A warning against elective surgery (e.g. hiatus hernia)

THIS COULD BE YOU
This was a couple of days after an emergency operation. My second op - the first was for a normal everyday hiatus hernia. I have since had a third non-emergency op. The tubes are a lot worse under the covers. I was trying to smile for my 11 year old daughter, Faye, taking the picture.
I was thinking this is going to be the last time she saw me.

This page is attempt to warn the true danger of elective surgery. In the UK it is unlikely to be as safe as you have been told. I know - the operation that lead to the above was, even after this, recorded as successful. This second op went wrong also. Amongst other things, it damaged nerve bundles. I would imagine that was also recorded as success - as my life was saved.

A surgeons reply - see what one has to say about my efforts at warning people.

Proven- in British Medical Journal - more than 1 in ten have at least one problem. The World Health Organisation recent report (October 2002) quote the same numbers - 1 in 10. I believe these figures are still under estimated.

Although incidental - you may consider it more important to the tax payer (everybody) - until it happens to your child or spouse, indeed any of your family or friends:

The article for BMJ says, "The cost of the extra days in hospital needed is running to at least £1bn a year, said the research team from University College London." - The article for WHO, "They also imposed an enormous financial toll on Britain, estimated at £2 billion a year in additional hospital stays alone." Same numbers of people - yet twice the costs - just for additional hospital stays alone.

Also Channel 4 had a series 'Why Doctors Make Mistakes', which confirms this problem. It has been recognize in America and UK that hospital operations are going wrong - a lot more than you think - more so than even doctors and surgeons think.

First a warning for those on Incapacity Benefit. When you fall ill, you expect the State to help until you can get back to work. I was not claiming all entitlements, just enough to get by - until I recovered from these ops. My Doctor and the Company Doctor advised me to do part-time therapeutic work. If you do any other work while ill you may be considered a fraud.

I have written proof that the Benefit Agency deny your right to legal entitlement - if you try to go back to work and fail to get better. Below is a scan of prejudiced evidence they used against me.

I did not get better - this was used against me, to stop my families legal entitlement to benefit. I was later to find out the rules allow them to use opinion against you (in legal action). This is against the old and sick - something that the police can not do with known rapists or child molesters. Yet they ignore the rules that help you - like the one that says they have to reply to any questions. Indeed, when I questioned their decision, they effectively tried to fine me £858 for doing so. You would not believe all what I found. The Benefit Agency even have rules to make you rob money from your children before allowing you benefit.

Perhaps worse of all, they have rigged the 'all work test' - used to disqualify sick and disabled people from benefit. Proof is with Social Security Commissioners File: CIB 5361/97. Mr PL Howell QC, on 20 May 98, said 'There are obviously some disturbing implications...' This abuse has been closed - but it does not close the reason behind it. By scrutinizing the figures and looking at trends, you can work out their true intent. My findings, analyzing Hansard figures, were a lot more disturbing than that discovered by Mr PL Howell QC. But enough of that - for now.

Hello, Garry here. First - exploratory surgery is nearly always necessary. I am not saying do not have any surgery - I may need more myself in the near future. More specifically I am talking about elective surgery, operations like hiatus hernia. This is just to warn you what can go wrong. I will make sure it is the last option, obviously using common sense. Dr Phil Hammond of television's 'Trust Me (I'm a Doctor)' has wrote a book telling of Doctors covering up for colleagues mistakes. Also doing operations they are incompetent in, misinforming patients about success rates etc. etc. There are 100,000 sickness with 5,000 deaths each year just due to bad hygiene actually caused in hospital. In the following account of events I have left out the names of those complicit to my problems. All my operations were performed at Papworth Hospital, one of the best in Britain, by one of their most experienced consultant surgeons. The first was a routine operation that is carried out many times daily all over the country. It might have killed me. If things can go wrong at Papworth then they will anywhere.

Hospital operations are going wrong a lot more than you think, more often than they need to. It makes sense to have better recording. My wife knows of someone that has had the wrong leg chopped off. It's not a joke, has anyone heard of anything more stupid? We have all seen on the news and read in the papers of blunders. The tragic MURDER of those infants in Bristol at the hands of a surgeon, it makes me angry. They all knew it was happening, they are all guilty. Yes, I know most surgeons, doctors and nurses are bloody brilliant. But these took an oath to save life, not risk it unnecessarily - would they play Russian roulette with their own children? Those poor parents, I can only guess at how I would feel had it been one of our girls. Had there been proper recording, these children would probably be alive today.

BUT - there is also misleading recording of results. Documentation shows my hiatus hernia op was recorded as successful, I have no reflux. Yet over 2 years later I still am in pain, and have taken ill health early retirement. There are a lot more operations going wrong. My first operation was a disaster, my stomach ended up in my chest. The second gave me irreparable nerve damage. Proper reporting and long term monitoring of ALL surgical problems, not just deaths, is needed urgently. Most the resources are there already - it will need little extra staff and computers. The managers waste millions on bureaucracy, Public Relations and Patient Satisfaction Officers. Hundreds of extra NHS beds are being opened in hospitals as part of the drive to cut waiting lists. What good if they are filled with dead infants? Why so many mistakes over the last few years. Could it be, as my reply to a surgeon says (below), because of the pressures to speed up patient throughput - to get the queues down. Now that hours are being increased by the Minister of Health, tired junior doctors will be giving more injection overdoses, killing more children. Do not get the wrong impression; I am not anti- doctor or surgeon, just against the piss poor mismanagement of the NHS.

In 1995 I started having bad stomach pains and acid which I thought was an ulcer due to pressure of work. Later, despite my aversion to medication, I took antacids and was prescribed omeprazole. This did not fully resolve the problem. I was slightly overweight, but relatively healthy, at 16 stone and six foot tall. I made some effort to change my diet and lose some weight at my GPs request. I should have tried harder - I should have kept with the tablets. I did not want to keep taking pills for the rest of my life - especially when they were having only a partial effect. I had two choices
1. No more curry and chips. No spicy foods. Just bland tasteless meals like boiled fish.
2. A normal routine everyday operation.
No contest. So in mid 1996 I was sent to Newmarket hospital for barium x-ray, they diagnosed hiatus hernia. Later to confirm this I was sent to West Suffolk hospital for a camcorder down the throat job. This is what it felt like - I ended up with a black eye and an oesophagus that bled for three days. This despite having warned them beforehand that I was likely to gag because of my sore throat - but things go wrong here. I then met the consultant surgeon from Papworth, a nice bloke, and he agreed to do the operation. During all this time I had some sleepless nights but did not take one day off work sick because of it - only a couple of days holiday when it got bad.

25 February 1997 - I went into Papworth for my operation. The following morning I had to initial a change on my consent form because of complications. They decided to change from a normal stomach entry to a side / back entry. This required cutting a rib and deflating my left lung to get at my stomach. All seemed to have gone well, mostly, and I was discharged after a week.

At the consultants clinic seven weeks later I complained of my pains / eating problems and was told it was just inflammation. After three weeks I went back to work still in pain and losing weight. I was thirteen and a half stone by this time and during the month back at work was to go down to twelve. Why did I not go to the doctor? Two reasons. Firstly, because I thought I could handle a bit of pain - after all it was just inflammation. Had they not been so dismissive I would have gone back and insisted on tests (which they were negligent in not doing when told). Secondly, I had just had nearly three months off work and you know how companies view absenteeism. Unable to bare the severe pain no longer I went sick and saw my GP. He gave me a sick note but was concerned enough to want a long appointment made to examine me more thorough. I could not keep the appointment, being sent by ambulance to emergency at Addenbrookes two days later.

22 June 1997 - I was given a tube up my nose to swallow into my stomach to allow liquid to be taken out, also an ECG to check heart and x-ray. These tests proved inconclusive, they denied this later, remember things go wrong here. During the next three days I was examined and had no water or food. I just was kept on saline drip and had my nose tube drawn from every couple of hours. Then during the evening a surgeon came to see me to say he had just seen my x-rays for the first time and told me that my stomach was in the chest cavity. He immediately organized for an ambulance to take me to Papworth hospital; it got me there around midnight.

The first thing in morning I was rushed into surgery for the consultant who performed the first op. I had my stomach relocated from chest, diaphragm repaired, my oesophagus greatly extended and had my spleen removed as it was damaged beyond repair. My two daughters came in a few days later when the photo above was taken. In the picture, I had the stomach drain down my nose/throat, saline drip in neck (now disconnected back-filling with blood), and vitramix pumped into my chest. Under the covers there are three garden hoses (approx. 15mm) sucking body juices from my chest and stomach cavities, a catheter and epidural for the pain. Also about three foot of scars, consisting of one on stomach and two around my side / back. That week the cocktail of drugs and painkillers were doing strange things to my mind. My consultant was later to tell me he did not know what had happened to my stomach. For most the sixteen days in hospital I had nil by mouth and left, now eleven stone, told not to put on weight in case of further problems. I look like a refugee at this weight.

At the consultants clinic six weeks later I complained of my pains and eating problems and this time, they did something about it. I was informed that another operation was required this time to dilate (widen by stretching) my oesophagus. Based on past performance this made me more than very concerned. I was worried that if my oesophagus split I would have live again without food and drink just thick vitramix being pumped into my veins 24 hours a day. It permeates through your skin, makes you smell and leaves a horrible taste in your mouth.

12 November 1997 - I asked to see the consultant before surgery, they held me in pre-op until he had finished the preceding patient. I wanted to make sure he remembered telling me he had not stretched an oesophagus as far as he had mine. I was now ten and a half stone, and had lost the equivalent of half of my current body weight. At my next clinic, he still did not know what went wrong.

27 April 1998 - I still have a sore tight and pinching rawness in my side. The consultant has told me last Thursday week that he can do no more, nor for the other health problems that I have had since. I still have shakes, poor sleep, no appetite, hair loss, and some personal stuff. He says the nerves into my stomach have been stretched - a quite common problem. It must be, Addenbrookes pain clinic say they will not see me for a year. I go back to work tomorrow (part-time therapeutic).

Trying to find out what went wrong I have searched medical web sites. There are a lot of ops going wrong. Better and proper long term monitoring is badly needed. In America, where there is better reporting, one case shown on MedSeek was of a poor woman that had fourteen operations to remove adhesions. People aren't told in the UK.

July 2001 - I have lost four years and still feel crap. I left out a lot - PLEASE talk over all the options with your doctor before surgery.

Update - a surgeons reply 19 March 99 I have received several supportive emails from all over. Mainly prospective patients. I replied to most, except a couple when my drive crashed, apologies to them. A few asked for advice regarding diet etc. To those seeking advice, each case is different - see your own doctor for that. This is the first email from a surgeon; I had to upload it. It is not what you would call a FLAME. However, I do think he was being slightly offhand. His point of view is very much appreciated. I will point out beforehand that when you start quoting percentages it is easy to lose sight of the fact these are actual flesh and blood people. Surgeons are more objective and have to distance themselves from the suffering caused - looking to positive side.

A couple of other points. 1) My op was not keyhole - I was led to believe open surgery better. 2) It should be noted that my hiatus hernia operation was recorded as successful, as I no longer have reflux. Therefore, I am one of the 95% who he says are delighted. Yippee, that is okay then. My condition has got no better and I have had to leave work. I hope the other 94 still have a job. Anyway here is the email and my reply.

But your advice is not sound. Hiatus hernia surgery is major surgery, and over 95% have excellent results after the keyhole operation. That means that there are 19 patients who are delighted with their operation for every one that does not have a good result. I guess that for every one who has a result like yours there will be 5 with poor results and 95 who are delighted. That is called playing the odds. There are no absolute guarantees in surgery.

There are no guarantees in crossing the road either. Sure the odds are better than hiatus hernia surgery, but even so are you saying that if the odds of not surviving crossing the road are one in a million you will discourage everyone from crossing it?

If you felt that the one in 100 chance of not getting a good result from your surgery meant that YOU would avoid surgery - then OK you avoid it. Please do not prevent others taking the chance if they think it is worth it.

I know that my patients are told the facts, and left to make up their own minds.

thank you very much for your email. I appreciate your opinion and hope you do not have the wrong impression of mine. I am not anti-surgeon. I do not have any bad feelings towards my surgeon, he was trying to help me, and I tried to convey the fact I liked him. I chose my words most carefully. I believe ops are increasingly going wrong (read newspapers) mainly because of pressures to speed up patient throughput.

Not ALL patients are told ALL the facts. I was told that I might need a second operation if the first was too tight. I was not told all my stomach might end up in my chest and give long term health problems. Also my mental health has seriously suffered and caused me to turn down more surgery, giving me another life long health problem. I was used to pain, when 17 all my right hand fingers were shredded in a machine. I got over that quickly. I doubt if I will ever get over this recent episode. I get many hits on my multi-registered site and have had positive emails from as far as Australia. I hope you can see that I am trying to do my best to warn the 5% of poor souls (and their families) whose lives may be taken or ruined. There are many thousands of them every year. I am sure you would want them to have all the facts.

I am afraid my advice is sound and logical, being built on my true experiences, and your analogy to road crossing is not fitting. I understand your wish that I desist and am sorry I cannot comply. I give you and your patients all my very best wishes for successful operations.

WARNING - IS YOUR OPERATION REALLY NECESSARY?