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A Second Opinion?

Friday, September 17, 2021

By Adam Ehlert

“But I don’t want to upset my doctor. I really don’t know what to do.”

I could empathize with my friend. Boy, could I empathize. Over and over, I was full of empathy.

My friend was really pretty happy with his provider. He’d been a loyal patient for years, but with a recent development, was not getting accountable answers. No progress, no consistency, no plan forward. He was frustrated. Beyond that, he was frightened. His wife was even more frightened, and now after months of wheel-spinning, had to shoulder more of the burden herself. They were both frightened, both wearied.

“Yes, my friend—I know exactly how you feel.”

You see, I had been a very fortunate frequent flier at my provider’s office as I went through years of chronic and unpredictable arrhythmias. They always accommodated me, even to the point where it felt like I had a standing order for an electrical cardioversion whenever needed.

But I may have worn out my welcome. I went through every combination of drugs they could imagine. I had a couple of ablations that were effective… for a few months at a time. All, of course, were complicated by the occluding device that closed my atrial septal defect (when discovered at age 39). And when I “broke through” my latest ablation or wonder drug, back into arrhythmic purgatory, the fine professionals calmly assessed and made another plan for me.

But when I maybe even wore out (in my mind, anyway) the electrical element on the cardioversion machine, the whole practice seemed to throw up their hands and say: “go see the surgeon.”

I was out of easy options. Surgery was to be my next avenue. Great, no problem. The referral was in the same system, and I was lucky to get an appointment in just a few days.

And the appointment went swimmingly. My wife and I both felt really comfortable with the physician, and he spent a significant amount of time with us, addressing all our Biology 101 questions and imagined fears. But as we left, we each realized we did not understand the procedure he was “prescribing.” We had no frame of reference, no context of options. After a while, we realized that this surgeon does this procedure, whatever it is. We could not discern how that would reconcile against other options for my case.

And so, dissention was sowing in our ranks. I was frightened, weary, and just wanted to feel better. Tomorrow. I did not want to analyze any further. And the appointment had been great—we had nowhere to go but down.

But I needed my wife to be comfortable with my heart surgery. After several days of difficult debate, I decided to seek an alternate opinion. I did so with all the feelings of disloyalty that my friend was now feeling. I called my regular providers, with a courtesy heads-up and “it’s nothing personal” message. They understood, and they were encouraging, even. I now understand that they were confident in their practice, and always had my best interests at heart—of course. If another option was a better fit for me, they were happy for it.

The visit to Door #2 was every bit as good as the first. The chasm in our household was spreading by the minute. It narrowed again once we each agreed to seek a third option.

Thank goodness. The third provider illustrated a wide variety of surgical options to us. My wife and I sometimes speculating: “that must have been the one Dr. #1—or Dr. #2—would do.”

After running through the entire menu, discussing the pros and cons of each, the physician let me decide. As I did, he agreed and approved. That was the last decision I was allowed to make. I had chosen the most complicated option, but the one that gave me the best chance at putting my whole saga behind me. From there, the physician referred me to “the doctor who does this procedure,” and told me I’d be fine.

I’ll admit, it was not easy. I had a cut-and-sew Maze procedure. I hurt in places I would have assumed unrelated, for months—even more months after the oceans of drugs cleared my system.

And after all that, it did not work. My arrhythmia “broke through” about a half a year after I was fully recovered. That was a tough blow.

But I was comforted by my knowledge that we had explored all options. We sought other literal and figurative opinions. As I still regularly visit my old friends in my longtime provider’s office, they harbor no resentment that I went somewhere else.

I am thankful they all sought to empower me, the patient, for my right fit.

If I had blindly gone along with Option #1, without furthering my own knowledge, I would have been bitter after the breakthrough. As it is, I am glad I weighed all options.

Seeking a second opinion was originally an uncomfortable concept for me. But it became the right decision.

My friend did finally pick up the phone to request his second opinion. He hasn’t yet been to his appointment, but we could hear the relief in his voice as he proudly reported his first step to a second opinion.

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Disclaimer

The opinions expressed by ACHA bloggers and those providing comments on the ACHA Blog are theirs alone, and do not reflect the opinions of the Adult Congenital Heart Association or any employee thereof. ACHA is not responsible for the accuracy of any of the information supplied by the ACHA bloggers.

The contents of this blog are presented for informational purposes only, and should not be substituted for professional advice. Always consult your physicians with your questions and concerns.

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