one more quick question....

Hi again! So my GI & PCP recommended this surgeon to me- he is a general surgeon, specializing in advanced laparoscopic colon surgeries. My GI has also recommended a colorectal surgeon in the past- problem is, this guy is over 2 hours away from my home. Which isn't too bad, but getting to him for pre & post-op visits would be a nightmare, and if I run into any issues, it's another day of driving to see him. I asked this particular surgeon about just this issue, & he told me that there are plenty of decent surgeons at my local hospital who could handle any troubles. So--- I'm planning to have the surgery at my local hospital with the general surgeon. But.. now I'm thinking "Should I go with a colorectal surgeon???". I trust my doctors fully, & know that they would not recommend him if they had any doubts. My GI is on vacation 'til next week, but I plan to talk with him & pick his brains about the local surgeons competence. It's not a jpouch, a proctocolectomy w/end ileo... I haven't met my local surgeon yet, but I plan to really pick his brains also. I suppose if I get a good feeling about him, then I should trust my instincts. Did the majority of you all get surgery done by a general surgeon or a colorectal surgeon? As far as I can tell there shouldn't be any complications- I'm pretty healthy overall, have not been on pred for a few years, & my UC is not horribly active at the moment.

     Eva, I agree with ddd.  This isn't just a minor surgery, this is major surgery.  I have a dear friend who had breast cancer and decided to have her breast removed by her niece's husband who is a general surgeon.  WOW did he ever mess up her breast and she has had nothing but problems ever since.  Now, I realize this is a far cry from breast surgery, but it is a very serious operation to say the least.

     I live in south Jersey and there are at least five hospitals in my area.  I asked my GI doctor to refer me to a colorectal surgeon.  Since he was adament against me having my colon removed, he told me he didn't "know any" colorectal surgeons .  Now you and I both know that is a whopper of a fib.  BUT, I am GLAD he said that because I didn't want to have my surgery in this area anyway.  I looked online for colorectal surgeons in Philly (about a 15 minute drive).  It was a toss up between Rambeau and Fry.  I eliminated Rambeau because he was at Temple Hospital and that is in a very bad area.  My husband worked at Temple Medical School for over 30 yrs and I KNOW it is a bad area and I didn't want my husband and daughter having to visit me there.  Fry is head of colorectal surgery at the Univ of Pa.  He does his operating at Pennsylvania Hospital.  I looked up his credentials....over 30 yrs experience and training at the Cleveland Clinic.  I was not a candidate for j-pouch...I was a LOT sicker when I went to see him than I thought.  He even insisted I pass a stress echocardiogram before he would operate.  My blood pressure had been reading 216/110 for months with me being on 3 blood pressure meds.  I was hospitalized four times in that past yr for my blood pressure.  This was due to prednisone.  I also had prednisone induced type 2 diabetes.  All this in addition to my diseased rectum.

     I don't want to scare you, but do see a colorectal surgeon.  There is a knack to creating a good stoma.  My ostomy nurse told me if he needed the surgery, he would definitely go to Dr. Fry.

     So, my advice in a nutshell is to investigate your surgeon...see how many total colectomies with end ileos he has performed, even speak with some of his patients if necessary.  Best of luck to you!!!

Eva - I was in a similar situation as you are. There were no colorectal surgeons in my area - it was a three hour drive to Los Angeles for the closest one. But there is a surgeon in my city that I am familiar with so I went to him. He does laproscopic sub total colectomies often so I felt comfortable asking him to do the surgery. There were no complications and I was out of the hospital in four days.

Everybody is different so only you can decide what is best for you. Please keep us updated.

No way would I go with a general surgeon. I highly recommend you have a colorectal surgeon.

I suppose if the general surgeon you are speaking of has done a lot of proctocolectomies/ileostomies then it wouldn't hurt to interview him if that is the extent of the surgery. If you are going for a j pouch then definitely get a colorectal surgeon that specializes in j pouch surgery. Good luck!

if this general surgeon is very well qualified to do this surgery and you have been able to confirm and verify it then you should be ok....I would make ABSOLUTELY SURE however. 

that being said however....my husband's GI Dr who treated him locally did all she could for him and asked his permission to send a referral to Mayo Clinic and Shands hospital.....Mayo answered first.  Mayo is 2 1/2 - 3 hrs away from here depending on traffic. (Shands is 90 minutes)  Regardless of the distance it was just too important to have the best resources for him....he went there for about 2 years when he finally accepted and decided to go ahead with the surgery which is a little over 2 years now.  The GI, CR surgeon, WOCN staff were all first rate.  Commuting to and from was an inconvenience but when your life is concerned it really isn't. I/we feel having one of "the best" possible CR surgeons operating increased his chances for a successful overall situation and we also felt  very fortunate having the opportunity to be able to use Mayo Clinic with our insurance with no problems.

Good Luck.

I had a general surgeon recommended by my GI , I had many complications and he just didn't want to know about it now I'm seeing a colorectal surgeon after speaking with four of his patients who speak highly of him and i would not hesitate to have him operate on me , I regret letting a general surgeon operate on me even the nurses and stoma nurses all say they would go with colorectal surgeon as its their specialty , I'm sure general surgeons are capable but it's your health and I think you deserve the best
Best wishes lucky

I guess most of us prefer the CR route as it is their "specialty" and that term in of itself denotes they are better qualified in my honest opinion versus a general surgeon. However, I have met a few people who have had a general surgeon who was in fact a very good surgeon for these matters. I would just be very vigilant in checking him out and like someone else mentioned a WOCN is also a very important part of the equation too. My husband had 3 excellent nurses tend to him from the beginning marking the site for the stoma before surgery and his 9 days of care in the hospital. We left there very well prepared and educated in the care of his stoma. The visiting nurses assigned to us after his discharge....I think we knew more than they did! lol

What we did not know or have questions with were easily answered here and on another forum. However, the head of the WOCNs made it perfectly clear....just because you are discharged does not mean we are not here for your care. Any questions at all call us and leave a message if we are out of the office. And they promptly returned telephone calls and e-mails. Very comforting to have this continuing access I find.

I would only go to a ColoRectal Surgeon...there are a million things that can go wrong and I would rather put my body in the hands of someone who has gone the extra with their education/training. I actually go to a teaching hospital that is a little over an hour for me...it is peace of mind, in my opinion.

I would recommend a Pro/Con list for both surgeons. Personally, I don't care if the doctor's bedside manner is perfect, as long as their skill in the OR is exemplary!

Write out your questions before your appointments and write their responses during your visit...it will help to make a clear picture for you to decide.

Always, always a good idea to bring someone along on these very critical doctor appointments.  Whether its a husband, wife, adult child or trusted friend, the other person always catches something you missed. 

     Best of luck to you Eva.  My husband always went with me too and I go with him to his doctors appointments.  He had a heart attack in March.  The entire day he complained of indigestion, which, for him is common...he eats (or I should say he did eat) like crap...donuts, regular ice cream because he said the low fat ice cream was garbage..lol.  He refused to take his cholesterol medicine because it gave him aches in his back.  Long story short, after suffering with the upper gastric distress that day, he woke at 1am to take two aspirin and told me his teeth ached.  BONG....I remember seeing an episode of Dr. Oz where someone mentioned that aching teeth could be a sign of heart attack.  I immediately dialed 911.  Luckily, all he needed was a stent, 100 % blockage of the major artery.  He was home in two days.  Now, since he is on quite a bit of medication...including the cholesterol drug (but a low dose) I go with him to the cardiologist because two heads are better than one.

     Let us all know who you decide to go with...the colorectal surgeon or general surgeon.

Since this is what I had.....colon,rectum removal with closure of anus.....I too agree that this is far more complicated than just a colon removal with the healing of the anal closure an issue in and of itself. Can be very tricky.

just a quick update- I just talked with my GI, who told me my recnt biopsies came back ok, but they did find a ganglio-neuroma in my colon...??? He called up the pathologist for more info, & it's not something that would prompt me to get the colon removed ASAP, it's not "cancerous". But it sure sounds gross! I asked more ???'s re. the general surgeon, & my GI did reiterate that he thinks this guy is really good, a great surgeon, he does many proctocolectomie w/end ileos.... He advised me to go meet with him, see how I feel about him. So again, he thinks I will be fine with a general surgeon- if I were to go for a jpouch he'd advise a colorectal surgeon. So now, I wait 'til the 12th for my face to face with the genral surgeon. I've been posting this same question on lots of ostomy forums, & the answers are totally varied- some ppl. had terrible experiences with CR surgeons, some would see nothing but....