What are major issues with selecting an out-of-town specialist...

[Marcia]

Other than the problem of getting home after surgery....which is major....how have you handled problems. You can't run to the doctor every time you have issues if he is hours away, so what are the things that I should know that will make it easier for me if I go with a doctor that is at least 4 hours away from where I live? How often have you returned for check-ups. How did you handle all the things like blood work/donation, pre-surgery tests etc? Did you have to go back and forth or were you able to do some of that in your home town?

I would love to see some input from those who have experienced this. I will have surgery for a double major 70/78 degree curve and I am 57 years old so this all feels kind of overwhelming to me.
Marcia

[SandyC]

Marcia,
I lived 45min. to an hour away from my surgeon (had A/P at 52 yrs old). If he writes a Rx for the blood work/X-ray/MRI you should be able to have it done in your area. Any lab will do the work and send the results to your doc.

When I went home after the surgery, I did two things. Ask for a pain pill BEFORE you leave the hospital, even if you are not in pain and have 2-4 pillows in the car. You will feel every pothole within 20 miles LOL

[Singer]

Marcia, I'm glad you brought this up because I will probably have surgery next year at a hospital two-plus hours from home -- and it's a nasty drive, with lots of NYC traffic. I was told that I could have some of the simpler pre-op tests done locally, but that they wanted to see me four weeks before surgery date for things like MRI, X-ray, and discogram (if needed). Then they want to see me about a week before the date for the final pre-op visit.

I'm also hoping to go to a rehab for as much time as insurance will allow after surgery so I'm in better shape to tolerate the long drive home. Before he realized how major this surgery is, my husband actually asked me if I would be able to take THE TRAIN home from the hospital after the surgery -- lol!!!
I'm also very interested in how out-of-towners handled their first-year post-op visits to the doc.

I'm older, like you -- will be nearly 52 by the time I have the surgery, with a 70-deg. thorocolumbar curve.

Best,
Chris

[katblack]

My surgeons main office is an hour + depending on traffic.
I was luckily able to donate my blood locally but towards the end right before surgery when I had a lot of appointments, it was once a week driving an hour or more.

Getting home from the hospital after surgery was ok, I had lots of pillows around me in the seat, had my brace on, reclined the car seat so I could try to sleep the drive away.

The first follow up appointment was harder. My body was still adjusting to the new hardware and I wasn't on the hardcore pain meds I had taken that morning before leaving the hospital. I was just on lortabs which are nothing basically. Every pot hole seemed to jar me.
But now I just take a ton of pillows and stuff them all around and under me and recline the seat and it seems to be ok.
I also take a pain pill before getting in the car even if it's not on schedule. I have learned that every pot hole is gonna jar my bones.

I also want to add, distance wasn't really an issue for me. To have the best surgeon and team possible was. I didn't care if I had to get from home to the moon as long as he could help me.
Somehow, knowing that everything was gonna be ok and things were just gonna work out, made the drives go by quickly.

[LindaRacine]

Hi Marcia...

Being relatively close to UCSF, I've met many patients who live as far away as Europe and the Philippines. I've actually known people who leave the hospital, and within 24 hours are on flights that will last many hours. While I can't imagine ever undertaking such a thing, none of these people that I've talked to, have ever felt the flights were bad.

I think most of the people have made arrangements for followup x-rays with a local physician (they have to find someone who has long cassette x-ray equipment), and to have the films sent to UCSF for review.

I had about an hour car drive home after my surgery. I was fearful of it, but was pleasantly surprised that it was relatively comfortable, and it felt absolutely grand to be out of the hospital and smelling fresh air.

Best of luck!

Regards,
Linda

[Marcia]

I appreciate all your responses and hope to see even more.

Even if I had my surgery right here in Houston, it would still be more than an hour drive. The surgeon I have appointment with first is 4 hours away or more depending on traffic. I worry about simple things like needing to stop at a restroom along the way. Guess where there is a will there is a way!

Chris, I sure am glad for you that you didn't have to catch the train home from the hospital! LOL

[sweetness514]

Hi Marcia...

I have had three surgeries and for the first two, I used the car with a pillow, but it was painful. I'm about 45 minutes to an hour away from the hospital, depending on traffic, as I live in the suburbs and it's located downtown. A LOT of potholes here b/c of our old streets and cold climate(I'm from Montreal, Canada), and so this last time I had surgery a few months ago, the nurse suggested we get one of those cabs/vans that can fit a wheelchair in and take care of people who either go or come from the hospital, or just need a ride anywhere. I took a pill before and besides the nausia, it was not bad actually. For my 8 weeks check up we decided to call them again and this time I didn't take any pill and the potholes were everywhere with the weird Winter we had, but it was better than if we used the car. I don't know if there is such a service in your area or what it would be called there, but I highly recommend it, even if it's just to come back from the hospital after the surgery.

If not, a not too low car with pillows is good too.

As for pre ops, I had to go to the hospital. Sometimes I want to kill time, since all the appointments are taken in the mornings only and it's usually a day of waiting for all the patients there, and so I want to take my X rays before in another medical clinic, but mostly big hospitals take those long X rays here. The blood work was taken at the Red Cross, wich is on the other side of town for me, but nowhere near the hospital.

[Carmell]

We have traveled out of state for Braydon's scoliosis surgeries. It is important (I believe) to have a LOCAL doc who you trust and can help with more minor issue and maybe even pain management. Our local doc helps coordinate many things for us. That's a huge help, especially when you can't "pop in" to have a fresh look. Also, technology is amazing. Being able to email docs is so helpful.

[crookedspine]

I live outside of San Antonio, TX, and had my surgery performed in Boston, MA. I was 48 years old at the time (am 49 now). It was NOT a pleasant ride home, but the rehab I was in after the surgery gave me extra pain pills to take just before getting on the plane. I rode in a shuttle to the hospital, which was difficult, also, but they gave me extra pills then, too. By the time I got to San Antonio, I was extremely tired, and uncomfortable, but kept taking the pain pills as soon as I could...not because I needed then necessarily but because I didn't WANT to need them. The hour drive home was in a blur. I was glad to be home and went to sleep as soon as I arrived. If you can afford it and it is available for you, they do have limos available for a more comfortable ride home. Good luck! Linda

[JoAnn5]

I was 2 hours from home. I don't know if the hospital didn't give me enough pain meds or what, but i was unable to make the drive. My daughter lives 20 minutes from the hospital and she had me stay with her for several days until i was stronger, thank heavens she was there!

I stayed there until i had my staples removed. Then finally on home .. having to stop along the way for more pain meds. The return trips for check-ups at 6 and 10 weeks were more comfortable. When i had questions or problems, i could call and talk to the nursing staff at the surgeon's office. If it was something they thought i needed to see the surgeon about, they would schedule me in, but if it was something that my local GP could handle, they sent me there.

I would do it again if i needed more surgery..even 2 hrs away, this dr. was worth the trip!

[sweetness514]

Just wanted to reply about getting pills by family doctors and such. Mine did prescribe a little more narcotics since my ortho advised me to ask him when I needed some(just for the first few weeks to a months post), but at some point I was still in a lot of pain and didn't want to use the narcotics anymore(at over a month post op), and my doctors agreed, as it can be addictive. So my family doc prescribed me some anti infammatories-HUGE mistake- since they're really bad for the fusion in order for it to heal. I took them no more than a few weeks as I developped other weird physical symptoms, but it goes to show how careful we have to be and check with our surgeon.

[Marcia]

Sweetness.....wow that is scary! Thanks for sharing information! That is something I would have never known!

[katblack]

Wow, Sweetness, I'm really shocked that your doc did not know that anti-inflammatories thin your blood and cause your cells to be growth inhibited during fusion. Great for pain, bad for cells and fusion!


As for prescription meds, if your surgeon is out of state, have your surgeon and your doc coordinate after surgery care like prescriptions.
That way, if you run out of what you need, your local doc will know what your surgeon had you on and be able to help you get what you need.

I myself cannot get to Clearwater from my house when I run out of meds. Some they can call in but others have to be mailed to me as the written script because they are of the massively controlled narcotics grouping.
It takes about 1 day for the mail to reach me. My surgeon has a website where you can request refills on-line, it can take up to 48 hours and they don't do them on weekends so if I know I'm going to run out by Sunday, I try to fill out the on-line form no later than Wednesday at midnight. They get it Thursday morning, write the script, mail it out same day, I get it by Friday or Saturdays mail.
They did give me 8 monthly refills on my muscle relaxers but not the pain meds. Only certain ones can be auto-refilled, not the heavy stuff.

Ooops, wrote a book, sorry. Just feeling under the weather and comfy in my chair so I'm "talking".

[sweetness514]

[QUOTE=katblack]Wow, Sweetness, I'm really shocked that your doc did not know that anti-inflammatories thin your blood and cause your cells to be growth inhibited during fusion. Great for pain, bad for cells and fusion!

I know.... He's a great doctor for everything, and is even open about alternative medicines but he doesn't know much about scoliosis and fusions I guess. Maybe he was so busy when we called him to get a prescription and didn't get that I had a fusion, or didn't remember what type of surgery I had, who knows. But man do we have to be careful here, since the docs are overworked and SOOO busy, with our free healthcare. We're finally getting some private care, not for scoliosis but at least in other areas, and maybe that will clear the hospitals and clinics a bit. I do worry at times about it and if it affected my fusion, but that's me and my head thinking too much lol. Another ortho prescribed me so much Vioxx right before it was taken off the market for my broken rod, as we couldn't see it on the Xray and I seriously had major heart palpitation problems during the night. Felt like I was going to have a heart attack. That's why I say we have to be our own doctors at times and be aware of how our bodies respond on certain meds...now I'm writing a book too

[summerfields]

Hi Marcia; I am a 56 yr old female with a 79 degree curve, and am looking for a specialist for older patients as well, but in the Ft. Lauderdale/Miami area. I went to www.spineuniverse.com, and www.srs.org, and they have physician locators by zip code. I then picked two doctors and checked out their fellowships. I made appointments with each and will get at least two opinions. Neither will see me until I get a MRI, so I am going to my regular GP to get an order for that. I had seen a specialist in AZ at the Sonoran Spine Center two years ago, but don't want to travel that far post op. Please keep me posted as to how your journey is going. I hope those two websites I listed above will help you.
Barbara