Opinion and second opinion, pre-surgery opinions

June 15, 2015

The rupture occurred on Sunday May 10, 2015. On May 12 I got in to see my surgeon, Dr. Kartelian.  He described surgical and non-surgical options.  I thanked him and told him that I was going to get a second opinion at George Washington University Hospital, a world-class teaching hospital here in Washington DC.

The following day I got in to see a Professor of orthopedic surgery at the University.  He told me the exact same thing about surgical and non-surgical options that  my "home" orthopedic surgeon, Dr. Kartelian, had told me.  Basically there is a non-surgical option which is not recommended because of the incidence of rerupture, the failure to return me to pre-rupture strength and activity, and the length of recovery.  Surgery had risks from infection and anesthesia but the incidence of each was low and the repair from surgery resulted in very good outcomes and very low chance of rerupture.

After these two consultations I decided to go with the doctor close to my house, Dr. Kartelian.  My surgery was scheduled for the following week, May 2o, 2015.

I am glad I got the second opinion.  While the two opinions were almost exactly the same, the post-op protocols that I discussed with each doctor were polar opposites.  Dr. Kartelian, who ended up performing the surgery, had a very aggressive post-op protocol, moving in to the boot, starting physical therapy, and bearing weight as soon as possible after the surgery.  The Professor at the university was an older man, and he was also a foreign educated physician although he had lived in the US for dozens of years and had fellowships and awards and an excellent reputation.  He told me that his protocol was eight weeks in a long leg cast before I could start therapy - a very conservative approach.  While not the deciding factor, I really liked the idea of an aggressive rehab protocol, and from my reading, this type of therapy was on the cutting edge and patients were having excellent success with it.

I am really glad that I picked the surgeon with the aggressive protocol.  I had some nominal atrophy of my right calf in just the few weeks I was down, I can’t imagine how the leg would look after 8 weeks in a full cast!  Getting in to physical therapy has motivated me to work hard and to get better sooner.  Being able to take the boot off and apply vaso pumps and ice has been a Godsend, although I realize how careful I have to be and how vulnerable I am in those brief intervals out of the boot.

I suggest to anyone who has the opportunity to get a second opinion that you just go ahead and do it.  Ask about the surgery, the anesthesia, pain relief, edema control, clot control, and post-op rehab protocols, as well as anything I forgot to mention.