Lesson on surgery authorization! Must read

I had surgeryMonday to eliminate some scar tissue that the doctors suspected was causing my pain since my major surgery last September. The good news is that the surgery went well and there was only a little scar tissue to remove; the bad news is that they discovered a gallstone the size of a golf ball and a gall bladder
twice its normal size. Because I had not authorized the removal of my gall bladder and it did not constitute an emergency (**** lawyers-my husband is one), they did not feel that they could remove it on the spot. I meet with the new Dr on Tuesday morning and had the gall bladder removed Tuesday afternoon!

Two surgeries in one hospital stay! Not what I had planned but i am sure happy it is over. The moral of the story is to be sure your operation authorization is broad enough to cover such a surprise. I hope someone else will benifit from my discovery!

Dear friend..
That happen to me!!.. I am 9 days post op TAH... I went to Laparoscopy surgery on Jan. 12 for removal of one cyst.. Guess what? When they open they saw everything was "Bad" they just closed everything (justo took some pictures) and explain to my DH and me, I will need another surgery.. for the removal of my WHOLE WOMB... I was sad, (and kind of upset) I told them I was "OPEN" and "READY" if I need something like this... but "LEGALLY" they need my sign.. What a shame!!!... 6 weeks latter... my surgery... I am still painful.. But like you... 2 surgeries at the same hospital and the worst part TWICE BILLS!!

Best wishes.

Me

Another thing to consider is the appendix.

My authorization paper said that the doctor could make a judgement call on the appendix and remove it if necessary. Mine was ok.

It didn't cover my gall bladder because I had it removed several years ago.

Can you tell me what kind of pain you are having, I had my surgery two days after you and have been plagued with problems, now having a ct scan to rule out scar tissue. Any help you could offer would be appreciated, swan sister.

I kept having pain on my lower left side along with the upper left side. No pain around the gall bladder! They think I might have been having radiated pain that masked the real cause. They did find some adhesions that they removed and did another repair when they went in on Monday. Pain increases when I tried to workout or do any reaching.

I am really worried about the appendix also. It is alomost my last item to be removed and I would really like the 17 surgery to be my last! I am not trying to borrow trouble and just have good thoughts about a healthy appendix.

Tracey

Let me present another perspective about the surgery authorization. I went in for a simple lap to remove my left ovary and woke up with everything gone due to severe, and asymptomatic endometriosis and adhesions. I only consented to a lapartomy to remove the ovary. But, when the doctor got in there and saw how bad things were, he told my husband it was best to take everything now because I would need further surgery anyway. My husband agreed and didn't want me to have to endure that. The consent form allowed for further surgery should it be warranted and considered medically necessary.
When I woke up, I was furious and I felt violated and raped! One of my first comments to my husband and physician was "so much for a woman's right to choose what happens to her body." This whole experience of not having been told a TAH-BSO was even a possibility prior to surgery, and then being denied the right to decide if I wanted further surgery beyond what I had consented to plummeted me into a depression that took months to get out of. The depression was not related to a lack of hormones because I started ERT while in the hospital. The depression was brought on by feeling violated, disregarded, and everyone around me constantly telling me "but it was for a good medical reason." Bull. I am no longer depressed thanks to antidepressant medications and many tears and feelings of rage, but I can tell you, I would have rather gone through a second surgery knowing that I was the one that made the choice and consented than enduring the depression and the rage I felt afterwards. It was far easier to physically recover from this surgery than it has been to emotionally recovery. The pain goes away, but the feelings of betrayal don't. That I just have to learn to live with.

The limitations about what physicians can do during surgery is for your protection. Be thankful you were allowed to choose what happened to you, and not be subjected to other people making those decisions for you. If the situation warranted a medical emergency, then of course I would want someone to act, but this wasn't an emergency. This is the other part of a "woman's right to choose."

My GP was upset the gyno didn't tell me about more of the common possibilities of what he could find during abdominal surgery. Don't give up the right to choose what they can do during surgery - I would recommend focusing on getting physicians to do a better job of preparing patients for the possibilities of what they might find and getting your wishes down on paper prior to surgery.

Sorry to hear of some of the terrible things that happened to some of the ladies here.

I was one of the lucky ones in that I had a great gyno who went through all the possibilities with me. Armed with this knowlege, I had clauses put into my prior approval with the insurance co. that there might be excision of endo etc. Thank goodness I did, as there was & that added at least $1500.00 to the bill (not counting the extra theatre time) which was all covered.

My gyno was so "by the book" though, that she noticed a dark mole "down there" which she said would have been easy to take off, but she wouldn't do it without my permission - I would have been happy for her to do it!

Hope everyone is healing well.

Cate

Perhaps this discussion belongs in the PRE-OP section, as important advice to those preparing to travel to the castle...

When I went in to do my pre-admission paperwork, the hospital asked if I had an Advance Directive, and encouraged me to do one, if I did not. Although it was more intended to deal with removal from life support and that type of thing, it did cause me to sit down with DH (who I designated to make medical decisions should I be unable to) and discuss my worries, concerns, possible complications, and what I wanted. It made him uncomfortable and he told me so--but it gave me peace of mind, especially after reading horror stories about others who woke up to surprises. (DH didn't appreciate my discussion on the way to the hospital either-- when I told him where my life insurance policy was filed, the PIN numbers for my bank account, and all that other stuff I felt he needed to know "just in case." But it helped ME relax to know that he could manage if the worst occurred.)

I went in knowing I was going to have a TAH, but I can't even imagine being told after the fact that "SURPRISE! We took out your uterus!"-- to me, that is the one thing that should ALWAYS be discussed as a possibility with female patients, even if it isn't initially anticipated. Many women have an emotional attachment to their uterus that they don't share with their appendix, gall bladder, spleen, etc. Why don't doctors understand this???

The whole point of informed consent is to discuss the risks; an advance directive is to make your wishes known. I'm rather horrified to read that it sounds like there are a lot of sisters who had not truly made an informed consent for their surgery. Some patients don't like being told that you could die from surgery or hear about specific complications-- because it is scary. But a frank discussion between the doctor and patient is really necessary to ensure that irreversible decisions are not made that the patient would never agree to, if given the choice.

Either commit your wishes to writing or ensure that DH or your designated decision-maker shares your values with regard to ALL of the possibilities. Because my DH has a medical background, I felt comfortable telling him to use his best judgment if something we hadn't discussed came up. Perhaps a "checklist" of possibilities would help patients.

I told my doctor I wanted to keep my ovaries, but if either or both looked abnormal, he should take them. I pre-authorized an appendectomy just in case, and it turned out they left it, it looked fine. I had specifically asked the surgeon to look for an unrelated problem that was discovered in an xray and fix it if they could--but we mutually agreed that if he felt the risks of doing so outweighed the benefit, he would leave well enough alone. As it turned out, he was unable to fix it and while I am somewhat disappointed, at least I feel confident that he knew and respected my wishes, and tried.

Fortunately, I was able to build a strong doctor-patient relationship with my gyn beforehand; he'd also done extensive testing (urodynamics, ultrasound, xrays, and several physical exams) so that I felt confident in his thoroughness and we pretty much knew how extensive the problems were, and were able to discuss most of the contingency plans. Despite all this, I do recognize the possibility that an unrelated problem might have come to light once my abdominal organs were visible. That's where trust-- AND NOT BLIND TRUST--is so important.

But had I woken up to learn they'd done a colostomy or some other procedure with life-changing implications, I'd have been furious-- unless DH had been consulted and confirmed the necessity.