The Fistual thing

[devon]

Well, I had my first visit with the Vascular Surgeon today. The nurse/assistant was very pleasant and informative. The doc was on time but that might be the highlight of the visit. He asked a couple questions about my medical history including asking why I am having dialysis. I was somewhat startled. It seemed out of place but I told him I'd had kidney problems since age 15 and it was thought to be related to a severe Strep infection or it could have been 1,000 other things that I was exposed to in Southeast Asia at that time.  He asked which hand was dominant. I told him left.

The doc listened to my lungs, listened to my heart and felt my arm for all of 15 seconds or so. Then, he announced that I should have an echo of the arm. I should schedule that and come back to see him. He wrote on the chart a bit, handed it to me and told me to see "Donna". I had no idea who Donna was! But found her nonetheless. She was the secretary type in the reception window. She took my co-pay and scheduled the echo for April 4th! My question to her, pleasantly put of course, was why couldn't they schedule it today? I mean its not like they didn't know I was coming and would probably need this? They had the referral from the nephrologist that I was coming. I guess he needs the co-pay.

I wasn't too impressed with the doc. No bedside manner. When I asked why they need a fistula, he responded, "for dialysis". I'm thinking like "DUH!"

As my friend asks, "What do you call the guy who graduated last in his medical school class?" The answer is "doctor". Unfortunately. 

Ya'll have a great day, please!

-Devon

[livecam]

Sounds like a doc I saw once in Woodland Hills.  I was going to start PD and he was going to be my new neph.  He was the antithesis of inspirational.  I cancelled the PD plans and never went back. 

[KR Cincy]

Sorry about the lousy experience. My vascular surgeon was outstanding...he explained about every type of access, the pros and cons, didn't see me until I had my vein mapping done so he knew what he was looking for, and most importantly (to me) as we were leaving he shook my hand and said "I'm sorry you had to meet me.." There ARE good docs out there.

[devon]

I will contact my regular doc and see what about referring me to a different surgeon. When I mentioned this doc's name to him previously, he seemed pleased. They know each other and have worked together.  But I'm just not comfortable with the manner and the inconvenience.

If he was on top of things, he would have set it up to do both in the same day, I believe. Am I wrong?

Thanks for the ideas!

-Devon

[petey]

Devon,
Marvin's vascular surgeon has saved his life several times in the past 13 years.  This surgeon has also created accesses for Marvin -- the one we're using now is a "miracle fistula" created from one vein in the back of Marvin's arm (moved around to the inside) and strengthened with one vein taken from his leg and wound together with the one from the arm.  The surgeon created this -- it's very, very unusual -- because Marvin had no other places to go in his body for an access except the leg, and Marvin really, really didn't want an access there.

Your vascular sugeon is literally your "life line" to dialysis, and, as you know, dialysis is what will keep you alive.  If I were you, I would find another vascular surgeon.  It's important that he's a great surgeon, but it's also important that you have faith in him and that he truly cares about you as a person -- and not just as another co-pay.

We love Marvin's vascular surgeon.  He knows us and always talks to us like we're his friends.  He truly has compassion and concern for my Marvin.  He answers all my questions (and I always have lots).  He goes out of his way to make sure we know what's happening and what could happen.  When I call his office, his nurse knows exactly who I am and, if at all possible, she gets me through to him.  We trust him.   

I think you got a "rush" job with yours.  I wouldn't stand for it.

[Joe Paul]

Not sure why they sent you to a   Vascular Surgeon first, I mean without a mapping of your veins. My Neph called the Surgeon, who then called in for the mapping of the veins in my arms, then to the Surgeons office after he had the mappings. Then we set a date for the surgery. This all happened within a 3 week time period. I agree with you, find another Surgeon.

[BigSky]

I will contact my regular doc and see what about referring me to a different surgeon. When I mentioned this doc's name to him previously, he seemed pleased. They know each other and have worked together.  But I'm just not comfortable with the manner and the inconvenience.

If he was on top of things, he would have set it up to do both in the same day, I believe. Am I wrong?

Thanks for the ideas!

-Devon

The people who do the echo usually are not controlled by the doctor and have their own schedule of patients they are doing which tends to be more than just people getting a fistula.  There can be some wait time but you should be able to get it pushed up to occur sooner than April.  Try calling the department that does the echos and tell it needs done sooner.

I seen the doctor, had it mapped about a week later and then a couple weeks after that had a chest cath inserted and then rougly two weeks later had the fistula put in.  The first time I had the fistula put in roughly a year before I started dialysis so I didnt need the chest cath.

[silverhead]

Let me relate a surgical incident I went through, I have had a total of 3 surgeries for the same problem with my back, 2 Lamenectomies at L4/5, after the 2nd one failed my Doc sent me to Seattle to see a surgeon he recommended, I went with the x-rays and scans for him to revue, he came in rather gruffly and looked at things and announced that I should be fused, and we set it up for 2 days later, I was a little put off by his manner and was even more so after I told him that during my second operation the surgeon made a lot of comments about the troubles he had with a large amount of scar tissue that needed to be removed, new surgeon simply said it was not a problem (really?), anyway, I entered surgery pretty apprehensive, after starting to wake up in recovery, the surgeon was there and my first question was, how was the scar tissue, he said no problem and apparently he was right, everything worked out just fine (this was 20 years ago) so for this particular surgeon the score was 0 for bedside manner but a definite 10 for skill......
Tom

[devon]

Thank you all very much for the replies. IHD is certainly a fountain of information! I came to the right place.

I appreciate the "0 bedside, 10 skill" point. I'm hoping to confirm that. If it's true in this case, I will continue. If it's not a 10 then a new doc is in order. If there's one thing I've learned about doctors its that fiding the top 10 percent means culling out the other 90 percent!

 

-Devon

[Sluff]

I hope things go well for you Devon, remember it's your body, your health, your choice, if you are not comfortable with one surgeon, find another. Good Luck 

[lola]

OK I need to say once again how much I LOVE IHD. Otto found out this morning he needs to go March 20th to see the Vascular Dr, and because of this post I e-mailed him and asked about mapping, well he just called to say Otto needs to go have an ultra sound Tuesday Morning for his Mapping. THANK YOU THANK YOU THANK YOU. Without this post we would have wasted a trip and a co-pay the 20th

[okarol]

Jenna's first vascular surgeon had no bedside manner. And as it turned out, he had no surgical skill either.
We had to get her first failed fistula fixed. This time we asked the dialysis nurses and the nephrologist who they would recommend, and it was NOT him. The second surgeon spent a great deal of attention to detail, did a beautiful fistula, and the experience was night and day.
Good luck!

[kellyt]

My VS was good, as well (and kind acute) .  I also had the vein mapping first.  It was performed at my VS's office, but not by my VS himself.  So I agree that maybe the people that will do this test are service contracted by the surgeon's office and they run on a totally different schedule than he.

I do think that a doctor's bedside manner is extremely important.  However, maybe he was having a particularly horrible day.  I prefer a doctor who will talk to me and explain things to me.  But I would accept him as an "ass" if her was known to be an excellent surgeon.  God willing you'll only see this guy a few times anyway.  Is he supposed to be good?

[devon]

An update ya'll.

I talked with my regular doc this weekend and explained the situation with him and my concern about this doc's bedside manner. So taking the advice from "silverhead", I ran it by him using the zero to ten scale for bedside manner and skills.  He told me I was right about the manner and assured me that this guy's skills are a 10/10. He was very praising in his assessment of this doc's surgical talents.  He suggested I call again and see what can be done. If I didn't get something satisfactory, he would intervene (Great Doc!).

I called this a.m. and explained the situation.  The secretary told me that she put it for April 4th because it would save me the "two" office visits as that was the first time available for both the Ultra sound and office visit on the same day.  Long story, short... the Ultra Sound is scheduled for Wednesday this week and the follow up for Friday.

Ta DA!

(thanks so much ya'll for the continued support!)

(Now I just have to figure out why I'm in such a hurry to get this done!?!!?   

[pdpatty]

I was sent to the vascular surgeon first. Since I live out of the city(he is in Columbus OH ,I am in Chillicothe Oh) he had his office girl set up the mapping that day.
On the 26th of this month I am scheduled for a second ultrra sound to make sure it is still having a good blood flow.
He is a marvelous surgeon. He put the fistula close to the surface and I have not had even the slightest amount of pain when being stuck.
His name is Dr. Foor  . The hospital is Mt Carmel West in Columbus Ohio for all the Ohio residents.

[thegrammalady]

i guess i've been lucky. i have a very good surgeon. a bit quirky, but then so am i. the first time i went they did an ultra sound mapping before i saw the doctor. they have a tech on staff and it's done there in the office.

[willieandwinnie]

devon, Hope you find a vascular surgeon that has great bedside manner and is very good in his field. We were lucky there, we love Len's vascular surgeon, he would even call us personally. That always makes me feel better. Keep us posted. 

[Sluff]

Glad you are getting some resolve out of this situation.