Lost faith in my physician

jake10 · August 2003

Not so long but.....I was dx with bc in Nov 2003 and had a .6cm tumor, had mastectomy with tram flap recontruction. Neg nodes, Neg HER2 ER/PR. I was lucky to have chosen the mastectomy because pathology found in situ cancer at other sites in the breast. I did not require chemo or radiation due to the size of the tumor and the node status and HER2-. But....My biggest problem since the cancer has been removed has been my recontruction. Namely the abdominal site. When I originally met with my plastic surgeon I told hm I had smoked for 30 years and had just quite 6 months before dx. He said as long as I didn't smoke 2 weeks before and 2 weeks after I would be fine. I also have a 6 inch gall bladder scar on my right upper abdomen. Since my surgury was to the R breast that should have been a major concern to him but he thought it no problem.
Well I've had tons ofproblems. The abdomen just kept draining and draining. It drained through my belly botton. 4 months after surgery I went back to the OR to get the wound debrided. An area about 10cm around my belly button had necrosed. The tissue just died. He debrided and reinstered drains. I was hospitalized for 17 days on antibiotices and recieved hyperbaric treatments for 90minutes 2 times a day for a total of 30 treatments. This involved being placed in a chamber (kind of like a torpedo tube) the chamber was sealed and then the pressure in the chamber was increased. This would help oxygen get into the tissue to promote healing. I'm a little claustraphopic so getting into the chamber 30 times was the hardest thing I've ever done. This treatment was mildly sucessful. But I still have a 50cent piece sized whole in my abdomen just off my belly button. The whole tunnels to the right and left and down a ways. I irrigate it with peroxide and pack it with saline soaked gauze 3 times a day. And it still drains but not so much any more. My abdomen is a roadmap of scars and is distended to the right and left of the wound. Not a pretty picture to be sure. My plastic surgeon says when I see him again in September he will have some idea about how to close the wound. The problem is I don't have any faith in him at this point. And the thought of more surgery just leaves me weeping.
What would you all do? I need all the advice I can get. Thanks, Beth

miraclemom · August 2003

Dear Beth,you have been to hell and back it seems and wish I could help in some way.Do you think if you got a second doctor and asked him what he thinks would make a difference?I know all to well about scars-where they had to do my hystectomy did not heal right because of the chemo still in my system and it got infected and drained for weeks.It was not anything like yours but the scar is awful to look at because it didnt heal right and left with dead tissue so I look like I just had a baby-you know the tummy sagging.Tell your doctor about how unhappy you are about what you have already gone through and the thought of you having to go it again just isnt right as far as your concerned.Demand what you want and tell him what you expect.Beth its your body and you have already been through so much.Please e-mail me if you would like.Takecare and ((((((HUGS)))))) to you my friend. Lori

DeeNY711 · August 2003

Good gracious, Beth, I am so very sorry for this terrible sequence of events. Whether you ultimately decide to continue with the same surgeon or switch to another, a second opinion with a wound specialist might be a middle ground to explore as an alternative to more surgery. There are separate wound specialist physicians in many hospitals now. It might afford you a way to work toward resolving the situation without more surgery. Perhaps your insurance company can help you find a local wound specialist. Again, I am so very sorry that things went badly. Love, Denise

momof4 · August 2003

A big hug to you first Beth and second please plese if you are not satisfied get a second opinion find a different surgeon you do not deserve to look or feel they way you do right now we all been tru too much and once we try to get our life back on track we should at least be half way satisfied, it is your body so keep looking for a different doctor til you feel confidence in him with out it i wouldnt do anymore surgeries
Hugs Mariat. keep us posted

Twinks56 · August 2003

I am so sorry to hear about all you have been thu.I had problems with my recon as well but nothing like you.My first husband was shot in the leg by his brother in law .The surgern's were able to close the one hole but not the other for awhile He was scheduled to have a skin graft on the hole after about a month and they did not have to do that because i had been putting aloe vera on it.I took a leaf ,peeled the skin and placed it directly on the hole wrapped it and changed it every day .The doctor's were totally shocked that they were able to just stitch the hole closed instead of having to do a skin graft.It was a 4 by 5 inch hole.Maybe this will help with your hole.Let me know I hope it helps.LOL Teresa alias twinks 56

jake10 · August 2003

momof4 said:
A big hug to you first Beth and second please plese if you are not satisfied get a second opinion find a different surgeon you do not deserve to look or feel they way you do right now we all been tru too much and once we try to get our life back on track we should at least be half way satisfied, it is your body so keep looking for a different doctor til you feel confidence in him with out it i wouldnt do anymore surgeries
Hugs Mariat. keep us posted

After the second surgery and the hyperbaric, I did get a second opinion. Doctors are funny about critisizeing another doctors work. He just said he would not have done this procedure on me. His first choice is always implants. He does the flap if the tissue is damaged by radiation. As far as the wound goes it had not opened all the way when he saw it. In the meantime I got a call from my general surgeon yesterday wanting to see me for a follow up. I am going to discuss this at length with her. The last time I did this she too did not wish to comment negatively on another physician. She visited me during my 17 day stay and made it clear it was a social visit not a clinical oversight. But now I am really getting angry and if she is not willing to truthfully tell me what she thinks I will be seeking other advice possibly in a larger referral area like Denver or Mayo in Minn. I live in a very rural area in WY so physician choice is not that great. I have to travel 100 miles just to get to surgeons and oncologists. Thanks for the advice and support. Will keep you posted on outcome. Beth

jeancmici · August 2003

jake10 said:
After the second surgery and the hyperbaric, I did get a second opinion. Doctors are funny about critisizeing another doctors work. He just said he would not have done this procedure on me. His first choice is always implants. He does the flap if the tissue is damaged by radiation. As far as the wound goes it had not opened all the way when he saw it. In the meantime I got a call from my general surgeon yesterday wanting to see me for a follow up. I am going to discuss this at length with her. The last time I did this she too did not wish to comment negatively on another physician. She visited me during my 17 day stay and made it clear it was a social visit not a clinical oversight. But now I am really getting angry and if she is not willing to truthfully tell me what she thinks I will be seeking other advice possibly in a larger referral area like Denver or Mayo in Minn. I live in a very rural area in WY so physician choice is not that great. I have to travel 100 miles just to get to surgeons and oncologists. Thanks for the advice and support. Will keep you posted on outcome. Beth

Beth,
So sorry to hear of your bad experience - it does indeed sound like a nightmare - and hoping that you get some good help.

You asked for advice - I am almost 66 and have had my share of doctors - good and bad - and learned NEVER to get another opinion from a friend of the first - in the same practice etc.

However this comment (>>He just said he would not have done this procedure on me. His first choice is always implants. He does the flap if the tissue is damaged by radiation. As far as the wound goes it had not opened all the way when he saw it.<<) made me think you could consider seeing this second opinion guy again. He did indeed go out on a limb to tell you essentially you got the wrong treatment which you also know. Some smart-**** doctors think they can always succeed even when as you said, with the smoking and gall bladder scar he should have hesitated - Heck, he's already got his money!

I would lay it on the line with your general surgeon which you indicate you intend to - and then decide further steps. For now though, do not even breathe a word about suing - it turns even the best doctors off who might be willing to try to remedy the mess from the other dr.

Hoping we hear some good news soon for your sake. You have been through a lot.
Hugs, Jean

jake10 · August 2003

jeancmici said:
Beth,
So sorry to hear of your bad experience - it does indeed sound like a nightmare - and hoping that you get some good help.

You asked for advice - I am almost 66 and have had my share of doctors - good and bad - and learned NEVER to get another opinion from a friend of the first - in the same practice etc.

However this comment (>>He just said he would not have done this procedure on me. His first choice is always implants. He does the flap if the tissue is damaged by radiation. As far as the wound goes it had not opened all the way when he saw it.<<) made me think you could consider seeing this second opinion guy again. He did indeed go out on a limb to tell you essentially you got the wrong treatment which you also know. Some smart-**** doctors think they can always succeed even when as you said, with the smoking and gall bladder scar he should have hesitated - Heck, he's already got his money!

I would lay it on the line with your general surgeon which you indicate you intend to - and then decide further steps. For now though, do not even breathe a word about suing - it turns even the best doctors off who might be willing to try to remedy the mess from the other dr.

Hoping we hear some good news soon for your sake. You have been through a lot.
Hugs, Jean</p>

Good advice! I haven't even thought about sueing, but its good advice not to even mention it to another MD. My family wants to string him up but I keep them apart. I was seriously considering seeing the other MD. He's from Denver and saw me as a favor to my medical Dr. Getting out of the health system I am currently in may just boost my confindence and get this wouund healing. Thanks!!!! Beth

raku · August 2003

Hi Beth,
First let me say that I am sorry that you are having to go through this experience. I think that all of us when trying to decide about reconstruction really give it a lot of thought and worry that we are choosing the right type of reconstruction for our particular body. Some women don't have any problems after what ever reconstruction they choose. Others, like us, do have on going problems that we have to deal with everyday. I did the expander/implant route and now the plastic surgeon is talking about taking it all out because of complications. So we continue to deal with the whole reconsturction process for months and it wears us out. I am not in your shoes but I have an understanding of how you are feeling and can identify with the turmoil.

I don't know much about wound healing (other than what my diabetic friends have told me...one even had hyperbaric treatment) but maybe a dermatologist might be able to shed some light. Also, I know this would be a major trip for you but some of the big cancer centers have plastic surgeons on staff. They may have had experience with the situation you are in. Just a few thoughts. I'll be thinking about you.

hummingbyrd · August 2003

So sorry to hear of the ordeal you've been through, I think I would definately find another MD. Warn you ahead of time, basic rule is, they don't like to clean up someone elses mess. Just the way docs are, they are also very non-critical of each other as you've found out. First question I have though is in regards to the 'saline soaked packing'. Personal opinion, it should be packed daily, with sterile gauze, not saline soaked. Both saline and peroxide can deter tissue growth. If you were my patient I'd try flushing with warm betadine solution (make it look like weak tea, or as the doc I used to work for would say, 'fine whiskey'). PROVIDED you aren't allergic to iodine or shrimp or betadine! Then I would pack it with a sterile dry gauze, using 'sterile technique', which they can teach you at Wound Care at the hospital, if MD orders it. General rule of thumb is....if its dry, wet it or if its wet, dry it. This is in regards to dry wounds vs. wounds that drain. Hope this helps. God bless. hummingbyrd

jake10 · August 2003

hummingbyrd said:
So sorry to hear of the ordeal you've been through, I think I would definately find another MD. Warn you ahead of time, basic rule is, they don't like to clean up someone elses mess. Just the way docs are, they are also very non-critical of each other as you've found out. First question I have though is in regards to the 'saline soaked packing'. Personal opinion, it should be packed daily, with sterile gauze, not saline soaked. Both saline and peroxide can deter tissue growth. If you were my patient I'd try flushing with warm betadine solution (make it look like weak tea, or as the doc I used to work for would say, 'fine whiskey'). PROVIDED you aren't allergic to iodine or shrimp or betadine! Then I would pack it with a sterile dry gauze, using 'sterile technique', which they can teach you at Wound Care at the hospital, if MD orders it. General rule of thumb is....if its dry, wet it or if its wet, dry it. This is in regards to dry wounds vs. wounds that drain. Hope this helps. God bless. hummingbyrd

Hummingbird - You sound very much like a wound care nurse. Do you by any chance live in South Dakota? Beth

hummingbyrd · August 2003

jake10 said:
Hummingbird - You sound very much like a wound care nurse. Do you by any chance live in South Dakota? Beth

No, I'm a Texas girl. I wish I was close enough to you, to help. It'd be my pleasure to see this wound heal quickly! I am a Physician Assistant, with 13 years of experience. However, please remember, my advice is freeeeee, so take it for what it's worth. LOL That's what I tell my family! (he,he,he,he,he) Seriously, I always recommend consulting a physician before changing any type of treatment, but I gotta admit, this doc sounds like he failed 'wound care 101'. OH! Also be sure you do have an adequate intake of protein. Strict vegetarians can have trouble healing as can diabetics, so you might want your blood sugar tested also. Just a thought. God bless you. hummb

joules112 · August 2003

One of my Reach to Recovery gals is having the same problems as you are - and she even changed the hospitals she was going to. As soon as it stops draining they're going to do plastic surgery and pretty it up.

Good luck and I'm so sorry you're having problems. I had a tram flap and had to have dead tissue removed but am very happy with final results.

Lost faith in my physician

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