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Ask Dr. Gott 10/12

To operate or not to operate?

    DEAR DR. GOTT: I am an 88-year-old male in reasonably good health. I have no heart problems, cancer or diabetes. I do have low blood pressure and have never smoked or done drugs.
    I have reflux, and my gastroenterologist referred me to a vascular surgeon in June for further investigation. The surgeon had a CT scan done, which revealed that I have an abdominal aortic aneurysm that is 5.34 centimeters in size.
    He recommended that I have an endovascular repair, which he said was much less invasive than open surgery. He assured me that he and his associates have performed over 300 of these procedures over the past several years, with a 98 percent success record.
    I am hesitant about going to the hospital unless absolutely necessary. While considering this, I conferred with a close friend who is a highly esteemed doctor. He suggests that I have another scan done in six months to see if it grows larger. If so, then have the procedure. If not, continue to monitor it every six months with additional scans.
    I am undecided. What is your opinion?
    DEAR READER: An abdominal aortic aneurysms that is 5.5 centimeters in a stretched state is considered to be the prime indication for surgical intervention or endovascular repair. If the stretched artery leaks or bursts, the outcome can be disastrous. You are on the borderline. I do not know you or your doctor friend, but I recommend that you have the aneurysm repaired. That's what I would choose were I in your position. Let me know your ultimate decision.
    DEAR DR. GOTT: Your response telling your reader that you, nurses and primary care physicians are "very stressed and busy" is a bunch of bull. Do you not still realize that you are dealing with sick people? My doctor always takes the time to call me personally, give me my bloodwork results and all other results! If this doctor, nurse and you are too busy to take care of your patients in a respectful manner, considering we, the patients, are paying the bill, then you are in the wrong field and should advise them to find a doctor and appropriate staff that could take care of them more professionally.
    You really disappointed me in your response, and I have no intention of reading your column again. You, as every other physician, nurse, tech, etc., need to listen and understand, as "professionals," that manners can and do help us all. Glad you're not my doctor.
    DEAR READER: Actually, I am also glad I'm not.
    Had you been a regular reader of my column, you would have known that I do not endorse laziness or rudeness in nurses, doctors — or me. But I think it's important for patients (and readers of my column) to understand that the stresses in modern medicine are extreme. I never said that medical professionals are too busy to be respectful to patients. But I hope that patients will work closely and respectfully with their doctors and be able to procure appropriate one-on-one care when needed.
    To give your related information, I am sending you a copy of my Health Report "Choosing a Physician."

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