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what to ask for in a surgeon?

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MMMNAVY
Veteran Member
Joined : Jul 2006
Posts : 6927
Posted 9/15/2010 5:12 PM (GMT -8)
So I finally got a surgery consult fee basised out. But the problem is I am trying to figure out what to ask for in a surgeon?  I am thinking someone board certified in corectal surgery might be a place to start?
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CrohnieToo
Veteran Member
Joined : May 2003
Posts : 9448
Posted 9/15/2010 5:20 PM (GMT -8)
Probably a colorectal surgeon, but not necessarily, just a good place to start.

What type of surgery is expected? Laparoscopy? open abdomen? Resection? Strictureplasty? How many of the expected type of surgery has he/she done? How many does he/she usually perform in a year of this type of surgery? Does he/she have an assistant surgeon? What part of the surgery does the assistant do? How many of this type of surgery has the assistant assisted at?

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pimfram
Veteran Member
Joined : May 2009
Posts : 506
Posted 9/15/2010 5:31 PM (GMT -8)
There's a decent chance there is one surgeon who has the most experience doing your specific surgery. I assume you'll have it done at the VA, so I don't know if that will be true for you. My hospital had a guy who is nationally known and does 2 or 3 resections per week.
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HJones
Veteran Member
Joined : Oct 2008
Posts : 1341
Posted 9/15/2010 8:01 PM (GMT -8)
When I had surgery last fall, my dad asked the surgeon how many laproscopic resections he had done. He said at least 800. This was a pretty young guy too!
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MMMNAVY
Veteran Member
Joined : Jul 2006
Posts : 6927
Posted 9/15/2010 8:12 PM (GMT -8)
there are just general surgeons at this VA so they decided to go outside
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yohimbe
Regular Member
Joined : Aug 2010
Posts : 109
Posted 9/15/2010 9:44 PM (GMT -8)
I am about to have ileum bowel resection and have interviewed the surgeon and surgeon 2 (who only does bowel bypasses for obese people). The good news is that over the last 15 years there has been millions of bowel bypasses because of the new technologies for gastric bypasses and all other variations. So in this general area of the body there is solid technology and methods to resect the gut.

The doctors title should be colorectal surgeon which also means colon, hemorroids and so on.

These guys are in their mid fifties with 25 years experience in this field.

Do googles on the doctors names, my favorite site is ratemds.com which gives you the year when they graduated, the progress of their career, etc.

Good luck !
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tsitodawg
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Joined : Aug 2006
Posts : 845
Posted 9/15/2010 10:19 PM (GMT -8)
I would ask them to hold their hands out in front of you. That way you can make sure they don't have shaky hands. j/k You can do research on most doctors through internet resources and see the reviews. Some of the good ones you may have to pay for but it may be worth the small price to read the good and the bad about each one. I would look for a surgeon that is not too old and not just out of med school. Reason for this is that you will find a surgeon that uses modern techniques but still has years of experience doing the same surgery. I would also look for someone that has good bedside manner. I know that it is good television the way Dr. House talks to his patients on the show "House" but if you have ever had a doctor with bad bedside manner it is horrible. I had a horrible experience with a doctor that was supposed to be one of the best Internal Medicine docs in the state and was covering for my doc when I was hospitalized. I had already been there for 3 weeks and diagnosed with a G.I. bleed and crohn's but he still found it in his heart to walk in my room and tell me that he had no idea why I was hospitalized and if it were up to him he would have released me about 2 weeks ago. Luckily my doctor brought my confidence back up the next day when he returned and told me had I been released 2 weeks prior I would probably not be alive. Bedside manner is huge when in the hospital for a few days.
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ivy6
Elite Member
Joined : Sep 2005
Posts : 10404
Posted 9/15/2010 10:51 PM (GMT -8)
Glad to hear they are at least starting to talk sensibly about surgery now, Navy.
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randynoguts
Veteran Member
Joined : Jan 2003
Posts : 6200
Posted 9/16/2010 1:45 AM (GMT -8)
experiance counts, as does success rates.. every dr should be able to tell you there sucess rate/complication rate for each type of surgery they do. also even the older experianced ones may not be up on the newest techniques. they may have read about some new way of doing things but the young guy has probably done it in his/her residency. smell there breath at an after lunch appointment. make sure there not having the old 3 martini lunch to get through the afternoon. if you can get an scheduled op at short notice , maybe they are not to good. a good surgeon should be booked for at least a couple weeks in advance. (emergencies dont count) how many do they do in a day. ? you want someone fresh, not one thats on his 4th op of the day. ask for the first one in the schedule in the day. everything is clean in the or from the night before cleaning and you wont have to wait for a cleaning team. also, first up's rarely get bumped you dont want to get all prepped and then get bumped cause an emergency came in at 9am. you want to be in the or at 6am! plus your first to the recovery room and get undivided attention till they start to fill up. i ve had all times of day and night and early has always been the best... ;o)

mattter of fact i just had a small OP last thrsday that i did not advertise. i was 1st at 630 am and was out of recovery by 930 and home by 11. although i did have some battle scars... i woke with a inch long abrassion on my shoulder and a sore stomach and hurting throat from the intubation. and some face brusing.. i was a little fiesty apparently going under. ;o).. i was tapping my finger and looking at the surgeon while they were expecting me to be under. i warned them that it takes a lot to get me under. they thought my IV was clamped, then they thought the face mask was defective. it old them again i could feel the IV sedative going in and smell the gas from the mask, but it wasnt enough. i guess they finally got it right!
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lamb61
Veteran Member
Joined : Jan 2005
Posts : 1947
Posted 9/16/2010 2:23 AM (GMT -8)
I was able to use a surgeon in the same department at the hosp. I go to. I go to a university teaching hospital and this guy was great. Plus a member here has used him prior and loved him -- that was a great recommendation for me.
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Becky77
Veteran Member
Joined : Dec 2005
Posts : 1768
Posted 9/16/2010 2:42 AM (GMT -8)
Personally, I've found that surgeons who are good don't necessarily have the best bedside manner. IMHO, it doesn't matter how they talk to you, it's how well they cut, and how well they know how to cut. Working with surgeons, I've found that most good ones aren't overly nice, but not mean either....right down the middle. My surgeon is great, and I HATED him the first time I met him. Over time, and working in the same hospital (and him knowing I worked at that hospital) I've come to respect him a great deal. Some of the surgeons who came across the best personality wise I would not want to touch ANYONE I know.

Oh, and I also want a surgeon who is brutally honest with me. I want to hear my expected outcome, possible complications, etc. without it being sugar coated. I'd rather know everything up front than have "surprises."

Can you talk to your GI and get suggestions of who they would use? I'd ask "who would you use if it was you" and not "who do you recommend"...there's a huge difference. Some drs get in the habit of referring patients to other doctors, but that's not necessarily who they would use if it was them having to be treated.
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Dagger
Veteran Member
Joined : Apr 2008
Posts : 1522
Posted 9/16/2010 11:17 AM (GMT -8)
I had a general surgeon do my resection, I had a tumor near my IC valve. She had saved the life of a friend about a year before and she did a lot of laproscopic resections. She explained the surgery in detail and didn't sugar coat the possible complications. She even agreed to take pictures of my insides to show my gyn so he could check on my endometriosis.

She was very concerned about my hypoglycemia and worked with me to schedule the surgery at the best time for me. This was a big deal because I had to schedule two docs doing two separate procedures within 4 days of each other. The other surgeons I consulted blew off the hypoglycemia - she didn't. She had me consult with the hospital nutritionist before the surgery to make sure that we had a plan for when I started eating again. She left orders with the nurses to check my blood sugar whenever I requested it. This turned out to be very important when my blood sugar crashed a few days after surgery but before my guts woke up.

The other surgeons said I would be back at work within three weeks, she said I'd need six weeks due to my job and other medical conditions. The "best" surgeon insisted there was no way my blood sugar could drop after the surgery because I wouldn't be eating.

While the other surgeons looked better on paper, I went with the one that listened to me and didn't blow off my concerns.
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randynoguts
Veteran Member
Joined : Jan 2003
Posts : 6200
Posted 9/16/2010 8:46 PM (GMT -8)
hey dagger, well in reality your sugar should have been managed through an IV and monitored so that it wouldnt have dropped to low. dr/nursing messed up on that.
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ski bum
Regular Member
Joined : Jan 2007
Posts : 451
Posted 9/17/2010 3:10 AM (GMT -8)
Small hands.
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MikeB
Veteran Member
Joined : Mar 2006
Posts : 1169
Posted 9/17/2010 4:43 AM (GMT -8)
Navy there is an American Society of colorectal surgeons -- might check their website to see if there is a certified member near you. A CR surgeon is usually one who has completed the basic general surgery residency (usually five years) plus a year or more in a fellowship in CR surgery to subspecialize. However, keep in mind that all general surgeons work primarily in the abdomen (gall bladders, colon resections, etc.) and are pretty well qualified to deal with any abdominal issues. And I agree that bedside manner is immaterial. I personally prefer the gruff no-nonsense type of doc who tends to business with my body to the one who spends a lot of time on PR frivolities.

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Dagger
Veteran Member
Joined : Apr 2008
Posts : 1522
Posted 9/17/2010 11:47 AM (GMT -8)
Randy, I had a dextrose IV and regular checks but my body never does the expected. Blood sugar management is based on diabetes - not non-diabetics with hypoglycemia. Since I am not diabetic, it is almost impossible to get the medical community to listen to me. I had been checked just about an hour before I crashed so none of the medical people expected it. Since the doc had a written plan, it was handled well and I was ok. Before the surgery, she had asked me many questions about when I am most stable and scheduled the surgery around that. She did a lot to make this work.

What scares me is that the other surgeons would not even listen. They insisted I could not possibly have a problem if I wasn't eating. The nurse told me that had they not already had orders, everything could have been delayed while they tracked down the doc.

My point is that you shouldn't choose a surgeon that doesn't take your entire medical history into account. You are more than your colon or whatever body part they are working on.
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