TexasCHLforum.com

mrvmax wrote:

rotor wrote:

mrvmax wrote: He wasn't inflating himself, he was telling me of the risks of the surgery and had just been asked to fix the other surgeons screw up. He said he didn't want to get involved in any possible litigation so he refused to get involved at that point and it seems as if that doctor has been involved in litigation before. He also stated that the problem needed to be corrected during another surgery, not at that time (I do not recall the reason). I didn't write all the details but I do not think you should jump to conclusions either. I specifically asked about how many times he had problems with this type of surgery so he answered me and explained.

If a doctor consults another doctor in an emergency "to fix the other surgeons screw up" as you put it and he/she refuses to help he/she is putting the patient in jeopardy. Failure to respond to an emergency consult is reason enough to lose hospital privileges. The place to weed out deficient doctors is not while a patient desperately needs help in the operating room, it is in the hospital's committee process. Sorry, I have no respect for your doctor's ethics or great skill.

I never said the place to weed out doctors was in an emergency, I said quite the contrary. My original point to the OP stands - mistakes by doctors are the highest risk with surgery so vet them as well as you can prior to the procedure. Read reviews, ask your referring physician, question them as best you can and get second and third opinions. The surgery may be routine but people die from routine surgeries too. I’ve run across too many bad doctors in my life to blindly trust them. I don’t see the point in debating it back and forth, I’m just giving my opinion from my experience with surgeries my wife and I have had as well as other family members and close friends. My best wishes to the OP with his health issues.

All very good ideas but..... Mistakes by doctors are not the highest risk of surgery. Surgery by itself without any mistake is a risk. Where do you go to read reviews? The internet? I know of no reliable place to find a review of the quality of a doctor including the referring physician. Did you not notice that the referring physician never refers outside of his group. Get second opinions? What makes you think that the second opinion is worth anything? My point being to all of this is that there is virtually no place to really find out if your doctor is great or a washout.

mrvmax wrote: He wasn't inflating himself, he was telling me of the risks of the surgery and had just been asked to fix the other surgeons screw up. He said he didn't want to get involved in any possible litigation so he refused to get involved at that point and it seems as if that doctor has been involved in litigation before. He also stated that the problem needed to be corrected during another surgery, not at that time (I do not recall the reason). I didn't write all the details but I do not think you should jump to conclusions either. I specifically asked about how many times he had problems with this type of surgery so he answered me and explained.

If a doctor consults another doctor in an emergency "to fix the other surgeons screw up" as you put it and he/she refuses to help he/she is putting the patient in jeopardy. Failure to respond to an emergency consult is reason enough to lose hospital privileges. The place to weed out deficient doctors is not while a patient desperately needs help in the operating room, it is in the hospital's committee process. Sorry, I have no respect for your doctor's ethics or great skill.

mrvmax wrote:

MaduroBU wrote:I can't give you medical advice, but i give you a few facts to consider and bring up with your doc.

A laparoscopic cholecystectomy is a relatively minor procedure, and the biggest risk is that they're forced to open you up with a subcostal incision. The other risks, like biliary strictures, missing a stone and provoking cholecdocholithiasis, and ascending cholangitis are all much higher if you're getting it done because of an acute problem (an inflamed gallbladder or a stone lodged in the common bile duct).

A laparoscopic nephrectomy is a significantly riskier procedure and as a result most failed kidneys still inhabit their original owners, even those who have gotten transplants.

A final point, fully 1/3 of humans have gallstones.

I would think the bigger risk is the surgeon screwing up and cutting something they should not have cut (I am referring specifically to the laparoscopic cholecystectomy) . I had my gall bladder removed last month and prior to that my surgeon told me of another surgeon that works out of Clear Lake regional that did just that - he cut something he should not have and the 1 hour surgery turned into 6 hours. Of course he would not tell me the name of that surgeon but he said he would never step into the OR with that doctor (the surgeon that screwed up called my surgeon for help and he refused to help him. He said he did not want to end up in court so it must have been a pretty bad screw up). I would do my best to vet the surgeon and the anesthesiologist since you are trusting both of them.

I would not have used your surgeon either. A doctor that inflates himself and talks poorly about another doctor and refuses to help in an emergency is not a doctor I would use. After all, he would be refusing to help a patient that needs help. Injury to the common duct is a known risk of gall bladder surgery and any doctor doing that surgery can be involved. Some doctors think they are god and brag about it, until they get into trouble. Human anatomy is different in each person and if your doctor has not injured the common duct yet, give him time. Those of you that delay surgery and end up with scar tissue which obscures the anatomy even more are more likely to have a complication.

mrvmax wrote: It's also possible that I could end up like my primary care doctors father who has had gallstones for over 40 years with no issues. There are a lot of possibilities but I have weighed my options and made my choice after careful consideration. I didn't give all the details but I have problems with anesthesia so I minimize its use as much as possible. I'll also get another ultrasound this year and every year after to check for issues. My point is that most doctors I have been to give an answer off the top of their head and won't invest time researching for every person to give the ideal solution. The only doctors I've run across that did was my daughters doctor at Texas Children's and my wife's doctor. All other doctors treat patients like cattle, move them in and out as quick as possible. It's up to us to make sure we have a good picture of the options then we can choose what is best for us.

Life is a gamble. The problem with a second opinions is that if it does not agree with the first opinion you don't know who is right. You definitely might go through an entire life with gallstones and never have any further problems. You also might develop scar tissue which can make surgery much more dangerous. As I mentioned my entire family seems to have a hereditary issue with GB disease and it seems to have skipped me but I personally would have it out before I got in trouble, not after. Let's say it was coronary vascular disease and your doctor said to get a stent or risk a possible heart attack. What would you do? I had the heart attack and then had the stent. When I developed symptoms 15 years later I made a fast appointment to my doc and set up a stent before I lost more heart muscle. We can all give you anecdotal stories but each of us has to make our own decisions. The problem with GB disease is that it can kill you. I don't think most doctors would suggest a wait and see attitude with gallstones. If they told you to wait and you had a complication because you waited then the attorneys start coming after the doc. You just have to decide on your own as to which is the least dangerous path to follow. Nowadays though the risk of problems with GB surgery is so small that it seems like a no-brainer. Now open surgery for GB is tough to get over.

mrvmax wrote:I have one large gall stone, so large it will never pass. I've never experienced pain that was as bad as when I had a gall bladder attack. On a scale of 1 to 10 it was an 11. The doctors/surgeons suggested removing it since that's the easiest thing to do. I'm opposed to having anything removed unless necessary so I refused (my primary care accepted it but two different surgeons acted like I was crazy when I said I wasn't going to have it removed). I changed my diet as stopped eating what irritates my gall bladder and so far I've been fine. I may have to have it removed one day or I may never need it, only time will tellbut I'm fine now.
My advice is to never trust the doctors to always spend the time to research and present you with the ideal option. The majority of doctors I've had in my life tend to offer the easiest options which are usually the most common ones - it's easier to do what everyone else does than to take time to research.. I would research, pray and continue to find others in a similar spot and take your time deciding if possible. Ask the doctors lots of questions, make them explain in detail what they suggest and question them. Look for alternative options and ask them about those. There are doctors in the Houston area that don't always take traditional routes (Dr. Hotze, Dr. Gilati, Dr. Clark in Webster) but none of these specialize where you are having problems. I would exhaust all avenues before deciding but that's my nature.

The problem with GB disease is that once you get an attack and it becomes inflamed there is scarring and subsequent surgery becomes much harder and more dangerous. So, the ideal thing is do it while it is not acute (and therefore safe) and not wait for a disaster later on. Relatively easy to do laparoscopically and you go home the same day. Everyone in my family seems to develop GB disease and I have expected it for me but sonograms have been negative. I personally would have it out if I had stones and have it done before I got in trouble. I don't know as much about non-functioning kidneys but from what I have heard this is relatively minor laparoscopically also.

What is the "ideal option"? Ideal for me would be never needing any surgery but in my 74 years I have had my share and wouldn't be typing this without having surgery. I trust my doctors. Many are personal friends. I hate to see this constant "don't trust your" doctor, LEO, attorney, mechanic, fill in the blank yourself. There are also a bunch of alternative medicine doctors and these are the ones that I don't trust. Same for chiropractors that sell you a package of xrays and will manipulate you to cure "disease" that really doesn't exist. Now I do know ethical chiropractors personally too but they are not spending the big $$ on advertising.

So, nobody "wants" surgery but sometimes it is better to have it before it becomes a real problem. Much nicer to present an easy surgery to the doctor to one that has been made more difficult (and complicated) by waiting. All your choice. Gall bladder disease can kill you though.