New and conflicted about surgeon options

a_oaklee said:

Surviving a teaching hospital

It never bothered us at all.  Every person we encountered was polite.  We felt like if our surgeon was teaching others, then he must be really good (knowledgeable and experienced).  The residents mostly listened and were present.  You can ignore them.  We felt good that we were helping new doctors, and were glad that more people were becoming doctors.  I kept a notepad to keep track of who everyone was.  The hospital we were at, all the staff had business cards with their photo on them.  We didnt feel like lab rats, or that we needed privacy.  It wasnt embarassing at all, nor any concerns with exposure and being examined or questioned.  We had a choice of having clergy visit during my husbands stay.  We welcomed all denominations because it was interesting.  Even the clergy had interns.  We are glad we helped people learn.  I think you should try to think of this differently, and if you cant, then go to a regular private hospital.  Honestly, I think that would be a big mistake.

We saw our urologic surgeon before surgery, during the hospitalization, and one time after surgery.  He is not our doctor.  He is a surgeon only.

After you get through this, you can visit a urologist as your caregiver going forward.  Or you see an oncologist.  We see a urologic oncologist.

I disagree that you are the one that chooses what approach to take with surgery.  Well, perhaps you do have the right to make the wrong choice.  I think this doctor felt that you didnt have a choice because he has determined what is best for you.  Too bad he didnt explain.  Surgeons are kindof known for being the most arrogant of all specialists.  If I had to guess, the guy got offended being asked about his experience in front of his students.  Too bad.  But I do get it.  

These big places have lots of assistants.  We always have contact with their nurse practitioners who are extremely knowledgeable.   Perhaps it would be good to talk with him/her about whatever questions you may have.  

Have you visited Emorys website to check out other doctors that do urologic surgeries?  I think you could try to see someone else, but you will have the same audience.

"I disagree that you are the one that chooses what approach to take with surgery.  Well, perhaps you do have the right to make the wrong choice. "

I meant that you can choose traditional lap over robotic lap; not that you determine whether it should be partial or whole, laparoscopic or open. But laparoscopic can be done either traditionally or robotically. I was told I can have open or lap, robotic or regular. I went with open for various reasons. I assume that the surgeon who does robotic lap can also do regular, non-robotic lap. And Mila should be able to say she does not want the robotic version.

I was also treated at a teaching hospital - a place I knew and was comfortable with - but I turned down the first doc they had me see despite him being high up (maybe top) in the department. I have to be comfortable with my doc, especially a surgeon. I researched all the oncologists and urologists  and asked for a second opinion from one of the others. I liked his attitude on his video and the way he talked about the surgery and patients - and his credentials are top notch. I was afraid to ask about second opiniion in the same hospital and the nurse said, "Oh we encourage patients to do that." Also I have found that I don't have to accept a resident working on me, at least in appointments, even at teaching hospital.  Maybe I've been lucky. It sure feels like it. I continue to see the same doc (oncologist/urologist/surgeon) for follow ups and would trust my life (or that of any of my family) to him again. I also had the luxury of a place to stay and friends and family nearby. I say research other surgeons at Emory. For me, I have to be confident and comfortable with the person cutting me open - that they will see me as a person. Take care -

You want the surgery to be done in a top notch way-so you get the best surgeon you can find.  I, too, was at a teaching hospital and had a team of two surgeons; one for the kidney and nodes in the lower abdomen and one doing the liver resect, gallbladder, and tubes.  11.5 hrs before being sent to ICU.  The following year, the same Renal surgeon was supervising a Resident for the recurrence in a node.  Both did great jobs, and were pretty good looking, too. In 2006, Surgeon #1 was Head of Urologic Surgical Oncology and #2 was Chief of Thoracic Surgery and in charge of the Liver Transplant Team.  That first surgery wiped me out for nearly 6 weeks and we ended up flying to Portland for my first check up and removal of 63 skin staples (I counted the little buggers). The release check up, we drove and met with the Medical Onc.  After reviewing my case he determined there were no drugs in any stage of testing to put me on at that time, since they considered there was no  active site.  Sutent was one of the only drugs approved at that time and it has been found to have numerous side effects.  But I surprised everyone and had 2 recurrences that were too small to detect in 2006.

A regular oncologist will take over your care, testing, etc. after that.  And you will have a GP or Primary Care doc for other needs.  The point I'm trying to make is try to tolerate a Surgeon with poor bedside manner if he can get you over the surgery hurdle.  My third surgery was done locally by an experienced doctor, but he was lousy at talking to me.  On a follow-up visit, I cracked a joke and he laughed.  I even said, "You can smile."

Although I had taught Health and Physical Education and subbed in biolgy, plus having had a couple of other major surgeries, Kidney Cancer was a new learning curve. I connected with a local support group that still meets once a week between Dx and the surgery and continued to attend for many years.  I read everything I could find-much on the internet, but sorted the scientific  facts from "quack cures". asked questions, found a couple of other locals with Kidney cancer dx's.  Once I got over the initial shock, I realized I desparately wanted to live and had a lot of things to get done before surgery and recovery.  That kept me focussed.  On the day I received the news, we knew that our daughter was moving back from the middle east with her boys prior to her husband's discharge from the service.  But did she follow thru with her plans to move to Portland, OR, or move to our town to help care for me for the 5-7 month death prediction I had been given.  After the group consult with the 3 doctors at OHSU, the first thing I did was call our son in our home town and tell him to call his sister and let her know she could still plan to move to Portland.

And here we are, going into 14 years since Dx and 12 years of no cancer.

Have HOPE  and many best wishes for success.

donna_lee

I've had surgeries at both teaching and non-teaching hospitals, and with a variety of surgeon personalities.  I also worked at a teaching hospital many decades ago.  One of the first things we were taught (unit clerks) was that surgeons could be SOBs, but it was because they were so focused on their work, and some developed a hard shell to do what they did: cut into living bodies all day!  That's a huge responsibility.  I want my primary care to have a good personality, but with any other doctor, it's not an indication of anything.  And the residents who assist already have plenty of experience.  If it's a medical student, they observe, and maybe take notes, but mostly make sure they're not in anyone's way.  I love the residents and senior students - they're the ones who will talk to you in the hospital and explain anything you need clarification on.  Same with the anesthesiology residents.

I kind of lost track of stage - one nephrologist after surgery listed me as stage 4; the one I see now lists me as stage 3. I'm away from home so can't find the surgeon's note. I try not to think about it too much. So I do have another doc - since my surgery was in another state, I go there each summer for my follow ups, see friends and family, work on or attend a retreat, and go to jazz band camp. During the rest of the year, I have an appointment with a local nephrologist. I have to admit I was a little intimidated by her in the beginning, but over these 3 1/2 years we've gotten into a good working relationship and I would not want to change. So I check in with one doc or the other every six months, with a scan every year, alternating ultrasound and CT. 

My husband only told me and the kids and swore us to secrecy.  I respect his choice, but its really hard on me.  I want to reach out and get the support from other people, but I cant.  CSN certainly helps when I need to connect and talk about it.

Its been 8 years now and I can see how wonderful it is to not tell people.  He doesnt want to be reminded of "c" everytime he sees someone.