My Story–Difficult Healthcare Decisions and Medical Second Opinions

In the coming months, our blog will feature a new series of posts called “My Story.” In them, our physicians will share a personal story or something from their daily practice that our patients may find helpful. Last month Dr. Whitehead offered some thoughts about how her childhood in Botswana continues to influence her commitment to women’s health education. In the following post, Dr. Sparks discusses his own recent surgery and what he learned about facing a confusing healthcare decision.

Most of us who choose a medical career are motivated by compassion for others. But sometimes actually being a patient or caring for a close family member reminds us of the many concerns that a health problem creates. And—more often than not—anxiety grows after we have left the doctor’s office.

My own recent surgery was exactly such an experience. Let me say that the personal details are only worth sharing if some insight I gained can be useful to others.

When Medical Advice is Confusing

I became aware several years ago that my swallowing difficulty was due to a condition that could be repaired with surgery. I did what any physician and most non-medical people would do. I read about my diagnosis—a bit easier for me than many others. Then I made an appointment to see a surgeon. He recommended a fairly simple repair. Unfortunately, my problem was not so common that surgeons see many such patients and perform the repair often. So, I looked for a second opinion. The second surgeon recommended a much more aggressive and risky procedure and offered his reasons. Now what? Unable to resolve my dilemma, I procrastinated. I continued to live with bothersome symptoms that affected my quality of life. My condition worsened, and I eventually consulted a third surgeon. His recommendation was different than both of the others!

It is normal to have some uneasiness when facing surgery, even when there is no difference of medical opinion. How does one know if surgery is needed? Is there another option for treating the problem? What will happen if surgery is not chosen? Are the benefits of surgery worth the risk? The end of my story: I chose the third option. The surgery went so well that I was left wondering why I tolerated so much discomfort for over five years.

Making an important health decision is difficult. I wish I could show you your personal “end of the story” at the beginning. Surgery is disruptive to family, job, and other responsibilities. It usually causes some discomfort. It involves some level of risk, though the potential benefit must outweigh the risk. I can reassure you about the level of risk and tell you what I would recommend to a loved one. But how do you find the comfort zone that allows you to make the best choice for your personal situation?

The Pre-operative Visit

Going back to my own story, I did not reach my choice by reading all the medical literature about my condition. Rather, I did what I try to help my patients to do—ask questions. My surgeon took time to discuss my three options, the pros and cons of each, and his reason for preferring the third option. He was candid about the negatives—discomfort, recovery time, and risk. He was reassuring of his experience and skill, but not arrogant. In short, what he said made sense to me and lessened my anxiety.

Every patient should come to a pre-operative visit with these expectations. Bring a family member or jot down a few notes if you worry about forgetting your questions or your doctor’s answers. Ask how to reach the physician in case you have another concern between the visit and the actual surgery.

In Birmingham, I am fortunate to be able to offer my patients state-of-the-art surgical technology. Minimally-invasive surgery (usually robotic) for GYN problems has shifted the balance of benefit and risk. Patients are usually home within 24 hours, require little narcotic pain medication, and many are able to return to work or normal activities within one to two weeks. Still, I understand that, when I recommend surgery, my patient needs to go through the decision-making process. My goal is for her to have all the information she needs to make the best decision for her individual situation, and to be comfortable with her choice.

With best wishes that you find this in all your health-related decisions.

Jimmy M. Sparks MD