Teacher Gal - Looking for NY Surgeon

[Teacher Gal]

I am new to the forum and have been told by a new orthopedic surgeon that I need to go to a scoliosis specialist and have surgery after he took my case to a difficult cases conference, and they conferred about my case.
I am 67 and would like to know whether I should go to a highly rated hospital like HSS so that I don't end up with infections, etc. due to age and previous surgeries. I first had a lumbar spine surgery, then a torn meniscus surgery, then another lumbar spine surgery, and finally a partial knee replacement all in three and a half years beginning when I was 61. I am fused with screws and rods in my lumbar spine.
Or should I be looking at finding the best possible surgeon? I have heard of Dr. Baron Lonner, Dr. Lenke, Dr. Errico, also, Dr. Frank Schwab and Dr. Kim who I think both are at HSS. I worry as some hospitals aren't rated as highly as HSS.
I live in Sarasota, FL, but my surgeon recommended New York.
Thanks for any help. Hope I am posting this correctly.
Teacher Gal




QUOTE=LindaRacine;163630]I had known that Dr. Boachie was going to retire for at least a year before it actually got announced.

I'm fairly certain that every one of your surgeons has been sued, probably multiple times. The vast majority of suits have no basis. When something goes wrong and a patient has a complication or a bad outcome, everyone suffers, including the surgeons and the anesthesiologists. Most of these problems are not caused by neglect. These medical professionals can do everything in their power to protect their patients from experiencing complications, but stuff still happens. When a professional is negligent, they're at fault. If they don't take the appropriate steps to minimize the possibility of something going wrong, that's negligent. If they operate while under the influence, that's definitely negligent. Otherwise, I think we need to understand that we're just one of the unlucky ones.

How many times have you heard of surgeons telling patients that there are no guarantees? In case someone forgot, THERE ARE NO GUARANTEES. And, yes, I believe that when this patient was consented, she was probably not told that she might lose some of her sight or that she might end up in a wheelchair. It would literally take hours for our surgeons to tell us absolutely everything that might happen to us during and after surgery. And, even then, we might have a complication no one else has ever experienced. I'm not sure of this, but I believe that the risk of death is actually higher than the risk of blindness (though both are rare). The patient was almost certainly told that there was a risk of death, and yet she decided to proceed with surgery. If she had been told that there was a risk of blindness, would she have changed her mind? We are all told that these are very serious surgeries with very serious complications. Have any of you ever changed your mind about surgery because of what you were told in the consent process? Look at the list of complications at the end of this post. I'd be interested to hear from people who would specifically not have surgery because of something on the list.

A few studies of interest:
http://www.ncbi.nlm.nih.gov/pubmed/25946720


http://www.ncbi.nlm.nih.gov/pubmed/22504517


Here's a list of complications put together by the International Spine Study Group:
Infection
• Major
o Deep
o Pneumonia
o Sepsis
• Minor
o Superficial
o UTI
o C Diff infection

Implant
• Major
o Hook dislodgement
o Interbody fracture
o Interbody migration
o Rod fracture
o Rod dislodgement
o Screw fracture
• Minor
o Painful implants
o Prominence
o Screw malposition
o Interbody subsidence
o Crosslink dislodgement
o Set screw dislodgement
o Screw bone interface loosening

Radiographic
• Major
o DJK
 Not requiring surgery
 Requiring surgery
o PJK
 Not requiring surgery
 Requiring surgery
o Pseudoarthrosis
• Minor
o Coronal imbalance
o Curve decompensation
o Heterotopic ossification
o Sagittal imbalance
o Adjacent segment degeneration

Neurologic
• Major
o Visual deficit/blindness
o Brachial plexus injury
o CVA/Stroke
o Spinal cord injury with incomplete deficit
o Spinal cord injury with complete deficit
o Nerve root injury with weakness
o Retrograde ejaculation
o Bowel/Bladder deficit
• Minor
o Neuropathy or sensory deficit
o Pain (radiculopathy)
o Peripheral nerve palsy
o Delirium

Mortality
• All major

Cardiopulmonary
• Major
o Cardiac arrest
o Pulmonary embolism
o Respiratory arrest
o DVT
o Congestive heart failure
o Myocardial infarction
o Reintubation
o Acute Respiratory Distress Syndrome
• Minor
o Coagulopathy
o Arrhythmia
o Pleural effusion
o Hypotension
o Congestive heart failure

Vascular
• Major
o Vascular injury
• Minor
o coagulopathy
o Thrombophlebitis

Gastrointestinal
• Major
o Obstruction
o Perforation
o Bleed requiring surgery
o Pancreatitis requiring surgery
o Cholecystitis requiring surgery
o Liver Failure
o SMA Syndrome
• Minor
o Ileus
o Bleed not requiring surgical intervention
o Pancreatitis not requiring surgery
o Cholecystitis requiring surgery

Renal
• Major
o Acute Renal failure requiring dialysis
• Minor
o Acute Renal failure requiring medical intervention

Operative
• Major
o Retained sponge/instrument
o Wrong surgical level
o Unintended extension of fusion
o Vascular injury
o Visceral injury
o EBL >4L
• Minor
o Dural tear
o Fixation failure (hook/screw)
o Implant failure
o Pedicle fracture
o Posterior element fracture
o Vertebral body fracture

Wound Problems
• Major
o Dehiscence requiring surgery
o Hematoma/seroma with neurological deficit
o Hematoma/seroma, no neurological deficit requiring surgery
o Incisional hernia
• Minor
o Hematoma/seroma not requiring surgery
o Hernia[/QUOTE]

[Joyce B.]

Linda, you are right on every point. Joyce B.

[susancook]

Hi teacher gal, unsure why on my computer there is a discussion about risk of surgery from
Linda under your post.

Since you asked....my recommendation is to go with the best surgeon and big teaching hospital with a great reputation. That does not mean that you will not acquire an infection. Stuff happens.

Get a few opinions.

There are challenges to traveling. If you want the details, private message me.

Welcome, Susan

[titaniumed]

Hi Teacher gal

I’m on the road, in NJ for my 40th HS reunion.... (smiley face) Some of my old classmates actually do remember my curves from the old days which was surprising to me after all the years. We try to forget these things, and they remember! They are all noticing my increased height.

Also flew on the planes without a pillow, what a milestone!

I cleared out my PM some, ....if not use titaniumed@hotmail.com

Pick your surgeon, not the hospital....

Ed

[Joyce B.]

Teacher Gal,

Wanted to ask if you have made further progress in your search for a surgeon. I have had two major surgeries for severe scoliosis and have been fused from t-2 to the sacrum. Last surgery was 10 years ago, but my ability to walk has diminished. I feel wobbly and unstable when trying to walk. I use a cane or walker at all times, but just walking around our house is a chore. I plan on finding a surgeon at HHS to find out if there is anything further that can be done to help me, so I am following your thread for helpful info. Please
let me know if you are making progress. Thank you. Joyce