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'General Surgery' posts

A patient's experience with the Swedish Digestive Health Network

We recently received this post from a patient who asked us to share her story and her experiences with Dr. Schembre and Dr. Tschirhart with the Swedish Digestive Health Network. Thank you, Yevette, for sharing your story with us!

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Dec 2nd,  2012 I was out of town doing some promotion for work when I collapsed in my hotel room. I went to the local hospital ER.  They found I had a gallstone lodged in my common bile duct. As they attempted to remove this, the surgeon ripped my intestine.  This created a whole host of life threatening problems. After 5 days I was airlifted to Swedish Medical Center in Seattle.  Dr. Tschirhart was assigned my case.  By June I was stable enough for surgery.  Dr. Schembre referred to this surgery as a “Leap of Faith”. There was a team of 4 surgeons involved in this surgery.  Their concern that I may not survive was apparent. I actually said goodbye to my 17 year old daughter before this surgery.  After having me in surgery for only a few minutes he told my family that he didn’t think there was anything he could do for me & that my insides look like paper mache and were very fragile. But he never gave up.  I ended up with 9 different drainage tubes in my abdomen along with a J tune, G tube, every tube possible I think.  When I drank, the fluid would go in and then come out several of the tubes.  Dr. Schembre from GI worked with Dr. Tschirhart to help make my treatment plans. In October I was in a better situation to endure another surgery. Dr. Tschirhart explained exactly what needed to be done & explained the “Best Case Scenario” that he hoped he could perform. Fortunately he was able to achieve what he set out to do.   I ended up with 3 major surgeries and countless procedures.

Finally in December of 2013 they wanted me to go to rehab but I insisted on recovering at home in Marysville. I felt if there was a chance I was not going to make it I wanted to die at home.  Dr. Tschirhart assured me that if I had trouble and had to go to my local hospital he would have me airlifted immediately back to Swedish. As soon as I got home and on my couch I felt better!  I was discharged Dec 18, 2013 after a total of 381 days in the hospital.

Recently (August of 2014) I was able to return to work and can drive too!  I did have trouble this past April when my side split open and went into Swedish ER.  I commented to my friend that I needed to call Dr. Tschirhart so he could come get me.  The intake gal overheard me and said doctors never do that.  I tried to tell her that Dr. Tschirhart would. The ER was trying to gather info as to what had happened to me. My situation is too much to explain so I kept referring them to my file.  I was very frustrated. As they were questioning me I saw this hand come through the door and slowly he walked in. There he was!  I instantly started crying. He immediately had me transferred up to the 10th floor, order CT, medication etc.  He came for me as promised. I knew he would.
 

Dr. Tshirhart always told me  ....

When you should seek treatment for abdominal pain

As a general surgeon, the majority of my practice is spent evaluating patients with abdominal pain and deciding whether the cause of their pain requires surgical treatment. These patients are only a small fraction of the number of people who seek medical attention for abdominal pain. Abdominal pain is fairly common and something almost all of us have experienced. Usually it is not cause for alarm and resolves on its own after a limited course if we wait and treat symptomatically. We have all had a moment however when we wondered whether this time was more serious, and how would we know if it was?

Every organ in the abdomen and pelvis (including the muscles and skin of the abdominal wall) has nerve endings and can cause pain. While nearly everyone has experienced abdominal pain, it is usually self limited and mild. Think antacids for heartburn symptoms, diet modifications for food intolerances, fluids and time for gastroenteritis, stool softners for constipation. While more severe causes of abdominal pain are rare, it is important they are recognized as they may have more severe consequences to health.

Only 15%-20% of people with abdominal pain require surgical treatment (this number increases with age). The most common reasons for surgery are  ...

When a mole is more than a mole

As a general surgeon, I am often asked to evaluate a patient with an abnormal mole (pigmented nevus) or one that has been biopsied, revealing a premalignant or malignant growth.  It is not uncommon for the patient to tell me they either were totally unaware of the lesion or dismissed changes in the lesion over time. 

All skin cancers are not alike, and melanoma, a malignant cancer of pigmented skin cells (melanocytes), is by far the most dangerous of the group, accounting for over 75% of skin cancer deaths in the United States.  This amounts to about 48,000 melanoma related deaths world wide per year. 

Found early, when the lesion is superficial and small, cure rates are high, but as the cancer progresses, it invades deeper into the skin, and becomes far more likely to spread far from where it started.  It is for this reason that  ...

What To Expect When You Are Going To Have Surgery

If you are reading this, and the thought of having an operation is a little daunting, it may be helpful to arm yourself with some useful information. For most folks, the mere idea of undergoing a surgery can be a stressful and confusing time. Many people are still recovering from the surprise that their condition requires an operation, and are unprepared and overwhelmed with the amount of information they are given in anticipation of the procedure. Below is a brief and simplified summary of some of the things you may be told and are expected to understand. Because every surgery is a little different in regard to indications, expectations, risks, and recovery, the guide below should serve as a road map to help you navigate the process.

Most surgeons use the terms preoperative, perioperative, and postoperative to describe the various stages involved, and we will break these down to make understanding them a little easier.

Preoperative

Everything involved in the preparation for a surgical procedure falls under this category. In some instances, this stage is ...

Are you ready for surgery?

For most folks, the idea of undergoing an operation can be a stressful and confusing time. If the thought of having a surgery is a little daunting, it may be helpful to arm yourself with some useful information.

Before any operation, you should have the opportunity to talk with your surgeon. This consultation should include an explanation of why you need a surgery, what other options are available, and what the surgery and recovery entail. All operations have risks and complications and you should learn about them as part of the decision making process.

It is often necessary to perform certain tests or studies prior to your surgery. These are for your benefit so that your surgeon has as much information about you and your situation as possible. Surgeons do not like surprises.

Make sure to follow your preoperative instructions. This is your side of the bargain after you have decided to have surgery. Following directions about medications, fasting (not eating), and other preparation for an operation is essential to making the day go as smoothly as possible.

Some other tips for the day of your surgery include...

Is Robotic Surgery Right For You?

In recent years, there has been a surge in the popularity of robotic surgery. This is an exciting new technology that is being actively used by many specialists here at Swedish. In General Surgery, we have been using a minimally invasive approach called laparoscopy for many years. This allows us to use smaller incisions, giving the patient much less pain and a quicker recovery.  Robotic surgery is very similar.

Here are the answers to some frequently asked questions about robotic surgery:

Are incisions smaller with robotic surgery than with laparoscopy?

No. The incisions are pretty much the same. As a patient, you might not be able to tell much of a difference from the surface.

Do the robotic instruments allow the surgeon to perform a better operation?

Activity after open or laparoscopic abdominal surgery

Every patient who visits my office with a surgical condition has several decisions to make and has a lot of information to absorb and understand.

I typically spend much of our time together describing the condition itself, why I recommend surgery, how I will perform the surgery and any risks involved in the procedure. While this is all critical to anyone’s understanding of their treatment plan, once the decision has been made to proceed with surgery, many patients’ concerns quickly turn to their recovery and what to expect after surgery. Most patients want to know when they can get back to walking, lifting, exercising, and their normal daily routine. While every patient and procedure is different, some generalizations can be made to help you know what to expect.

General abdominal surgery can broadly be separated into two categories: 1) open surgery where a large incision is made through the abdominal wall and 2) laparoscopic (or robotic) surgery where the procedure is preformed through multiple small incisions. Both types of surgery are used for a wide array of surgical problems.

The recovery from these two types can be different. Every patient should ask their surgeon wound care questions, dietary restrictions or signs of possible complications specifically related to their recommended procedure. There will be activity restrictions in the early postoperative period for all surgical procedures.

Many people wonder why we limit activity after ..

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