Crohn's specialist vs surgeon...different opinions!

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BillyLitt
Regular Member


Date Joined Dec 2006
Total Posts : 57
   Posted 10/25/2017 7:12 AM (GMT -7)   
My wife is facing a surgery. This will be her third in 28 years. She's doing well, but she has a stricture that has been giving her problems and all parties agree that it is time to start planning. The problem is we have different opinions on the details of the surgery.

The surgeon believes that less is better. Focus on only the stricture and other areas that are causing problems. Leave the other areas alone.

The crohn's specialist believes there are options to fix other areas as well. One area in particular is from her previous surgery. They did something to save from removing intestines, but it has become a small pouch that gives her problems moving food, so the crohn's doctor believes. The surgeon doesn't believe that small pouch is the issue and he doesn't want to mess with it because it's not diseased, it's just a pouch.

I could write a small book, just trying to give the high level cliff notes!

Anyway....when it comes to surgery, do we follow the surgeon's lead or look further into the crohn's specialist's ideas?

So confused!

straydog
Forum Moderator


Date Joined Feb 2003
Total Posts : 15534
   Posted 10/25/2017 7:58 AM (GMT -7)   
Welcome to the forum so sorry to read about what your wife has going on. Just my thoughts, any time there is a difference of opinions such as this, I opt for another opinion from drs that are not connected in any way. It can be time consuming seeking other opinions, but I always think it is a bad idea going into any kind of surgery where they may be doubts & conflict of opinions.

Take care.
Susie
Moderator in Chronic Pain & Psoriasis Forums

scifigal2k
Veteran Member


Date Joined May 2012
Total Posts : 3362
   Posted 10/25/2017 8:10 AM (GMT -7)   
I appreciate that the surgeon isn't wanting to cut where it isn't "necessary" - so many surgeons are the opposite. However, the GI makes a great point that while you're in there, you might as well fix anything that might be a problem later. Is this a colo-rectal surgeon? I agree that a third opinion is worth getting.
"For this thing I besought the Lord thrice that it depart from me. He said, My grace is sufficient for thee: for my strength is made perfect in weakness. Most gladly therefore will I rather glory in my infirmities; I take pleasure in infirmities, reproaches, necessities, persecutions, distresses, for when I am weak, then am I strong" 2 Cor

BillyLitt
Regular Member


Date Joined Dec 2006
Total Posts : 57
   Posted 10/25/2017 8:38 AM (GMT -7)   
I cornered one of the nurses from the surgeon group and asked why the differences of opinions. She said that both groups will work together and plan out the best approach...both from a crohn's disease view point and a GI surgeon view point.

The head surgeon made the comment that there were some doctors "thinking out loud" when discussing my wife's current situation.

I think we are on the correct path.

BillyLitt
Regular Member


Date Joined Dec 2006
Total Posts : 57
   Posted 10/27/2017 12:42 PM (GMT -7)   
Just another update in case anyone is following this.

There was a different surgical group. This group is the intestinal transplant group. Although they don't believe my wife is in need of a transplant at this point, they want us to speak with this group because they can perform an intestinal rehabilitation surgery.

We have appointments with both the gastrointestinal surgeon and the transplant surgeon. We are leaning towards limiting this to fixing the stricture(s) only and holding off on the intestinal rehab surgery.

Stevo68
Regular Member


Date Joined Jun 2011
Total Posts : 61
   Posted 10/28/2017 4:01 AM (GMT -7)   
Good luck brother. I will keep you and your wife in my thoughts.

mirowpl
Regular Member


Date Joined Nov 2009
Total Posts : 472
   Posted 10/29/2017 5:23 AM (GMT -7)   
keep in mind that things change once they get inside during the surgery. The scans do not show everything. my surgeon also believes is less is better as I just had my second resection. the scan showed a small but problematic section of about 6 inches, so the surgeon said they would attempt lapro, but might need to switch if needed. well, they had to switch to open and took two feet of small bowel and 4 more or large. the surgeon said my intestines were a mess all stuck together from chronic inflammation. she tried to unwind things with her hands but in the end had to cut it out the problem areas

my point is cover all possibilities before surgery as you really don't know until they open you up0 nd look around. our surgeon was great and patient with us prior to surgery to explain everything.
surgeries: 2 resections at terminal ilium, open heart surgery, infected lymphocele surgically removed, crainotomy to remove benign tumor; adominal hernia,

conditions: A-fib, High blood pressure, gout, crohn's, edema, cellulitis, other heart issues,, osteopenia

medications:
Entyvio,methotrexate injections, , verapamil , quinipril, labetalol, clorithidone, atorvastatin, alluporinol, elliquis
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