The Coast News Group

Surgeon failed to properly inform patient before surgery

Dear Dr. Gott: In mid-September 2009, I had a lung lobectomy and was in the hospital for about 2-1/2 weeks. There were complications, including atrial fibrillation and a delay in the lung sealing, which caused the drain tubes to remain in for most of my stay.
I was told that I would be in the hospital between five and seven days and back at work within three months. As yet, I have not been able to return to work.
Prior to the surgery, the only thing that was brought to my attention was that sometimes things “go wrong,” and when I was discharged from the hospital, I was given minimal instructions. For some naive reason, I thought that if I woke up from the anesthesia that things had “gone right.”
While the doctor did mention separation of my ribs, he did not tell me that I would have severe pain for months following the surgery. I was also never told that some nerves would be severed and that both pain and nausea could result.
It is now May 2010, and I am still having problems. I tremble most of the time and have started to feel like one of those dolls with my head bobbing. My bra is very uncomfortable, as the right breast is numb, and I often feel as if barbed wire is being rolled over my skin. This sensation is getting less frequent, and I am starting to notice a slight improvement from a few months ago.
My family physician helped relieve the nausea and pain with two medications. I took both for only six to eight weeks and then weaned off in order to avoid side effects.
To make matters worse, it is questionable that I even needed the surgery. Few options were discussed with me. Because I have had few medical problems in my 64 years, I was not versed in the correct questions to ask. After the surgery, it turned out that I had a mostly self-contained infection and not cancer, which was indicated before the surgery.
I am having difficulty exercising. I seem to strain the muscles on my right side whenever I do even light stretch-band exercises. I walk on a treadmill but am only able to do about 10 minutes at a time before I get winded.
Since leaving the hospital, I have had no more atrial fibrillation, which is a blessing, and I have been able to wean down my Coreg to 6.25 milligrams, which has helped restore some of my energy. When I was on a higher dose, all I wanted to do was sleep for the first several months. I also take extra vitamins A, B and D to help repair the nerve damage and boost my immunity.
How long can I expect these problems to last? Why don’t surgeons tell you what to expect prior to surgery and then later in the hospital-discharge instructions? I was totally blindsided by these complications, many of which happened after my discharge.
Please advise patients to get a second opinion and ask surgeons to be up front about what to expect following any surgical procedure. I encourage everyone to get a second opinion, even if they feel that the surgeon knows his stuff.
I realize that removal of a lung is an intense operation, but I feel that I would have been better prepared to handle the complications if I had known that they could happen.

Dear Reader: Whether or not you were medically naive, it is no excuse for your surgeon to have neglected to inform you what the surgery entailed, both during and after. I am also shocked that you were urged to have removal of a lung without even undergoing further diagnostic testing to determine whether your “lung tumor” was truly a lung tumor. Surgical removal of any organ should be done only when and if there is medical necessity, and there are numerous tests available to determine what type of tumor or other abnormality is present. You have endured months of complications and pain for a lung infection that could probably have been treated with oral medications.
As to your question about why surgeons don’t inform patients, I would certainly hope that this is not the norm. When I was in active practice, patients were always informed about possible complications of surgery and provided with alternative options, as well as the surgeon’s opinion of which would be best. This also held true for diagnostic testing, such as imaging studies that involved dyes, tissue biopsies and more.
I urge you to get a referral to another surgeon or a pulmonologist, who can review your operative report, examine you, and offer suggestions regarding treatment of your complications. You will also benefit from pulmonary rehabilitation, which aids your body in adjusting to having only one lung in a controlled, safe manner. Speak to your family doctor about these steps.