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Need Dr. referal in Atl area

Ga2536
Posts: 6
Joined: Jul 2012

Hi, I'm new to the network. I had an open partial nephrectomy on my left kidney 4 weeks ago, and am in need of some help that I hope fellow survivors can offer.

My surgery went well, but I need to find someone in the North Atlanta area for follow up.

My doctor neglected to tell me of a study he is conducting on pain medication following surgery. This study was not mentioned in my office consultation or the pre-op visits with him or the hospital. I did not find out until after the surgery, in the recovery room, that my surgeon does not believe in pain medication following surgery and believes that patients heal faster and leave the hospital sooner if they are not given pain medication. (The case manager and nurses on the floor confirmed that this is something he does on a regular basis.)

I was finally able to get pain medication through the case manager in the patient advocacy department, but it has been a nightmare. Since our disagreement on such a fundamental portion of after care, he is not helping with simple things like what to expect during the healing process and what to do or not do to speed recovery and avoid creating post-op complications.

I know I have to follow up in 3 months, but I am hoping to find another doctor that will care for my healing and recovery, follow up, and any further treatment that might be necessary.

I have seen a few posts from folks in this area, would anyone recommend a doctor?

Thanks

Phoenix Rising's picture
Phoenix Rising
Posts: 157
Joined: Jul 2012

Hello! Is your renal specialist Viraj Master at Emory Hospital in Atlanta?

NewDay's picture
NewDay
Posts: 178
Joined: May 2012

Hi,
My nephrectomy was performed by Dr. John Pattaras (Urologist) at Emory last Monday. I really like him. He is the director of minimally invasive surgery there. He has me on pain medication. It is unbelievable that they didn't tell you that beforehand. Can you possibly talk to your primary care doc about getting something?

Kathy

Phoenix Rising's picture
Phoenix Rising
Posts: 157
Joined: Jul 2012

Dr. Master is my urologist at Emory in Atlanta and I was not given pain meds after surgery, but he let me know this as surgery was being planned, and I had to sign a consent form. He explained his logic, I consented, and post-surgery, a large ice pack was placed over my incision which was from mid-chest straight down to the pelvis. I was fine with the ice, but also had a pain pump. The morphine from the pain pump kept me nauseated and I asked to stop the pump. I believe I did recover faster without pain meds.

If your physician is Dr. Master, he WILL give you pain meds if you ask for it. Once I went home I had lots of other pain and tingling and numbness and agony and inability to lie down to sleep, so I gave in and asked for pain killer and he seemed disappointed but gave me oxycodone with no argument. I didn't take very much of the oxycodone.

I found Dr. Master to be an excellent physician. I had a cyst in the kidney that had burst and bled, cancerous tumor in the kidney, a mass in the inferior vena cava, and several affected lymph nodes. The surgery he performed was quite radical and might not have been performed anywhere else in metropolitan Atlanta, and maybe not anywhere else in the U.S. I would have been sent home with, "there's nothing we can do."

In comparison, I had a single mets removed from my lung via a small incision two years later, and begged for ice because the pain meds seemed not to provide as much relief as the ice did on a much, much, much (did I say much?), larger incision. I never took the oxycodone they gave me after this sugery, and placed ice over the incisions at home. I was back to work in one week, drug-free.

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

I'm interested in the idea of ice rather than drugs for major pain control. Can you share the logic, as put to you? The practice has so much to commend it that I'd love to learn more about it.

Phoenix Rising's picture
Phoenix Rising
Posts: 157
Joined: Jul 2012

Since the logic of not using pain meds after surgery was explained to me 3 years ago, I don't remember the conversation verbatim, but the fundamentals were:

--Pain meds slow recovery. Without debilitating pain meds, patient is more conscious, is able to eat, and walk when the anesthesia wears off.

--Pain meds are not good for the kidneys

--Patients can become addicted to pain meds

--Ice is just as effective, if not more effective in reducing pain.

--Ice assists healing of the incision

--Reduces the opportunity for fever (or something else about reducing fever)

--Ice reduces swelling at the incision site and other associated areas

I'll list the other benefits as I remember them.

pjune127's picture
pjune127
Posts: 127
Joined: Dec 2011

I go to an excellent oncologist affiliated with Northside and St. Joseph's. Atlanta Cancer Care. Doctor Thomas Seay (pronounced SAY). He is a wonderful doctor and the practice is top notch. Highly recommend.

Ga2536
Posts: 6
Joined: Jul 2012

NewDay and pjune: Thank you for sharing the names of doctors Pattaras and Seay for follow up care. It's a great help to have positive feedback from patients who are satisfied with their doctors and treatment plans.

Phoenix: Thank you for sharing your "experience" with Dr. Master. Sharing our journeys always helps to make us feel better, even when they are completely different.

At this point I am not certain what kind of specialist I need so, if you are reading this and happy with your surgeon/specialist, please add their name to the list.

Thank you

ourfriendjohn's picture
ourfriendjohn
Posts: 72
Joined: Jun 2012

I am in Walton County, out towards Athens. Dr. Robert Jefferson (urologist) did my right radical nephrectomy at Northside in Atlanta. I think he did a good job with pain management while in the hospital. I never needed more than an asprin after that. Although he does not seem to think consultation with an oncologist is necessary, I am pursing a referal with my general practitioner. I was given a couple of names by Susan Poteat at ACOR. Here is a portion of her e-mail to me.

"MD Anderson is one of the top places in the world for the unusual RCC's. Emory recently recruited Brad Carthon who trained in their GU cancers group-if you need something special later on he will be wired in to trials and support

http://winshipcancer.emory.edu/find-a-physician/WinshipContentPage.aspx?nd=8
07&id=2038&typ=33

Dr Charles Henderson at Piedmont took care of my husband when we lived in Atlanta-he has an interest in RCC, usually has a trial or two, but I would not call him a specialist-very competent keeps up with the literature."

My life is complicated by being part of the Kaiser Permanente HMO so out-of-network specialists may be more difficult. Translated: our of pocket expense.

I am glad that several of us have common ground here. Best wishes to all. Keep the string going.

John

NewDay's picture
NewDay
Posts: 178
Joined: May 2012

John,

It is a small world. I know I recommended my Urologist at Emory to ga2536, but I'm wondering if that's the right way go since they have already had their nephrectomy. Maybe an Oncologist is more appropriate at this point. I don't know. I'm very new at this. I may go over and add that question to a thread I had started.

I made and appt with an Oncologist at Emory(Winship) who I just picked off of a list. Since you actually have a recommendation, I'm thinking I may change my appt to be with Dr. Carthon. It is good to have people share their experiences with doctors because I hate just picking somebody off of a list.

Kathy

Phoenix Rising's picture
Phoenix Rising
Posts: 157
Joined: Jul 2012

My oncologists at Emory Winship are Dr. Carthon and Dr. Harris. Dr. Carthon specializes in targeted therapies and clinical trials. Dr. Harris administers the High Dose Interleukin 2. Dr. Carthon is very personable and a good listener. Dr. Harris is straight-forward, no nonsense.

pjune127's picture
pjune127
Posts: 127
Joined: Dec 2011

Sorry...It's pronounced SEE.

OC4YearsPlus
Posts: 1
Joined: Jul 2012

Hi Ga2536,

First, let me apologize for being off topic from your request for a referral and please feel free to delete this post from your thread. I am new to the discussion board, as I have been using another Forum for the past 4 years (Oral Cancer Foundation). But I think I have read every post there at least twice and wanted to try another route.

My husband has been treated for oral cancer for 4 years now, so when I joined this forum, one of my first searches was Emory, since that is where he is treated. That is how I came across your post.

Seeing the pain that my husband has gone through, and knowing what a strong man he is, when I got to the post about using ice to control pain, I wanted to both cry and laugh. The first thought that crossed my mind was: Treatment Plan for Stage 4 OC - throw some leaches on his jaw and pack it with ice. Then, I did cry.

I am truly sorry for all the pain you have had to go through. I can't imagine what an emotional toll this must be for you when you feel you can't trust your doctor. I hope this forum provides you with the answers you are looking for.

Ga2536
Posts: 6
Joined: Jul 2012

Hello OC4years

I am so sorry to hear about your husband. I can't imagine what the two of you have gone through...4 years is a long time.

Like you, I wanted to laugh/cry when I saw the post using ice to control pain after surgery.

I really wanted to go in to more detail about the suffering I experienced at the hands of a doctor who was more interested in his own research than he was in his patients, but I have not quite gotten to that point yet. Like you said, it takes a great emotional toll to wake up from surgery and realize you have been lied to and cannot trust your doctor.

And, like you, a lot of tears.

Maybe I will get the courage to share some of that here. Support from others is helping to get me through this.

Texas_wedge's picture
Texas_wedge
Posts: 2807
Joined: Nov 2011

I think it would take an overpowering reason for it not to make sense to part company with a doctor one can't get along with. [There's just such a situation going on on KIDNEY-ONC currently, as it happens, which will be interesting to follow.]

Nonetheless, could we have a few more facts? Are you saying (without naming names) that your surgeon refused to give you pain relief immediately after your nephrectomy? Or, rather, that he didn't offer it? Or that he expressed a preference for pain relief with ice instead of drugs?

I would find it astonishing if a surgeon deliberately left a patient in pain that could have been relieved without risk.

Phoenix Rising has given a very convincing case for ice rather than drugs, BASED ON PERSONAL EXPERIENCE DURING TWO PROCEDURES. Accordingly, I don't think it's appropriate to deride that practice unless you are a doctor yourself, with countervailing experience. You're the customer and you're entitled to vote with your feet and to ensure you get the best treatment you can but I don't think it's in order for a patient to seek to dictate to a doctor what treatment that doctor should give.

I'm guessing that it's possible there was a failure to follow the consultation procedure that Phoenix Rising underwent and a resulting oversight in not explaining the intended follow-up pain relief to you beforehand. That would be a deplorable slip up but is the sort of thing that can happen and wouldn't justify the claim that your doctor lied to you. I hope you can clarify the facts but, anyway, please believe me when I say I hope that you find capable doctors that you can trust and who will see you through to a complete recovery. As usual, members here have rallied round with helpful recommendations that i hope will prove useful.

Pain relief is an important topic and getting it right is crucial. I had a long and difficult open nephrectomy with a 10" main incision, much bleeding and difficulty with pain control. I'm a physically very active individual but for the first 2 days post-op I was barely able to move and had difficulty breathing due to the pain. My Wife was afraid I wouldn't survive the first night after surgery. I was on high doses of morphine plus paracetamol for some time (morphine for a month afterwards) but healed rapidly and completely. I needed to be opened up again, on the same incision, 4 months later. On different pain meds I bounced back very quickly and was golfing and lifting weights again fairly soon, illustrating the need to get the pain relief right.

The case laid out by Phoenix for the use of ice seems to me to be compelling and I, for one, want to learn a lot more about it. I may need further surgery soon and I intend to ask my surgeons about the role of ice in pain relief.

robert_douglas_smith's picture
robert_douglas_smith
Posts: 84
Joined: Oct 2011

My laproscopic nephrectomy of my left kidney was at Rockdale hospital by Dr. Chen with Georgia Urology. Morphine also made me sick so Dr. Chen switched me to loratab and I did fine. After a mass was discovered in my right kidney on my second follow-up Dr. Chen referred me to a Interventual radiologist Dr. Krebs at St. Joseph's. I have just had my second treatment for a total of 3 masses in the right kidney and am very pleased with the treatment by Dr. Krebs and his staff. This will be my course of treatment as long as it seems to work.

Ga2536
Posts: 6
Joined: Jul 2012

Thanks for the name of Dr. Krebs at St. Joseph's. I don't want to pry too much, but what kind of treatment did he do for the 3 masses in your right kidney? Was it Ablation?

It's nice to hear from someone who is pleased with their doctor and the hospital staff. Good luck with your future treatments, I hope all goes well for you.

robert_douglas_smith's picture
robert_douglas_smith
Posts: 84
Joined: Oct 2011

I had my second cryoablation procedure last Friday. My last ct showed where the first procedure killed the mass but it still shows up on x-ray. The first tumor they treated was 2.7 cm. The two treated Friday were less than a cm or less each. The way Dr. Krebs, my interventional radiologist, explained it to me was the cryo (freezing) only destroys .5mm of live kidney tissue outside of the tumor. With only the one kidney at this point I am very pleased with the treatment. They preformed the procedure at 9 AM Friday and I was home by 4 PM.

Will find out in 6 weeks whether I'll have a NED for a while!!!!! I'll recommend this treatment to all.

If you would like to talk I can seen you my info.

Ga2536
Posts: 6
Joined: Jul 2012

Robert, yes, I would like to talk and learn more about ablation. This was one of the treatments I considered but did not know anyone who had done this as opposed to surgery.

NewDay's picture
NewDay
Posts: 178
Joined: May 2012

Hi Ga2536,

I'm assuming that, by now, you have found a new doctor, but, if not, I wanted to retract my recommendation of Dr. Pattaras. I have nothing against him. I'm sure he is a fine surgeon (at least I hope so), but have not been able to see him since surgery. He was very good about answering questions before hand, but apparently his procedure is to hand you off to his physician's assistant after surgery and it is even hard to get hold of her. The few times I have called to ask her anything, she has had the nurse call me instead. It took her a week to submit the one week extension on my short term disability so she may have cost me a week's pay. I'm sure she is a very fine doctor, but I just don't feel safe with my ongoing treatment and decisions being made by a PA. Emory has an excellent reputation, but I think they may just have too many patients to provide much individual attention. I have met with an Oncologist and I have a Nephrologist keeping an eye on my remaining kidney, so I plan to drop Dr. Pattaras and his PA now. I hope you found someone you are happy with.

Kathy

Ga2536
Posts: 6
Joined: Jul 2012

Hi NewDay

Sorry you are having this trouble with your surgeon. Mine was with Emory as well, and I have had a very similar experiences; very friendly before surgery, but absent after.

The office is not good about returning calls or following up on any problems, and when I do get a nurse on the line it's like they have no training in Urology and have little to no idea of what I'm talking about; not even certain they are really nurses. Very frustrating.

I think I am going to follow up with my old Urologist that is not in the Emory network, and check into the recommendation of Dr. Seay, Oncologist.

pjune127's picture
pjune127
Posts: 127
Joined: Dec 2011

Good choice. I have been very pleased with him. His office is busy, but you can indicate when you make an appointment that you want to see HIM and not a PA. I will say that his 2 PA's are excellent. Tom is very quiet, but thoughtful and intelligent. He has a dry sense of humor that I really appreciate. Good luck and perhaps our paths will cross. I have been seeing him for a year.

Paula

robert_douglas_smith's picture
robert_douglas_smith
Posts: 84
Joined: Oct 2011

robert_douglas_smith@yahoo.com

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