pissed off at my doc

[mellowrama]

hello,  as many of you know I've been struggling with my BAHA device since I had in implanted  NOV of 2009 Dr. Stanley Baker at Hough Ear Institute in OKC.

Not only did the device not seem to work correctly, but I've had many issues concerning the surgical area of the post.  I've traveled (8 hour drive) see him at least 3 times with complaints of rawness, crusty, sore, and bumps developing around the area.  He always, says it looks normal.  Meanwhile, I've been seeing a skin doc, he last week saw me again and said those little bumps are cysts  (I thinks scars) and he could remove them...this kinda annoyed me as Dr. Baker didn't seem concerned about them.  My skin doc also took a culture, and now I find out I have Staff infection!  This seems too much for me that the ENT surgeon is saying looks normal...and I'm concerned about having an infection post one year later!  I never had this much trouble with the major surgery "translab"!

What to do?  File a complaint?  I'm already scheduled to see a new ENT in my area asap.

melinda

[leapyrtwins]

Wow, Melinda, very sorry to hear this 

Have to say though that your previous posts about your BAHA sounded like you were having issues.

I've never known an ENT to implant BAHAs - at least not here in Illinois.  Typically neurotologists implant BAHAs; my ENT didn't even know what one was.

Don't have any advice for you regarding filing a complaint, but IMO you shouldn't go to another ENT, you should go to a neurotologist.

Just my two cents worth.

Hope things get better soon.

Jan

[mellowrama]

Ok, now I'm reviewing DR. Baker and he is a Doc of Otolaryngology

[Kencutus]

I had a few cyst growing around my surgery site a few months ago.  I can relate to that problem.  I had more in the left side than the right side.   My surgery was last year.  My doctor popped a few cyst and cleaned up the area and found no infection.  He did prescribed oral anti-biotic for 10 days just to be on the safe side.  As for keeping the site clean, I used saline water with Q tip or cotton ball and then I use a dab of Bracitravcin Plus on a Q tip to put around the outside of the abutment on the skin.  You don't want to use hydrogen peroxide too much because it can cause skin irritation.  It works for me.  I hope yours will clear up soon.

[dalern]

I agree with Jan about going to a neurotologist.  That is different than an otolaryngologist.  An otolaryngologist is an ENT.  Otolaryngology is just the medical name.  However, that being said, I do know that at UCSD, there are many residents that go through the ENT rotation with Dr. Harris and they do not become neurotologists, but just ENTs.  They are trained in the procedure of BAHAs.  I have a friend whose daughter trained under Dr. Harris.  She has an ENT practice in Colorado and she does do BAHA placements.  She trained under the best, so I would not have a problem with someone of her caliber and experience performing the procedure.  So, it all comes down to the training and experience.  Now, if you were having AN surgery, I would hope an ENT would not perform that!
~Dale

[mellowrama]

To clear things up - I already had AN translab surgery with Dr. Rick Friedman and Dr. Shwartz at House, post failed radiation...the surgery went as well as I could hope for... 
What I'm upset about is the BAHA surgery - and the doc that did that is obviously "sanctioned" with Cochlear to do BAHA surgery - I was told prior to surgery he had done over 50 BAHA implants, and had the impression via the posts here that BAHA surgery was a simple and almost routine, with great results. 
Now, I'm questioning that impression I had and wished I made the trip to LA to see Dr. Friedman.  I think its important to share my story for others to learn from it.
I have not been able to wear the BAHA without it exasperating the situation on my skin/head...this has been communicated to Dr. Baker numerous times and during examination he always replied that it looks fine...well, now its a fact that it is not fine, thanks to my Dermatologist getting a culture.  I have Staff infection (& cysts), don't know how long and have felt like crap.  I put a call into Cochlear and I'm waiting for their response as I feel that the Dr's response was inadequate.
The doc that did the BAHA -"R. Stanley Baker, M.D., completed a one-year fellowship at the Hough Ear Institute in 1988 and immediately joined Drs. Hough and McGee in practicing adult and pediatric otology and neurotology at the Otologic Medical Clinic. His clinical interests include hearing and balance disorders, ear diseases, facial nerve conditions and cochlear implant evaluation and surgery. He is currently serving as the principle investigator in Cochlear Corporation's Nucleus CI-24m cochlear implant clinical trials through the INTEGRIS Cochlear Implant Clinic. He has also worked on research projects involving middle ear implantable hearing devices."

Meanwhile, I'm scheduled to see Dr. Karl Horn in ABQ (otolaryngology) to followup on related issues to the BAHA and Tinnitus. 

I'm venting a bit, I would appreciate advice on how to respond to Dr. Baker (BAHA) about his services, and possible to Cochlear...would you be upset?

[CHD63]

Melinda .....

What bothers me about this is the fact that the doctor blew you off.  Any patient coming in with complaints such as you had deserves to be listened to and followed through to a resolution of the problem.

Here's hoping the new doctor will be on top of things and can resolve this quickly.

Clarice

[Jim Scott]

I would appreciate advice on how to respond to Dr. Baker (BAHA) about his services, and possible to Cochlear...would you be upset?

Melinda ~

Yes, of course I would be upset, as would any normal person. 

On that basis, I would certainly send a letter to this physician.  Take your time composing it, remain completely civil , be succinct and don't make accusations.  I've had to write such letters in the past (Not AN related) and I always use a 'more in sorrow than anger' approach.  Let him know that he came highly recommended and that you had high expectations but have been very disappointed with his care, in this instance.  Don't call him incompetent, just 'disappointing'....'deeply disappointing'.  This leaves him little option but to apologize, even if it is perfunctory.  Of course, correctly assuming he's now lost you as a patient, he may ignore your letter.  Whether or not he does that will depend on his ego and his integrity, neither of which you can do much about.

I would definitely send a missive to Cochlear to politely inform them that Dr. Baker proved to be somewhat below the standards for care you expected from  a physician closely associated with their company. Again 'more in sorrow than anger' often gets a much better response that flat-out complaining or too-vague complaining. I'm sure Cochlear will appreciate being informed about this doctor.  If not, they should be, although they may not do much about it unless you're one of many BAHA patients sending them complaints about Dr. Baker.

I'm sorry you had to go through these hassles with your BAHA implant.  As far as I know (I don't use a BAHA) this is quite unusual. I trust you'll do better with your new doctor.

Jim

[leapyrtwins]

First and foremost, Cochlear does not "sanction" doctors to perform BAHA implants.  The doctors that are listed on their website are docs that do BAHA implants - they are NOT endorsed by Cochlear. 

Second, BAHA surgery is very simple - had mine while wide awake with only local anesthesia and could have literally jumped off the table in the OR and walked out of the door when it was over.  The surgery is almost always "routine" and the healing is usually swift and without complications.

However, doctors can't guarantee anything.  Patients' results can vary - just like they vary with AN surgery - and for some reason you have had more than your fair share of problems.  Is it Dr. Baker's fault that you had "complications"?  No; nor is it your fault.  Unfortunately it's just something that happened - and it's perfectly understandable that you are upset.  In your situation, I too would be upset.

Although Dr. Baker had no control over your healing - or lack thereof - I would agree that he was not proactive in treating your issues and definitely should have done something about your infection, your cysts, and the fact you told him you "felt like crap".

Last, but not least, there was no logical reason for you to travel all the way to LA to have a BAHA implant.  Many docs do them every day and many patients have great outcomes.  I'm confident that Dr. Friedman is a wonderful doctor, but he would have had no more control over your  "complicatons"  than Dr. Baker did.  I would expect him to be more proactive though.

It is not fair to give people the impression that only Dr. Friedman is qualified to implant BAHAs - as this is far from the truth.  I realize that you only made that comment out of anger but this statement is a huge disservice to a whole group of doctors.

I agree with you contacting Cochlear.  Jim is correct, they would want to know that a doctor "associated" with their company raised concerns with you.

Jan

[lori67]

Melinda,

Sorry to hear you're not happy with your BAHA.  I've had no big problems with mine and wouldn't trade it for the world.  Well, maybe I'd trade for the upgraged one, since I have the Divino!   

To answer your question, no I would probably not be upset.  Surgery of any type poses a risk.  In your case, it sounds like the staph infection is affecting the skin only.  If it were in the bone or underlying tissue, that would be a bigger deal, but since we all have staph on our skin normally, any open area is a possible site for a staph infection.  Some oral or topical antibiotics, or a combination of them should clear it up just fine.  I did have one icidence of a slight infection around my BAHA site in the beginning, and I took some oral antibiotics and but some Bactroban cream on it and it was better in no time and I have not had any issues since.

I guess we'd all like to think and believe that things are going to go "by the book" with every procedure we have done, but that's just not reality.  All we can do is accept that sometimes things don't go as planned and adjust our sails accordingly.

Hopefully, this problem will be fixed soon and you will start to love your BAHA as much as I do!

Lori

[Funnydream]

Call your local Bar association about the ENT not doing his job and find out what type of attorney you need.

My ENT does do Baha. And tried to push it on me. But I declined. I'm waiting for soundbite to get FDA approval. And I'm living just fine being SSD.

Also those ENTs make a ton of money. Allot more than a Brain surgeon. Google it up. It will make you sick. And I bet its from those simple Baha's. So don't feel sorry for his pocket book.

After I told my ENT that I googled up his income compared to other doctors. He turned white. And he gave me a free office visit.

I talk to all the other people in the waiting rooms all the time. And he knows it. So I guess he wanted me happy.

[lori67]

Funnydream,

Just out of curiosity, why would a lawyer be necessary?  And what does the income of the doctor have to do with Melinda having a skin infection?  I feel like I missed an important part of this discussion or something.

Lori

[dalern]

This is NOT something to litigate.  I am a legal nurse consultant and work on malpractice cases all the time.  Post op healing, or lack thereof, is a known risk and does not have merit for a law suit.  It is irrelevant if the doctor is paid a lot, and I am not sure why your doctor gave you a free visit because you knew about his income.  What's important here for Melinda is to be with a doctor she feels comfortable with.  Dr. Baker may have done absolutely nothing wrong.  I had a brief post op infection that cleared up with antibiotics just a few weeks after my BAHA surgery.  In no way is it the doctor's fault that I had an infection.  I think it is so easy for us to be angry and lash out and become litigious.  That does not make the practice of medicine any better.  I'd like to see us save law suits for truly negligent cases.
Just my 2 cents.
~Dale

[Jim Scott]

Dale ~

I assumed that Melinda's BAHA implant problems were not worthy of litigation and so, considering your profession and experience I appreciate your post on this issue, offering facts and sound advice.

I don't see how a patient having an adversarial relationship with his doctor and using knowledge of the doctor's income as a tool for intimidating him into offering freebies is necessarily astute but then, my doctors have been skilled, supportive, compassionate and borderline indifferent about their fees ("pay what you can, when you can") so, my criticisms regarding doctors may be somewhat attenuated. 

Jim

[CHD63]

As my mother used to say, "You can catch more flies with honey than you can with vinegar."  In other words, all of us react differently to how things are said or done to us ..... but it is always better to be positive than to be negative.

Just my two cents .......

Clarice