Bone Hardware Contractor

March 23, 2006 4:02 PM

What should I do, in the way of homework, before elective surgery?

I broke my femur in 1999. It has a good bit of hardware, now (a 6-8 inch metal plate, three medium screws through that plate, and one very large screw up into the ball of the femur). It has healed very well, as far as the bone goes.

But it hurts, and remains weaker than the other leg to this day. Certain exercises, especially if they are heavy on the lateral motion, cause muscular aches and pains along the scar. This has only gotten worse with time. The theory is that the plate is irritating muscles along the outside of my left leg. I’ve tried physical therapy twice now, and it hasn’t lessened the pain (it’s actually made it a bit worse, this last time).

I’ve talked to an orthopedic surgeon, and I can have the plates and screws taken out. His run down was: 1/100 chance of serious complication, 5/100 to 10/100 chance of minor complication (screws not coming out), and a 50/100 chance of this fixing the problem. I’d be walking on crutches the day of the surgery, trying to walk crutch-free by 3 weeks, beginning general rehab by 6 weeks. There will probably be at least one week where I was so doped up on meds for the pain that I’d be completely useless.

At this point, I’m leaning toward the surgery, as I’m being held back by my leg (I used to do a lot of outdoor stuff: climbing, hiking, skating, and skiing are all now much less fun). Sometimes I limp for no apparent reason (well, other than it just hurts). I can’t run for squat.

But what should I do before I finalize the decision? How do I research my orthopedic surgeon? I have an HMO (Kaiser Permanente), so I don’t get to shop around for doctors, but how do I at least find out that this guy is not a hack with 12 outstanding malpractice claims? How do I check up on the facilities where the surgery is to take place, to make sure they don’t have a hundred cases of flesh eating bacteria killing patients or something? Is there any place I can research this general type of procedure to educate myself about the soundness of his decision?

General advice?

He’s the doctor, but it’s my leg and I live with consequences. (The whole idea of elective surgery freaks me out a bit). I want as much information as possible before I commit. It was an easier decision the first time, as I was lying in an ER with the choice of “sign this consent form” or “don’t walk ever again.”

posted by teece to health & fitness (9 comments total)

I'd probably do as much as you can. The pain meds will make you groggy as hell and incapable of coherant thought. Make sure your teachers know about it, so they don't get too peeved if you miss class. Since its elective, can it wait until the summer?
posted by ChasFile at 5:53 PM on March 23, 2006

I know this is somewhat off-topic, but really think about what the negative cases would mean to your life, and how you'd react.

You'll feel brilliant if the problem is solved... but how will you react if you hit that 1/100?

Unfortunately, they don't just list the low-percentage outcomes to make the surgery more exciting. They're real dangers that you have to be totally and completely willing to accept.

As for the doctor and facility, do you have any local friends who work in the medical field? Unfortunately, the only way I've managed to get decent advice in these matters is through trusted friends, family and acquaintances in the field.

Hopefully somebody else knows a better way.
posted by I Love Tacos at 5:54 PM on March 23, 2006

There is a member around here somewhere who is an orthopedic surgeon. Pagin Dr. *...
posted by MadamM at 6:20 PM on March 23, 2006

or paging, rather.
posted by MadamM at 6:21 PM on March 23, 2006

Sorry, I was being too metaphorical. I'm not a student. I meant research on the doctor/surgery, but I stupidly said homework. Sorry for the confusion.

I Love Tacos: the 1/100 is really what has me hesitating. I could live with the 50% chance of no joy -- I'll just be out a hospital co-pay, a couple of months, and some pain and suffering, from my understanding. It's "serious complications" that bother me -- the two specifics mentioned being a blood clot or serious infection.

And it's not just a hypothetical for me: I had an aunt that went in for routine back surgery and bled to death on the operating table.
posted by teece at 6:28 PM on March 23, 2006

To check on the doctor, you can find out about his credentials through Kaiser (it's probably on the web). Many states boards of registration in medicine have websites that list basic malpractice information such as any lawsuits and settlements that involve the doctor.

You should also get a second opinion. Your HMO should welcome your request for a second opinion since the surgery is going to cost them a lot of money.
posted by DrAmy at 6:41 PM on March 23, 2006

www.mybrokenleg.com

Lots of good info.
posted by fshgrl at 8:03 PM on March 23, 2006

One place to check out your potential surgeon is the state medical board. I see from your profile that you are in denver which is good; the ski resorts have made that area a haven for orthpods. My brother broke his arm snowboarding and got it fixed by one of the surgeons at the Steadman Hawkins clinic, who did a good job. Of course, one good experience does not guarantee that you will get similar results, but metal removal is pretty straightforward and you should have plenty of good surgeons to choose from.
posted by TedW at 6:48 AM on March 24, 2006

IANAD. The better your general health, the better your odds, so make sure you're getting vitamins, and get as much exercise as possible before surgery. Your best defense against blood clots is good cardio-vascular health.

Check out the hospital's infection control rate, this should be publically available. And find out who the anesthetist will be and check them out as well. I believe that doctors are more likely to be extra careful with a patient who is know to be thoroughly checking them out.
posted by theora55 at 8:18 AM on March 24, 2006