Bravo to Erik Peper’s Article on Medical Self-Defense

I applaud Dr. Erik Peper’s excellent and extremely practical tips for preventing and surviving medical errors. There are indeed a number of strategies that one can use proactively to experience better medical and surgical outcomes. There are just a few things I would add to Dr. Peper’s recommendations.

I, personally, have experienced a number of surgeries and have learned a number of my own lessons in the process.

My first surgery, in early 1998, was a complete surprise, after being diagnosed with DCIS (ductal carcinoma in situ). Fortunately, I knew enough to choose probably the best-trained surgeon in the Seattle area in the most avant-garde surgical technique for breast reconstruction at the time: a nine-hour abdominal free flap procedure. Rita Wong, MD, had learned well from her UCLA mentor, and she was one of only two surgeons here who knew the procedure. I interviewed a surgeon at Swedish Medical Center but went with Dr. Wong despite her being at Highline Hospital way down south in Burien. I did not fare as well with the breast surgeon, who did the mastectomy. Nor did I find out until post-surgery that she had removed nineteen (!) lymph nodes because the DCIS was so large. Her name escapes me, which is just as well. She apparently had a nervous breakdown shortly after my surgery, and I never saw nor heard from her again. No surgical follow-up whatsoever from her! Fortunately, I never needed radiation or chemotherapy.

Six months later, still 50 years old, I had my second surgical procedure: a hemi-thyroidectomy. I had a large thyroid nodule and needle biopsies couldn’t give a definitive diagnosis. After my breast cancer scare, I didn’t want to take a chance. When I suggested removing only half my thyroid, the endocrinologist gave me a hard time. “Within 10 years you’ll be on thyroid anyway because the other half of your thyroid will burn itself out from doing all the work.” Still, it made no sense to me to remove the other lobe of my thyroid, which seemed perfectly healthy. Now, twenty- one years later, I have plenty of energy and have never needed thyroid medication.

Twelve years later I was diagnosed with invasive ductal carcinoma of my other breast. Had ultrasounds and MRIs been done annually, instead of only mammograms, the DCIS would have been diagnosed years early before it became invasive. Again, I opted for a mastectomy as sole treatment. I chose an excellent breast surgeon at Seattle Cancer Care Alliance to do the mastectomy: Dr. David Byrd. Kind man, highly skilled, excellent bedside manner. I thought I chose the best plastic surgeon as well. In fact, he was the president of the national association of surgeons of the US. What I didn’t factor in was that he was too busy and traveled too much to be there for me. So, a month post-surgery when I developed significant swelling in my lower leg and was hospitalized at the UW, he was there for my admission, suggested a high-tech vascular radiographic procedure to rule out a hematoma, but his attending physician never followed up on it. In fact, I felt like I knew more about my own case than this young substitute doc. I was pumped full of Vancomycin, was never offered a port, and was discharged three days later. It was only from the RNs that I learned how destructive Vanco is to the veins.

Three days later, never having gotten to the root of the infection, I was back at the UW. This time the surgical staff had the sense to do the vascular procedure (very painful) to locate a huge hematoma in the area of the thigh reconstruction of the breast. Another three days of Vanco with no port recommended. The result: I have almost no veins in my arms adequate for drawing blood and it is very traumatic when I go for my annual bloodwork. I inquired afterwards about a possible malpractice suit but was told (by a woman in the field) that I should just count my blessings that I was a breast cancer survivor! What I learned: When you shop for surgeons, find one with a great deal of experience but who is not too busy to be around when you need her/him.

My last surgical procedure, nine months ago, was for an abdominal hernia resulting from that abdominal reconstruction twenty-one years ago. I called around to find the most experienced hernia surgeons and interviewed two seasoned male surgeons. The first spoke only to Bob, my husband, though it was my body that was in question. Well-dressed and well-spoken though he was, he was just too sexist for me! The second surgeon, about the same age with decades of experience, was about as folksy as you could ever find. It was his relaxed attitude and the Converse sneakers that sold me. He wore those sneakers into the office and into surgery. Laparoscopic surgery wasn’t needed, I required only one stitch, and I healed very quickly.

In all cases, of course, I used a naturopathic and homeopathic pre- and postsurgical protocol, which can be found on our website www.lhealthyhomeopathy.com.

Judyth Reichenberg-Ullman, ND