Outpatient Surgery Magazine - Subscribers

Clear Cut - July 2015 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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Page 129 of 132

O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | J U LY I Cannot Tell a Lie Sometimes it hurts to tell patients the truth. W e should always tell patients the truth, even when, as in these scenarios, the news isn't what they want to hear. • 'More arthritis than we bargained for.' Sometimes even the most sophisticated MRI unit misses appreciable arthritis. What initial- ly looked like a reasonable shoulder really has less mileage left than my 1964 Studebaker. A patient who may have aspired to pitch for the Yankees may have to settle for a mixed softball league. Thankfully, underhand throwing is not just for sissies. • 'We couldn't fix it all.' Many patients put off rotator cuff surgery until their tissue quality approaches that of Kleenex. At surgery, at best we can accomplish a partial repair and not fully restore native anatomy. The patient needs to know that bench pressing is not in his future and that his rehab is going to be longer than the turnover time at the Veterans Administration OR. Patients usually find significant pain relief, but when they return 6 months later and still can't lift a laun- dry basket, they'll know why. • 'We didn't really find much.' Some patients display many signs and symptoms consistent with meniscus tear of the knee, yet have equivocal imaging findings. After months of rehab and exhaustion of every conservative means possible, I'll sometimes recommend arthroscopic evaluation just to be sure and for closure. Sadly, on occasion, the findings at surgery are meager at best. In surgeon parl- ance, this is called a surgical "airball." The presumed meniscus tear causing the medial knee pain was simply not there and some softening of the patella was the likely cul- C U T T I N G R E M A R K S John D. Kelly IV, MD z SCOUT'S HONOR It's sometimes easier said than done to come clean with patients and families after surgery.

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