Surgeons, How To Talk To Your Patients

[abbanabba]

...You're fairly young(56) no other health problems and My team and I are the best in the business so don't worry we're going to get you safely through this surgery.You have my word on that.Wouldn't you feel better to hear that from your surgeon.So come on docs, jeezz install a little confidence in your patients!!!!!!!!!1

This would concern me more than the straight up truth! Why? Because I'd feel he was full of BS because I KNOW they can't make any guarantees and it's hard to have faith in someone full of BS!

After informing me of the risks (and yes, they're obliged to) my sugeon then pointed out that my age and overall health meant I stood a very good chance of making it through without any complications, but didn't make any guarantees. His forthright manner was just what I needed to have confidence in him.


A : )

 

[Lynlw]

Llnw thanks for that link.It makes you feel a little reassured that other people have had this procedure done.The 2% sounds a whole lot better than 5% to 7%.With my health I figure I'm down to maybe one half of one percent.Thanks again for getting me out of the funk I was in for the last two days!!!!!

Glad to help,That's the good thing about this place, you can usually find someone that has had or done something you are looking for (and Justin seems to have run into alot of things, to keep my on my toes but help others in the future )

 

[netmiff]

As far as I know, I was "cooled" to 32F. Have had no problems at all.

I also thought I was asymtomatic, that my sob, tiredness etc. was due to overwieght, smoking, not being as young as I once (52 at surgery time) was and not being very active. Hah ! This is one time I don't mind admitting I was wrong!

I also wanted to say that the guy who did my cath gave me the "we have to tell you ..." routine, and went on to add that these were overall stats and included people who had been taken in to the lab on their last breath, and that I would fare much better than that!

 

[bookjp]

This would concern me more than the straight up truth! Why? Because I'd feel he was full of BS because I KNOW they can't make any guarantees and it's hard to have faith in someone full of BS!

After informing me of the risks (and yes, they're obliged to) my surgeon then pointed out that my age and overall health meant I stood a very good chance of making it through without any complications, but didn't make any guarantees. His forthright manner was just what I needed to have confidence in him.


A : )

I'm not looking for any guarantees just a shot of confidence.Same way I would talk to my teammates before pitching a big game.I wouldn't go to them and tell them hey we have a 50% chance of losing this game.I would tell them hey guys get me ONE RUN and we're going to win this game.Dosen't mean we won all of them but gave everyone a boost in the confidence department.I see nothing wrong with that!!!

 

[abbanabba]

Horses for courses!!

 

[Curtsmum]

Personally, I refused to watch any pre-surgery movies until they found me one that only showed the parts of the hospital and rehab, but not the surgery itself. I had NO interest in seeing -- or hearing about -- exactly what they were going to do during surgery. I DID want a hospital tour, like the kind I had before giving birth, but I guess they only do that for pregnant women, probably because most of us could pretty much have our babies anywhere, so they want to sell you on how great their hospital is.

I can't get my head around pre-surgery movies, why would you wan't to watch what is going to happen. I remember Jackie telling me about it and i was thinking gross. We don't have to watch them in the uk, well i don't think you do, we have never had to with Curt, it may be different for adults?
That is one horrible part having to listen to the risks and signing the papers to go ahead.

 

[Curtsmum]

I'm not looking for any guarantees just a shot of confidence.Same way I would talk to my teammates before pitching a big game.I wouldn't go to them and tell them hey we have a 50% chance of losing this game.I would tell them hey guys get me ONE RUN and we're going to win this game.Dosen't mean we won all of them but gave everyone a boost in the confidence department.I see nothing wrong with that!!!

I think a lot of them have to be carefull of what they say, of fear of being sued!

 

[abbanabba]

I can't get my head around pre-surgery movies, why would you wan't to watch what is going to happen.

I watched a doco with 2 surgeries about a fortnight before my own, and one of them was actually a PVR, which was what I had. Normally I can't watch anything like that, but for some reason I felt compelled to watch it and found it very comforting (and fascinating!)... maybe because the patient was more high risk than me and made it through just fine. I also watched another doco on the history of heart surgery a couple of weeks ago and was absolutely amazed at what they could do and how far they have come in such a relatively short amount of time. It made me really hopeful for the future and the technological advances they can make.


A : )

 

[Nancy]

Re: doctors telling the possible problems--

My husband had many, many medical procedures and thoracic surgeries. Joe was unafraid of anything they might want to do to him. His surgeons and doctors would come in a tell him all the dark facts. Joe would joke around with them regarding their serious demeaner. But almost all of them said that they knew how it sounded, but nevertheless, they were forced to reveal all of the possibilities because they had to give their patients a basis for "informed consent". You will have to sign forms right before you go under the knife. That is what that is all about.

It is legalese and doctors have to do it. And you may find they do it again when you are in the surgical prep room.

Of course, like all things some are better at it than others.

BTW, they might also suggest getting your affairs in order (wills, advanced directives, etc). That too is SOP for anything medical now.

Not fun, but it is the way it is in our litigious society.

 

[axeldog]

I only had one day notice, Dr. Fowler came in and told me what he was going to do and that it was happening the next day. He as very straight forward and business like, I couldn't have ask for a better person.

 

[lance]

Pre surgery films

Pre surgery films

Oh I remember that cold day in January when I was summoned to appear at the hospital to watch a film about my surgery. Because of the distance, two hours it being winter, snowy roads, leaving prior to daylight I requested a later showing. The film is shown at 9:00 a.m. only. Failure to comply meant my surgery would be cancelled. So off I went as requested to be sat in a room with a TV and a VCR. The play button was pressed to reveal a film about by-pass surgery because they didn't have a film about valve replacement.

So I drove for two hours over bad roads to watch a film about surgery I wasn't having so my surgery wouldn't be cancelled. Priceless.

 

[bookjp]

Oh I remember that cold day in January when I was summoned to appear at the hospital to watch a film about my surgery. Because of the distance, two hours it being winter, snowy roads, leaving prior to daylight I requested a later showing. The film is shown at 9:00 a.m. only. Failure to comply meant my surgery would be cancelled. So off I went as requested to be sat in a room with a TV and a VCR. The play button was pressed to reveal a film about by-pass surgery because they didn't have a film about valve replacement.

So I drove for two hours over bad roads to watch a film about surgery I wasn't having so my surgery wouldn't be cancelled. Priceless.

Lance,unbelievable that they can do something like that.I've heard other people mention a film you have to watch.So far I've not been told about having to watch a filmbut I would be in the same boat as you .Hospital about an hour and a half away!!

 

[Bryan B]

Lance,unbelievable that they can do something like that.I've heard other people mention a film you have to watch.So far I've not been told about having to watch a filmbut I would be in the same boat as you .Hospital about an hour and a half away!!

bookjp,

You have not been told about having to watch a film because you are not from Canada. No offense Lance or any of our other Canadian members. Canada has Universal Health Care so the government dictates what must or must not be done. Having said that there are pros and cons with the health care system here in the states just like there are pros and cons with universal health care programs adopted by other countries. My experience at Duke did not include watching a video. Instead I was met by a nurse whose job was to give patients a tour of the facilities they would be at and explain the process of pre-op, ICU, and the step down unit. I also received a folder with pretty much the same information he had gone over that day. I've got a pretty strong stomach, but I don't know if I would have wanted to watch a video of an actual heart surgery the day before I was having mine.

 

[lance]

My experience was 10 years ago ..................

My experience was 10 years ago ..................

so procedures have changed. There was a second film I was supposed to watch, I don't know what it was about because as it started I had what turned out to be a panic attack and spent the time in the washroom crying. So maybe watching films is not a good idea. Communication, at that time, in that hospital, was practically non-existent. What information was given would inevitably be contradicted at the next appointment/consult. So I meant it when I said pre-surgery was far worse than the surgery itself.

That hospital had a complete governmental review within a year of my experience. The results indicated the break-downs in the lines of communication between departments just as I had experienced as well as poor communication between doctors/patients and staff. I had been scheduled for surgery Monday at 10:00 a.m. and had to be in the hospital by 8:00 a.m. or my surgery would be cancelled. So I arrived at the day surgery department as ordered, lines were hooked up, I was pre-sedated and left on the bed. The sedation wore off, and I waited. Day surgery patients were returning from their procedures and I waited. Day patients were being discharged, and I waited. It crossed my mind I be discharged the same day too. At 3:00 p.m. I'd had enough. Nurses would not answer questions so I told them to remove the IV line, I was going home. I was hungry and thirsty. They refused saying the surgeon would be down to talk to me. Maybe it's just as well she never showed. Surgery had been rescheduled for Wednesday and I would have to stay hospitalized until then. Tuesday evening I went for a shower. There was no hot water. No one told me the boiler would be turned off that afternoon so we managed with a kettle and basin. This was undoubtedly the most expensive hotel in Hamilton--no hot water. My chart indicated I had refused to shower without stating why. Yeah, I was Pssd off.

It would have been re-assuring to be kept informed and surgeons really need to understand that. Zipper and Cameron had that re-assurance and it must have helped a lot. They knew why their surgeries had been canceled--I never did. Surgeons really need to understand their patients' needs--in BC and Alta they certainly do.

 

[pamela]

Oh I remember that cold day in January when I was summoned to appear at the hospital to watch a film about my surgery. Because of the distance, two hours it being winter, snowy roads, leaving prior to daylight I requested a later showing. The film is shown at 9:00 a.m. only. Failure to comply meant my surgery would be cancelled. So off I went as requested to be sat in a room with a TV and a VCR. The play button was pressed to reveal a film about by-pass surgery because they didn't have a film about valve replacement.

So I drove for two hours over bad roads to watch a film about surgery I wasn't having so my surgery wouldn't be cancelled. Priceless.

Lance, I'm sure that if you'd spoken with your surgeon then arrangements would have been made to accomodate your situation. You didn't say if you had your surgery the next day or if there were other pre-ops booked so that you could take care of everything at once.

I needed to drive 3 hours to my surgical centre and every attempt was made to keep my appointments coincidental with each other so that neccessary winter driving was kept to a minimum.

If you ever need to do something so senseless again try going over the head of the gatekeeper directly to your surgeon's secretary; they have ways of dealing with those whose only job it is, is to call people and make them adapt to their schedule rather than the opposite.

Take Heart,
Pamela

 

[pamela]

Oh My! I honestly hope that improvements have been made to their system. It sounds as if the "provincial employee" syndrome was rife in that hospital... ie: there's a nursing shortage (or medical secretary shortage, fill in your preference here shortage) so "I" can do a lousy job when I feel like doing it at all and not be fired...

I'm glad you got out of it alive. I'm a very vocal self-advocate and will also not hesitate to chastise any public employee on staff if I see that they're not acting in my or my friends' or family's best interests. Someone needs to correct bad behaviour or else it becomes standard rather than undesirable.

Take Heart,
Pamela

 

[catwoman]

Re: mortality risks & complications of surgery.
Those are provided for just about all surgical procedures. I don't know whether it's a U.S. law, state law, American Medical Association procedure or malpractice insurance requirement. I've read articles in medical magazines at doctors' offices that addressed how to present mortality risks/complications of surgery. They were very interesting......


Pre-op, I did not see a film. However, I pretty much knew what to expect from my father-in-law's 2nd MVR in 1989 and from the information my cardiologist had given me.

When John shopped for a surgeon for his MV repair, we consulted with my surgeon, who provided a video for us to watch. It was very helpful, informative and not the least bit scary. Actors in the film were from the hospital staff and cardiac volunteer group.

 

[lance]

Lance, I'm sure that if you'd spoken with your surgeon then arrangements would have been made to accomodate your situation. You didn't say if you had your surgery the next day or if there were other pre-ops booked so that you could take care of everything at once.

I needed to drive 3 hours to my surgical centre and every attempt was made to keep my appointments coincidental with each other so that neccessary winter driving was kept to a minimum.

If you ever need to do something so senseless again try going over the head of the gatekeeper directly to your surgeon's secretary; they have ways of dealing with those whose only job it is, is to call people and make them adapt to their schedule rather than the opposite.

Take Heart,
Pamela

Hi Pamela,
It seems there is logical thinking taking place at your hospital. As to scheduling appointments I was informed of the next one, one at a time. They always referred to my surgery as by pass and failure to attend would result in cancellation. Surgery was scheduled, arrangements were made and the surgery was cancelled over and over. No explanation was ever given. All I could do was wait for the next date. It was impossible to get past the surgeon's secretary so I left messages. Any questions were inevitably answered with "I don't know" so I stopped asking. That amusing incident about the wrong film occurred several weeks prior to surgery being scheduled. An attempt was made to co-ordinate my blood banking with something or other but they were scheduled concurrently so I banked my blood. Surgeon referred to me living in Timbuctoo so she knew.

As for the surgeon communicating anything--forget that. Secretary assured me I would receive a call back that very day about the valve she installed. It had been recalled from the market. That was in 2000. I'm still waiting.