We met with Vicki, our birth provider, for our final appointment on Monday. During the visit, we discussed ‘what happened’ in great detail. The most interesting part of our discussion was revisiting what Dr. Maher found when he opened me up… the extensive scarring (“intra-abdominal adhesions”) throughout my abdomen and mis-placement of organs. According to Vicki, Dr. Maher spoke candidly at length to her about it the day after the delivery, using colorful and pointed language about the horrendous job the surgeons had done.
(Note, this is the part where things get personal.) Immediately after the surgery, I noticed a drastic change in my ability to pee — since Will’s birth, I’d had a very difficult time going to the bathroom… it took time, I rarely felt “empty”, and had to visit the WC much more than before. I chalked up the changes to normal stuff that happens after having a baby. Another change I had post-Will was pain during intercourse. I figured it would take time to “get better” and again, chalked it up to pregnancy and body changes. Now, at 8-weeks post-partum, I can say that that symptom has also gone away. Which makes me believe that both were related to the poor job the surgeons did during my first Cesarean.
If Kate had been born vaginally, I never would have known how the scarring was affecting my quality of life. I would have gone on without complaint. It makes me wonder what else I could be missing.
Another issue that Dr. Maher explained during our 2-week follow-up was that the scarring is so extensive that it actually includes my bowel — now attached in layers of scar tissue to my uterus. This is a bit alarming to me because of my history of Inflammatory Bowel Disease. Normally the bowel is able to move and twist in the abdomen… now, mine cannot. Should I have a flare of IBD, how will this impact it? During this visit, he also mentioned that I may need future laproscopic surgery to repair some of the damage. He addressed the areas that needed to be disturbed for the purpose of delivering Kate, but decided not to go further because of the great impact it would have had on my recovery. With a new baby to handle and feed, getting me healed quick seemed the better option (for this, I’m thankful.) But does this means I face further surgery in the future?
Now that we’ve had time to process — and I’ve had time to enjoy the relative ease of using the bathroom and being intimate with my spouse — I’m shocked to think that I would have lived with these impairments for years. And I feel compelled to do something about it; I’m just not sure what.
I’m puzzled as to how an attending allowed my surgery to happen the way that it did. I understand that there is no clear way of performing surgery… it’s not like you can do a random assignment of different surgical styles and then re-open patients years later to see which healed better. So does that mean that what was done on me (basically, very very over-zealous and unnecessary stitching) is what is taught at this facility? If so, then I really need to follow-up; perhaps my experience could provide insight into better practices.
What would you do?
Violet | 07-Jul-06 at 6:43 am | Permalink
I would ask the new surgeon if you can have this case documentation in writing, and then consult a malpractice lawyer. I wouldn’t get into lengthy (and expensive) litigation, but it sounds like this stuff should at least go on record, in case you have further health problems down the line.
eli | 07-Jul-06 at 8:01 am | Permalink
I somewhat agree with Vicki. I think while the thought of having the additional surgery is scary, I would talk very seriously and ask as many questions as possible with the new surgeon about the scarring and IBD issue. IF he thinks additional work could remove the scar tissue and possibly ease some of the bowel issue then I would seriously consider it.
However, I would consult at least the licensing board in Michigan regarding your case. They need to know how bad things were botched and what you have lived with as a result.
deb | 07-Jul-06 at 8:02 am | Permalink
I would request that Dr. Maher send a copy of his surgical report with findings and impressions to the surgeon who did your first C-Section.
I would then, if possible, make an appointment (by phone if necessary) to discuss your experience with the first physician. With that person, you should discuss the continence and sexual concerns that you have had as well as others. I wouldn’t involve a lawyer unless you intend to sue. If you do so intend, then do what Violet said, not what I did.
Holly | 07-Jul-06 at 8:37 am | Permalink
I’m not exactly sure what I want right now… I’m still sort of in shock. I put so much faith into the UM medical system. The residents who operated on me made a huge deal out of the great job they did; they were very proud of their work. I never would have doubted them. This came as such a surprise; I’m still processing it all.
Dr. Maher refered to what they did as a “beginners error.” I truly believe that it is a result of the residents really WANTING to do a good job — so what they did was stitch everything, layer upon layer, without thinking about how it would heal over time and how the organs would settle. But aren’t there Attendings looking over the work of residents?? This is what surprises me. Dr. Maher told Vicki that he would have fired the residents on the spot. So what did their Attending do?
What I’m not sure of is what, if anything, would make a difference. Would Dr. Maher’s comments make a difference? I feel like I need to “make this right” — but I’m not sure what that means right now. I guess I am just disturbed that this happened and feel let down. The “great job” that I thought was done with Will’s delivery was the only positive part of that experience. If nothing else, I guess I can be happy to be out of that health system. For the most part, the UM medical system was a huge let down.
stardust | 07-Jul-06 at 9:35 am | Permalink
Hi holly girl!
I don’t know that there is a right answer to your question but I say go as far as you want to take it.
Under hipaa regulation you can gain access to your medical file here at UM and learn what was actually written up in the sugery dictation as well as the name of the attending P.C. who signed off.
I don’t know if your current doc would inquiry on your behalf, may be in violation of his practicing creed, but I think if he has dictated any of what you are saying in your medical file with him, I’d get my hands on that and forward it to the attending P.C. at UM. I would only have written communication with the contacts at UM so you can have record of correspondances should you need them later.
Maybe litigation is more involved then you want to get at this time, but if future surgeries become required. I’d at least look into now, how long you have to file a grievance of this kind and whether or not you have some recourse about who is to blame or even pay for it particularly in the case of future surgeries – ya know!
Just my 2 cents… You know I know all too well about “botched surgeries” 🙁 Sorry you have to deal with it but I am relieved that fate would have it that you are able to live with a better quality of life then post your first c-section.
P.S. the babes are looking great! 🙂
Love,
Deneil
Holly | 07-Jul-06 at 11:55 am | Permalink
Thank you, everyone! It is so great to get feedback on this. We are really unsure about what to do.
I’ve got medical records from both procedures. Dr. Maher’s (surgery #2) references the “extreme intra-abdominal adhesions,” having to move the mis-placed bladder, and the fact that he could not excise the uterus because of the extent of the scarring and had to clean it out and stitch it back up in situ. It’s all in medical speak; the only reason I understand what he’s saying is because of my discussions with him. The first surgery reads as if everything was completely normal… I’m not sure how to look at it. But yes — all the names of the surgical team are on the record.
Deb | 08-Jul-06 at 12:21 pm | Permalink
Holly,
I think you need to decide what you want to get out of your actions. As I see it, there are several potential outcomes.
First, the residents should be made aware of the harm they did with their over-zealous treatment.
Second, the attending needs to know what happened to you under his watch.
Third, you need UM to pay for any future surgeries that you may need to undergo to correct the injuries incurred as a result of the treatment that you had there.
Fourth (and this, I think is the least of your concerns) you could ask for some form of compensation for your pain and suffering as a result of their treatment.
The situation is ripe for a malpractice suit, and I am certain that the risk management department at U of M would do its best to do something on your behalf to avoid a suit.
You may very well want to talk with a malpractice lawyer to find out more about your options. The issue is not urgent, but you might want to get it resolved soon.
Here are the reasons: 1) You are necessarily spending a lot of mental energy on this problem that you will need for other things. 2) You should be able to get the next surgery(s) as soon as your physician thinks they should be done and you don’t want to have to wait for this issue to be resolved. 3) If U of M does offer you compensation beyond covering needed medical care, you could use that money for your education (e.g. not have to work at a paying job, and using that time to focus on your dissertation.)
I am not a litigious person, but I do believe that you should be protected from harm, and since it will cost money to have the next procedures, if you have to pay for them, that would be more harm done to you.
When I was in graduate school, a pharmacist filled one of my prescriptions wrong. He gave me the drug that was next to the prescribed one on the shelf. I felt lousy while I was taking it, and when I went to refill it, I realized right away what had happened. It turned out that what he gave me was a blood pressure medication. Now, my bp runs very low anyway, and with an extra high dose of that med, I was in danger of passing out anytime. As it was, I took it at night and passed out in my sleep. Fortunately for everybody in my life, I didn’t pass out while driving from Sacramento to Berkeley. Unfortunately for me, the drug made me feel so bad that I didn’t get much work done that month. Anyway, I suddenly got a call from the pharmacy chain’s risk manager who asked me if I wanted to make this all go away. He offered me some money and I realized that they were trying to make sure that I didn’t sue them. I talked to a lawyer who promised me that he could get 3 times what they were offering. He would take a third and I would end up with twice their offer. He was absolutely right. I used the money to pay for my next two terms in school.
So, the upshot is, I think you need to protect yourself, and I think the attending and residents need to know what they did so it won’t happen to another woman.
One last thing. If the same thing has happened to other women treated by this attending, it could be grouds for a class action suit – something the hospital would really find frightening!
In the meantime, enjoy motherhood.
love you
Deb