Follow ups after having PS out of country

We have been lucky as well. I often hear friends talk about how they can't get into see their doctor, or their doctor seems too busy when they do get in - my advice is that they should find a new doctor. One who meets their needs.

You need to have a good relationship with your PCP.

I am so glad that we do. With any procedure things can go wrong - you can get an infection, etc. It is good to know that I have someone who truly cares when I get home - just in case!!

I had my PCM and Weight Loss group on board before I left. 

I had to have CBC, PT, and PTT drawn within 6 weeks of surgery.  I also had all my yearly labs done at the same time.  Dr S gives his patients instructions on what needs to be done prior to surgery.

Jessica

I've been very impressed with how thoroughly Dr S has answered all my questions.  He even gave me a "what to expect" day by day break down!

Dr S is very thorough and very nice.  He has no problems answering questions, no matter how small they are.  He truly cares about his patients and just doesn't see $$$. 

Jessica

I have been with my PCP since my first pregnancy 35 years ago. He was so excited when I got my DS  and I educated him about it...he had not been familar with that bariatric procedure.

I had a full physical (my usual annual thing) in early October and decided to have my PS soon cuz Dr S wanted fresh labs (within, I think a6 weeks was ok) and I was concerned my insurance would not cover the second round...esp. for a cosmetic thing they werent covering,

He required a 'CBC, full met. panel, and PTT, PT and EKG. I threw in my mammo since I was having implants. I guess you wont need that, tho, But I dirgess...

My PCP was so happy for me about the plastics and said he could do whatever I needed for after care, (within reason, I suppose)

I am getting my stitches evaluated tomorrow and Dr S will remove  what he deems ready, Whatever I go home with on Saturday, I can remove myself if they are within reach, or I will have my PCP do it. He wants see my results anyway!

Have a  chat with your PCP. Feel him out. Some are uncomfortable or flat out refuse to help in any way when you go out of the country. Sad, but true, But others are just fine,

Good luck. YOu will love your time here in MTY, Mx...and Dr S!!\

Soapy

Receiving followup care is important, and I am really glad to see this topic being discussed. 

I understand there may be frustration when a PCP refuses to care for a postop patient, but look at it from their standpoint. 

Nothing in their training or credentialling would prepare them to adequately care for a patient undergoing the most involved of all plastic surgery procedures (i.e. LBL).  Most general docs (i.e. fam practice) do a 3 year residency with 8 weeks of surgery exposure, almost none of it plastics. 

They also assume liability for the case, and may be the only one left "holding the bag" in case of complications or bad outcomes.

I realize they may be the best and only option, but I think its also relevant that we all understand their hesitancy.

Along that line Dr. L, I have found that the other Plastic Surgeons in my surgeons practice don't do that many large body procedures - most do facial stuff or breast reconstruction - I have Kaiser HMO - so they don't do just cosmetic procedures for the most part.  The Kaiser I use does do cosmetic work as well as a fee for service.  I have had even these other plastic surgeons let me know that this is really outside their scope of practice, and that they are not all that comfortable working on me if I've had an issue while my doctor is gone.  I think we can really take these big procedures for granted and we have to be followed up by a surgeon who knows what they are doing and has experience. 
The surgical skill is key but so is knowing how to manage the issues after, and I agree that this is too much for my primary to handle or an inexperienced plastic surgeon to handle.
I for one am very glad that I didn't travel so far for my surgeries.  I do have an hour drive from my home to the west side of Los Angeles, but I would rather go and see my guy there than a plastic surgeon closer to home in my HMO that doesn't deal with these procedures.  Maybe it is because I've been that rare exception patient -- but for me, the followup care was critical.

Hi Jennie. I'm going to quote you:

"we have to be followed up by a surgeon who knows what they are doing and has experience. "

And here is the policy of the American College of Surgeons:

"Itinerant surgery is proscribed.... The elements of time and distance are not pertinent in determining whether an individual has performed "itinerant surgery." An ethical surgeon will not perform elective surgery at a distance from the usual location where he or she operates without personal determination of the diagnosis and of the adequacy of preoperative preparation. Postoperative care will be rendered by the operating surgeon unless it is delegated to another physician who is as well qualified to continue this essential aspect of total surgical care."

When I trained, you took 100% responsibility for everything before and after a patient's surgery.  If you failed, you didn't stay in the surgery program for long.  Getting cut after 10 years of college and med school was a tough pill to swallow, but many programs were a "pyramid"  Start with 9 interns, end up with 4 chief residents at the end of 5 years. The rules were unwritten, but crystal clear.

I realize its different today, but can I be allowed to say that it just goes against my grain to hear about patients pulling their own drains, and removing their stitches while trying to find a PCP to care for them ?
 

I am just amazed that we want to make sure that the person doing the surgery is qualified, and we agonize over credentials -- WHICH WE SHOULD --

But we need to make sure that the person doing our follow up care is just as qualified, experienced and credentialed.  Why would a patient think that just anyone can step into those shoes and manage the case? Why would that other doctor want to assume the responsibilty.

I "hired" my surgeon to do a complete job - preop, surgery, post op, and continued care and revisons afterward. I don't want just part of the job done.

Just my opinion - others may differ in opinion, but know that you might have long term complications. Plastic surgery is one of the most disruptive surgeries that people can have, and they go into so lightly.  I think that some of the reality TV shoes have done a HUGE disjustice with this.

Anyone, off my soap box for tonight.
Maybe it is because I've had to be "drained" for the 3rd time in 6 days, or maybe I'm just cranky, or just afraid for those who will face future problems, but we really need to be wise here.

The resident who saw me today is CURRENTLY attending to 4 patients in the hospital who have had plastic surgery out of the country in the past month. They have infections and open wounds. Nuff said.