I struggled with a number of issues related to my most recent surgery (a partial quadriceps tendon repair) by you, Dr. A and your resident. I initially thought about raising these issues at my next appointment but I realize how your clinic time is limited and therefore I've written this letter. An additional letter related to matters outside of your control and not concerning you is also being prepared to be sent to the hospital.
Let me begin by saying that I have great respect for you as a surgeon and have appreciated that you are a doctor who listens to his patients. I cannot however say the same about the resident you were working with on Sunday, March 31, 2013 at the hospital on your orthopedic cases.
I further appreciate that when undertaking last minute surgeries it must be extremely difficult to coordinate and complete all the cases. That being said, this was by far the worst experience I have endured from beginning to middle to end during a long list of surgical experiences.
These issues relate exclusively to your resident, the surgery, aftercare orders and instructions given prior to my release.
When I received the call on Sunday March 31 at 10:30AM asking me to come to the hospital, I was instructed to bring my health card, my blue card, and a toothbrush. When I arrived at the hospital shortly before noon I was directed up to the 7th floor, asked to change and the nurses started intravenous therapy (I.V.). A few hours later the resident showed up and asked me to sign the consent and an additional form for permission to use blood products should they be required. He then inquired about any medications and previous surgeries. I explained that both were a pretty extensive list but that they should be in my file given that I had had knee replacement by Dr. A in mid-December of 2012. When the resident returned, he advised me he was unable to locate any of this information and asked that I write out the entire list of medications, dosages and use. A nurse was kind enough to write the list of relevant surgeries for me.
I had to stop the resident in order to supply the list to him. This resident was rushing through everything and lacked the ability to stop, listen or even give me, the patient, an opportunity to speak. This was an ongoing issue every time I was forced to deal with him both before and after the surgery.
I was extremely uncomfortable with the fact that I did not get the opportunity to speak to or even see you, Dr. A, before, during or after the surgery. The most upsetting part of this was at 8PM when I was taken to the operating room and, as I lay on the operating table, everyone was in the room, including the 2 anestiseologist, the resident and several nurses, but not you Dr. A. Once they had me strapped to the table, oxygen mask in place and medication being injected, I asked the staff to confirm that you were coming and would be present in the room throughout the surgery. Having had dozens of surgeries in the past, this is the very first time the surgeon has not been present prior to me being placed under anesthetic, which was more disturbing then words can express.
Following the surgery I awoke experiencing a level of pain that exceeded what I had endured after the knee replacement or the tearing of the quadriceps tendon. Whatever the medication instructions were, they failed miserably and were offering even less pain medication then I take at home to manage my neuropathic pain. I was offered 20mg less of my Oxyneo, little oxycocet and no lorazepam at night. I was in so much pain that I was crying uncontrollably, and when the nurse finally came I was told "this is all you can have for the next 4 hours so don't even bother asking." The pain was so severe the woman in the bed next to me was begging for better pain control on my behalf. I was in so much pain I could barely get a word out.
Prior to the surgery the resident inquired if the pain service had meet with me (during the 8 hours I waited for surgery) I said no and was advised they would meet with me tomorrow prior to my release. They never did.
The next morning I unwrapped the wound to take a look and to clean the iodine on the leg. In doing so I discovered the wounds and the entire area had not been cleaned following the completion of the surgery; the entire knee was filthy and covered in caked blood. I have never seen a wound left in such condition following a surgery. Later that morning when the resident appeared I immediately inquired what the tendon looked like, how the knee looked, and so on. I was told that “it has been fixed, there will be no further problems, I can go ahead and weight bare without concern as there was no way I could damage the work that was done.” I was then informed I would be released shortly. I instantly expressed concern about being released due to a number of issues, including the fact that I live in a townhouse which requires climbing 15 stairs, that my mother is on crutches, so I had no help should I require it, and the level of pain I was experiencing, and the fact that the surgery had taken place at 8PM the night before. All this information fell on deaf ears. On top of all of this, the resident offered no postoperative instructions other then my needing to make an appointment two weeks later for the staple removal.
When I called to make an appointment in the fracture clinic the morning of Friday, April 5, I was asked to leave a message, I left my name, phone number, blue card number and reason for the appointment. To date I have received no return call.
I know I haven't known you, Dr. A, for long, but because my former orthopedist, Dr. C, has great faith in you and I respect and trust his judgment, I was willing to entrust you with one of the most important surgeries of my life and my continued care relating to those issues. This last experience has rocked that trust and while I am aware and appreciate that this is a teaching hospital, some students will always require more supervision than others. The resident assisting you on March 31, 2013 was one of those students, and I didn't deserve the less than adequate care I received. I can only hope that any damage done will not cause me long term problems.