THINGS YOUR SURGEON WANTS YOU TO KNOW

My name is Dr. Chris Raynor. I am an orthopedic surgeon, sports medicine specialist. Having practiced for over ten years now, I have a few patient tips and issues regarding what I do that I’d like to share with the general public. Hopefully, in shedding some light on these subjects, I can make people’s visits with me (or with other surgeons) go a little more smoothly.

One of the first things I need everyone to know is that…

I’m busy – like REALLY busy. I can see anywhere between 50 to 70 people in clinic a week, sometimes more. I’m on call at least one day a week, and one weekend a month. A few days a week, I am in the OR, operating on about three to four people each time.

I’d say on average, I work about 80 to 100 hours per week.

The take away? If things don’t happen for you in the expeditious fashion that you were expecting, it may be because of a myriad of other factors that lie outside my control – government funding, hospital cutbacks, staffing issues, etc.  I can assure you, I’m not trying to torture my patients with long wait times and unsatisfactory care.

Typical OR wait time (for me) is about six months, and that’s AFTER you’ve had your consultation. Total time from injury to getting fixed could easily be a year or longer. Again, for other surgeons/specialists I know, the wait is longer still. So if you’ve been told to expect a call from my secretary to book you an appointment, if she doesn’t call you the next day or even the next week, don’t worry. It’s because your appointment isn’t going to be immediate. She WILL get to you.

Also, expect that when you come to see me, you might be waiting for fifteen, thirty, forty-five, sixty minutes or longer. I’ve had people wait up to three hours in my office. Now you’d think it would be a relatively straightforward thing – just book the clinic and see people in a timely manner, but it’s more complicated than that. Sure, if I only booked ten people a day for a clinic, I would have lots of time to talk to everyone, and lots of time to allocate to each patient’s visit.

The thing is though, seeing ten patients per clinic would mean you’d wait years for your appointment. The deal is, you either wait over the long term, or you may have to potentially wait on the day of your appointment. I know which one I’d choose. Plus, if you know to expect it – and I’m telling you now, expect it – you can plan for it. Bring work with you, or a book. Take the appropriate time off work. Hire a babysitter. For other tasks you might want me to do – like filling out return-to-work forms, etc. – I get to them as soon as I can, but as you might imagine, there will be other items that take priority.

You need a referral to see me.  I know, this is a pain, but because I’m a specialist, I’m trained to be really good at solving only certain problems. The more patients I see with ailments that DON’T pertain to this specialty, the more my time is wasted, and the longer it will take for people I SHOULD be seeing to get an appointment. The family and emergency doc’s job then is to sift through potential patients, and only send me the ones they think I can help. While it may be inconvenient for you to have to see your family physician first, it really benefits you (and everyone else) in the end. Your wait time otherwise would be even longer than it is now.

In order to assess you properly, I will need updated imaging – x-ray, MRI, and/or an ultrasound. Surprising as it may sound, I’m a surgeon, not a superhero, and I can’t see inside your body. While I typically make an initial judgement based on experience before looking, I use the imaging to solidify my suspicions. My secretary will need both the referral and updated imaging before she will book your appointment with me. Last year’s imaging simply won’t do. Things change over time, and you wouldn’t want to come to see me after months of waiting, only to have me say that I can’t help you because I don’t have the proper imaging. Suddenly, the time it takes for you to get fixed is extended by five or six months, and I know you wouldn’t appreciate that.

Recovery is in large part YOUR responsibility. And it’s not going to be easy. It’s going to be very difficult. If instructed, get moving as soon as possible. Active physio. You can go to anyone you want, but I feel that finding someone who encourages and helps you to get moving on your own – even though it may hurt like heck – is the person you should want to see. Recovering from an injury or surgery is no small feat. It can be a very difficult and painful process, and you WILL be tempted to just sit back and let someone else do all the work. Take my advice – don’t. Manual therapy, ultrasound, TENS – while these have their place – the idea is for YOU to move the affected appendage through as great a range of motion as soon as possible. You are going to have to do work on your own and work through the pain. We’ll talk more about pain in a minute.

I practice stoicism for my own peace of mind. Some people say that all surgeons are heartless bastards. Keep in mind that we deal with suffering people all day – sometimes in life or death situations. That means WE have to be strong. Because of this, it may seem like we are emotionless or insensitive, but if we let our emotions take over every time there was a sensitive issue or case, we would never be able to do our jobs. We need to be clear-headed and rational. When you come into my room, you are a procedure. That allows me to do what I do. When shit hits the fan in the operating room, I need to be able to function.

We encourage you to ask questions. Having surgery is a complicated thing and a difficult time for you and your family. Undoubtedly, you will be given lots of information that is new to you, and you will have questions about it. As the questions come to you, it’s a good idea to write them down, that way you will have them ready when we come to talk to you. The more informed you are, the better you can make good decisions, the better your outcome likely will be, and we both want that.

Second opinions are fine, but using Dr. Google isn’t the best idea. We know that the moment we give you a diagnosis – especially if it’s not what you expected or wanted to hear – that you are likely going to be looking it up online. And while we want you to be informed about your condition and your upcoming treatment, the internet isn’t the best place to look for specific advice. No one is policing the advice that is given there. Getting a second opinion from another board certified surgeon who has trained in his or her field for many years is a much better idea.

Surgery starts even before you go into the operating room. If you smoke, stop smoking as soon as possible. The longer you are smoke free, the better. Even a few days or a week is beneficial. If you are not exercising, start a walking program under the guidance of your physician. If you are not eating healthy, that’s something else you should do. Your overall health directly affects your recovery post surgery and how likely it will be to have a complication.

Complications happen. Pneumonia, urinary tract infections, wound infections, unexpected bleeding, are all types of complications that can happen under even the best of circumstances. Other things happen because a surgery is difficult. Remember also, that surgeons are not robots – we are not perfect. If you are worried about complications, be proactive about it. Ask your doctor what could happen, and how those particular complications are treated. Better still, ask what the best ways of preventing them are. Knowing your risks will help to allay your fears, and rest assured, your surgeon likely already has a plan in place for anything that could happen. It’s also very important to follow instructions post-op very carefully.

When I tell you to do something or NOT to do something post surgery – I mean it. Like don’t get the wound wet for at specified length of time, like move or don’t move, like DON’T take the bandages off (don’t even let the physio take the bandages off) for however long I say. So many people – SO many people – say whoops doc, I got my knee or my ankle or my shoulder wet, but you know, I had to have a shower. But I told you not to, and I don’t say these things just to hear myself talk. I say them because I want you to heal properly. If that means NOT having an actual shower and washing the rest of your body with a washcloth for a little while, then so be it. You could end up with an infection.

Pain is inevitable. That is, you are GOING to have it, and there is a BIG misconception that pain medication will erase it completely. In fact, it is almost impossible to take away ALL of your pain without other (sometimes dangerous) side effects. The main objective of pain management is to DECREASE the pain (not completely remove it) so that it is tolerable and you can walk around, shower, and participate in therapy the that you need. I want you to get better as quickly as possible, and you taking an ACTIVE role in your therapy is the best way to do it.

So there you have it, a few things that – as a surgeon – I want you to know. I hope these tips that I’ve provided help you to be a better patient, and help you to have a better surgical experience.

That’s been a word from me (Dr. Chris) – #notyoureverydayortho 🙂

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