Tuesday, October 7, 2008

Don't want to make the same "Dr. Dangles mistake"!

The thought processes, priorities and egos of doctors never ceases to amaze me.

Let me bring you up to date:

1. Duke orthopedic surgeon # 1 refers me to orthopedic surgeon #2.

2. Duke orthopedic surgeon #2 refers me to Duke anesthesiologist/pain management specialist to perform diagnostic nerve blocks.

3. Duke orthopedic surgeon # 2 tells me:

A. To surgically remove hardware in my leg (contrary to what orthopedic surgeon # 1 advised);

B. To surgically cut nerve in my leg (contrary to what anesthesiologist/pain management advised).

3. I ask Duke orthopedic surgeon # 1 how I should handle the disagreement between physicians. He tells me to contact the physicians and ask that they make a plan.

4. Per Duke orthopedic surgeon # 1's suggestion, I sent a facsimile to the Duke physicians, pointed out the disagreements and asked that they physicians communicate and make a plan.

5. Duke anesthesiologist/pain management specialist's office contacts me and tells me that the
Duke anesthesiologist/pain management specialist will not speak with the Duke orthopedic surgeon. I am not kidding. She actually told me this!

6. Ten days pass and I am in horrible pain. I am having difficulty sleeping because of the pain. I cannot put any pressure on the leg from any angle. I am also losing stability and have injured my left ankle.

7. I sent another facsimile to the Duke physicians and, again, asked for guidance.

8. The
Duke anesthesiologist/pain management specialist telephoned me and said that "it is a lie" that she will not speak with the Duke orthopedic surgeons.

The Duke anesthesiologist/pain management specialist reiterated that the nerve should not be cut. The anesthesiologist/pain management specialist explained that she will make a charting entry in the clinic computer system so that the orthopedic surgeon can read it.

Okay. Thank you for confirming that you disagree with the Duke orthopedic surgeon. But why put the opinion in a charting? You picked up a telephone to call me. Why not just telephone the orthopedic surgeon that sent you the patient?

9. From the "what am I missing" file?

A. The
anesthesiologist/pain management specialist still will not speak with the orthopedic surgeon that send me to her.

B. The
anesthesiologist/pain management specialist disagrees with what the orthopedic surgeon's recommendation to cut the nerve.

C. I have been suffering for a very long time.

Most recently, I explained the leg pain to Duke orthopedic surgeon # 1 in September 2007.

Then, in December 2007, Duke orthopedic surgeon # 1 recommended removal of the hardware left in my leg from a December 2004 surgery. Duke Orthopedic surgeon # 1 sent me to a neurologist for an EMG/NC to determine where the nerve damage was located and therefore to make certain that the surgeon did not injure the damaged nerve.

Then, in Spring 2008, Duke orthopedic surgeon # 1 denied ever sending me to a neurologist and denied ever recommending removal of the hardware in December 2007, and denied ever sending me to a neurologist. Why on Earth would I make this up? Duke orthopedic surgeon # 1 told he me that removing the hardware would not relieve the leg pain.

D. Wouldn't it be quicker and more useful if
the anesthesiologist/pain management specialist actually spoke directly with the orthopedic surgeon? Are these doctors shy?

And so after the weeks of going back and forth between orthopedic surgeons and
the anesthesiologist/pain management specialist, I (the patient) am put in the inappropriate and uncomfortable position of running interference between two physicians. And, when push comes to shove, it will be me (the patient) who will have to pick either the orthopedic surgeon or the anesthesiologist/pain management specialist's medical opinion.

The patient should not have to pick which advise is best when both physicians are affiliated with the same clinic. in essence, I will have to "tell" one doctor or the other that I do not believe his or her opinion.

The doctors should actually speak with each other and come up with a plan of action.


This is precisely what I went through at Carle Clinic Association in 2000. And, in that case, the results were horrifying. The common denominators are ego and lack of accountability.

1. Dr. Robert Gurtler told me that surgery on my ankle would be a bad idea.

2. Dr. Chris Dangles told me that the only reason Dr. Gurtler advised against the surgery was because Dr. Gurtler did not know how to do the procedure.

3. Both doctors are with Carle Clinic Association. As with the Duke doctors now, if the two physicians/surgeons disagreed about the care and treatment of a mutual patient (i.e. me) then the physicians/surgeons should have resolved the dispute between themselves and let me know what they ultimately decided.

4. I originally underwent the surgeries with Dr. Dangles because he seemed confident and, frankly, pitched a good case for the operations. In reality, it was all about Dr. Dangles' ego.

5. I do not want to relive the Carle Clinic mistake at Duke University.


I am my own advocate. What would happen to the patient if he or she was not strong enough to keep contacting the doctors? Clearly no one is contacting me and interested in helping me.

If I were the type of person who was intimidated by doctors then I would be simply forgotten. And I would remain injured and in great pain.

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