Great in-network surgeon or BETTER out-of network one?

thanks to everyone for sharing this information and insight! i HAVE been told that i cannot get an LSH because of the size of my uterus, but after consultation with other doctors (i've seen 5) and research online, i have found that the cutoff for elibility of an LSH isn't related to uterus size, but to the willingness and expertise of the doctor. as one doctor who routinely performs large-uteri LSH's told me, "I'm not surprised other doctors are recommending a TAH to you - if the only tool you have in your toolbox is a hammer, every problem is a nail."

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Originally Posted by daphne6 thanks to everyone for sharing this information and insight! i HAVE been told that i cannot get an LSH because of the size of my uterus, but after consultation with other doctors (i've seen 5) and research online, i have found that the cutoff for elibility of an LSH isn't related to uterus size, but to the willingness and expertise of the doctor. as one doctor who routinely performs large-uteri LSH's told me, "I'm not surprised other doctors are recommending a TAH to you - if the only tool you have in your toolbox is a hammer, every problem is a nail."

I found out in April I needed a hyst. I took everyday thereafter to research different surgerys, like I already mentioned. The fact is there are DR's that will perform the surgery for you, HOWEVER, you are putting yourself at risk. If you have done so much research you would realize that the reason alot of DR's dont want to do it for a uterus your size is because of the risk of complications to you! If you ask me your DR is being negligent and is probably making a fortune giving women the easier surgery simply because it is what they want, not what is best for them. And a TAH is not given simply because that is the only procedure they DR is trained in most DR's are trained in laporoscopic use. The only difference is, a DR may request a TAH because that is what he feels will bring less complications to you. I am sure your surgeon will have you sign at the hospital right before surgery, a waiver, waiving your right to sue him if there are any complications. This is also a common practice if you are requesting a surgery which the risk is higher for you. Listen, I just want to help you, please be careful. It is easy to get lured into the hype of an "easier' surgery. But honestly are you willing to live with the complications? Read the post op forums, dont just take my word for it.

thanks for your words of caution. Respectfully, though, i've been treated by my doctor for several months now and i don't think - as you imply - that he is being negligent or greedy or insidious by recommending the LSH to me. (an LSH is less, not more, than a TAH.)
I checked the post-op forums and you were right - there are people who had complications with their LSH surgeries - but the rate of complication is small and the number of overwhelmingly positive experiences with LSH (even for large uteri like mine) far outnumbers the negative ones.
i regret that you had bad experiences with your lap surgeries, and i understand that your TAH went well, so you are a huge proponent of that. However, the decision on what type of surgery to get is a very personal one, and I think for me, all things considered, the rewards of LSH may outweigh the risks.
i know that you strongly disagree, but i want you to know that i appreciate your experience and input very much.
Take care and best of luck.

Actually the recovery of my laporascopic surgery was fine. I didnt have any complications. I was reffereing to the pain afterwards. For me the TAH was ALOT less painful. Although with my Laporoscopic procedure I was on my feet and back to normal in 3 days. And with the TAH it took ten. It wasnt until I started seeing my GP for always having to go relieve myself that he told me this could be cause by my prior laporoscopic procedures. I completely respect that this is yoru decision and I wish you the best of luck, with whatever you choose.

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Originally Posted by daphne6 I have a uterus the size of a six-month pregnancy thanks to a bunch of fibroids. I have all the heavy bleeding, anemia, discomfort, etc. that you'd expect, and I've decided to take my life back and get a hysterectomy. I'm pretty excited about it, actually. After some searching I found an OB-GYN who specializes in LSH's on oversized uteri like mine. He's great and would even do the surgery on an outpatient basis! (My original OB/GYN wanted to do an obdominal surgery with a north-south incision - ugh! I said you might as well put an apple in my mouth because I'm going to feel like a pig at a luau. He did not find this funny. ) Anyway, the issue with the specialist I've been seeing is that he's out of my insurance network and out of state, so the surgery will be more expensive and will involve travel. Also, I found this doctor on a web forum, so I don't have a personal recommendation from someone I trust, but I've been treated by him since April and really like him. I've looked for a similar doctor within my network and couldn't find one. I did find, though, someone who comes highly recommended and who has a lot of LSH experience, but not on uteri the size of mine. I met him last week and he said he can try an LSH, but that he'll likely (80% shot) have to switch to an LAVH, and that there's a 10% chance that he'll have to switch to an abdominal surgery. He did say, though, that he could do an east-west incision if that happened. I love the minimal invasiveness of the LSH, but the convenience and low stress of going to the local guy is alluring. What do you guys think? Who would you choose?

You story sounds too much like mine I chose the out of state incredible outpatient surgeon and would do it again in a heartbeat! Are you in Atlanta? If so, I may know your doc. I also found him on a web forum, but I checked him out very very well.

Best of luck in your decision

sounds like a difficult choice for you
my question is - how much do you really know about your out of state surgeon?
have you checked his state licensure, where he did his training and whether he was any fellowship training in laparascopic surgery or is listed here: http://www.aagl.org/ and have you verified that he is board certified
have you asked him how many of these surgeries he has done and what his outcomes are like?

also, think about after the surgery -
when you return home, who is going to do your follow-up care? i know that you can drive back to him for some post-op stuff, but think about what you are going to do if you have immediate problems after surgery...e.g., i had to go see my doc again due to a high fever just 3 days out from my surgery, and I don't think I could have dealt with a long drive
who is going to prescribe more pain meds if yours aren't doing the trick? (federal law will not allow a doctor to fax schedule II narcotic prescriptions) who is going to deal with problems like post-op infections? a lot of doctors refuse to do follow-up for doctors they do not know because there is an increased risk of malpractice for them on a surgery they did not do

not criticizing you at all, just some food for thought, and it sounds like you have lots of time to figure all of this out
and actually, I would ask some of the same questions about any doc

I am a contractor for hospitals for hiring doctors and I do a lot of research on doctor's credentials...you'd be amazed at the amount of incompetence I find out there. I had one the other day that I asked him why he had a blank 3 years on his resume and he just said, "I was not able to practice." That's all he said. I then did my research and discovered it was because he had been incarcerated for medicare fraud. He was the nicest guy in the world, but I had to tell him I could not work with him. The stories I could tell...anyway, I get really scared when I hear of people trusting a doctor because they found his name on a forum, or even because he has a nice bedside manner. There's a lot more to competence than that.

I hope you are able to find a good solution.

your concerns about follow-up care make A LOT of sense. i'd love to go to the out-of-state guy (i've done lots of research on him and his experience and reputation are impeccable), but i think with the traveling it's just not going to work.
after reading your post i checked aagl and found a doctor near me who routinely does large-uteri LSH's and WHO'S ON MY PLAN! i am so thrilled. i am scheduled for a consult next week, so we'll see how it goes!
thanks for your amazing help!

That's great news!!! Keep us posted
KS

You're welcome!