Re: Laparoscopic Complications
From: Vict. (anonymous@obgyn.net)
Wed Apr 26 14:31:25 2000
Hello,
sorry it took so long to get back with you. I've had computer related
trouble.
One of the many wonderful aspects of this site is the opportunity for
men and women to share their experiences, positive or negative, with
particular surgeons who treat adhesions. I think it is important to
keep in mind that because one person may have a negative experience with
a particular surgeon this does not mean that this surgeon's quality of
care or skills are substandard.
I do think it is very important to allow patients to feel free to share
their experiences and state their personal opinions and feelings about a
particular surgeon; in a respectful and civil manner, mindful that this
is ONE person's experience.
I do not believe in doctor bashing. I also do not believe in experience
bashing. Others should not feel afraid to share their experiences for
fear that someone will "bash" them. One person's experience with a
surgeon may be fantastic while another may have been just awful...When I
am choosing a surgeon I want to hear all the details. I want to sort it
out myself...form my own opinions and come to my own conclusions. It
may be that those whose experiences were negative all share a similar
thread of truth...maybe this particular surgeon's skills in one area are
not as good as his skills in other areas. This may be important to two
different individuals. Maybe one person is seeking a surgeon who is
excellent in the area this surgeon excels or maybe the other individual
is seeking a surgeon who excels in the area that this surgeon seems to
have difficulty in. None of us are perfect. We all have gifts. We may
be perfectly capable of doing many different tasks...some may be a real
struggle for us while others we may excel at...then there are a few who
are amazing and just excel at everything they put their hands on...I
hope this helps you understand where I am coming from. It's important
for us not to feel guilty, humiliated, or afraid to relate our honest
opinion, feelings, and experiences...good and bad...in a respectful
manner. It's important for those who had the positive experiences to
relate those experiences without seeming to pass judgement on those who
relate their less than positive experience.
I am not saying that any of this is happening on this board. I have
seen it happen to many people (though not here). I just feel it's
important to mention once in a while as a reminder.
Okay...I am familiar with Dr. Reich and his work. He is highly skilled
and is truly an expert to be trusted. This is based on my personal
research and on the feedback I've gleaned from others.
What I was tying to get across in the other e-mail is: I think it is
important to excercise utmost caution in choosing a surgeon if you have
severe dense adhesions that cause pain. First I believe one needs to
really consider whether surgery is appropriate and is going to
help...Has it helped in the past? For how long? Do you need surgery due
to severe bowel problems...strictures...obstructions...? Do you need
surgery for fertility? Also, one needs to keep in mind: what is the
possibility that somewhere in the future I am going to need emergency
surgery for bowel related problems due to adhesions or bowel perforation
(I don't mean to exclude bladder probelems)? Are the new adhesions that
are forming following surgery upping my risks for future emergency
surgery...what do all of the studies say...not just select ones. Next,
what is the best procedure for me personally? What are the real risks to
patients that have adhsions like mine...there is a difference. It can
make a difference as to what type of adhesions you have and where they
are located. It's also important to check into potential complications
and risks...don't believe a doctor who laughs off a risk and makes you
feel stupid for asking...Run!! There is a reason for me saying this.
Oh, I'm not talking about trocar injuries here. Experts are very aware
of trocar injuries and procedures to minimize them. They are also aware
that some of these procedures don't really work and I think most people
are aware of this type of injury. There is a lot of information about
this subject available to the general public.
Also, we need to ask what are my alternatives? Some people have
absolutely no problems from adhesions. Maybe some day researchers will
figure out why and enlighten us. It may be that accupuncture will help
you. It didn't help me. I take all kinds of supplements and there are
a couple that help...but don't cure my symptoms. I actually drink a cup
or two of coffee per day as a therapeutic tool...it works for me (bowel
related). It doesn't hurt to try altering your diet. I find this
beneficial too. Also huge amounts of water...I drink up to 3 gallons
per day easy. You may need heavy duty narcotic pain medication. You
have every right to live your life to the fullest you are capable of and
if it means narcotic pain medication...well...goes without saying.
Narcotics won't cure it...they also will not take all of the pain
away...but it does help some people so they are no longer invalids. I
think it is important to find a physician or clinic who will work slowly
with you to find a proper maintenance dosage that actually works. Many
people I know have recieved excellent help from pain clinics...most of
these people are men. Most of the women I've talked to say they had
trouble getting any relief because the problem is "adhesions". Also the
women complained the pain clinics tried to say they had emotional
problems concerning sexual issues. That adhesions is actually chronic
pelvic pain and that, "everyone knows chronic pelvic pain is actually
emotionally related sexual dysfunction". Men generally are not given a
diagnosis of chronic pelvic pain when they have pain from adhesions...I
don't get this. Women are though. Let's give women a proper diagnosis
of Adhesion pain...chronic abdominal pain...Mine is chronic abdominal
pain...that's why I'm recieving treatment. One gentleman I spoke with
who had been run over by a bulldozer was unable to get help at a pain
clinic because the clinic's psychologist told him, "first you need to
deal with issues surrounding your anger with your father. I believe
this is what is causing all or most of your pain".
This man's life was ruined...so was his entire family's...his children
too. He lived propped in a chair. Holidays...even Christmas were no
longer celebrated. He used to be a very active member of his community
helping many children. After hearing all of these experiences I chose
not to visit a pain clinic although I may research some and visit one in
the future.
I do not believe it is fair for a physician to back a patient into a
corner by stating their only choice is surgery...if they don't have
surgery they will not provide medication for pain control. Some
patients are aware that after surgery, at least for a month or two, they
will be relieved of pain due just to the post operative pain
medication(I don't think most of the patients make this connection
though-I think they just remember feeling better than they did prior to
surgery). Some patients and physicians don't seem to see this very real
connection. I don't think it's fair for a physician to take away a
chronic pain patient's pain medication if the pain medication is
working. Matter of fact a physician who does this is just as guilty as
one who prescribes pain meds to an addict...by addict I mean someone who
has no pain, who lies and steals to obtain medication, and who takes
more medication than prescribed for the, "high". Doctors are in fear of
providing pain meds thinking they will lose their license. I think
physicians should also be in fear of losing their license for witholding
pain meds (for someone in obvious distress due to a chronic pain
problem...and not referring them to a pain clinic on an emergency
basis), offering only surgery as an alternative when the patient's
entire medical history reflects that surgery is not helping, the patient
has chronic (not acute) pain (that is helped by medication), the patient
doesn't have a "surgical abdomen", and the patient has a long history of
surgeries with temporary or no relief of pain. There are patients
who've walked into appointments and undergone emergency surgery that day
or soon after because the doc takes them off their meds. Is that really
emergency surgery? Is the surgery really necesarry? Most docs are out to
help their patients. They don't want to see them hurting. They also
don't want to lose their license. They won't lose their license for
doing surgery...they can justify the operation saying it may help or the
patient was in severe pain (and this is acute pain even though the pain
flared up when the patient went off their meds) but many docs are afraid
they will lose their license for prescribing pain medication.
Some adhesion sufferers go from surgeon to surgeon seeking help and
relief hopeful that they will find the right one...one whose techniques
will finally help them and they'll be able to live a life again. I've
cried countless times for people...the complications that can happen,
the loss of life or just bodily functions saddens me...and they are
usually attributed to something else...an excuse...not what they were
really caused by...the surgery...Laparoscopic surgery is a big deal.
It's important to HMO's, insurance companies, and surgeons. It's being
heavily promoted. These people cannot run the risk of allowing the
horrible complications and other problems to be focused on. There are
many reasons why laparoscopic surgery is a big deal and many reasons why
it is important.
I'm not nullifying the fact that there are proper uses for it. I am
saying that I question any doctor (and I"ve heard many) who says it is a
cure-all, the only way, the best way, free of problems, less expensive,
fewer complications,or better for the patients. I've met a number of
people who begged their surgeons for an open laparotomy (they wanted an
open procedure due to their complex adhesions-not all were undergoing
adhesion lysis) and were flat out denied either by the surgeon or the
insurance company...and the patients suffered horrible life-long
consequences because of it. Some of the surgeons later admitted that
the patients probably would not have suffered those specific
consequences with an open procedure.
I don't think its right to always attribute relief of adhesion pain to
surgery if the patient only has relief of pain immediately following
surgery, while taking post surgical pain medication. Many patients are
on pain meds 4 to 8 weeks post operatively. There may even be a period
after stopping the pain meds that the patient still has relief. Many
people I"ve talked to only have relief from adhesion lysis surgery for
about six weeks post op...while on pain meds. So, you have surgery.
Take pain meds. have relief. The doc says no more pain meds. You stop
taking them. You have pain. He says you have to have surgery. You are
a good patient and trust him. You have surgery. You have temporary
relief. This isn't fair to you. I know some people who were
essentially "black-mailed" into undergoing surgery. The options they
were given: No more medication for pain or You must undergo surgery. If
you want to have a fulfilling life...which would you choose? Is there
really a choice being offered? Do you know a 35 year old woman died due
to complications following this type of surgery...? Are you aware of the
risks associated? If you do have complications you have to cross your
fingers, pray, and hope that you will be treated...That you will not be
sent home from the ER on meds to mask your severe post surgical
complication, that your surgeon is not so arogant as to think there are
no post surgical complications associated with laparoscopic surgery or
so arrogant it prevents him from admitting to his mistakes, or to admit
that complications can well take over seven days to show up. If you are
one of those whose life-threatening complications take 4,5,7 or more
days to show up...cross your fingers again because chances are the
surgeon will try to attribute it to something completely unrelated. It's
well known and documented that complications can take days or weeks to
show up. It's not fair to mislead the patient into thinking that their
bladder, ureter, intestinal, gallbladder, etc problem is due to
something other than the real cause...the surgical
complication...Laparoscopic surgery does make it easier to attribute
complications to other causes. Oh, heck, it took 14 days to show up..It
has nothing to do with what I did inside you...that may or may not
be...but...it is documented that there are injuries that you can sustain
that take quite a while before you exhibit acute symptoms. Several
times I've had the opportunity to hear surgeons discuss post op
complications...I've heard honest docs tell the surgeon...you need to go
and tell the patient and be honest with them...and I've heard less than
honest docs say...place resonable doubt in your patient's mind...tell
them it could be "blank" or it could be "blank" but it's probably
totally unrelated to the surgery I did on you.
I personally know of two docs who push Laparoscopic lysis of adhesions.
They claim it is always necesarry. Always justifiable. It is the only
treatment. That every instance of adhesion pain needs to be treated
with laparoscopic lysis of adhesions. They are gleaning much
information from their guniea pigs. It is helping them with a study and
their experiments. Problem is they are not making their patients aware
of this. One of them has over six board complaints in just one state.
I'm afraid to warn anyone for fear I'll be charged with slander...thats
why I say...you need to do the research. Matter of fact I"ll probably
be slandered for talking about any of this...I do having back from other
surgeons that are aware of all of these problems.
There are people with bowel symptoms...who gain relief from surgery for
a longer period of time than six weeks. It may have just been a section
or sections of bowel causing problems. Pain meds for them can be
difficult as the narcotics tend to slow the bowel down. Diet can play
an important role with the narcotics. There are radiologists who are
able to make fairly good diagnostic guesses utilizing radiographic
techniques to determine whether adhesions are causing bowel problems.
They cannot see the adhesions but with specific tests and the
radiologist present for the test they can make some fairly good
assumptions.
I believe all options should be open to all people regardless of sex,
religious beliefs, insurance plans, socio-economic status, or any other
factors. All living beings deserve a chance to live to the fullest of
their abilities! We also have a right to honesty. With the advent of
managed care it's becoming necesarry for patients to become informed
consumers (decisions are being made by those without M.D.'s). As
consumers we have a right to all information. We should all have
complete copies of our medical, surgical, and nursing notes, if we want
them. Our questions should be answered in complete honesty, we should
have access to any medical information or studies that we desire, to
medical board information, and hospital information and statistics. If
we are consumers we should have all the rights that apply to any other
types of consumer. Medical care is costly. It is also dealing with our
physical well-being. We need to be able to make important decisions
about our bodies based on all the information. I heard a general
practice doctor brag the other day that he has a caseload of 3,000
patients. I wish we could go back to the way it used to be. Family
docs who knew us...thank the good Lord that I found one. I believe that
we should have input in our care. That what we say because we know our
bodies and because we've researched should be taken into careful
consideration by the doctors. It used to be we put all our trust in our
doc. If he said you needed surgery...he did not merely suggest it...he
stated it was necesarry. He told you, and you believed him, you need
medication, you have an illness, you must be hospitalized, you must have
a particular type of surgery, you don't need to go to the hospital, you
are fine...you did not question him...you didn't ask how he came to this
conclusion...you didn't suggest other surgeries, you didn't question his
authority or decision making, you did not override what he said...You
Did Whatever He Said! Now days if you do whatever they say you can run
into problems...especially if they have a caseload of 3,000 (I don't
know how he does it). The other problem is if you do question a
procedure, or you point out your personal medical history, or question
anything the doctor says, you run the risk of being labeled a "bad
patient" or an "uncooperative patient"...even if you are quite pleasant
and only seeking information or to understand a problem or decision. The
label follows you in your records. If you go from doctor to doctor
seeking the right one...you are condemned for that too.
Sorry I got lost in so many tangents. I've seen so many people across
the country needlessly suffer. I've heard too many good doctors state
that patients needlessly suffer.
I'd like to see us all healthy!!
P.S. don't forget that with the internet we have international
information and studies available to us.
I know of a doctor who works at a religious hospital in the U.S. yet
has a sick antireligious website...looks satanic...with a famous
painting of Christ on the cross...only they took Jesus' face off and
replaced it with something else...a particular animal. Would you want
this doc doing surgery on you? Would you expect it from a Christian
hospital? I know someone who did (they didn't know about the website at
the time) and the person almost died on several occasions requiring many
more surgeries.
I know of many more horrors too. I just think you all have a right to
know some of what happens...good and bad.
|
