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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To think this is no way to consent for an operation?

21 replies

JacobReesMogadishu · 08/11/2020 14:40

I’m due fairly major and unusual orthopedic surgery. I have a very good consultant but even he’s never done an operation like this. Last time I saw him he was pulling slight faces and saying he knew what needed to be done but wasn’t sure how to do it. He did a steroid injection and told me if that worked that would confirm what the issue was and I’d then be booked for fairly significant surgery. But that it’s something he’s never done before.

So injection worked and I went back for an appt expected to see him but it was some guy I’d never seen before, not even his regular Reg. no idea if this was a different consultant or a reg as he never introduced himself. He said great, steroid injection worked and I could be discharged.

I had to stop him and say that wasnt the plan, that my consultant had said I’d need surgery. New guy pulled faces and said it was risky, my leg bone might collapse as I’m going to have a massive hole, etc. I said nope, my normal guy seemed to think he could do something and I want it done.

My pre op appt next week has been cancelled. His secretary rang me on Friday to tell me. Apparently I’m just to turn up on the morning of the operation and they’ll consent me then.

So I’ll have no time to think about it, to think of any questions, to go away and google anything. No time to weigh up pros and cons and make a decision.I’ve no idea if my leg is going to have a bone graft, pinned/plated, whatever. No idea if I’ll be on crutches afterwards. Don’t even know if it’s under a general anaesthetic. Secretary didn’t know. I’ve no idea how real the risk of losing my leg is.

OP posts:
Pavlova31 · 08/11/2020 14:47

That sounds awful Sad
I hope someone more knowledgeable comes on to reply soon Flowers

GrimDamnFanjo · 08/11/2020 15:04

This terribly worrying. I'd send some emails before the op outlining your concerns.
Hopefully all will be well as your usual doctor should know your situation the best but if there are complications it would be preferable to have a paper trail.

slipperywhensparticus · 08/11/2020 15:07

Email them state you need details prior in order to make an informed decision in order to not be wasting everyone's time

JacobReesMogadishu · 08/11/2020 15:11

I’m worried if I start being awkward it’ll get cancelled. They’ve told me there’s a good chance it’ll be cancelled the day be. Was already cancelled in March. Im struggling to walk so guess even if there’s a risk I lose my leg it’s worth the gamble. I’m just pissed off.

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LifeBeginsNow · 08/11/2020 15:12

Just be prepared that by emailing and asking questions, your pre op and operation date is likely to be cancelled.
When I did the same, I think there was a realisation that everything had been rushed and we hadn't really addressed any questions such as rehabilitation length and when I'd be able to look after my son. I guess fearing a lawsuit, everything got cancelled and rebooked once we'd had a chat.

PeigiSu · 08/11/2020 15:12

Agree - thank them for the appointment and say that you appreciate trying to limit footfall in the hospital by omitting the pre-op but you feel really unable to provide appropriate valid consent as things are and ask if there’s any way you could have a phone or virtual appointment beforehand to go through things with the surgeon then you can just sign the paper on the day but have been through things first.

Mrsmorton · 08/11/2020 15:13

I dont think you're being unreasonable OP. There is strong case law to support you as well. Chester vs Afshar and Montgomery spring to mind.

Squiffany · 08/11/2020 15:15

What exactly is the operation?

Only minor or emergency surgery can be consented on the day as they need consenting in two stages.

MatildaTheCat · 08/11/2020 15:15

No way would I proceed with this. You have not got the information you need to give informed consent. I would be tempted to ask to be referred to a specialist orthopaedic centre for another opinion.

I have successfully taken legal action against a surgeon for failing to adequately explain the risks of a surgery that went wrong. All surgeons should be aware of this.

I’m sure you are tempted to go ahead and hope for the best but that sounds very risky.

CSIblonde · 08/11/2020 15:20

I'd ring the dept , ask for an email adrss for the consultant or his secretary of they won't divulge his, summarising your conversation re the 'never done it before' conversation (that would terrify me) & asking for risks etc in writing. Always put it in writing for a legal paper trail when stuff gets as dodgy as this sounds.

justicedanceson · 08/11/2020 15:27

My auntie had a similar thing happen. I suggest ringing the consultant's secretary and say you have some more questions and are unsure what operation exactly you are consenting to. They should be willing to give you more information (even if it's a case of "if we see x we'll do a and if we see y, we'll do b" on the operating table).

GreySkyClouds · 08/11/2020 15:46

I was consented in the day for my operation too. By a foreign nurse who didn’t speak much English and couldn’t answer any questions I had.

Suggest you ask any questions you have by email before hand.

Are you private or nhs?

JacobReesMogadishu · 08/11/2020 15:55

@Squiffany

What exactly is the operation?

Only minor or emergency surgery can be consented on the day as they need consenting in two stages.

I’ve got a growth in the middle of my bone which needs removing as it’s causing a lot of pain. It’s not cancer so not exactly an emergency.
OP posts:
JacobReesMogadishu · 08/11/2020 15:57

Work keep asking me how long I’ll be off for afterwards and I’m like I honestly don’t know if it’ll be a day or two months!

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SimonJT · 08/11/2020 16:04

My partner had surgery in August (in Sweden, so couldn’t fly out for pre-op), it was however carried out by someone who has previously operated on him so could reliably do a fairly decent pre-op over facetime. It was unusual surgery, but one where there are some significant risks and lots of smaller ones, all were discussed at length, this was once again done the day before the operation.

AcrossthePond55 · 08/11/2020 16:40

Honestly, I don't think I'd want a surgeon to do surgery on me if he wasn't happy to be doing it and wasn't at least reasonably optimistic about the outcome.

Can't you find another surgeon more in line with what your orthopaedic specialist thinks?

(I'm coming from a US-centric mindset where if we don't like the doctor we 'fire' them and 'hire' another one)

JoeBidenIsGreat · 08/11/2020 17:01

They don't know how they are going to do it. That's why the consent will be a bit vague. They told you from start they weren't sure how to do it. They will have a few ideas & then have to wing it if the initial ideas don't work or if something goes wrong. The surgical team will be discussing the how to do it very close to the actual surgery date.
There's a lot of winging in surgeries. Read Henry Marsh books.

I can agree with you that there's rarely such thing as truly informed consent; I don't think you can get it here, either.

JacobReesMogadishu · 08/11/2020 17:26

@AcrossthePond55

Honestly, I don't think I'd want a surgeon to do surgery on me if he wasn't happy to be doing it and wasn't at least reasonably optimistic about the outcome.

Can't you find another surgeon more in line with what your orthopaedic specialist thinks?

(I'm coming from a US-centric mindset where if we don't like the doctor we 'fire' them and 'hire' another one)

I’ve already “fired” two! Grin

It was a year ago that he said he didn’t know how he was going to do it but I very much got the impression he was going to go away and think a bit more and have more of a plan. I do accept he may need to wing it on the day depending on how it goes, but I’ve had numerous mri scans so he has a good picture of what’s going on where.

He’d talked about a bone graft but his stand in said I’d be left with a massive hole in the bone which worried me so I’d like to know what they’re planning and if having a big hole is ok or not.

OP posts:
Arrowcat · 08/11/2020 17:30

It's not unusual for consultants to do procedures they've never done before. That doesn't make it more or less risky and that he's discussed this with you is a good indication of your relationship. I'd forget the new guy in the middle - sounds like your regular guy was away etc and you just happened to be on the wrong clinic / not rebooked to make sure your normal consultant was in.
The pre op consent was cancelled because it wouldn't be your normal consultant who would do the consent - just a nurse / general etc. You're having a specialised procedure so really only your consultant should be consenting you - again a good sign of a conscientious clinician.
You're right that you don't have enough time to think it over - you have two options, rebook onto a normal outpatient clinic and do the consent then but accept that your op will be postponed. Or keep it and trust that you can have a proper conversation on the morning of the op. (You could give the secretary a call to warn your consultant of this so he can rearrange things to take account of this).

Toddlerteaplease · 08/11/2020 17:51

Only minor or emergency surgery can be consented on the day as they need consenting in two stages.

Not true. It's often done on the day.

JacobReesMogadishu · 08/11/2020 19:09

Thanks @Arrowcat, that possibly makes sense about why the pre op was cancelled.....although his secretary said it was due to covid and my letter had said the pre-op was with the consultant? Think I’m just going to go on the operation date and see what he says. Make my mind up then. But if I end up doing a 14 day self isolation for no reason I’ll be annoyed.

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