Posts Tagged ‘Surgical Notes’

(Don’t) Follow the Plan

October 28, 2008

First, a quick update on two of our friends: Colby is home! As it says on his blog, he went before the Doctor’s Parole Board and they released him on good behavior. As of this writing Katie is still scheduled for a Glenn Shunt tomorrow. Keep this young lady in your thoughts.

If you are putting together a heart book, a good starting point is a copy of the surgical notes. The surgical notes are written by the surgeon (or one of his assistants) after an operation; basically they are a “play by play” description of the operation. Modern operating rooms can be outfitted with recording equipment; the surgeon describes the operation as he works. A boom microphone above his head picks up his words and the tape is transcribed later. (Modern operating rooms are amazing, a surgeon can pause long enough to say “Please replay the MRI from last Monday” and it will appear on a video screen. Usually there is a computer tech controlling the system, but more and more often the computer can do it automatically!)

Surgical notes are very detailed, as operations have become more and more complex the level of detail in the notes has increased. Alfred Blalock’s notes on the first Blalock-Taussig Shunt are an incredibly short two pages. (Page One, Page Two) In surgical notes being written today, you may read a page and a half before the first incision is made.

Reading the notes are very difficult: they are meant for the official medical records. Normally you won’t receive a copy of them, you will have to ask. If you or your child are still in the hospital, getting them could be as simple as asking “Say doc, can I have a copy of this for my personal health records?” If you’ve recently been released, make an appointment with the surgeon. You’ll probably have a follow up appointment anyway, let him know beforehand that you’d like a copy of the surgical notes… and for him to go over them with you. Surgical notes are written in “Medical Talk”. If you don’t speak Doctor and have a good working knowledge of Anatomy, you’re going to be lost. That’s why you want an expert to review them with you – and who better than the person who performed the procedure? (It would help to give the doctor ample warning and to discuss the notes during a regularly scheduled appointment, even if you have to make an appointment just for the discussion. Extending your “usual” appointment really isn’t fair to his other patients.)

If you had your surgery a long time ago, you will have to contact the hospital where the surgery occurred and request the notes. Be prepared for a wait. You will have to fill out a form to release the records (even though they are your records)… the HIPAA laws require it. And then… be patient. Your records may be stored somewhere away from the hospital, and someone’s got to dig them out. That might take a while.

You really need a copy of all your surgical notes, if you can get them. Surgery is like Chess – everything starts from the same point, and there are a limited number of opening moves. All Bi-directional Glenn Shunts, for example, start the same way. Surgeons are the Grandmasters; they have the ability to think three steps (or more) ahead and they know when it’s time to deviate from the accepted course. You can’t learn this skill by reading a book, it only comes with training, repetition, and an inborn skill. They just know what they need to do next, how it is going to affect the body, and how to react if a crisis develops.

Every surgery is different, because your surgeon is reacting to what he finds inside of you. So even though we may share the same defect and the same surgical procedures, our insides may be totally different. So get those surgical records, having them could save your life!