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  1. #1
    wallock is offline Junior Member
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    Surgery not needed...

    What is the name of your state? Wisconsin

    I apologize in advance for the details of this question - I will try not to gross anyone out. After about a year of seeing a GI doctor for unexplained vomiting, I was at a point where I knew I would not be able to continue my insurance (thus, no more doctor). I told the doctor that if there were any surgeries/procedures that needed to be done, now would be the time.

    In November of 2004 I was referred to a surgeon to discuss options for a specific surgery on my stomach. Instead, he said I absolutely needed a different surgery, a fundoplication (permanant cure for reflux - prevents you from throwing up as well). I never had heartburn, I just threw up quite often. I went through the procedure and it changed my life, negatively, but I feel the 'outcome' is irrelevant.

    I managed to re-aquire insurance and have been told by several GI doctors that the surgery was completely un-needed and it is not done with a situation like mine. I understand that doctors can have different opionions, but everywhere I look I find this is not an acceptable surgery.

    I DO feel I am partially to blame for only getting two opinions from the same hospital. Nonetheless, what would my odds be of getting back the $8,000 I paid out of pocket to have the surgery. Do doctor's typically settle on something like this? I am not looking for any other damages (I went to the pain clinic for months and months at my expense).

    Thank you dearly and please be kind, I am far from an evil person
  2. #2
    seniorjudge is offline Senior Member
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    Quote Originally Posted by wallock
    What is the name of your state? Wisconsin

    I apologize in advance for the details of this question - I will try not to gross anyone out. After about a year of seeing a GI doctor for unexplained vomiting, I was at a point where I knew I would not be able to continue my insurance (thus, no more doctor). I told the doctor that if there were any surgeries/procedures that needed to be done, now would be the time.

    In November of 2004 I was referred to a surgeon to discuss options for a specific surgery on my stomach. Instead, he said I absolutely needed a different surgery, a fundoplication (permanant cure for reflux - prevents you from throwing up as well). I never had heartburn, I just threw up quite often. I went through the procedure and it changed my life, negatively, but I feel the 'outcome' is irrelevant.

    I managed to re-aquire insurance and have been told by several GI doctors that the surgery was completely un-needed and it is not done with a situation like mine. I understand that doctors can have different opionions, but everywhere I look I find this is not an acceptable surgery.

    I DO feel I am partially to blame for only getting two opinions from the same hospital. Nonetheless, what would my odds be of getting back the $8,000 I paid out of pocket to have the surgery. Do doctor's typically settle on something like this? I am not looking for any other damages (I went to the pain clinic for months and months at my expense).

    Thank you dearly and please be kind, I am far from an evil person

    Q: Nonetheless, what would my odds be of getting back the $8,000 I paid out of pocket to have the surgery.

    A: Zero.
    There are two rules for success:

    (1) Never tell everything you know.
  3. #3
    wallock is offline Junior Member
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    Can you please explain?
  4. #4
    rmet4nzkx is offline Senior Member
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    Quote Originally Posted by wallock
    What is the name of your state? Wisconsin

    I apologize in advance for the details of this question - I will try not to gross anyone out. After about a year of seeing a GI doctor for unexplained vomiting, I was at a point where I knew I would not be able to continue my insurance (thus, no more doctor). I told the doctor that if there were any surgeries/procedures that needed to be done, now would be the time.

    In November of 2004 I was referred to a surgeon to discuss options for a specific surgery on my stomach. Instead, he said I absolutely needed a different surgery, a fundoplication (permanant cure for reflux - prevents you from throwing up as well). I never had heartburn, I just threw up quite often. I went through the procedure and it changed my life, negatively, but I feel the 'outcome' is irrelevant.

    I managed to re-aquire insurance and have been told by several GI doctors that the surgery was completely un-needed and it is not done with a situation like mine. I understand that doctors can have different opionions, but everywhere I look I find this is not an acceptable surgery.

    I DO feel I am partially to blame for only getting two opinions from the same hospital. Nonetheless, what would my odds be of getting back the $8,000 I paid out of pocket to have the surgery. Do doctor's typically settle on something like this? I am not looking for any other damages (I went to the pain clinic for months and months at my expense).

    Thank you dearly and please be kind, I am far from an evil person
    This surgery is indicated for treatment of GERD and has a 50-90% effectiveness rate, apparently you fell in the 50% where for one reason or another the surgery was not succesful. You did not say how or how you had changed your lifestyle following your recovery. It is not necessary to have heartburn to require treatment, the cells physically change due to the acid present during vomiting which increases the risk of cancer and may also decrease your preception of heartburn. Thus far nothing suggests medical malpractice however you may consult a medmal attorney with the facts of your case.

    Fundoplication surgery for gastroesophageal reflux disease (GERD)
    During fundoplication surgery, the upper curve of the stomach (the fundus) is wrapped around the esophagus ...
    [url]http://www.webmd.com/hw/heartburn/hw95701.asp[/url]

    Professional Malpractice: Medical malpractice actions must be filed within three years of the date of the act or omission resulting in injury, or one year from the date the injury was or reasonably should have been discovered, whichever is later. However no medical malpractice action may be filed more than five years from the date of the act or omission underlying the claim.
  5. #5
    wallock is offline Junior Member
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    I do not have GERD - I had a vomiting problem that had nothing to do with typical heartburn/GERD...

    To be more clear, the procedure was done for the condition 'Barrett's esophagus' which resulted from throwing up. All the doctors I have spoken to said it was WAY too extreme considering my condition and should not have been done.

    Looking forward to your response!

    Thanks!
    Last edited by wallock; 02-17-2006 at 06:38 PM.
  6. #6
    weenor is offline Senior Member
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    Quote Originally Posted by wallock
    I do not have GERD - I had a vomiting problem that had nothing to do with typical heartburn/GERD...

    To be more clear, the procedure was done for the condition 'Barrett's esophagus' which resulted from throwing up. All the doctors I have spoken to said it was WAY too extreme considering my condition and should not have been done.

    Looking forward to your response!

    Thanks!
    Then find one of those doctors to testify that the physician breached the standard of care in the medical community by performing the surgery. The doctors will tell you one thing but often its a whole different story under oath.
  7. #7
    wallock is offline Junior Member
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    I have copies of my medical records from the new doctors that state the surgery is 'very questionable'. I know one for sure would testify - the question is... is it worth my time? Do doctor's settle this type of thing, do you think an attorney will take the case? Assuming all the previous statements to be true, do I have a case?

    I don't want you to think I am searching for a specific answer, I am just trying to give all the info I can.
  8. #8
    weenor is offline Senior Member
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    Quote Originally Posted by wallock
    I have copies of my medical records from the new doctors that state the surgery is 'very questionable'. I know one for sure would testify - the question is... is it worth my time? Do doctor's settle this type of thing, do you think an attorney will take the case? Assuming all the previous statements to be true, do I have a case?

    I don't want you to think I am searching for a specific answer, I am just trying to give all the info I can.

    You should get an attorney in your area to review the medical records and advise you...he/she will take the case on contingency- which means you will that person a % of the settlement amount plus expenses with no money up front. I cannot possibly tell you whether you have a case without reviewing the medical records and determining the amount of your damages.

    Medical malpractice are difficult cases to win and are highly dependent on expensive expert testimony. Yes the insurance companies that insure doctors do settle without trial sometimes, but that will be based on the experts lined up by your attorney to support liability.
  9. #9
    rmet4nzkx is offline Senior Member
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    Actually Barrett's is caused by chronic GERD! This was recently in the news.

    [url]http://www.gicare.com/pated/ecdgs40.htm[/url] ....
    What is Barrett's Esophagus?
    The cells lining the esophagus differ from those lining the stomach or intestines, mainly because they have different functions. They also have a distinctly different appearance, so it is usually easy for a physician to tell them apart when examining the esophagus and stomach. Normally, there is an area at the end of the esophagus that marks the border between the cells of the esophagus and those of the stomach. Barrett's esophagus is the abnormal growth of intestinal-type cells above this border, into the esophagus.

    Since the cells lining the stomach are protected from contact with acid, their growth into the esophagus may actually be a defense mechanism. It may protect the normal tissue in the esophagus against further damage by GERD. This may explain why the symptoms of GERD seem to lessen in some patients with Barrett's esophagus. Unfortunately, these tissue changes may be a forerunner of cancer of the lower esophagus, known as adenocarcinoma. Cancer of the upper esophagus (squamous cell cancer) is usually related to alcohol and smoking. This type of cancer appears to be decreasing in the population, while the rate of adenocarcinoma is increasing sharply, especially in white males.

    In time, the Barrett's cells may develop abnormal changes known as dysplasia. Over a period of perhaps two to five years, the dysplasia may then progress to low grade, then to high grade dysplasia, and finally to cancer. Fortunately, this happens only in about 1-5% of patients with Barrett's esophagus.

    Cause and Symptoms
    For unknown reasons, Barrett's esophagus is found three times more often in males than in females. In some instances, Barrett's esophagus appears to be congenital (present at birth). However, current evidence is strong that in most instances, it develops as a result of longstanding GERD.

    Patients with Barrett's usually have symptoms similar to those produced by chronic GERD, such as heartburn and reflux of stomach acid into the mouth. Some Barrett's patients may also suffer from other complications of GERD, such as esophageal peptic ulcers and stricture -- narrowing of the esophagus that comes from scarring. These facts are why it is important for patients with these symptoms to see their physicians regularly.

    Diagnosis
    Diagnosis of Barrett's esophagus requires an examination called upper endoscopy or EGD (esophagogastroduodenoscopy). A barium x-ray is not accurate for detecting Barrett's esophagus. An EGD is done with the patient under sedation. The physician examines the lining of the esophagus and stomach with a thin, lighted, flexible endoscope. Biopsies are performed, taking pieces of tissue to be examined under a microscope for abnormal cells which have the potential of becoming malignant. The changes may be indefinite dysplasia where the pathologist may be uncertain of the changes. In this circumstance, medical treatment is intensified and repeat biopsies are performed in 6-12 months. When dysplasia is definite, some type of definite correction is necessary.

    Treatment

    Things Patients Can Do
    Currently, there are no medications to reverse Barrett's esophagus. However, it appears that treating the underlying GERD may slow the progress of the disease and prevent complications. Following are some things the patient can do to help reduce acid reflux and strengthen the LES.

    * Avoid eating anything within three hours before bedtime.
    * Avoid smoking and tobacco products. Nicotine in the blood weakens the LES.
    * Reduce consumption of fatty foods, milk, chocolate, mints, caffeine, carbonated drinks, citrus fruits and juices, tomato products, pepper seasoning, and alcohol (especially red wine).
    * Eat smaller meals. Avoid tight clothing or bending over after eating.
    * Review all medications with the physician. Certain drugs can actually weaken the LES.
    * Elevate the head of the bed or mattress 6 to 8 inches. This helps to keep acid in the stomach. Pillows by themselves are not very helpful. Wedging pillows under the head tends to bend the body at the waist which can push more fluid back up into the esophagus.
    * Lose weight if overweight. This may relieve upward pressure on the stomach and LES.

    Medications

    A certain category of drugs called proton pump inhibitors are the main tool used to markedly reduce stomach acid. These include Prilosec (omeprazole), Prevacid (lansoprazole), AcipHex (rabeprazole), Protonix (pantoprazole) and Nexium (esomeprazole) taken once or twice a day. All of these are equally effective despite some deceptive advertising. Other acid reducing drugs such as Zantac, Pepcid, Axid, and Tagamet are also available. Reglan (metoclopramide) is a drug that can strengthen the LES and so help.

    Surgery

    Certain patients with GERD may need surgery to strengthen the LES. This type of surgery is called fundoplication. It is now done by laparoscopy. Laparoscopy is minimally invasive surgery, performed with a tiny incision at the naval and a few needle points in the upper abdomen.
    Now what happened that you are unhappy with the results?
  10. #10
    wallock is offline Junior Member
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    Yes, you are correct in that Barrett's can be caused by GERD. It can also be caused by bulima and other things, such as my condition. It is also present in many children from birth.

    Barrett's cannot be cured and only contributes to a higher rate of cancer (even that is debatable, however). It is also an irresponsible way to cure the vomiting in my condition (as I recently found out, again from my doctors and research).

    I was told I needed the surgery because I had Barrett's which, as it turns out, is NOT a reason to perform the surgery as my new doctors have told me.

    In all honesty, the surgery has wrecked my life to an extent that I cannot begin to describe. Put it this way, you cannot burp or vomit after this surgery, therefore, all that gas and pressure has to head in another direction, 24 hours a day.

    It is even more upsetting when I know it wasn't necessary - the reason I am posting here. If it were necessary, I wouldn't have thought twice about posting here even after the complications I have had.

    Hope that helps clear things up. Thank you all so much for your time. Looking forward to hearing from you.
    Last edited by wallock; 02-17-2006 at 07:16 PM.
  11. #11
    rmet4nzkx is offline Senior Member
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    Quote Originally Posted by wallock
    Yes, you are correct in that Barrett's can be caused by GERD. It can also be caused by bulima and other things, such as my condition. It is also present in many children from birth.

    Barrett's cannot be cured and only contributes to a higher rate of cancer (even that is debatable, however). It is also an irresponsible way to cure the vomiting in my condition (as I recently found out, again from my doctors and research).

    I was told I needed the surgery because I had Barrett's which, as it turns out, is NOT a reason to perform the surgery as my new doctors have told me.

    In all honesty, the surgery has wrecked my life to an extent that I cannot begin to describe. Put it this way, you cannot burp or vomit after this surgery, therefore, all that gas and pressure has to head in another direction, 24 hours a day.

    It is even more upsetting when I know it wasn't necessary - the reason I am posting here. If it were necessary, I wouldn't have thought twice about posting here even after the complications I have had.

    Hope that helps clear things up. Thank you all so much for your time. Looking forward to hearing from you.
    And what have you changed re your diet so that you are not gassy all the time? What is the condition you were born with? Barrett's is common and often asymptomatic, it is the body's response to the constant exposure to stomach acid, making it like the cells that line the small intestine which are constantly exposed to stomach acid.
  12. #12
    wallock is offline Junior Member
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    My current GI doc has me on a few different meds that are helping and we have tried everything from gluten free to lactose free diets. The condition has never been diagnosed, other than IBS (but that likely wasn't the cause of the vomiting). Barrett's has no real signs of being present, it was caused by the vomiting or could have been there since birth.

    At any rate ....

    Do you think I have any case at all? On my GI Docs notes that I have it says the surgery was 'very questionable' and others have expressed the same thing to me. I am a young man (22) and everyone I speak to about this says it just wasn't something you do in my case.

    Again, if the answer is 'NO, you don't have a case', that is fine. I would just like to know if I do and what the odds are that a settlement occurs (I don't want something long and drawn out).
  13. #13
    rmet4nzkx is offline Senior Member
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    Quote Originally Posted by wallock
    My current GI doc has me on a few different meds that are helping and we have tried everything from gluten free to lactose free diets. The condition has never been diagnosed, other than IBS (but that likely wasn't the cause of the vomiting). Barrett's has no real signs of being present, it was caused by the vomiting or could have been there since birth.

    At any rate ....

    Do you think I have any case at all? On my GI Docs notes that I have it says the surgery was 'very questionable' and others have expressed the same thing to me. I am a young man (22) and everyone I speak to about this says it just wasn't something you do in my case.

    Again, if the answer is 'NO, you don't have a case', that is fine. I would just like to know if I do and what the odds are that a settlement occurs (I don't want something long and drawn out).
    There is not enough evidence that the surgery was not indicated for Barrett's
    Try a low sulfur diet, avoid processed soy products, cal/mag/zinc (3-4 times a day), virgin coconut oil or coconut proudcts, small meals, no carbonated drinks, ask about a medication called Provigil it may help better than traditional GI meds.
  14. #14
    wallock is offline Junior Member
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    Thanks,

    I am not quite sure where you are getting that info... let's assume that my new doctors are correct about the surgery not being standard practice and it being unecessary. Is that enough to try and take this to the next level.

    I appreciate your help with diet tips, but I have tried them all. I go to the doc twice a week or so to try and figure this out.
  15. #15
    loveumms is offline Member
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    Just to throw another idea into the mix as to why the surgery would be indicated.

    Nissen fundoplication wraps a portion of the stomach around the esophagus - it is primarily used for GERD that has not responded to medical therapy (as others have stated).

    Just for your info - in GERD, part of the issue is the gastroesophageal sphincter (GES) tone is not high enough. At the junction where your esophagus meets your stomach there is a sphincter that prevents stomach contents from being refluxed into your esophagus. The cells lining your esophagus are not used to seeing the acid/bile that is contained in the stomach and over a period of time, being subjected to these caustic fluids causes them to change. This change is visible under a microscope taken from biopsies - that is why many patients with chronic GERD have upper endoscopies every so often. Barretts esophagus is a very serious diagnosis b/c it signifies the cells have become pre-cancerous.

    Like you said, many can remain asymptomatic even though they have GERD or they might have these changes for a different reason.

    OK -fundoplication tightens the GES so that the contents of the stomach have a much more difficult time getting into the esophagus. Even though I could not find any literature about fundoplication curing persistent vomiting, it would make sense that tightening the GES would help prevent stomach contents from coming up.

    You decided to have an elective surgery - meaning the surgery was performed to correct a condition that was not life threatening. I'm assuming the surgeon didn't tell you that you would die if you didn't have the operation. All they did was recommend that the surgery may cure your vomiting (has it?).

    What people don't understand is when they go to the doctor they are receiving an educated opinion. It is not the absolute ... you are in charge of your medical care and you can at any time refuse to have something done if you do not agree. Yes, doctors are trained to give you advice and they are bound to give that advice in an honest and just manner but, it is still just advice. The doctor is supposed to give you the information (pros and cons) of their advice, and then let you make the decision.

    Furthermore, if you go to two different doctors they might give you different opinions, especially if you see two different doctors for the same condition two years apart. What might be a reasonable treatment in 2004 might not be a reasonable treatment in 2006 - medicine is constantly changing.

    As far as the side effects - I'm sure you signed consent that stated all the possible outcomes of the surgery. This summer I worked with one of the leaders in minimally invasive surgery and saw several of these procedures performed. I was also present with the same doc in clinic when he explained to the patients what could happen as a result of the surgery - both the good and bad. I remember him specifically discussing the 'burping' issue with patients and he told them there was a possibility of having to reverse the surgery if they could not tolerate the side effects.

    I am a little confused with your statement: "Put it this way, you cannot burp or vomit after this surgery, therefore, all that gas and pressure has to head in another direction, 24 hours a day". Wouldn't that be the whole point of you having the surgery performed - to stop the vomiting?

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