tag:blogger.com,1999:blog-2760353953251845523.post3829273928682926352..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: It's never easy....Jeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-2760353953251845523.post-41980956006144593532011-01-11T22:04:51.766-05:002011-01-11T22:04:51.766-05:00All I can say is I hear you. Good job saving her. ...All I can say is I hear you. Good job saving her. You describe the profession accurately.Philo Calhoun MDhttp://Chief of Surgery, Roseburg ORnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-52917163085025943762010-11-24T20:16:45.601-05:002010-11-24T20:16:45.601-05:00Great case and write-up, doc. I am a surgeon too,...Great case and write-up, doc. I am a surgeon too, and I was with you the entire way until you chose to demean our dermatology colleagues.<br /><br />I don't know about your level of familiarity with dermatology, but let me tell you, this specialty has contributed volumes to principles of wound healing and pathology for many decades before you ever picked up Netter's atlas. If you've never set foot in a busy dermatology clinic or made rounds with them, I can understand the infantile misconceptions about a stress-free life filled with "routine" cases.<br /><br />The same goes for many, many other specialties that are traditionally frowned upon by surgeons. It's OK to illuminate the fundamental stress of the surgical lifestyle, but let's not come across as flippant and dismissive of our colleagues in other disciplines.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-29640998154552346012010-09-13T10:49:12.672-04:002010-09-13T10:49:12.672-04:00Trooper-
An error like that one you assumed would ...Trooper-<br />An error like that one you assumed would be like inadvertently cutting a known blood supply to an end organ, i.e. if one had mistakely divided the hepatic artery while doing a cholecystectomy. This case is much different. The small bowel almost never receives blood supply from the IMA. She needed the exact operation i performed for the colon cancer, which necessarily divided the arterial branch feeding her bowel. The complication was unexpected and unforeseen. The arterial anatomy only showed up on CT scan in retrospect, after reconstructing coronal/saggital views.Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-21576183976126469732010-09-13T10:35:16.262-04:002010-09-13T10:35:16.262-04:00Perhaps did not read your post correctly. It soun...Perhaps did not read your post correctly. It sounded like it was your error in the original operation that stopped her blood supply to her small bowel and caused it to die. That's what I was referring to. As far as billing, does Medicare allow billing of remedial operations to correct physician error?ParatrooperJJnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-29380038999866561262010-09-05T09:14:05.550-04:002010-09-05T09:14:05.550-04:00How did you do the hemi? was the roux limb for th...How did you do the hemi? was the roux limb for the whipples antecolic or retrocolic?<br /><br />The reason I ask is that my attending and I did one of these (hepatic flexure tumours post whipples) a couple of weeks back; the tumour was right under the roux limb (antecolic) which was quite stuck down so after all of the adhesiolysis the transverse colon was transected with stapler, ligasure of the mesocolon, and then delivery under the roux limb. <br /><br />Anyhow, we couldn't find any literature on post-whipples right hemi; I can't imagine that any one surgeon's experience with them is particularly large. do you know of any?DHShttps://www.blogger.com/profile/00251680600047999918noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-27726300341234124742010-09-03T09:48:45.146-04:002010-09-03T09:48:45.146-04:00Trooper-
You seem to be implying that I've som...Trooper-<br />You seem to be implying that I've somehow exploited this patient for financial gain by submitting an insurance claim on the second operation. Let me explain it in a another way. Say your brakes go out on your car. You take it into the shop and the brakes are fixed. Two weeks later your transmission goes out. You mean to say that the transmission ought to be repaired for free?<br /><br />The idea of "surgical warranties" does have some validity however. Take back operations for leaks or bleeding maybe ought to be billed at half or reduced reimbursement levels. <br /><br />But your implication on this particular case is absurd.Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-76764965617117564632010-09-03T09:37:59.863-04:002010-09-03T09:37:59.863-04:00I guess that means you did charge.I guess that means you did charge.ParatrooperJJnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-42655349342971888442010-09-02T10:08:18.127-04:002010-09-02T10:08:18.127-04:00Paratrooper: That's a pretty asinine question...Paratrooper: That's a pretty asinine question. But I wouldn't expect anything else from someone who mindlessly supports state sanctioned torture, warrantless surveillance of AMerican citizens, and illegal constant war.Jeffrey Parks MD FACShttps://www.blogger.com/profile/15650563299849196122noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-68644188411851025752010-09-02T09:30:29.358-04:002010-09-02T09:30:29.358-04:00I assume the second operation was at no charge?I assume the second operation was at no charge?ParatrooperJJnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-47944850849735311932010-09-01T18:06:40.469-04:002010-09-01T18:06:40.469-04:00Ok. This really terrifies me. I'm only an MSI,...Ok. This really terrifies me. I'm only an MSI, and was gunning for surgery.... but as I said, this really scares me. <br /><br />I do have to say however, that your a true professional-well trained, steely-eyed. You very quickly figured out what was wrong with the patient and somewhat ameliorated the effects. This counts for something. I guess I'll have to wait until 3rd and 4th year to figure out if gen surg (with the glory, terror, and shame) is right for me.<br /><br />nikAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-20463187097565702822010-09-01T10:39:14.549-04:002010-09-01T10:39:14.549-04:00OK, Buckeye, got a serious question...
Was Woody ...OK, Buckeye, got a serious question...<br /><br />Was Woody Hayes Gay??? Would explain alot.<br /><br />I mean, did your patient really get a Whipple for BENIGN DISEASE!?!?!?!?!<br />WTF??? is that even ethical? Hate to see what she'd have gotten if it was malignant.<br />I mean, sure I once put in a spinal to take out an ingrown toenail in the ER, say what you will, he didn't feel nuthin...<br /><br />FrankAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-58528996922821492152010-09-01T08:10:05.815-04:002010-09-01T08:10:05.815-04:00and if bein a Surgeon wasn't bad enough the In...and if bein a Surgeon wasn't bad enough the Indians are 60 games out of first place...<br />But hey, you've got the Browns!!!!!!!!!<br /> I know, Ohio State's ranked #2, which is just a publicity stunt to keep interest up in the rust belt, you know they'd be lucky to finish 3rd in the SEC...<br />The SEC WEST, that is...<br /><br /> But can't wait for that great Ohio St tradition, Woody Hayes punching the Clemson Player...<br /><br />Frank "SEC RULES" DrackmanAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-30641089547822258722010-09-01T08:00:03.693-04:002010-09-01T08:00:03.693-04:00I am in total agreement. It's tough..I still t...I am in total agreement. It's tough..I still think every day (and sometimes perseverate) about complications I have had. And "S," I agree with you as well. We have to find a way to better further one another. <br /><br />BTW- Sure it wasn't a saggital reconstruction? That usually shows the takeoff disease best?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-69563103761883896692010-08-31T22:30:21.668-04:002010-08-31T22:30:21.668-04:00Agreed. I am 16 years out in "practice"...Agreed. I am 16 years out in "practice" (funny word that). My last weekend was SMA embolus patient, pancreatic necrosis patient (everyday - "you need to operate") , hydrops on a cirrhotic patient, PSBO on a 95 year old (Family: "what do you mean he might have postop complications?"). The stress of it came home with me to significant personal family disruption wish is crushing my soul. I truly wish we (general surgeons) could collaborate more. Forums like your help.Snoreply@blogger.com