Losing faith in my surgeon - should I get a new one?

[IslandBreeze]

Hi, I really need some advice! I need a laparoscopic Nissen fundoplication to close the top of my stomach as it doesn't close. I have huge acid and reflux problems. I've been advised to get it done as fast as poss as it's already done huge damage to my throat and my vocal cords and it's generally ruining my life and health.

However I live on an island in the middle of the ocean and it can't be done here. The island has no airport and you can only get to the UK or Cape Town, South Africa from here. It takes about a week to get to either and if you want to go anywhere else you have to travel on from there. I have been planning to get it done privately in Cape Town as that's the nearest land to the island and surgery there is supposed to be good and much cheaper than Europe.

It takes 7 days on a ship to reach Cape Town (we're really remote!) so I want to have a certain amount of info from the surgeon before I spent 7 days and a lot of money dragging me, hubby and baby across the ocean. The doc here gave me a recommendation to a surgeon and I've explained that I need to know a few things before setting out. He just won't give me answers!!! I feel my questions are reasonable. I've asked:
1) assuming the op goes to plan with no complications, what is the total cost?
2) what methods of payment are accepted?
3) Can I continue with my current medication until my consultation with him?
4) can I stay on Atkins til my consultation with him?
5) how many of these ops has he done and what's the failure rate?
6) is he likely to repeat the gastroscope and other tests I've had done here and if so, do I need an empty stomach for the initial consultation?

I chase and I chase and every so often he actually sends me an email and promises to reply the next morning without fail and never does. His admin team are even worse.
I realise this doesn't necessarily reflect on his skill as a surgeon but this is making me very nervous about the quality of customer service and aftercare.

Am I right to be concerned about this? Should I be looking for a different surgeon or am I over-reacting?

I'm wondering if I should have it done elsewhere.

Belgium is only slightly dearer. I preferred the SA option over Belgium largely because SA is the only place I can get it done that doesn't involve a long-haul flight and it's thought that you shouldn't take long-haul flights close to general anaesthetic as your DVT risk goes up.

I could probably afford to have it done privately in the UK but it would hurt financially. It's about 3 times dearer than SA or Belgium and has worse MRSA and C-diff rates than either of them. On the other hand, I can get good refs for a really top-notch surgeon for the UK.

Although I'm overseas I still have an entitlement to NHS treatment as my hubby works for the UK government. I originally discarded that option as the waiting lists would probably mean unpaid leave for hubby or me being stuck in UK without him. It's so difficult to get to this island that I'd have to stay in the UK right through the whole waiting list process.

I'm sorry this has been such a long post but I really need some advice as I'm going nuts trying to work it out. It's not actually WLS but it is often done alongside bariatric surgery so a friend who's an ex-bariatric nurse tells me.

The ship leaves in 2 weeks - that's my only chance for ages to leave, so I need to make my mind up and if I'm going to change surgeon, get on with it! I've been chasing this guy for about 6 weeks while the ship is away and it's now getting critical. Please help!!!!

 

[Sambucca]

aww hun, I dont have all the answers but I can totally understand why you are so concerned. These are basic questions that you are asking of your surgeon and Im shocked and appalled that you are not getting the answers you need.

I have no knowledge of the operation you are about to have, but I know from your diary thread the difficulties you face as a result of your condition.

Have you made any enquiries about getting the surgery on the NHS here in the UK? I understand you not wanting to be parted from your husband, but by having your surgery on the NHS, any aftercare/follow ups/complications would have to be dealt with by them too...

No one can advise you really hun. You have to take the decision yourself. Do you think this could be a bit of last minute nerves? Have you been able to do any research on the surgeon?

Sorry, Ive probably thrown up more questions than answers. I hope you get things moving soon hun xxx

 

[IslandBreeze]

aww hun, I dont have all the answers but I can totally understand why you are so concerned. These are basic questions that you are asking of your surgeon and Im shocked and appalled that you are not getting the answers you need.

I have no knowledge of the operation you are about to have, but I know from your diary thread the difficulties you face as a result of your condition.

Have you made any enquiries about getting the surgery on the NHS here in the UK? I understand you not wanting to be parted from your husband, but by having your surgery on the NHS, any aftercare/follow ups/complications would have to be dealt with by them too...

No one can advise you really hun. You have to take the decision yourself. Do you think this could be a bit of last minute nerves? Have you been able to do any research on the surgeon?

Sorry, Ive probably thrown up more questions than answers. I hope you get things moving soon hun xxx

Thanks Sam. I don't think it's last-minute nerves as although I am nervous I'm determined to have it - I just feel I should be able to get these questions answered. It seems disrespectful and disorganised and that worries me.

My NHS timescale concern is largely about my 14 month old son. I have no family in the UK (my dad was a orphan and my mum's family was very small). I don't think I can care for baby whilst staying on my own for the op and I'd have no family to help but I don't want to lose baby for weeks either if I send him back to St H with his dad.

The waiting times quoted to me between consultation and op were off-putting but I might have to re-investigate. It wouldn't matter to me where in the UK I had it done so maybe some PCT somewhere has a quicker list.

Thanks for posting - I'm feeling pretty rubbish and in need of support today so it's appreciated. x

 

[hopelesscase]

Hi IB
I have several friends in SA and also a cou[le of south African friends here in the Uk and they all have such a layed back attitude so hearing of your plight with the surgeon doesnt surprise me.
I took a party of 33 16yr old rugby players along with 60 of their family members on tour to SA 4 yrs ago and boy did we do some waiting around when checking into the hotels etc.
I would email him again and explain that yr boat leaves on whateverdate and you will be there on said date and that you need to know now so that you can book yr ticket etc. make sure you request a read receipt so you know when he has read it.
If that fails then NHS here sounds like yr best option like sam said at least you know you will get any followup you need.
good luck and take care
hc

 

[thinkbethin]

Hi there, so sorry you are going through this. I can't really help with the questions but wanted to wish you all the luck in the world in getting this sorted.Is there any chance you can get more info on this surgeon on the net from previous patients??? Perhaps if you could find out more about him and the after care you may feel able to cope with the wait. I know this isn't going to solve the problem for you but the not knowing is worse than the wait itself.HUGE HUGS to you and hope you finally get some answers xx Gaynor xx

 

[girly girl]

Hi
Im so sorry you are having this trouble i no a small amout about what you are having my now 6 yo had some thing like it when he was 2 i do have to say i wouldnt put up with that from a nhs doc never mind pri and i have had a lot to do with nhs doc over the years and never had a problem if it was me i would be looking else where just the fact he is not getting back on basic things would worry me but thats just me. i no being away from your baby would be hard but if it is getting you down that much is it not better being way for a little then going home happy than being sick all the time i hope you find a way through this
keep in touch
sorry for spelling

 

[quetiapina]

Hi there, I wouldn't trust my life to a surgeon who can't even reply to e-mails. How much is the op in S Africa, could you stretch to having it done in Belgium or UK? The current surgeon isn't the only person in S. Africa who does WLS? I hope that things get sorted for you quickly.

 

[belbouteloup]

wishing you all the luck in the world, my motto has always been "If in doubt,chuck it out "go figure. anything we can do to help, just ask xxxxx

 

[IslandBreeze]

I think I have to ditch him. Hubby thinks I should just be patient and see what happens when I meet him but then hubby is a chilled manana kind of person and I'm not - and it's not his cash or his body. Hubby figures I can easily arrange quickly to see someone else if I'm not happy at the consultation but it will be harder than he reckons I think.
It's disheartening to think I'm back to the drawing board with less than 2 weeks to organise an alternative (and of course there's the Easter bank hols....). Will doubtless continue to ponder rather than sleep tonight, it's weighing on my mind and I need to make a certain decision and act on it. Thanks for the advice, it does help.

 

[IslandBreeze]

Hi there, I wouldn't trust my life to a surgeon who can't even reply to e-mails. How much is the op in S Africa, could you stretch to having it done in Belgium or UK? The current surgeon isn't the only person in S. Africa who does WLS? I hope that things get sorted for you quickly.

It's probably £2500-3000 in SA (can't be sure as can't get an answer
It's £3000-3500 in Belgium
£7-8000 in UK.

I can afford the UK price but it'll sting - like most parents I can find plenty of other things to spend money on. But my priority is getting it done successfully and safely.

 

[IslandBreeze]

Hi
Im so sorry you are having this trouble i no a small amout about what you are having my now 6 yo had some thing like it when he was 2 i do have to say i wouldnt put up with that from a nhs doc never mind pri and i have had a lot to do with nhs doc over the years and never had a problem if it was me i would be looking else where just the fact he is not getting back on basic things would worry me but thats just me. i no being away from your baby would be hard but if it is getting you down that much is it not better being way for a little then going home happy than being sick all the time i hope you find a way through this
keep in touch
sorry for spelling

Thanks. Was it successful for your little boy?

 

[IslandBreeze]

Is there any chance you can get more info on this surgeon on the net from previous patients??? Perhaps if you could find out more about him and the after care you may feel able to cope with the wait.

All I can find is his name on a couple of research papers. I've googled and googled and nothing..... don't know if that's good or bad - unhappy patients tend to post more often that satisfied ones I guess so it could be good.

 

[IslandBreeze]

wishing you all the luck in the world, my motto has always been "If in doubt,chuck it out "go figure. anything we can do to help, just ask xxxxx

Thanks. Where did you have your surgery?

 

[quetiapina]

The Hospital Group in the UK does a Why Go Abroad package which is £4950. Where would you get your fills?

 

[IslandBreeze]

The Hospital Group in the UK does a Why Go Abroad package which is £4950. Where would you get your fills?

It's not WLS - it's an op to close the top of my stomach to keep the food in as it doesn't close at present and I puke all the time involuntarily. Do The Hospital Group do just WLS or other stuff too?

 

[quetiapina]

Other stuff as well but mainly WLS or cosmetic. The Spires are in a variety of towns and cities - they used to be Bupa hospitals - they would do everything - a lot of NHS surgeons do their private practices at these private hosps.

 

[IslandBreeze]

I've finally had a response from the SA surgeon this morning and I'm not entirely happy. We seem to have a huge expectation gap in terms of customer service.

He's basically said that his practice are far too busy and important to answer questions and I should just wait til I get there. He has finally told me that yes, I must not eat on the day of the consultation as they will want to shove a tube down my throat for a look. Surely this info should have come with the appointment confirmation? I shouldn't have had to ask and ask for it. If I hadn't asked, then I'd have arrived for my appointment with a tum full of lunch.

He says he can't tell me if I need to come out of ketosis until he examines me. I don't get this. From everything else I've read on here, surgeons either figure ketosis is safe or they want you out of it a few weeks in advance so that all your blood, chemicals, hormones etc are back to normal before they put you under anaesthetic. I really don't get this "dunno, wait and see" approach.

I'm wondering if the expectation gap here is due to the fact that in the UK and Europe we all have access to generally competent state healthcare so when we choose to pay to go private it's because we're choosing to buy a quicker op and higher level of customer service. In South Africa, state healthcare is rubbish so everyone who can afford it goes private and there might not be the same attitude of it being a luxury (with associated service levels) rather than a necessity.

 

[brett30]

all i can suggest is that you contact some UK surgeons .. i think because the way of the national health is here they have to give u support and answers .. i would email as many as you can and explain my situation and see how that goes .. i have lived all over the world and worked in the nhs for many years my self and i think i would pref my self in the hands of people who have to work along side bigger rules and a national health system rather than private in another country ..

few suggestions ...


Surgeon's Profile

Mr Tim Worthington

Consultant Surgeon. MB ChB, MD, FRCS.
Contact Details

Tel: 01483 555958
Email: [email protected]
Biography

Consultant Surgeon, Royal Surrey County Hospital, Guildford. Laparoscopic Tutor, Minimal Access Therapy and Training Unit, University of Surrey.
Member of The Association of Upper Gastrointestinal Surgeons; International Hepato-Pancreato-Biliary Society; Pancreatic Society of Great Britain and Ireland.
Trained at the Hammersmith Hospital, Imperial College London. Awarded the Royal College of Surgeons Simpson Research Fellowship and studied the biology of pancreatic cancer. After being awarded his doctorate in 2001, Tim spent his higher surgical training in London and undertook further specialist training at Flinders University, Adelaide, Australia. Appointed consultant surgeon at University College Hospital, London in 2004.

Mount Alvernia Hospital

46 Harvey Road, Guildford, Surrey, GU1 3LX

Who We Are

This GenSurgeon recognised hospital is located at the centre of Guildford. Mount Alvernia is part of BMI Healthcare. The hospital has 76 beds and all rooms are furnished to a high standard, each with its own telephone, television, radio and en-suite bathroom. A wide spectrum of surgical procedures are performed by our specialists at this site,
Contact Details

Tel: 01987456234
Website: www.bmihealthcare.co.uk/hospital/details?p_hosp_name=Mount%20Alvernia%20Hospital&p_hosp_id=310 ..............

http://www.nuh.nhs.uk/about/foi/ser...09lite_Laparoscopic_Nissen_Fundoplication.pdf ...............

Laparoscopic Nissen fundoplication: cost, morbidity, and outcome compared with open surgery


best of luck hun x

 

[Caroline101061]

I agree with Brett - dont think this guy is for you - Id give him a wide berth if it were me.

Im also very concerned about MRSA rates in NHS hospitals but things are better than they were. Private hospitals here have a much better reputation when it comes to post op infections unfortunately.

If you want this done fast then your best option is to go private. Whilst the NHS is fabulous (Brett and I are both at the same hospital - the Whittington in North London), there are funding and waiting lists to be considered too - you might have to bite the bullet and fork out the cash unfortunately.

Good luck!

 

[IslandBreeze]

Thanks Brett and Caroline. Good responses. Brett, have you any experience of healthcare in South Africa or Belgium?

I saw my GP this morning. He's South African himself and said all Cape Town doctors are like this. He reckons that the hospitals and procedures are all top-notch but that the Cape Town docs are rude and poor at answering queries. He's offered to chase up the answers for me himself but I'm not sure there's any point to that. He has someone in the Cape who physically goes to the hospital and gets answers. I don't think that bodes well if I have concerns or queries post-op and I'm back here.

I've been talking to an Irish company who organise these ops in Belgium and I'm leaning towards them at the moment. They've answered all my questions politely and promptly. They've taken on board my weird travel position and have accepted my need to know more than usual in advance. Some of my questions about the surgeon they can't answer right now as he's on Easter hols but they've phoned me to assure me they'll be onto him on Tuesday when he returns and will have an answer for me then. So far, they're professional, prompt and polite. The price is reasonable and the insurance is excellent - for £151 it covers all additional medical and hospital costs if you have complications and also the resulting costs of changing your flights. I feel reassured by their handling of this and I feel comforted by the fact that Belgium also has an excellent state healthcare system and that in case of complications I have the cover of my EU health card as well as the insurance and can get to the UK quickly. They seem to mostly speak good English and hubby and I are both fluent in French which might be helpful.

What with their low post-op infection rates, I'm leaning towards Belgium. I'm also checking out my NHS options though and getting a couple of private UK quotes also.

Oh well, the Mother-in-law will be chuffed if we change our plans - we've told her she won't see us or the grandson this year because of the op being in SA. If we change to Europe, we can see family after all.

Oh I also asked doc about my DVT/long haul flight concerns. He said that as long as I was active for one week prior to the flight I'd be fine but also there is a drug you can be given in advance of the flight to reduce the risk of DVT if the surgeon is concerned. I found that reassuring.

I'm really glad I posted here, the support has been great.