This may be a useful point. I have had multiple surgeries whereby when put to sleep I was thinking a specific procedure was to be completed, yet when I was conscious again...sometimes a day or two later I find that something totally different was done.
I.E. with OS #1 After my initial TKR, I had swelling, hot, stiff knee. MUA's failed. 40 degrees of flexion. OS indicated he would replace the joint. During surgery he took a culture and it was negative. He carved out a lot of scar tissue and closed me back up. 1. Good because I learned on KG later that the procedure is to remove the joint, 6 weeks of I.V. antibiotics with antibiotic spacer in joint, then new TKR after 8 weeks. Bad news because he failed to diagnose AF. Early treatment would have limited the complication. Revising the scar tissue only caused the scar tissue to return with a vengeance. He prescribed no PT that would have limited the AF. I knew nothing of the new procedures necessary to treat AF and obviously this doctor did not also. He then told me he could do no more for me.
OS #2 He told me again I was infected. This guy thought he was God Almighty. He bragged of over 6000 TKR's. Told me if he removed the TKR, took samples from inside my leg bones, he would know exactly what the infection was and treat it with specific antibiotics. All this despite multiple tests for infection with everything from blood tests, fluid samples, tissue samples, nuclear 3 phase bone scans, and a 9 day bout with pneumonia that was blamed on the infection. I awoke with no knee. I had a spacer as discussed. I was supposed to have a diagnosis in 2 wks post op. All cultures came back negative. He left me on vancomycin for 13 wks causing havoc with my immune system. I was supposed to have the joint put back in after Christmas (8 wks post op). Six months later I am still hobbling around on an antibiotic spacer with my knee stiff, and my wound looks like he let the janitor close the wound. He keeps telling me he can't put the TKR back in because I need a plastic surgeon to do a flap (skin graft because skin on my knee has no blood flow and is dying). Plastic Surgeon can only do the surgery on a Friday in his hospital and my OS #2 only works Monday thru Thursday so time keeps passing with no resolution.
OS #3. I finally take the hint that OS #2 is scared he took out a completely healthy TKR and is ignoring me in the manner of my mother in law thinking I will go away if he pretends we never met. OS #3 who just happens to be my back and shoulder OS. He sent me to OS#1 because his previous clinic would not allow him to do knee revisions. He went out on his own a year after my first TKR. He does several TKR's. First one i thought I was getting a new joint. The knee was too "inflammed" so he cleaned it out and put a new antibiotic spacer in the knee. Another six weeks of vancomycin directly into my heart thru a pic line. Only good news my knee surgery site improved due to skills of OS #3 and his closing the wound.
OS #3 states he is putting in a flexible hinged joint that will give 60 degrees flex maximum due to all of the bone loss from 8 months on an antibiotic spacer which floats between your upper and lower leg bones. Each step I took while very painful, had the added feature of grinding off the ends of my leg bones. I awaken to find out that he heeded my pleas for a fully floating TKR (he was afraid that with no patella, if he did not put a hinged joint in my knee would be unstable. I disagreed because I had dealt with no knee cap for 29 years). I was happy that I did not get what he stated he would put in.
OS #3 does another TKR 3 months later. No flexion. He changes tendon lengths, releases my quad muscle and turns it, and changes the spacers in the TKR to give me more flexion. Not what was supposed to happen. He was supposed to remove scar tissue. He did not saying it was inches thick and he was afraid my knee would be unstable. These are all full blown surgeries with the pain that goes with any patient that has a high tolerance for pain medication hoping that an anesthesiologist who has not even had his/her tonsils out will understand what a successive TKR will cause.
OS #3 does another TKR. This time he removes the TKR, cleans out as much scar tissue and again changes the lengths of the spacers to allow more flexion. He does not clean out all of the scar tissue as discussed. My flexion is still less than 60 degrees after aggressive PT for 2 hours a day or more, five days a week for six wks after each surgery. His diagnosis is still infection....I am getting him to realize scar tissue is a problem. The problem is he does not administer a simple anti-inflammatory and now I have a new pain.
I find that due to so many surgeries, I am now growing bone in my scar tissue. The space he created caused a complication called Heterotropic Ossification.
I apologize for the diatribe, but I have come to the very real understanding I must make sure I order that if the surgical procedure changes, they should close me up and let me decide to proceed with the next procedure.
I see so many patients here who are told they are getting a procedure only to wake up and find something totally different is done without their consultation. It is very unsettling to not know what is going on while you are unconscious. I would feel better about it possibly if they consulted my wife regarding the proposed changed procedure. They do not. Moreover, my wife does not spend countless hours roaming the halls of KG College finding out what complications are possible. She probably would have to rely on the doctors recommendation because of her lack of knowledge.
I actually had a back surgery a little over 3 years ago. After surgery the neurologists hook up electric leads to the patients entire body to test nerve function and make sure there is no paralysis. Evidently, I am still under anesthesia and when they test my nerves, the mouth guard they placed in my mouth pops out and I bite thru my tongue severely. I am bleeding profusely and ingesting blood which is actually filling my lungs. OS #3 rushes out of his next surgery back into my OR...stuffs a breathing tube down my throat after trying to suction the blood. He sews up my tongue and puts me in ICU sedated for four days.
The point is I was unaware that any of this was going on. I actually awoke five days after the surgery..not the day of the surgery with no memory and my tongue swollen out of mouth.....very uncomfortable.
With my previous posts on this thread....two OS diagnosed my 14 year old daughter with needing an LR and having Chrodomalcea. One of these was the infamous OS#3 from my story. The second was the OS whose partner 15 feet away stated that an LR would ruin her knee.
We must make sure we ask them to specifically detail our surgery procedure and demand that if something changes, we have a process in which we can have some sort of control with the decision that will affect the rest of our lives.