Author Topic: Who will actually carry out the surgery.  (Read 2099 times)

QRM

  • Jr. Member
  • **
  • Posts: 65
  • Was an architect now stay at home dad
Who will actually carry out the surgery.
« on: December 22, 2008, 12:12:36 am »
I recenly went to the HEI and had a chat with Dr. Brackman, Dr. Feildman, and Dr. Schwartz,  from what I can gather the surgeon work in teams, so in my case, Dr. Schwartz will work with either Dr. Brackman or Fieldman,

One just works on the bone bit and once the tumour is revealed,  the second surgeon jumps in a works on the tumour itself.  or do they swap roles ? Which role is the more critical one? I suppose they are all critical even the guy who steralise the equipment play a major role.

Nearly Xmas its stinky hot here, and lots of fake snow everywhere, we will have xmas a few hours before you lot in the US so merry xmas to everyone.

Rick
2.5 cm x 1.1 cm AN 30 Oct 08  Singapore Gleneagles Hosp.
Translab on  29 Jan 09 Dr. Friedman & Dr. Schwartz of HEI
Surgery a success!! had wonky head for a while and odd tastes
Everyday things are improving and getting back to normal.

Pooter

  • Hero Member
  • *****
  • Posts: 1291
  • The Official Breeze Conjurer - PBW
    • Blog Website
Re: Who will actually carry out the surgery.
« Reply #1 on: December 22, 2008, 10:32:07 am »
The way it was described to me is that the Otolaryngologist will do the opening up and "get you there", while the neurosurgeon will deal with the tumor, then the Otolaryngologist will "close up".  I think they are both "critical" for different reasons.  One should be the expert in the ear area (Otolaryngologist) while the other is the expert at brain-based work (neurosurgeon).  So, they each have a role to play in the surgery and you should be comfortable with both.

That's how I understand it anyhow.  Others could have a different understanding.  :)

Regards,
Brian
Diagnosed 4/10/08 - 3cm Right AN
12hr retrosig 5/8/08 w/Drs Vrabec and Trask in Houston, Tx
Some facial paralysis post-op but most movement is back, some tinitus.  SSD on right.
Story documented here:  http://briansbrainbooger.blogspot.com/

"I must be having fun all wrong!"  - Roger Creager

JohnnyDiaz

  • Jr. Member
  • **
  • Posts: 57
Re: Who will actually carry out the surgery.
« Reply #2 on: December 22, 2008, 11:11:21 am »
I agree with Pooter... For my surgery there was 2 Dr's working as a team. It is my understanding that the team works in 2 hr intervals. In my case my 2 Dr’s had worked with each other before and had a great respect for each other. I look at it this way, for the general stuff - surgery, overall health and facial functions came down to my neurosurgeon. For the balance, hearing, and dizziness went to my ear dr. My ear dr. was very meticulous and that made me feel better while my neurosurgeon was very calm and matter of fact which really made me feel calm during my complications. Hope this helps....
Diagnosed 6/08 - 2.5 cm Left AN
9.5hr surgery 10/7/08 w/Dr. Chandler and Dr. Green Baptist Hospital - Jax, Fl
Post Op Complications - Additional Surgeries 10/12 & 10/13
SSD on Left
7 months later I feel great!!!

Kim Zingale

  • Jr. Member
  • **
  • Posts: 59
    • My AN Blog
Re: Who will actually carry out the surgery.
« Reply #3 on: December 22, 2008, 11:24:02 am »
My doctors told me that the neurosurgeon starts and opens up the head to expose the tumor. He will also remove the part of the tumor in the cerebellopontine angle. Then the otolaryngologist drills out the part of the IAC and removes the part of the tumor that's in there. Then the neurosurgeon comes back and they close it up, etc. Maybe different teams do things slightly differently?

Kim
Retrosigmoid surgery Feb. 9, 2009 at Johns Hopkins with Drs. Tamargo and Carey.
http://adventureswithmanny.blogspot.com

Syl

  • Hero Member
  • *****
  • Posts: 765
  • Forgive me. I'm having an AN moment.
Re: Who will actually carry out the surgery.
« Reply #4 on: December 22, 2008, 12:48:21 pm »
Rick,

In my case, I had retrosig. The neurosurgeon opened and drilled. Once it was time to work on the tumor the 2 ENTs step in and take turns. Then the neurosurgeon steps in again when it's time to get at the tumor on inner side. The neurosurgeon also closes and in my case--stapled.

Had it been translab, the ENT would have opened and drilled and also would have closed.

That's how it was explained to me.

Syl
1.5cm AN rt side; Retrosig June 16, 2008; preserved facial and hearing nerves;
FINALLY FREE OF CHRONIC HEADACHES 4.5 years post-op!!!!!!!
Drs. Kato, Blumenfeld, and Cheung.

Jim Scott

  • Hero Member
  • *****
  • Posts: 7241
  • 1943-2020 Please keep Jim's family in your hearts
Re: Who will actually carry out the surgery.
« Reply #5 on: December 22, 2008, 04:39:02 pm »
Rick:

Obviously, the team approach for AN surgery varies with each doctor.  I had two neurosurgeons performing my retrosigmoid surgery but not an Otolaryngologist or ENT was in sight   I came through the 9-hour operation in splendid shape with minimal complications that soon resolved by themselves.   Oh, along with the scrub nurses (hand-picked by my surgeon) I had a technician (or doctor, I don't recall his title) that was brought in from out-of-town to conduct the nerve monitoring process.  He must have done a fine job because I had virtually no facial nerve damage, even though I had a large AN. 

Let me add this caveat: no AN surgical patient's experience should be taken as establishing a template.  Frankly, I don't think there is one.  Surgeons operate in the manner that they see best for the patient - and for them.  While almost all neurosurgeons work in teams, not all employ the same type of specialist to assist them in the operation, which is their prerogative, of course.   For me, it was the results that counted.  If my neurosurgeon had employed a podiatrist or dentist to assist him, I wouldn't have complained (well, not much, anyway).  As it was, his assistant, a female neurosurgeon and his partner in the medical practice, did a great job.  I believe she did the initial incision as well as the bone-cutting and sewed up my incision. She was the doctor that signed my discharge, 4½days later.  As far as I can see, the absence of any other medical disciplines in the operating room was not a factor.  However, that's one case, one surgery - and one surgery does not a 'standard', make. 

I don't believe the 3 fine doctors involved in your case would mind if you asked who does what during the surgery.  That would answer your question with full credibility....but first, you have to ask.  :)

Jim

4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.

leapyrtwins

  • Hero Member
  • *****
  • Posts: 10826
  • I am a success story!
Re: Who will actually carry out the surgery.
« Reply #6 on: December 22, 2008, 08:17:38 pm »
My surgery was performed by a neurotologist and a neurosurgeon who worked together as a team.

I'm not really sure who did what - although I'm sure I read it in my operative report.

AN surgery is long, tedious, close work (most of it is done through a microscope) and docs need to take turns.  From what I understand eye strain can be a big issue.

Jan
Retrosig 5/31/07 Drs. Battista & Kazan (Hinsdale, Illinois)
Left AN 3.0 cm (1.5 cm @ diagnosis 6 wks prior) SSD. BAHA implant 3/4/08 (Dr. Battista) Divino 6/4/08  BP100 4/2010 BAHA 5 8/2015

I don't actually "make" trouble..just kind of attract it, fine tune it, and apply it in new and exciting ways

cherrypiper

  • Full Member
  • ***
  • Posts: 160
  • Hope is what this is all about
Re: Who will actually carry out the surgery.
« Reply #7 on: December 23, 2008, 01:41:02 pm »
well the neuro surgeon cracked open the skull, got every thing ready, then watched the ear surgeon go in and do his stuff to remove tumor.

in my case, here In Houston, they have their own AN operating room. were 10 folks there. and the Neuro surgeon was in charge. He stopped my surgery about 1/2 way for a potential problem he saw in my vitals......

so that's how my team went...........
10 mm x 2.4mm surgery date 12/03/07

glad to be here

elderbirds

  • Jr. Member
  • **
  • Posts: 77
Re: Who will actually carry out the surgery.
« Reply #8 on: December 23, 2008, 09:56:11 pm »
Mine followed those above, neurosurg opens and does their part, ENT removes the portion in the IAC and neurosurg closes.  I was on the neurosurg. service in the hospital.  Both teams visited me daily, although neurosurg, wrote orders and discharge instructions.  I follow-up uo with both teams, but am followed now by ENT for facial monitoring, hearing etc. and will have anual visits with neurosurg who ordered the yearly MRI.  Hope that helps.
Hope

QRM

  • Jr. Member
  • **
  • Posts: 65
  • Was an architect now stay at home dad
Re: Who will actually carry out the surgery.
« Reply #9 on: December 31, 2008, 09:23:21 pm »
I only ask as it seems only one doctor in the team seem to take all the credit and equally all the flack for any complication, I asked Dr. Shwartz at the HEI, and his reply was if he works with Dr. Brackman, Brackman will do all the work up to exposing the inside of the skull and he takes over the inside the skull, which if i understand it correctly all the issued with nerves etc is actually Shwartz doing, and yet we always hear of Dr. Brackmans wonderful or not so wonderful work.

Maybe its like any office, the big cheese will always take the credit for all the work even if the sidekick did the bulk of the work?

Rick
2.5 cm x 1.1 cm AN 30 Oct 08  Singapore Gleneagles Hosp.
Translab on  29 Jan 09 Dr. Friedman & Dr. Schwartz of HEI
Surgery a success!! had wonky head for a while and odd tastes
Everyday things are improving and getting back to normal.

satman

  • Sr. Member
  • ****
  • Posts: 411
Re: Who will actually carry out the surgery.
« Reply #10 on: January 01, 2009, 10:41:30 am »
wow, i honestly dont know it happened so fast,meaning being rushed to the hospital and operated on the next morning.
the surgery was long,17 1/2 hrs to remove the lemon sized obstruction (8 cm).
just hope this is a better year for all.
kicked my little 8cm buddy to the curb-c ya !

Jim Scott

  • Hero Member
  • *****
  • Posts: 7241
  • 1943-2020 Please keep Jim's family in your hearts
Re: Who will actually carry out the surgery.
« Reply #11 on: January 01, 2009, 02:02:16 pm »
Maybe its like any office, the big cheese will always take the credit for all the work even if the sidekick did the bulk of the work?

Most likely.  I guess it depends on the doctor 'in charge', who, in the final analysis, is responsible for the operation - whether it goes well or not. 

My neurosurgeon, who has a very impressive reputation, locally, didn't hesitate to give his assistant (a board-certified neurosurgeon) credit.  He emphatically stated that she had been 'invaluable' during the 9-hour surgery.  I met her, once.  Nice lady (in her mid-30's) and apparently my neurosurgeon's heir apparent to his practice.  I'm sure they made a great team as I had a very good surgical outcome.  Something else I found both unusual and refreshing was that my neurosurgeon, as I complimented his skills, demurred by giving the 'credit' to God.  Although I'm a Christian, religious beliefs had never entered into any of our conversations and never did, again.  I have no idea what this doctor's faith may be but I was pleasantly impressed by his humility and willingness to share the credit with his assistant and, fundamentally, the Deity. 

Jim
4.5 cm AN diagnosed 5/06.  Retrosigmoid surgery 6/06.  Follow-up FSR completed 10/06.  Tumor shrinkage & necrosis noted on last MRI.  Life is good. 

Life is not the way it's supposed to be. It's the way it is.  The way we cope with it is what makes the difference.