Re: Laparoscopic Complications

From: Vict. (
Wed Apr 26 14:31:25 2000

Hello, sorry it took so long to get back with you. I've had computer related trouble.

One of the many wonderful aspects of this site is the opportunity for men and women to share their experiences, positive or negative, with particular surgeons who treat adhesions. I think it is important to keep in mind that because one person may have a negative experience with a particular surgeon this does not mean that this surgeon's quality of care or skills are substandard.

I do think it is very important to allow patients to feel free to share their experiences and state their personal opinions and feelings about a particular surgeon; in a respectful and civil manner, mindful that this is ONE person's experience.

I do not believe in doctor bashing. I also do not believe in experience bashing. Others should not feel afraid to share their experiences for fear that someone will "bash" them. One person's experience with a surgeon may be fantastic while another may have been just awful...When I am choosing a surgeon I want to hear all the details. I want to sort it out myself...form my own opinions and come to my own conclusions. It may be that those whose experiences were negative all share a similar thread of truth...maybe this particular surgeon's skills in one area are not as good as his skills in other areas. This may be important to two different individuals. Maybe one person is seeking a surgeon who is excellent in the area this surgeon excels or maybe the other individual is seeking a surgeon who excels in the area that this surgeon seems to have difficulty in. None of us are perfect. We all have gifts. We may be perfectly capable of doing many different tasks...some may be a real struggle for us while others we may excel at...then there are a few who are amazing and just excel at everything they put their hands on...I hope this helps you understand where I am coming from. It's important for us not to feel guilty, humiliated, or afraid to relate our honest opinion, feelings, and experiences...good and a respectful manner. It's important for those who had the positive experiences to relate those experiences without seeming to pass judgement on those who relate their less than positive experience.

I am not saying that any of this is happening on this board. I have seen it happen to many people (though not here). I just feel it's important to mention once in a while as a reminder.

Okay...I am familiar with Dr. Reich and his work. He is highly skilled and is truly an expert to be trusted. This is based on my personal research and on the feedback I've gleaned from others.

What I was tying to get across in the other e-mail is: I think it is important to excercise utmost caution in choosing a surgeon if you have severe dense adhesions that cause pain. First I believe one needs to really consider whether surgery is appropriate and is going to help...Has it helped in the past? For how long? Do you need surgery due to severe bowel problems...strictures...obstructions...? Do you need surgery for fertility? Also, one needs to keep in mind: what is the possibility that somewhere in the future I am going to need emergency surgery for bowel related problems due to adhesions or bowel perforation (I don't mean to exclude bladder probelems)? Are the new adhesions that are forming following surgery upping my risks for future emergency surgery...what do all of the studies say...not just select ones. Next, what is the best procedure for me personally? What are the real risks to patients that have adhsions like mine...there is a difference. It can make a difference as to what type of adhesions you have and where they are located. It's also important to check into potential complications and risks...don't believe a doctor who laughs off a risk and makes you feel stupid for asking...Run!! There is a reason for me saying this.

Oh, I'm not talking about trocar injuries here. Experts are very aware of trocar injuries and procedures to minimize them. They are also aware that some of these procedures don't really work and I think most people are aware of this type of injury. There is a lot of information about this subject available to the general public.

Also, we need to ask what are my alternatives? Some people have absolutely no problems from adhesions. Maybe some day researchers will figure out why and enlighten us. It may be that accupuncture will help you. It didn't help me. I take all kinds of supplements and there are a couple that help...but don't cure my symptoms. I actually drink a cup or two of coffee per day as a therapeutic works for me (bowel related). It doesn't hurt to try altering your diet. I find this beneficial too. Also huge amounts of water...I drink up to 3 gallons per day easy. You may need heavy duty narcotic pain medication. You have every right to live your life to the fullest you are capable of and if it means narcotic pain medication...well...goes without saying. Narcotics won't cure it...they also will not take all of the pain away...but it does help some people so they are no longer invalids. I think it is important to find a physician or clinic who will work slowly with you to find a proper maintenance dosage that actually works. Many people I know have recieved excellent help from pain clinics...most of these people are men. Most of the women I've talked to say they had trouble getting any relief because the problem is "adhesions". Also the women complained the pain clinics tried to say they had emotional problems concerning sexual issues. That adhesions is actually chronic pelvic pain and that, "everyone knows chronic pelvic pain is actually emotionally related sexual dysfunction". Men generally are not given a diagnosis of chronic pelvic pain when they have pain from adhesions...I don't get this. Women are though. Let's give women a proper diagnosis of Adhesion pain...chronic abdominal pain...Mine is chronic abdominal pain...that's why I'm recieving treatment. One gentleman I spoke with who had been run over by a bulldozer was unable to get help at a pain clinic because the clinic's psychologist told him, "first you need to deal with issues surrounding your anger with your father. I believe this is what is causing all or most of your pain". This man's life was was his entire family's...his children too. He lived propped in a chair. Holidays...even Christmas were no longer celebrated. He used to be a very active member of his community helping many children. After hearing all of these experiences I chose not to visit a pain clinic although I may research some and visit one in the future.

I do not believe it is fair for a physician to back a patient into a corner by stating their only choice is surgery...if they don't have surgery they will not provide medication for pain control. Some patients are aware that after surgery, at least for a month or two, they will be relieved of pain due just to the post operative pain medication(I don't think most of the patients make this connection though-I think they just remember feeling better than they did prior to surgery). Some patients and physicians don't seem to see this very real connection. I don't think it's fair for a physician to take away a chronic pain patient's pain medication if the pain medication is working. Matter of fact a physician who does this is just as guilty as one who prescribes pain meds to an addict I mean someone who has no pain, who lies and steals to obtain medication, and who takes more medication than prescribed for the, "high". Doctors are in fear of providing pain meds thinking they will lose their license. I think physicians should also be in fear of losing their license for witholding pain meds (for someone in obvious distress due to a chronic pain problem...and not referring them to a pain clinic on an emergency basis), offering only surgery as an alternative when the patient's entire medical history reflects that surgery is not helping, the patient has chronic (not acute) pain (that is helped by medication), the patient doesn't have a "surgical abdomen", and the patient has a long history of surgeries with temporary or no relief of pain. There are patients who've walked into appointments and undergone emergency surgery that day or soon after because the doc takes them off their meds. Is that really emergency surgery? Is the surgery really necesarry? Most docs are out to help their patients. They don't want to see them hurting. They also don't want to lose their license. They won't lose their license for doing surgery...they can justify the operation saying it may help or the patient was in severe pain (and this is acute pain even though the pain flared up when the patient went off their meds) but many docs are afraid they will lose their license for prescribing pain medication.

Some adhesion sufferers go from surgeon to surgeon seeking help and relief hopeful that they will find the right whose techniques will finally help them and they'll be able to live a life again. I've cried countless times for people...the complications that can happen, the loss of life or just bodily functions saddens me...and they are usually attributed to something excuse...not what they were really caused by...the surgery...Laparoscopic surgery is a big deal. It's important to HMO's, insurance companies, and surgeons. It's being heavily promoted. These people cannot run the risk of allowing the horrible complications and other problems to be focused on. There are many reasons why laparoscopic surgery is a big deal and many reasons why it is important.

I'm not nullifying the fact that there are proper uses for it. I am saying that I question any doctor (and I"ve heard many) who says it is a cure-all, the only way, the best way, free of problems, less expensive, fewer complications,or better for the patients. I've met a number of people who begged their surgeons for an open laparotomy (they wanted an open procedure due to their complex adhesions-not all were undergoing adhesion lysis) and were flat out denied either by the surgeon or the insurance company...and the patients suffered horrible life-long consequences because of it. Some of the surgeons later admitted that the patients probably would not have suffered those specific consequences with an open procedure.

I don't think its right to always attribute relief of adhesion pain to surgery if the patient only has relief of pain immediately following surgery, while taking post surgical pain medication. Many patients are on pain meds 4 to 8 weeks post operatively. There may even be a period after stopping the pain meds that the patient still has relief. Many people I"ve talked to only have relief from adhesion lysis surgery for about six weeks post op...while on pain meds. So, you have surgery. Take pain meds. have relief. The doc says no more pain meds. You stop taking them. You have pain. He says you have to have surgery. You are a good patient and trust him. You have surgery. You have temporary relief. This isn't fair to you. I know some people who were essentially "black-mailed" into undergoing surgery. The options they were given: No more medication for pain or You must undergo surgery. If you want to have a fulfilling life...which would you choose? Is there really a choice being offered? Do you know a 35 year old woman died due to complications following this type of surgery...? Are you aware of the risks associated? If you do have complications you have to cross your fingers, pray, and hope that you will be treated...That you will not be sent home from the ER on meds to mask your severe post surgical complication, that your surgeon is not so arogant as to think there are no post surgical complications associated with laparoscopic surgery or so arrogant it prevents him from admitting to his mistakes, or to admit that complications can well take over seven days to show up. If you are one of those whose life-threatening complications take 4,5,7 or more days to show up...cross your fingers again because chances are the surgeon will try to attribute it to something completely unrelated. It's well known and documented that complications can take days or weeks to show up. It's not fair to mislead the patient into thinking that their bladder, ureter, intestinal, gallbladder, etc problem is due to something other than the real cause...the surgical complication...Laparoscopic surgery does make it easier to attribute complications to other causes. Oh, heck, it took 14 days to show up..It has nothing to do with what I did inside you...that may or may not is documented that there are injuries that you can sustain that take quite a while before you exhibit acute symptoms. Several times I've had the opportunity to hear surgeons discuss post op complications...I've heard honest docs tell the need to go and tell the patient and be honest with them...and I've heard less than honest docs resonable doubt in your patient's mind...tell them it could be "blank" or it could be "blank" but it's probably totally unrelated to the surgery I did on you.

I personally know of two docs who push Laparoscopic lysis of adhesions. They claim it is always necesarry. Always justifiable. It is the only treatment. That every instance of adhesion pain needs to be treated with laparoscopic lysis of adhesions. They are gleaning much information from their guniea pigs. It is helping them with a study and their experiments. Problem is they are not making their patients aware of this. One of them has over six board complaints in just one state. I'm afraid to warn anyone for fear I'll be charged with slander...thats why I need to do the research. Matter of fact I"ll probably be slandered for talking about any of this...I do having back from other surgeons that are aware of all of these problems.

There are people with bowel symptoms...who gain relief from surgery for a longer period of time than six weeks. It may have just been a section or sections of bowel causing problems. Pain meds for them can be difficult as the narcotics tend to slow the bowel down. Diet can play an important role with the narcotics. There are radiologists who are able to make fairly good diagnostic guesses utilizing radiographic techniques to determine whether adhesions are causing bowel problems. They cannot see the adhesions but with specific tests and the radiologist present for the test they can make some fairly good assumptions.

I believe all options should be open to all people regardless of sex, religious beliefs, insurance plans, socio-economic status, or any other factors. All living beings deserve a chance to live to the fullest of their abilities! We also have a right to honesty. With the advent of managed care it's becoming necesarry for patients to become informed consumers (decisions are being made by those without M.D.'s). As consumers we have a right to all information. We should all have complete copies of our medical, surgical, and nursing notes, if we want them. Our questions should be answered in complete honesty, we should have access to any medical information or studies that we desire, to medical board information, and hospital information and statistics. If we are consumers we should have all the rights that apply to any other types of consumer. Medical care is costly. It is also dealing with our physical well-being. We need to be able to make important decisions about our bodies based on all the information. I heard a general practice doctor brag the other day that he has a caseload of 3,000 patients. I wish we could go back to the way it used to be. Family docs who knew us...thank the good Lord that I found one. I believe that we should have input in our care. That what we say because we know our bodies and because we've researched should be taken into careful consideration by the doctors. It used to be we put all our trust in our doc. If he said you needed surgery...he did not merely suggest it...he stated it was necesarry. He told you, and you believed him, you need medication, you have an illness, you must be hospitalized, you must have a particular type of surgery, you don't need to go to the hospital, you are did not question didn't ask how he came to this didn't suggest other surgeries, you didn't question his authority or decision making, you did not override what he said...You Did Whatever He Said! Now days if you do whatever they say you can run into problems...especially if they have a caseload of 3,000 (I don't know how he does it). The other problem is if you do question a procedure, or you point out your personal medical history, or question anything the doctor says, you run the risk of being labeled a "bad patient" or an "uncooperative patient"...even if you are quite pleasant and only seeking information or to understand a problem or decision. The label follows you in your records. If you go from doctor to doctor seeking the right are condemned for that too.

Sorry I got lost in so many tangents. I've seen so many people across the country needlessly suffer. I've heard too many good doctors state that patients needlessly suffer. I'd like to see us all healthy!!

P.S. don't forget that with the internet we have international information and studies available to us.

I know of a doctor who works at a religious hospital in the U.S. yet has a sick antireligious website...looks satanic...with a famous painting of Christ on the cross...only they took Jesus' face off and replaced it with something else...a particular animal. Would you want this doc doing surgery on you? Would you expect it from a Christian hospital? I know someone who did (they didn't know about the website at the time) and the person almost died on several occasions requiring many more surgeries.

I know of many more horrors too. I just think you all have a right to know some of what happens...good and bad.

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