

Zazzy

 

[Ross]

Hi Zazzy

I know what you your talking about.

It's been awhile since I knew everyone and they knew me, so we're not on a first name basis anymore. It will be interesting to see how many familiar faces are seen roaming the floors.

 

[John Cochran]

Ross,
Have you made a decision yet? I too was torn between local (Minneapolis) and the Mayo Clinic, which is only 90 miles away. However, my choice of surgeon was so important to me, plus being able to have much of my family with me, that I elected to stay at home.

I don't think there is any "right" answer to this...it is much more what feels right to you and gives you the most confidence. What ever you choose, Ross, I'm sure it will work out great!

Best,
--John

 

[Zipper]

Choices!!!

Choices!!!

Hi Ross,

I agree the decision you make has to be what you feel best about, and there are so many things to consider.

I feel the Surgeon's record and the team he works with are a most important factor. A Surgeon that works with the same team all the time has a 'well oiled machine'...so to speak. Confidence in your surgeon is uppermost in my mind.

Best of luck in deciding and I hope your wait is not too long....that wears on one's nerves, for sure!

Take care,

Joan

 

[ALCapshaw]

Hello Ross,

Here's some advice given to me by a friend who is an Internist (MD):

He told me that the difference between a GOOD Local Surgeon and the top guys in the country is now pretty small so if your local hospital does a reasonably high volume of operations per year, they should be competent.

Did you check HealthGrades.com? You can get hospital ratings by procedure for any hospital in the country. If your local surgeon came from Cleveland Clinic, he should have the benefit of their excellent training. It sounds like either choice is a good one and comes down to personal preference.

Regarding your transportation problem, a simple solution would be to rent a car for the few days you would be in the hospital, which would provide you and your family with safe reliable transportation at low cost.

'AL'