January 4, 2010

Finally, the Holidays are over. The confetti and tinsel are over for another year. And here we are in the beginning of a new year, of a new decade. Here’s hoping it’s a good one….
 
As for me, I’m recovering from my recent herniorrhaphy (inguinal hernia repair), which I had done last Thursday morning, New Year’s Eve Day. The idea was to get this problem fixed, while in the old year, so I could begin the New Year with the surgery behind me and start a new chapter of my life, with healing. 
 
Now, my wife has a dim view of all things Floridian and would have preferred that I have my surgery in New York, with one of my old compadres. But my attitude was that, if I’m living down here, I’d better learn who’s good, on an elective basis, before any emergency occurs.
 
I was referred to Dr. Possada, a general surgeon recommended by my cardiologist, of whom I think very highly. I asked the correct question of him: “Who would YOU use, for this procedure, for YOU or YOUR FAMILY?” 
 
Very important point and the best teaching, with which to start the New Year: Never just ask for a referral. Depending on the doctor (or nurse) and the relationship they have with the specialist, you may get lucky, or you may get referred because of business reasons. I saw this many times in my years in private practice.
 
I got many a back-handed compliment: these guys would send all their referrals to other docs, for business reasons, but when it was someone from their own family, why then, they wanted them to come to me.
 
It’s considered “unethical” for nurses or docs in the ER, for example, to refer to the docs who they KNOW are the best. Instead, if asked for a referral, they are required to refer to the person on the ER call roster, who may or may NOT be the best choice for you.
 
The case for this is that they can otherwise “steer” referrals to their favorites and away from those not so favored. However, what they are NOT doing is looking out for YOU. They don’t know you. They have to live with all these guys, long after you’re gone and forgotten.
 
So, be smart. Ask instead who THEY use, personally. Different question. And not unethical to answer. Repeat this a few times, with different health professionals and the same two or three names are going to keep coming up. THAT’S who you pick from.
 
In Medicine, as in Life, “birds of a feather DO flock together.” The best hang around with the best. Always did. Always will.
 
Anyway, I met this guy and was immediately impressed with his manner, his confidence, his over 20 years of experience in doing this procedure. I trust my gut. And I like and trust my cardiologist. So that’s how I made my choice. I didn’t look up his credentials, or whether he had any malpractice suits, or any of that other crap that people think matters. It doesn’t. I know a good man when I meet him.
 
So we scheduled the surgery, in accordance with my wishes that it be done in 2009. And he accomodated me, despite a solidly booked schedule (another indicator that he has a good reputation and a busy practice–which he wouldn’t, if he was leaving dead bodies all over).
 
So, Tuesday, I went to the Florida Hospital, Orlando, for presurgical testing–simple blood work, interviews and collection of my medical history. Early…and I mean EARLY…Thursday morning, I got up at a little after 4AM, showered, dressed and drove with my wife to the FLORIDA HOSPITAL outpatient surgery unit, what they call their RIO, an acronym for Rapid In and Out. 
 
When you think about it, that’s a sort of unfortunate name they’ve chosen, with echoes of “A Clockwork Orange.”
 
Contrary to my usual tardiness, we were precisely on time, at 5:30AM. A nurse picked me up and took me, with my wife, to a patient station in the preop staging area. I undressed, put on thigh-high TED (thromboembolic disease) stockings, a prophylactic measure to minimize the risk of blood clots, during the immobility of surgery, a pair of socks with rubber treads, to provide non-slip surfaces, and a johnnie (those ridiculous patient gowns that tie up in the back, leaving your naked butt exposed).
 
Then, I was visited in turn by the preop nurse, who started an IV, gave me some preop antibiotics and worked through her checklist, then the OR circulator nurse, the nurse anesthetist and the anesthesiologist. The plan was for LMA anesthesia–laryngeal mask airway.  This is used for light general anesthesia, which my surgeon prefers, as it provides maximal muscle relaxation, a must for a good hernia repair.
 
I advised the anesthesiologist to forget that I was a surgeon, myself, treat me like any other guy off the street and do whatever he thought was necessary, at any time, even if that meant full intubation, with an endotracheal tube. That’s always the best way to survive. It’s when they think they’re doing you a “favor” and treat you different from the standard of care that you get into trouble.
 
Then, they slipped a little Versed (a very short acting hypnotic agent and relaxant, that causes retrograde amnesia, as one of its little benefits) into my IV, started wheeling me out to the OR and….
 
When they roused me, a little later, I thought I had just dozed off and was now in the OR, ready to begin. But the procedure had already been done. I felt no pain, at all. My surgeon had infiltrated the repair and all the tissues with a long acting local anesthetic, with epinephrine (adrenaline, which constricts blood vessels, minimizing bleeding and allowing the local anesthetic to stay much longer in the tissues, keeping them stone numb).
 
Thanks to the short acting anesthetic agents, like Propofol (Deprivan, the same stuff that killed Michael Jackson, used incorrectly, but a great drug, when used by pros and monitored correctly), I was wide awake in a very short time. Very chatty, according to my wife, but hopefully, not too obnoxious to the nurses, who I’m sure are used to this. 
 
Hey, it’s like the old movie title–”Blame it on RIO.”  The residual anesthesia inhibits your inhibitions, like you were a little high. Well, that was my “drink” for the night….
 
A few hours later, once I was able to walk, urinate on my own and appeared to be stable, I was ready to leave. And so we did. All in all, everyone involved, start to finish, in the RIO did a simply an exemplary job. I was very favorably impressed. And comfortable, the entire time.
 
And that’s how I spent my New Year’s Eve, this year.
 
Tomorrow, I’ll tell you about the early recovery process and the new things I learned from this experience, that I didn’t know before. I still can’t start my fish oil, which I really do miss,   http://www.favoriteformulas.com   but for reasons I’ll explain, I can’t suppress my inflammatory response, just yet. Neither can I start my isometric exercises, as yet, for fear of stirring up bleeding. But soon, I’ll begin with these fundamentals from my newly expanded, completely redone PAIN-FREE PROGRAM & brand new DVD:
 http://www.drbillsclinic.com/execise_eliminate.html 
 
2010: This will be a different year, a new chance to get healthy, get fit and leave your bad habits and health care problems behind. And despite the wretched economy and the forces arrayed against us, from ignorant & arrogant fools in our own government, who would dare to use your life, your health and that of your family, as a political means to power, to Big Pharma plots to make statin drugs “preventive care” for everyone, to internationalist efforts to interfere in our personal rights, to use supplements as we see fit (Codex Alimentarius), against all these and more, we will join together and fight back, with the truth and with actions. 
 
This year, we will explore, together, the best ways to relieve pain, restore function, prevent disease and disability, lose weight; to be better, stronger, leaner, fitter, happier, healthier; to live as we ought to live, in optimal health, for as long as we may….plus many new surprises, new products, new features and more emails, to educate, entertain and amuse you.
 
And if you will stick with me, this year, continue to be part of our extended family of friends, one of “Dr. Bill’s Wellness Warriors,”TM and DO what I teach you to do, together we can all enjoy a brighter, happier, healthier future. So stick around and I’ll promise to do my very best to make you glad you did. Til next time, my friend, be well….
 
Yours for a pain-free tomorrow, with optimal health & wellness,
 
DR. BILL
“The Wellness Warrior” TM
 
P.S. For DR. BILL’S LITTLE GREEN BOOK ON ELIMINATING KNEE PAIN, a concise, but complete handbook on the root causes and the various options for treating knee pain, go to http://drbillsclinic.com/eliminate_knee_pain.html 
 
P.P.S. For DR. BILL’S PAIN-FREE PROGRAM: EXERCISES TO PREVENT OR ELIMINATE KNEE PAIN, please go to
 http://drbillsclinic.com/exercise_eliminate.html 
 
P.P.P.S. For conventional and alternative treatments and exercises to relieve knee pain without surgery click on http://drbillsclinic.com/avoid_knee_surgery.html 
 
P.P.P.P.S. For the giant, comprehensive ADVANCED MASTERS’ COURSE: HOW TO ELIMINATE KNEE PAIN–ONCE & FOR ALL!, everything you need to know on causes and solutions for knee pain and the complete exercise program, too, go to
 http://drbillsclinic.com/advanced_masters.html 
 
FREE BONUS CD with any order: THE HEALING POWER OF POSITIVE PAIN PERCEPTION
 
Copyright, 2009 by William Thomas Stillwell, MD, FACS
All rights reserved