NARRATIVES
TALK TO A
ADVICE
Established April 15, 1995
University of West Georgia Disclaimer
It is now almost a year (September 20, 1994) since I had corrective surgery for an AAA. On the one hand I am happy to be alive and recognize that having it found on a routine annual physical examination was luck of the first magnitude. On the other hand, the quality of my life has yet to equal what it was prior to surgery.
As a heavy smoker for 46 years (I was 64 years old when the surgery was done) some of my problems may be related to the damage I did to my body as a smoker. I walk 4 miles about 6 mornings out of each week. But it took almost 8 months to get back to that level and I seem to have no stamina beyond that exercise. I have an abdominal "pouch" about waist high on the right side that I was told would gradually disappear, but it has not. I have frequent pain in that area which I have been told is in the abdominal wall and is probably muscular or a nerve pinch.
I am also partially impotent since the surgery, probably brought on by the 2 blockers prescribed following surgery. The explanations that I was given for needing the blockers was:
There was an echo pulse in the abdomen prior to
surgery and one of the blockers was to suppress that pulse.
The other blocker was to keep the blood pressure low.
My arguments with the medications are:
The echo pulse was, supposedly, a function of
the aneurysm so I do not understand why that blocker was needed
post-surgically;
I have always been a low blood pressure type so why was the other
blocker needed?
Yes, I understand that the surgeon needs to protect his backside and so prescribes to be on the safe side. On the other hand, why did I not have something to say about what medications I would receive?
When we could not correct severe nausea and constipation several weeks after the surgery (both lasted for more than 3 weeks), I suggested that the blockers might be responsible. In conversation with the surgeon the physician determined that I could discontinue the echo-pulse suppressor. Within 48 hours the nausea was gone and the constipation was broken. Two weeks later, in consultation with my physician, I also stopped using the blood pressure suppressor.
I was told that the impotence would disappear, but it has not. Luckily, it is partial. I am able to function sexually except for climaxing. That is a lot better than being incapable of being intimate with my wife.
My questions include:
If the doctors know of the side effects of these
drugs (I looked them up via CompuServe when the symptoms occurred)
why do the doctors not inform the patient of what the medications
are for as well as the potential side effects and why did I not
have the option to not be medicated or to use alternative
medications?
Do the doctors, who may not share my feelings of the importance of
the sexual components of my life, or who may assume that at my age
sex is of trivial importance, not ask the patient about their
priorities?
What I am trying to say is that I do not need a God/Surgeon, would much prefer someone who recognizes their limitations and is willing to determine my priorities and explain the options and risks so that I could have input into the decision making process. I might very well have opted for the exact treatment that was selected for me, but I doubt it. More likely I would have suggested that they monitor for the echo-pulse post-operatively and only administer the blocker if it developed, along with a much shorter medication time for the blood pressure suppressor.
As for the abdominal pouching / nerve-pinch (?) / muscle pull (?), I have great difficulty believing that the doctors, in particular the surgeon, can not give me a more succinct answer regarding the cause(s), and perhaps suggest some kind of exercise that might correct or alleviate the condition(s).
So I am happy to be alive, and thankful to the physician who discovered the AAA and to the surgeon whose skills corrected it. But I am annoyed as hell that at the age of 65 it appears that I am being treated as someone who can not understand (because I am not a doctor?) or can not be trusted to understand if any of my current problems are functions of errors made. No, Doctors, all Americans are not interested in taking you to court. Most of us only want a clear definition of the problem(s), a reasonable prognosis, a chance to understand what is going on in our bodies so that we do not speculate on non-relevant possibilities.
So, am I making sense or am I merely complaining about what is common? Can I expect the impotence to go away after X more months or should I adjust to a permanent change in my sex life? The physician came up with the lovely idea that it is probably psychological (surgery and beta-blocker therapy followed by partial impotence is obviously merely a coincidence) and will not authorize a visit to a urologist (I belong to an HMO).
Will the pains and the pouching go away over the next Y weeks or should I accept the fact that I must wear a support belt whenever I lift more than 20 pounds, although it also occurs (the pain, that is) sometimes when I get into my car?
Conclusion: I did a poor job of researching the surgical and post-operative procedures. I should have asked many more questions of both the physician and the surgeon and, if the surgeon did not respond to my liking, chosen a surgeon who did.
Still, it is good to be here to complain!
Discussion, comments, or questions: Irv Sarnat or Judy Skotzko
© Copyright 2006 Irv Samat
All Rights Reserved - Fair Use
acknowledged
