The dumbest things people have said to you/about you
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LFree--next time you see that idiot Rad doc, ask him to put IN WRITING that his rad tx guarantees that you will not get the beast back in the breasts. If he's so sure, make him put his signature where his mouth is. then HE can pay for any further treatment if he's wrong!
What a Mah Roon!
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Some docs should not be working in Oncology.......oh brother.....Mah Roon is right! I think thats what Bugs Bunny used to say, lol
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I was telling someone I've been dealing with breast cancer, and they went on to tell of their relative who had multiple cancers, had their brain "eaten away", then died a horrible death.
Thanks, appreciate it. Now can I choke you?
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feel free to choke that one, perhas that persons brain has been "eaten away" that they would say such a thing?
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I've been reading this thread the last few days while recovering from my BMX two weeks ago. The surgery was terrible! The dr didn't take me off plavix and aspirin and I bled so bad I had to go back into surgery to stop the bleeding. Before the second surgery, the anstegiologist told me that I had a high probability of dying in surgery. I was given 8 units of blood (13 altogether during the week), 10 units of plasma, and 2 units of platelets. Obviously, I was quite happy to have woken up after that surgery. After a week in the hospital and I finally get home, my dear friends and family started bringing me meals. I don't know what got into my cousin because she's the sweetest thing ever, but she brought over a meal and said that just wait until I start radiation - it will make this (the mastectomy) seem like a piece of cake.
I can only think of one thing worse than almost dying!0 -
Herstrong I'm so sorry u had all those problems with u'r surgery. Wow that's scary.
Well since we are all different but rads don't make u bleed, u'r not pit out and it take 10-15 minutes of being still. Oh u might feel tired but it's nothing like u'r surgery so I don't have a clue what she's talking about---what a thing to say LOL
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herstrong, didn't you have pre-surgery work-up????? That is just horrid!!! You can't tell someone that just as they're about to go under...shame on that anaethetist!!!
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Yeah, I did.
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So sorry for you, that is unforgivable, I had a biopsy last week and do remember the docs telling me no aspirin etc. Since I am alergic to aspirin, I was easy to say I would not take any but wow...times we needd to be in control of our own stuff
I tortured the docs before the biopsy to ask if it would make my lymphodemia worse, assured by 2 docs that it would not be a problem but I bugged them
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Herstrong
I didn't have RADS and there not without SE's but most will say its a cakewalk compared to surgery and chemo never mind what you just experienced!
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Herstrong I am so sorry you had to go through all of this! It is SO wrong on so many levels! Even when I have had my simple colon & endo scopes I had to come off even green tea, fish oil pills....anything prescribed & over the counter. As well as my lumpectomy! THE surgeon should be REALLY scared right now & his office! How many others has this happened to. I am a CNA & already know that you don't take certain drugs & over the counter meds. But most people don't have a medical back ground to even suspect this could happen! I call this a GROSS INJUSTICE! For your surgery team this is medicine 101! I have been in for surgery & procedures 7-8 times in the past 6-7 years. That is one of the first things they say when they are going over pre surgery instructions a few weeks before you have surgery. In fact most of the paperwork already has it on the list of instructions. Let alone they should also review ALL MEDS prescibed & over the counter also. Again I am so sorry you have endured so much on top of what what intended! Above & beyond!
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I am very thankful indeed to be alive. Obviously, this would be a very different matter if I didn't overcome the blood loss. Fortunately, there is no damage to my organs but there very easily could have been. But to come through all this and to be told with certainty that rads would be worse by someone who's never had BC just takes the cake. Thank God I have the sense to not believe that. I never got sick or tired from chemo and expect rads to go better than expected. All our bodies respond differently to these treatments and it's anyone's best guess how each will handle it. I stayed on the drugs for a lumpectomy and was just fine so go figure! Guess I know now
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Herstrong_Barbie's right-----standard pre-op workup which is the standard of care ---You should have been taken off both drugs 7 days pre surgery. Clearly written in drug information. So many screw ups on this one Re: rules at every level DOC..PREOP workup>>preop nurse>>anesthesia review of chart before sx the first time>>>anesthesia in sx room. Huge lawsuit. So, many rules breached. You survived-- Amazing. Others have died b/c of this type of screw up.
Even certain types of emergency surgeries are delayed b/c of Plavix. I.e bone fractures that need would be done asap are put off for a week, b/c there is no reversal agents. You should have been transitioned to heparin which has a reversal agent. The doc that had you on Plavix should have been consulted several weeks ahead to develop the plan. Get a really good lawyer. The settlement will be huge. There is absoolutely no excuse for this. The anesthesia doc for the 2nd surgery may have sounded cruel, but he was telling you the truth. The breach by all before him was not his fault.
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My surgeon told me to stay on it for the lumpectomy and it was good. Granted, a BMX is much more invasive. I went to pre-op a week before and was told that the nurse would confirm with my cardiologist and surgeon if I were to stay on or off and that she would follow up with me. Well, she never called so I just stayed on like last time. After the surgeries, my surgeon said it is easier to deal with blood loss than blood clots that could have caused a stroke or heart attack. Those outcomes could have had severe permanent consequences. At pre-op, I told the nurse that I was more concerned about blood loss than clotting but no one seems to listen to me. Well not any more.
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Herstrong---they are trying to cover there assess now. As I said you should have been put on Heparin protocol. They will all be pointing fingers now. BUT they are all responsible Do not let them convince you of anything else. Once someone puts the chain of events that shows the lack of appropriate care in this situation , You will see the many screw ups. Your story could and probably will be used for years as an example of malpractice.
Even if for some reason they didn't want to use heparin, One of the low molecular wieght heparins could have been started 7 days before. They at least wear off in 12 -19 hours depending on which one. To be left on the Plavix for the lumpectomy is very highly dangerous, b/c complications can happen with any surgery.
Are you allergic to heparin?
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SAS thanks for the backup with more knowledge! You know your stuff! I agree with everything you said! What's to say this won't happen this won't happen again. Again on so many levels are life threatening problems with all that happened! I'm off for the night Burt will continue to read!
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Herstrong, I want to move on, I was waiting for a response. If you were not allergic to heparin. There is a National standard of care for use of heparin. It's a very cookbook approach. The fact that no one pre-op caught the fact that you were on Plavix again being redundant breaks so many pre-op rules. All the docs involved screwed up, all the nurses, all of anesthesia Doc/crna. The hospital is responsible too b/c they apparently didn't drill every one in all the rules. This is not a new drug with an unusual response. The things I have stated have been known since the drug came out.------forgot Pharmacy --they screwed up too
Thanks Julz,
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Herstrong reminds me of a case when Plavix first came out. Patient schedule for am sx for hip fracture. I had already studied Plavix as I did with all new drugs. Notified Doc>>he said to talk to anesthesia b/c he didn't know>>>anesthesia said to talk to pharmacy>>>Pharmacy even waffled. It was so new that the ones that should have known didn't. I pushed everyone until her case was cancelled, but to get someone to make a decision took work. She was lucky that I was such a bitchy nurse aka a patient advocate. Your case inexcuseable
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No, I am not allergic to Cumadin. Plavix is not a blood thinner and does not affect INR like Cumadim. I have not been recommended to take Cumadin at all and from what I know, it is not a substitute for Plavix. One affects INR, one affects platelets. Not a medical student by any means here. Plavix reduces blood platelets from forming along my cardiac stents. My cardiologist says Plavix is a long term drug to reduce playelet build up and it doesn't hurt to go off of it for a week. Yeah, everyone screwed up and I'm not done asking questions. I had a stroke in 1999 due to a chiropractor tearing an artery in my neck. Now this was malpractice. I'm okay this time but there is definitely a lesson to learn here.
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I hate when some people say to me, at least you got some new boobs out of this. It must be great to have implants! Do you like them? How does your DH like them? How do they look, are you hot? You must love being cute and perky like a teenager again!
Ummm.... how would you respond? Does anyone have some smart responses?
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Plavix is not a substitute for coumadin, but is an alternative blood thinning agent used to prevent clots, strokes and heart attack. Plavix works on the platelets, very much like aspirin, while coumadin works on one of the chemicals needed to create a clot. Plavix is considered more convenient than coumadin since it doesn't require blood work to monitor it's effectiveness. Plavix has a standard dose, coumadin must be adjusted to the individual, which takes time. Plavix, like aspirin, permanently alters the platelets, which is why it must be stopped 2 weeks before surgery. There is no reversal agent for Plavix or aspirin. Coumadin is much shorter acting, can be stopped a few days before surgery, and can be reversed with a shot of Vitamin K.
I second what has been said before--there are MANY places where the Plavix should have been noted and you should have been told to stop it. A similar thing happened to my Mom when she had surgery earlier this year--the surgeon's office never contacted her cardiologist, so she was not told to stop taking her Plavix. Fortunately this was picked up on the last pre-op visit and her surgery was post-phoned a month. The practice of having the cardiologist or primary doc manage the anticoagulation bit is creating a lot of problems since the surgeons offices are not very good at contacting the cardiologists. Just another example of how we have to be our own advocates.
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Fearless foot...you could respond with well, at least they haven't tried
To kill me like the last pair did...that way you are pointing out the seriousness of your situation while still keeping a little humor. Of course if you wanted to be more pointed, you could say something to the effect of yeah, having a mastectomy was awesome, you should try it some time. And maybe mention the most awful parts of having it done and say but yeah, at least I have perky breasts.
I realize some people who may make comments like that honestly think they are trying to cheer you up, maybe help you look on the bright side. But I don't think that excuses such insensitivity, and it is totally okay to call them on it.0 -
Yeah, I was totally going for the perky boob outcome after cancer diagnosis, chemo, three major surgeries and months of recovery. Hotness was what I was going for... Not just the hot flashes with early menopause. (lots of dripping sarcasm)
Or how about this?
I know a good doctor that can remove that foot from your mouth!
Or, here's the name of a proctologist so you can get treatment for being such a big a$$.
Or, simply and innocently stated, what do you mean?
I agree most people say the stupid things they do because they think it's ok to comment on something. But until it's their cancer, their boobs/hair/uterus lost, they really don't have a clue to how tough it is physically, emotionally or financially. Cancer sucks, period, end of rant.0 -
Maybe, one day you'll get lucky too. I expect you'll find the new boobs really make up for the (list your favorite se's here)
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Another reason we need to not only be our own medical advocates.....but have an EXTRA person to be double checking.... jeez
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Herstrong----coumadin is not heparin----totally different drugs. Coumadin affects Prothrombin activation, and is tested by doing a prothrombin time PT/INR International normalization ratio. Heparin affects partial thrhromboplastin activation and is tested by PTT levels. The cascade of platelet activation is plus or minus 12 -13 steps long. PT and PTT are at separate levels. The point with each drug, coumadin and heparin, is each has a drug, that can reverse it's action. Plavix does not. Plavix has many good qualities as a drug. You were subjected to it's worst. That's why I say everyone was wrong. Your BMX should have been done 7 days after being off the drug--plavix in your case. If you were not allergic to heparin, The national and worldwide protocol call for management pre-op is heparin protocol. It is a step by step approach, from the time the drug that it, is to replace preop, is stopped.ie. Plavix and any drug in that family, or coumadin which takes several days too wear off also.
I agree with everything that NM says accept that the Physiscians Desk Reference only requires 7 days off Plavix. Now there may be more recent data that I'm not aware of 7 versus 14, but that isn't the point that NM and I are trying to make.
Also, your cardiologist is mistating the fact aout it not hurting to go off a week. As the blood level of Plavix falls the closer it gets to the 7th day(15th whatever) and normal platelet activity can then begin to occur. The safest route is to cover with the heparin protocol, then transition after surgery by overlapping heparin and coumadin watching the PTT and PT/INR levels. OR use a Low molecular weight Heparin--Lovenox,arixtra, Fragmin for a time and then once bleeding risk returns to pre7 day level restart the plavix. But it may take longer than 7 days for that to occur, so, it is not an absolute that someone would be returned to Plavix use at the 7th day b/c of extenuating circumstances.
All drugs have consequences. The choice of Plavix and Pradaxa has been support by clinical studies. The biggest negative consequence of each is death do to hemmorrhage. Reinterating all the negatives of your case.
The treatment that you received by all the units of blood and platelets was an appropriate response to an uncontrolled bleeding situation. This treatment can have negative long term results which when your lawyer consults with a Hemotologist etc they can be outlined for you. You have already lived past what the negative short term problems could have been---so a disscussion of those would be useless because they didn't happen.
Thats why I said early on that what you need to see is adocument from beginning to end what the human errors were in sequence. Then a second document(Hematologist/Nephrologist/Immunologist etc) that shows you how the use of all the drugs, blood,platelets impacted your body and is there or isn't there a potetional for long term consequenses.
Right now each of your docs will give you what appears to you to be a plausible answer as to why they weren't responsible and ________someone else was.
The term "Guardrails" is frequently used to describe the safety mechanisms that are put into written policies to prevent adverse drug or equipment EVENTS. ADVERSE EVENTS are required by law to be reported to governing agencies that then do an analysis of the event. From that, then a report is made. When Humans are found to be at fault they can be censured/ license suspended/license revoked. Criminal charges. Civil suits can be filed. In the case of drugs or equipment, the governing agency of that area issues either an alert, a recall, requirement to discontinue use immediately.
The number of guardrails that were in place for your medical/nursing/pharmacy caretakers to prevent what happened to you are countless dozens. It will take quite sometime to put this chain of errors together.
Nm and julz and I are not writing to make you angry, rather to help you understand your rights.
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Herstrong my intention is not to get mad at you.....rather WE ( SAS, NM, & I ) are mad on YOUR behalf at this miscarriage of injustice!!!! Scared for anyone else who might ever be in some way a similar instance as you. Has this happened before & they never learned? Hopefully not! It's sad that we have to become our own advocates today as I have found a few blips on the way. But I am not the only one. As I knew the basics & SAS, NM know far more complex intricate things about these drugs. Shows even more how many safe guards that were in place that were missed/ignored with you! It's beyond scary. The reason why in my opinion I think these safe guards are in place is because there is SO many many many things to know in this day & age of medicine. That is why there are so many specialties in medicine today. No One person can possibly know them ALL. We as non medical ( although some do have some medical back ground ) mostly general population should expect someone to put a red flag up in the amount of Medical people that this info passed by in your case to put a halt to it! Major failure in my humble opinion! Very SAD but Thankfully for your sake not worse. Although it really was. This brings tears to my eyes just thinking of it ALL I can't imagine what you still must be going through!
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You can see why the anaesthetist was pissed. He got you through the first surgery safely and then had to take a chance on a second one immediately which did not have a good prognosis! He was scared for you and mad, but he still shouldn't have said that to you, IMHO!!
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Herstrong, did the same anesthiologist give you anesthesia for the second surgery? MY guess is no b/c he'd already made one error---hospital risk management would have made sure a different anesthiologist was assigned b/c if something happened during the 2nd surgery and it was the same anesthiologist that could muddy the legal quagmire even further. Now as far as the surgeon in a mess like this, the same surgeon was likely the doc b/c the hospital can't order another surgeon to take over the case unless there were extenuating circumstances like drug impairment , mental impairment. ERGO, surgeons will refuse and have the legal right to not accept another surgeons patient
Barbie I agree It was a horrible thing to say. But the doc was probably getting her to sign the" Consent for Anesthesia" form. Almost always death is listed as a risk of surgery and then the doc is required to verbally say what the risks are that are written on the consent form. It's part of the law on "Informed consent". Most/ many people hardly pay attention when these forms are reviewed by the docs.
In your case Herstrong, his phrase was remember by you only too well b/c you had been through a harrowing week in the ICU(?).
Julz---you are on mark on everything you have said---chickie-poo(meant with great respect) I would have loved working by your side. A nurse and a CNA have to have implicit trust in each other. I would have been proud AND happy to be your partner in patient care.
BTW the first anesthiologist did not get her through the first surgery. He /she are one of the people that committed an egregious error. Here's why. Anesthesiologist are responsible to check the patient record which includes patient drug list and the most responsible would put the last day taken (not required ,but an OC--obessive complusive docs and nurses do). Anything that may affect/effect the surgery. They are required to write drugs that may interfere with anesthesia drugs i.e cardiovascular/sympathomimetics/parasympatholytics, Drugs that would potentiate bleeding, drugs that would affect/effect the respiratory system, Same with kidney function etc on the anesthesia record. If he wrote Plavix on the anesthesia record---His error is documented that he knew---if he didn't write Plavix on the record then it would be considered an error of omission. SO, either way his ass is grass.
I guarantee your medical record has been made inaccessible to all personnell that had anything to do with your first surgery. The hospital knows they are in deep do-do on this one. They are required by law that if a case has breached the policies and procedures of the hospital and/or the outcome is outside of the usual , the chart is made unavailable so, that it can't be tampered with. Ahhh should have gone into forensic nursing.
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SAS thank you for the wonderful compliment. As I work these days so much is changing & fast. Nurses & Aides are so often pushed to the limit. Working with each other is how it should be! I would of liked to work with you as well!
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