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 Surgery: Medical Disasters and How You Can Avoid Them (Part 1) - (Part 1) 
The new documentary by Michael Moore called SICKO has launched nationwide heralding the cry of health care reform due to the inadequacies of the health care system. Dr. Pierce Scranton, an Orthopedic Surgeon, arms us with practical tips on how to take charge of our own experiences while at a hospital and he teaches us how to protect ourselves and prevent any travesty that could occur. In a series of six articles, HealthWorld Online and Dr. Pierce Scranton, will provide actual case by case, behind the scenes scenarios, along with tips on how NOT to have these experiences happen to you. In this first installment, you will hear the story of the mishandling of a woman's knee surgery and the questions she could have asked to have had a more positive outcome.

Case 1 - J.W.'s Knee Surgery
J.W. was an active 53 year old female who had a destroyed, arthritic right knee joint. The family doctor in her rural community referred her to a new orthopedic surgeon who seemed very nice, bright and had joined another doctor in practice. She agreed completely when he told her she needed a knee replacement because she was in pain everyday. "It will be good as new," he said. She was too embarrassed to ask questions, and so she trustingly went ahead and had the surgery.

The operation took four hours, almost twice the average time. Three months later after difficult physical therapy, she needed a manipulation under anesthesia because she couldn't bend her painful, scarred knee. At six months post-operative she had swelling, stiffness, and a bone scan showed uptake around the prosthesis, indicating that it was loose. The orthopedic surgeon advised her that, "something was wrong with this implant."

He brought in his senior partner to help and they revised her total knee to a different prosthesis. However her swollen woody tissues around the knee made the surgical exposure difficult. As they tried to pry open her knee, her patellar tendon avulsed from its attachment to the tibia during the surgery. They had to screw the tendon back with a bone screw. The screw head was prominent and later the wound broke down and popped open. The screw stuck out and became infected.

Now a year and a half after technically poor surgery she is looking at a crippling knee fusion because of chronic infection.

How to avoid this problem by asking the right questions.

  1. If you need surgery, be actively engaged in the process - collaborative, not confrontational. Ask questions.
  2. You need to be able to ask in a nice way, "Doctor, how long have you been in practice, and what is your experience with this kind of problem?"
  3. Be informed! Don't be afraid to ask about complications. Ask what can go wrong in the surgery, and what the doctor will do to avoid those problems.
  4. Don't be afraid to ask for a second opinion. A doctor that gets angry at a second opinion is not a good doctor.
  5. Ask what other options are available? Do you even have to have surgery?
Remember, it's your health and well-being that's on the line. Be engaged in the process, and stay healthy!
(Excerpted from Death on the Learning Curve: The Making of a Surgeon ISBN: 1600700144)
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 About The Author
Pierce Scranton MDPierce Scranton Jr. is a graduate of Kenyon College. After completing medical school and an orthopedic residency he entered private practice in Seattle, Washington. He was team physician for the Seattle Seahawks......more
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