Another consideration about surgery -- death!

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SkeeterZX22v
Regular Member


Date Joined Apr 2011
Total Posts : 240
   Posted 6/8/2011 2:35 PM (GMT -6)   
 
(made link clickable)

Post Edited By Moderator (Steve n Dallas) : 6/8/2011 1:42:13 PM (GMT-6)


EnglishBob
Regular Member


Date Joined Jan 2011
Total Posts : 126
   Posted 6/8/2011 2:51 PM (GMT -6)   
I too came very close to dying on the operating table, my keyhole surgery went wrong due to a massive hemorrhage and they coverted to open surgery to find and stop the bleed, it took an extra 3 hours and 17 units of blood, so yes IT IS possible, but hey i survived !!!
Age 58
Prostate problems since early 40s
Ed since early 40s
April 2007 biopsy & all clear
July 2010 prostate swollen more, psa up to 5.6 August 6.7
September, biopsy again
October 7th diagnosed prostate cancer, Gleason grade 6 at 10% mass
December 13th 2010 open Radical Proctatectomy (non nerve sparing)
Pathology results came back Gleason grade 7 at 12% mass BUT clear margins
Catheter out Jan 5th 2011
Caverject for penile therapy 22nd Jan 2011
Dry at night since 1st Feb 2011
Psa at 3 months post op is now 0.03
Dry in day and pad free from 16th April 2011 :))

clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2680
   Posted 6/8/2011 3:00 PM (GMT -6)   
HD-Rider:  if you're reading this, with surgery scheduled tomorrow, please bear in mind that such an occurrence is rare, rare, rare.  People also die from having their appendix removed, or tummy tucks, or maybe even getting their ears pierced.  And we don't know this patient's medical history....he may have been "high risk" because of pre-existing conditions. 
 
Cases like this is why we sign all those waivers prior to surgery, but they're very uncommon.  Someone probably has reliable stats on this.
 
Glad you came thru, EnglishBob!

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 6/8/2011 3:05 PM (GMT -6)   
The commonly quoted stat is 1 in 200 or .5%. I don't know if it is true, but seems reasonable considering that older men are undergoing surgery and the high incidence of resistant staff infections going around in hospitals. It should not play a part in the decision making process as it is rare, just like secondary cancers from radiation.
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 6/8/2011 3:05 PM (GMT -6)   
I was a little worried about dying on the table, until I talked to the surgeon about the reality of % and my situation, age, health, etc.

He said the biggest danger I faced that day was the car ride to the hospital. He said I'd never be safer than I was once I was in his OR and I believe he was right.

English Bob's story above doesn't indicate to me that he came very close to dying on the operating table -- quite the opposite. It is proof of how safe he was. A disaster and he walked out of the hospital. That's the story.

I was once on a jet over the Pacific Ocean when an engine went wonky. We turned back, landed safely. I suppose I could claim I "almost" died in an airplane disaster but the real story is that the plane had such great lift, and redundant systems, and pilots trained to handle this, that we landed safely --- I really was never in any danger.

At least, that's how I see it.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 6/8/2011 4:54 PM (GMT -6)   
I was more worried about needing blood during the operation, and my doctor recommended banking my own blood in advance, since we had some time. We had plenty of time because I was his first live patient. He needed some training on cadavers and models. :)

I didn't need the blood, btw.

Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2358
   Posted 6/8/2011 5:06 PM (GMT -6)   
My surgeon almost missed seeing on the chart that I am allergic to Amoxicillin, which was an antibiotic they planned to give during surgery. A simple checklist is very important to use before and after surgery. The Checklist Manifesto, a new book by Atul Gawande is an incisive look at this issue.

lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 686
   Posted 6/8/2011 9:34 PM (GMT -6)   
We live in a society that seems to overreact to everything.  The news media (even mainstream) is now tabloid in nature.  Everything is said to be an emergency or "breaking news...breaking news".  The Kentucky article said that the police chief died during prostate surgery.  They didn't say if he died of a heart attack, or a hangnail or what?  Once again the media has done a bad job of reporting, leaving people to conjecture about the worst possible outcome. We deserve better.
 
There is no doubt that going to the hospital is a scary experience, but until we are given rational facts in a logical and measured way we should not respond.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2217
   Posted 6/9/2011 10:07 AM (GMT -6)   
A relevant point, but statistically not one to worry about IMO. Also the article referred to does not actually report on the cause of death, qwhich may well be quite a complicated stroy. (A friend of my dad died when he had a heart attack during surgery, which may have been the strain of the surgery or he might have been going to have the heart attack then any way - and that sort of thing tends to be quite major given the patients can't be resucitated even though they have the heart attack right in front of a group of medics, with all the right equipment and skill to help.)

My hospital published their stats on deaths during surgery (though I didn't see them until after I had my surgery) If I read them correctly then the uro department has not lost a patient on the operating table for years and years, and there did not seem to be any deaths in the immediate post-op period either.

I think surgery going wrong in some way can though be more frequent, but a good surgeon will be able to deal with it and you will still be able to walk out of the hospital a few days later. The above posts are spot on about "near misses" etc.
In the old days (excess) blood loss during surgery was almost the norm. Nicking bloodvessels can happen very easily, especially as no two patients have exactly the same internal layout. (My tongue once twitched while I was at the dentist and the drill severed a large vein under my tongue, the dentist just calmly pressed a finger against it, asked the assistant to get some sutures and then stiched it closed.)

Hospital infections are another issue all together and are perhaps another advantage of Da Vinci's involving a shorter hospital stay. (My father-in-law had a quadruple by-pass last year, which went well, but he obviously had to stay in hopspital for several days afterwards and towards the end of that period he caught an infection. Similar story when my sister was hospitalised for a while after surgery)

There was a comment here recently that I agree with, that the best surgeons to have are the ones who have done lots of open AND lots of da Vincis, as among other things they will not be caught out if they have to switch half way through.

I hope all those reading this who are soon to have surgery will be able to have a very good conversation with their surgeons and anaethetists beforehand to have all such aspects explained to them in the right way.

Alf


Alf

brainsurgeon
Regular Member


Date Joined Jul 2009
Total Posts : 137
   Posted 6/9/2011 10:15 AM (GMT -6)   
As a surgeon who has spent many hours in an OR for 30 years of my life, I can agree that it is one of the safest places in the world. A patient under a general anesthesia these days has far healthier physical parameters ( blood levels of oxygen, blood circulation, etc.) than one has walking down the street. Hospitals scare the dickens out of me because most unpleasant things that I have seen have been in these institutions. BUT one should remember that in an OR things are expected to go wrong sometimes, so plans are made accordingly. Surgeons always have a "what if" in the forefront of their minds. The drive to the hospital is indeed the riskiest part of the equation.
72 years old (1939) USA citizen
Prostatic carcinoma dxed June 2009 by PSA (7.0) and then Bx
PSAs yearly since 2001 ranged 1.52 to 7.0. RALP July 2009
PSAs 0 since

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/9/2011 10:54 AM (GMT -6)   
well said, brain surgeon
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 6/9/2011 9:22 PM (GMT -6)   
Alf, and Brainsurgeon, great posts. My father-in-law "passed gas" as he used to say, for 40 plus years, starting back around 1939 and never lost anyone. While I was worried to start with about the OR I learned the real danger was a staff infection back on the ward.

Sheldon AKA Sleepless

P.S. English Alf, the other day I was going to email you a "hello" but you don't have an address listed, which is fine. But I did want to send you warm regards,
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

rcroller
Regular Member


Date Joined May 2011
Total Posts : 327
   Posted 6/10/2011 1:44 PM (GMT -6)   
Stopped by the office today for a brief visit to learn that one of my coworkers underwent knee surgery shortly after I left the office for the open RP. He apparently reacted to the anesthesia and almost died. This reaction caused his intestines to fail and resulted in another operation to remove much of his colon with subsequent colostomy. From what I was told, he is in really rough shape and not out of the woods yet. All this from a seemingly routine knee surgery.
Age 53- PSA 2/11 3.5
4/21/11 BX Path Report: 3 of 12 Left PCa , 3+3, 3+4, 4+4
4/29/11 Received PCa DX, G-8
5/18/11 open RP Performed, Right nerve bundle spared
5/24/11 Post Op Path Report: G-7(4+3) 7%, pT3a N0MX, EPE, PNI+, SVI-, Left margin <0.1mm from inked margin
6/1/11 Cath removed - Incontinence-No, ED-so far, Yes.
6/15/11 4 Week Post-Op PSA Scheduled
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