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Heart condition and GS

Discussion in 'Surgery and Surgical Subspecialties' started by reblzski22, Dec 2, 2005.

  1. reblzski22

    reblzski22 New Member

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    Hi all,

    This is my first post here, though I've been reading this board for a while (I'm in my anesthesia residency right now), but this question is about a good friend of mine. She's a second year surgery resident at a pretty prestigious program. She has a pretty bad heart condition/arrthymia (actually wpw (amoung other things), but the worst case of wpw, I've ever seen or heard of) And she's pretty symptomatic. Normal RF didn't work, and she has multiple accessory pathways, not just one.

    To make a long story short, she had a run of v-fib--which triggered a whole chain of horrendous events. She's been in the icu for the last month and underwent 3 cardiac surgeries. Her EF is somewhat low and basically she's having tons of issues.

    She's pretty much in denial. My question is for all you surgical attendings/residents...in your opinion, is she gonna be able to go back to surgical residency after this? Can someone with this serious of an arrthymia even be alright to do surgery?

    I feel horrible for her. I want to give her a postivie outlook, but I'm just not sure. Any other surgery residents know of anything like this?
     
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  3. drrouz

    drrouz Member
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    Let me begin by saying that my heart goes out to your friend and her family. It is hard to imagine a worse fate. I don't know how to say this other than: somethings are more important in life then ones career (yes, even a surgical career). I know of a former neurosurgeon at our hospital whose experience may console your friend. This particular neurosurgeon was apparently a hot shot, malignant personality. He developed some kind of heart condition, for which he underwent heart transplant. By all accounts, having spoken with people who were around at the time, he was a very difficult patient. Eventually, he came to terms with his condition and realized that he had to give his surgical practice. He now has a very successful career as a palliative care physician. It is by no means an exaggeration to say that this physician is among the most beloved and respected doctors in our hospital. Yes he was highly respected as a neurosurgeon. But he may be even more respected as a palliative care physician. I hope this gives your friend some hope.
     
  4. Apollyon

    Apollyon Screw the GST
    Physician Lifetime Donor Classifieds Approved 10+ Year Member

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    There's a critical care attending at our hospital who has some exotic disease that our brilliant docs can't figure out, and she refuses to be seen until she needs to be tubed (like now, 3rd time in 6 months). That shows bad judgement, but, also, that it can be done. However, at the same time, people with disabilities or are debilitated in some regard have to appreciate the strain they put on other people in their group due to their obstinacy. It's one thing to leave the program, but it's another thing to be scheduled to be on call tomorrow, but it turns out today you can't take your call because you're an inpatient.
     
  5. FliteSurgn

    FliteSurgn This space for rent.
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    It's not reasonable to think that she will be able to practice surgery unless she has been rendered asymptomatic. Since that seems unlikely, she needs to find a new field. It's just not safe to have a patient under your knife when you can become incapacitated at any moment.
     
  6. reblzski22

    reblzski22 New Member

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    Thanks everyone for your replies.

    This is gonna be really really tough on her. Once she comes out of this medical nightmare, she may have to face the fact that she might not be able to do surgery. And that might be harder on her than this whole past month.

    I tend to agree with what most of you are saying, though. I admit, I was hoping for some stories that showed me otherwise. It just doesn't seem like she'll be able to do it.

    Any other opinions/stories are much appreciated.
     
  7. surg

    10+ Year Member

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    I have met or heard of practicing surgeons with chronic disabilities ranging from physical (hearing impaired) to medical (type I diabetic) to neurologic (head trauma), so if she can get the V-fib attacks to go away and is just left with cardiomyopathy, I think it would be possible to continue on with surgery. If not though, I think probably the most analogous situation to this would be to someone with seizure disorder. It would probably have to with how often and how able she is to avoid the trigger and how well in control she can keep it. If the attacks come often, then the answer is probably not a good idea. A good rule of thumb might be, would you trust her behind the wheel of a school bus? If not, she probably shouldn't be operating either.

    In the short term though, just be supportive, I'm sure she is worried enough about her career without you agreeing that it might be down the tubes. Once she gets healthy, there will be more than enough time to come up with a plan.
     
  8. boston

    boston Junior Member
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    Whether to continue in surgery is not a decision she needs to make now or is capable of making now. She needs to get better first. Once she stabilizes and gets discharged home, she can reassess based on whether her wpw can be controlled long-term. But just because she is in a terrible state now, doesn't mean she should necessarily close the doors on pursuing a surgical career. There is a plastic surgery attending at our hospital who ten years ago, as a young hot-shot attending, was involved in a horrendous car accident, long ICU stay, permanent brain damage, etc. At the time, they weren't sure if he would live or function as a normal human being again. Slowly he learned how to walk, talk, etc. He has a permanent speech impediment. But eventually he regained his operative skills and is now back to being a full-time plastics attending. So you never know...
     
  9. beary

    beary Pancytopenic
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    Hi - it was amazing for me to read your post because basically this exact scenario happened to me. Fortunately, I was in college when I had my v-fib and long ICU stays. I ended up mostly recovering after multiple surgeries, a pacemaker, and anti-arrhythmics. I have made it through med school with minimal problems (just an occasional admission here and there for VT). Anyway, I am an M4 now and chose to go into pathology. I absolutely love pathology, and I am not at all saying I chose it because of my heart condition, but it probably was somewhat of a factor in my decision. I personally would not have the energy to do a surgery residency.

    I agree with a previous poster who said that your friend doesn't need to decide what to do about a specialty now. First, she needs to get better, and then she could try to go back to surgical residency. Fortunately, if it doesn't work out, there are many other specialties that are less physically demanding. Though of course I understand that would be a huge adjustment.

    Feel free to PM me if I can give any help or advice at all. I am sorry to hear what your friend is going through and I really do understand.
     

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