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Old 06-16-2008, 05:34 PM   #1
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issues w/ surgeon, heading to post-op appt -help

Hi, I haven't been to the board in a little bit and am coming in to ask a question kind of too close to when I'm hoping for answers (cest la vie), sorry. I have my post-op tomorrow for my second surgery (my low back) and am not sure how to proceed with the appt. We have definitely had a falling out with my neurosurgeon and I'm not sure how I want to handle this appt (ask post-op ques, then have our 'discussion' or have the discussion first, then questions... request another neuro to follow me from now on or not?). I thought I might pick the experienced brains here for some ideas. Has anyone else had a falling out with their neuro before the post-op --and how did you handle it? I don't have any issue with my neurosurgeon's skill -he did a grand job with both surgeries. I have issue with how I was treated and spoken to before and following this second surgery. Also, there were some misunderstandings and miscommunications (or lack of listening) on his part that I very much want CLEAR (for the record). I called his office a while back wanting to clear the air, but his nurse told me I did not need to talk to him about the issues b/c she already had set him straight. I was remiss to drop it there and figured I'd wait 'til the post-op to address him myself --and just concentrate on my recovery, set the anxiety aside. Now, it's post-op time and I am trying to organize my questions and my 'discussion' -and figure out whether I am comfortable continuing with him for post-op or not. He did the work, so he seems the best to follow me, but not if we can't resolve the issues.

 
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Old 06-16-2008, 06:28 PM   #2
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Re: issues w/ surgeon, heading to post-op appt -help

The first thing that came to my mind was to write down your issues.. I don't mean a long conversational letter, but just succinctly summarise your issues with him in a typed letter. So at a glance he can see the main points.
I did this once when I was getting nowhere with back problems ,and the GP kept dismissing it as "stress", "posture" etc. I knew I had a serious problem, so I listed my symptoms in a letter, and just handed it to him on my next visit.
He referred me to a surgeon, and 7 weeks later I was in surgery for a "mangled" disc with all sorts of messes that were successfully operated on.
I find that putting things on paper can separate emotion from facts, and because I find it hard to express myself when I'm nervous, it really helps.
If it's on paper too, he might just re-read it again after your appointment and understand what you're trying to convey to him, without him feeling defensive or whatever.
Just a suggestion.

 
Old 06-16-2008, 06:32 PM   #3
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Re: issues w/ surgeon, heading to post-op appt -help

PS.. I meant to add, that my Dad was in business and "law" for years, and he always encouraged us to put things in writing. He said people can ignore a conversation, but when something is on paper, it means it is "evidence" and has to be addressed or answered or dealt with in some way. People aren't as likely to dismiss written words as they are spoken ones.

 
Old 06-16-2008, 06:41 PM   #4
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Re: issues w/ surgeon, heading to post-op appt -help

Try to mend your tiff with this guy,as any other neuro will be reluctant to follow-up with you. This is one tight knit group! I had similar problem and my gp told me straight up I would have problems getting another neuro to follow up. Thank God he relocated!

Good way of getting your point across is to type your letter with key points in bullets and MAKE A COPY FOR HIS FILE. I did and it worked. When I transferred records to new dr, yep there was my letter included with all surgical notes.

Good luck

July

 
Old 06-16-2008, 10:45 PM   #5
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Re: issues w/ surgeon, heading to post-op appt -help

Thank you both for responding. I'm not sure how to type some of it up, but I'm going to try. Any ideas for how to type up not feeling you weren't treated well without it coming off as accusatory? I know the 'no adjectives' rule (which is a big help), but am not sure how to phrase some things without putting him off (ironically, since he has phrased things to me in upsetting ways and with angry tone).

 
Old 06-17-2008, 03:48 AM   #6
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Re: issues w/ surgeon, heading to post-op appt -help

I think if you express yourself similarly to how you did in the first post here, you'll be doing fine.
One thing I find helps get "through" to people is to mix a compliment in with the complaint. Let the other person "save face", or they tend to get defensive.
Express your gratitude to him for his skill as a surgeon and that you respect and trust him enough to put your health and life in his hands, but that you would like him to respect your feelings as his patient, by listening to you.
Another thing that I find works is to kind of throw the ball back into his court. After you've expressed your wishes, ask his advice.... no one can resist that. Like, "What would you advise me to do in my place. What would you suggest would help us to re-establish our relationship.?" It's a dignified form of flattery, asking advice, and enables you to express your dis-satisfaction without actually allocating blame.
I quote my Dad again, but he was very skilled in forceful diplomacy.. his motto was always "Truth, seasoned with grace".
Let us know how you get on? I hope you achieve the rapport you want to with your neuro. all the best.

Last edited by lilydilly; 06-17-2008 at 04:30 AM.

 
Old 06-17-2008, 12:20 PM   #7
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Re: issues w/ surgeon, heading to post-op appt -help

Thanks again, Lily. I wrote a letter last night, but am going to revise it today with some of your suggestions. I'm not sure how the letter sounds and worry it's like kissing up to someone who was unkind to me (wrong person apologizing sort of thing) -or that it sounds like veiled digs (neither of which is my intention), but I want to mend fences and that's how it came out while trying to on paper. I was vague (or 'general') in my first post and I want to be crystal clear w/ my neuro, so that gets a little tricky on paper.., can sound 'wrong' if I don't figure out how to word it right. I'm a little worried to address some of the things he said and told me because he may now realize that they were hurtful and even incorrect. I want to address directly everything that went awry the day of my surgery and with my discharge, so I don't want to leave what is important to me out. I really had a time with writing out the discharge issues we need to resolve. There were some stunning things said on his part regarding this (at the time) and I just can't let it go, also there was a major misunderstanding that came about b/c we were trying to sidestep his anger.
Hmm, I stopped writing my post to you to try to revise in microsoft word and am suddenly making the letter longer. I don't think that's a good idea, though! I wish this were easier. I need an editor.
I'm still going to try. Thanks, Lily

 
Old 06-17-2008, 12:45 PM   #8
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Re: issues w/ surgeon, heading to post-op appt -help

Me again. How long is too long for this letter? sigh.

 
Old 06-17-2008, 07:30 PM   #9
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Re: issues w/ surgeon, heading to post-op appt -help

Truly, only a suggestion, but if it was me, i wouldn't try to address every single thing that was said, hurtful or not. I guess it's a bit like an argument in any relationship. Some things get said because we lash out with words, not because we mean them fully.
So what I'm trying to say, remember it's not about the words, but about his attitude towards you as his patient, that matters most.
Perhaps specify just a few of the things he said, only to use as an example of how you have been made to feel. If he has any decency at all, he won't need to be reminded of what he said, because he'll remember his own feelings at the time as well.
So I'd still keep it brief. This is about healing a relationship, not stirring up the muck again. To me one page is always sufficient for getting any kind of point across.
Sometimes it's best to just wipe out all that's gone before and simply begin afresh, unless of course there is an issue that is still affecting your health and your treatment, that needs to be addressed in detail.

Many years ago, when I was young and really ill, I was given a reference to see a neurologist 1000 kilometres from where we lived. I had an appt. with him on the day, and he was very uncommunicative, and arranged for more tests to be done next day, with further appointments etc through the week. That night I became frighteningly ill, and we didn't know what to do. My husband decided to ring the neurologist's after hours number, because we'd just seen him that day about my illness, and we thought he'd be upset if we went to another doctor, etc. Well, he absolutely BLASTED my husband..... I could hear him yelling from the other side of the room, through the phone. My hubby apologised, and explained that we really did what we thought was best in a frightening situation... We'd have got an ambulance, but we didn't know what hospital this Dr would prefer me to go to etc, we were only young and simply didn't know what to do for the best.
Well, the dr. contintued to rant and rave like a madman. Finally my hubby said in a really loud but calm voice, "NO, Stop RIGHT there, Now you listen to ME. We have travelled 1000 kilometres to see YOU, If you want us to get another doctor, you tell me right NOW, because I have not brought my wife over 1000 kilometres to be treated like an idiot by you, but for the precise reason that she IS so sick. Now what do YOU suggest we do?"
Well the neuro said, "have her at ..... hospital in a half hour and I'll see her there in the morning ". He'd rung the hospital and had arranged the right medication etc for me. but I was dreading seeing this neuro in the morning.
Well, he walked into the ward, and said, "Before you say one single word, I want to apologise to you with no reserve". I started to say that I understood we might have rung at a bad time for him etc, but he said, "NO, there is absolutely NO excuse whatever for my reaction and for my behaviour, and I'm totally ashamed of how you were treated. Now, please don't say one more thing about it. I'm the one who was at fault." I started to say it was ok, but again he said, "I don't want you to say one word in my defence. You did the absolutely RIGHT thing, and I did the wrong thing. And all that's left now is for me to apologize to your husband as well, when I see him. Now not one word from you on the matter".
He treated me after that as though I was the Queen of the universe, with the utmost care and courtesy and gentleness.
Talking to the nursing staff later, they said this neuro was the most respected skilled neuro in the city, but a total control freak, and my husband was probably the first person who had ever stood him up for being a plain rude man, instead of kowtowing to him as some God of Medicine.
Just wanted to share that with you, because we both learnt then that some very authorative type people have more respect for people who demand to be respected themselves. I do hope you get that reaction from your surgeon.
And don't feel you're crawling to him by expressing respect for him... it's just that you BOTH need to respect each other,,, him as your surgeon, you as his patient. You are employing HIM after all.
But yes, keep it brief, rather than long. He doesn't need long explanations for why you feel like you do. And try to remember that the whole point of the letter is to re-establish your relationship on a different footing, to get it right from now on, not to rehash what went wrong. And don't be afraid of under-explaining. Leave him some room to ask you himself if he doesn't understand something.
It's a shame I can't take my own advice... Just going by my own posts to you, I'm the master of Over-explaining and long detailed letters. LOL.
Here's a little poem I thought you might enjoy, that I try (try being the operative word here) to practice. I know it doesn't apply to you, because you do need to let your NS know how you feel, but thought it might give you a grin.
Keep us posted. I'd love to hear how it all goes for you. Cheers from Lily
"It doesn't pay to say too much,
when you're mad enough to choke,
For the word that stings the deepest,
Is the word that's never spoke.
Let the other fellow wrangle,
Till the storm has blown away,
Then he'll do a heap of thinking,
About the things you didn't say"..... by James Whitcomb Riley

Last edited by lilydilly; 06-20-2008 at 01:01 AM.

 
Old 06-17-2008, 07:31 PM   #10
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Red face Re: issues w/ surgeon, heading to post-op appt -help

How long a letter? Take a look at the one I just wrote you.. that's too long... LOL. Lily

 
Old 06-19-2008, 07:03 PM   #11
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Re: issues w/ surgeon, heading to post-op appt -help

Oh, Lily, I wish I'd spoken like your husband did -a while ago. sigh. I ended up having written a more appropriate (and short) letter, but didn't hand it to the NS when we saw him on Tuesday. We intended to ask our post-op questions first, then have a 'talk' and hand him the letter. Then we dropped the ball entirely and just asked our questions. I haven't made peace inside myself with what direction I'd like to go 'talk-wise', but then my indecisions led me to do nothing. Not so great. I definitely could tell the NS has no issues on his side with seeing us, but then he wasn't the one who was being spoken to harshly and inappropriately. There was one thing that was 'on us' and he seems not to mind at all with that. I'd wanted to clear that up, too, though -to make sure he understand what really transpired. I didn't even do that (although, that's the one thing I left in the letter.. the letter I never gave him). I'm not a wimpy person by nature, not sure what's going on w/ me. If my son had been spoken to and treated the way I was, I'd be quite proactive about it, yet not when it's me?? I do thank you, though, for your advice. I'm so glad that your negative doc situation turned around so beautifully.

 
Old 06-20-2008, 12:59 AM   #12
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Re: issues w/ surgeon, heading to post-op appt -help

Wynoma, at least you've got the letter to give him if the situation deteriorates. Sometimes I find just writing a letter is enough for me to get the feelings out, and I don't need to send it. And you weren't being "wimpy", sometimes we just get a feel about a situation, and if the time wasn't right to give him the letter, than you were right to go with your intuition.
Sounds like you're not having any problems with him at present. Hope it all stays good for you. Keep us posted. All the best. Lily

 
Old 06-20-2008, 05:56 PM   #13
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Re: issues w/ surgeon, heading to post-op appt -help

Yes, writing a letter WAS helpful. I wrote one version just for myself --felt good. There is a problem w/ him still, but he didn't speak rudely or unkindly to me and wasn't angry at my post-op, which was a nice change. He didn't ask me about my recovery (just one question --verrrry different from how my first post-op went), didn't ask to see how I'm walking (which he did in my first post-op and in my pre-op), didn't really 'ask' much of anything and gave very short answers (unlike when I first began seeing him --it's morphed over time to a very different relationship and very different appointments (and morphed much more quickly after my the experiences with him this 2nd surgery go 'round). For my post-op, I'm assuming that before he came in he used the body picture sheet as his guide (the pictoral sheet I fill in everytime I go that shows where I feel this or that at that moment) and he did listen to (and answered) our post-op questions of what changes to make in my post-op care now that I'm 4 weeks out, but went no further, nothing from him to us, just from us to him. He no longer seems interested to 'check me out' (in the doctor sense), which, I feel as a lack of receiving appropriate care, but which I also feel 'right' about b/c I don't feel comfortable with him anymore myself -otherwise, I'd have asked to walk for him and asked what he wanted to know about my recovery. I'll never doubt his surgical skills, but I no longer feel confident that he's interested in helping me at this point. I intend to see my GP soon (she's still following me for the distention I still have -from both surgeries, 10 weeks of abdominal distention now) and I'm going to ask her to 'check me out' and go over recovery w/ her. The NS did not believe I was in the pain I was in when I left the hospital and that leaves me distrustful that he'd believe what I'd say about my recovery since, too. My GP knows me, trusts me, wants to help me. NS's answer to my long-term recovery question asking what things I should no longer do after I'm fully recovered was, "I'd say in 3 months, you can do anything you want from then on." I just don't feel "doing anything" I want is actually a good idea if I don't want all my other bulging discs and mild to moderate areas of stenosis to 'go' the way the herniated disc and severe stenosis did, leading to surgery. It's the opposite of what the NS's nurse has told us, what the booklet on DDD he handed us says, what the PT's who saw me in the hospital said, even what others here have said (and experienced). I'll be starting PT soon (at my request) and am hoping to have appropriate guidance from my PT, too. Later, I guess I'll go back to the neurologist my NS referred to me after my first surgery since I'm now 'established' w/ him and felt I received appropriate care from him (I was referred to see the neurologist for weird post-op neuro symptoms I was having that my NS said were not something for the NS to take care of, but for a neurologist). I can go over things with him. I do have a 2 month post-op with the same NS scheduled, but I don't feel 'followed' by him and doubt I'll keep it. He did two awesome surgeries on me and I did get what I sought, his expertise and skill. I don't think I'm going to be getting care beyond that and I don't think I want it (from him). He got what he wanted from me, too. He enjoys doing successful surgeries and he got two out of me. They weren't successes in terms of giving me back all the functions I'd lost, but they were in that they both met their goals (neck surgery goal was not to return function but to stop the problems from progressing; low back was to return function, to take away the sciatic pain and clean things out). Oh, btw, when I asked the NS when I would be able to drive, he said 'now'. He didn't ask any questions before saying 'now', so I offered up that my left leg goes numb when I sit for too long. He didn't even ask how long 'too long' was, but did say, "well, no then" (to the driving) and added that was normal (the numbness when sitting) and it should get better soon. I'm still riding as a passenger quite reclined and with pillows all about. I didn't offer that up, though. I didn't even care to. I think I knew I didn't want to see him anymore, but knew I didn't want to 'break from' him (and risk getting 'labeled') and I just asked my questions and left. I don't want another NS, but I think a neurologist would do fine for follow up. I had no surgical complications and it's just about working through recovery now and dealing with the functions that are still 'gone' due to my cervical having gone so long before getting fixed.
Wow, I was in a chatty mood! Sorry, Lily. My son is on the Playstation (so I can't watch a show or relax in my hospital bed in our living room, unless I want to watch him attack orcs) and I'm bored, Lol!
I guess I should read through to find out how you've been, too. I don't want to be one-sided. You've been very helpful and I appreciate that.
Take care! (and thanks again)

 
Old 06-20-2008, 07:28 PM   #14
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Re: issues w/ surgeon, heading to post-op appt -help

If it's any consolation I've seen some minor problems with my orthopedic spine surgeon lately. He is a fantastic surgeon and for years had been in a practice with his dad. I think his dad is in the retirement phase, plus they were undergoing office reconstruction and they added a new surgeon. I've been very tolerant of him lately as I can see stress (from the construction going over time and budget to the change in the practice) really getting to him.

When I saw him in my first post-op I did ask him to remain for a moment and just told him that I can tell he's under a great deal of stress but I just need him to take a little more time to "get where I'm coming from". And if I do, others may too. He got a very serious look on his face and basically thanked me. He and I are about the same age and we've had a good doctor patient relationship for a while....so since he and his new partner are premier and wonderful I'll take some of the bad beside manner sometimes, but when it comes down to it I'll always let him know when I've hit my limit. He has a great new Nurse Practitioner and so for today's post-op appointment I asked to see her. I was in tears since my cervical muscle spasms have been so bad and I felt so much better being able to let it out to her. My surgeon had felt that I could return to work on 6/30 but she was able to talk to him and the 3 of us agreed on 7/10 instead.
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