Post-op care locally after surgery at Mayo?

Posted by amywood20 @amywood20, Jul 2 8:14am

Hello – I am considering traveling to Mayo for a second opinion on my shoulder. I won't bore everyone with all of the details but do have a question. If someone has an orthopedic surgery at Mayo, are they able to get post-op care (i.e. follow up appointments) with a local specialist versus having to travel back to Mayo? I am a Mayo patient for my polycystic kidney and liver disease (PKD/PLD). And after having two local OB/GYNs attempt to figure out a problem I am having, I have also started seeing a Mayo OB/GYN. I had testing done here with results sent to Mayo and have used virtual appointments with plans to visit the doctor later in the year when I am there for my annual PKD/PLD appointment. I haven't had any surgery at Mayo though so I wasn't sure how that is handled in terms of having a surgery there but then handing post-op care, physical therapy, etc., off to someone at my local level. Any insight is appreciated!

I can not answer all questions, but can shed light on physical therapy. You can do physical therapy at non-Mayo locations. Many of my relatives who live in Rochester and had orthopedic surgery at Mayo Rochester did their PT at other facilities. The Mayo provider wrote a prescription? (instruction) to the PT facility about treatment needed.

Laurie

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Hellon @amywood20 My wife had very complex brain surgery at Mayo (Rochester), but after her hospital stay she did her rehab for over a year back in our home community, Her Mayo specialists interfaced terrifically with her gp back home, too.

Strength, courage, and peace

Liked by amywood20

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Amy, I'd like to bring @jolinda @rosemarya @lilypaws @jenniferhunter and @ken82. They can add their experiences to Scott's and Laurie's with respect to have surgery at Mayo Clinic and follow-up care locally back home and how Mayo clinicians coordinate that care.

When will you be having surgery?

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@colleenyoung

Amy, I'd like to bring @jolinda @rosemarya @lilypaws @jenniferhunter and @ken82. They can add their experiences to Scott's and Laurie's with respect to have surgery at Mayo Clinic and follow-up care locally back home and how Mayo clinicians coordinate that care.

When will you be having surgery?

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@colleenyoung I don't have surgery scheduled yet. I am getting a guided injection into my shoulder on the 9th and then am supposed to see the spine surgeon in August as a follow up. He is the one who thinks this is a shoulder issue that was made worse by the cervical spine surgery. Depending on how it goes, I may end up at Mayo for their expertise.

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@colleenyoung

Amy, I'd like to bring @jolinda @rosemarya @lilypaws @jenniferhunter and @ken82. They can add their experiences to Scott's and Laurie's with respect to have surgery at Mayo Clinic and follow-up care locally back home and how Mayo clinicians coordinate that care.

When will you be having surgery?

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@colleenyoung I didn't know where to send this to for Scott's and Laurie's surgery, so I'm sending this to you. It depends on the surgery. I had a back fusion from T-10 to my pelvis. My surgery was 9 hours long and 3 hours in recovery. To tell the truth it was very painful and I had low blood pressure, which they thought could be the valium they were giving me, but one of the nurses change my cuff to a smaller one, which also made a difference. I take flexiril now for the muscle relaxant. The day after surgery I had to go down and have anesthesia for them to inject cement in my T-10 and T-11 to keep my back stable. The anesthesia can really make you loopy and not able to think straight. When I had low BP I would almost pass out and my husband said I would talk, but it did not make sense. I also had low Hebagobin (SP) and had to have a Red Blood infusion. Mayo is the best place to have surgery. My surgeon was excellent and had all the qualifications to do my surgery. The surgeon resident that came and saw me everyday didn't do my meds correct. I was only sent home with oxycodone, because I told the nurse I had Tramadol at home and she said my doctor at home could order it for me. They mainly gave me Tramadol in the hospital. My husband called my surgeons assistant and he said, NO, NO, No, I was to also have the Tramadol filled at Mayo. And the way I take it is
is I take tramadol and then 3 hours later the Oxycodone and continue taking the meds that way, They did not tell me that when I was discharge. The surgeon came up to see me the day I was night before I was discharged. He didn't like the way my thing to keep me up right and to protect my back. He did not like it fit, but my husband made it fit better when I got home. Sorry I can't think of the name of it. I hope I didn't give them too many wrong ideas. It was just my surgery and like I said it depends on what kind of surgery they are having. I hope all goes well for them and Mayo is the best place to go.

Liked by amywood20

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@lilypaws

@colleenyoung I didn't know where to send this to for Scott's and Laurie's surgery, so I'm sending this to you. It depends on the surgery. I had a back fusion from T-10 to my pelvis. My surgery was 9 hours long and 3 hours in recovery. To tell the truth it was very painful and I had low blood pressure, which they thought could be the valium they were giving me, but one of the nurses change my cuff to a smaller one, which also made a difference. I take flexiril now for the muscle relaxant. The day after surgery I had to go down and have anesthesia for them to inject cement in my T-10 and T-11 to keep my back stable. The anesthesia can really make you loopy and not able to think straight. When I had low BP I would almost pass out and my husband said I would talk, but it did not make sense. I also had low Hebagobin (SP) and had to have a Red Blood infusion. Mayo is the best place to have surgery. My surgeon was excellent and had all the qualifications to do my surgery. The surgeon resident that came and saw me everyday didn't do my meds correct. I was only sent home with oxycodone, because I told the nurse I had Tramadol at home and she said my doctor at home could order it for me. They mainly gave me Tramadol in the hospital. My husband called my surgeons assistant and he said, NO, NO, No, I was to also have the Tramadol filled at Mayo. And the way I take it is
is I take tramadol and then 3 hours later the Oxycodone and continue taking the meds that way, They did not tell me that when I was discharge. The surgeon came up to see me the day I was night before I was discharged. He didn't like the way my thing to keep me up right and to protect my back. He did not like it fit, but my husband made it fit better when I got home. Sorry I can't think of the name of it. I hope I didn't give them too many wrong ideas. It was just my surgery and like I said it depends on what kind of surgery they are having. I hope all goes well for them and Mayo is the best place to go.

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Thanks @lilypaws. Your message is posted for all to see. I'm confident that @amywood20 will appreciate your response.

Liked by amywood20

REPLY
@lilypaws

@colleenyoung I didn't know where to send this to for Scott's and Laurie's surgery, so I'm sending this to you. It depends on the surgery. I had a back fusion from T-10 to my pelvis. My surgery was 9 hours long and 3 hours in recovery. To tell the truth it was very painful and I had low blood pressure, which they thought could be the valium they were giving me, but one of the nurses change my cuff to a smaller one, which also made a difference. I take flexiril now for the muscle relaxant. The day after surgery I had to go down and have anesthesia for them to inject cement in my T-10 and T-11 to keep my back stable. The anesthesia can really make you loopy and not able to think straight. When I had low BP I would almost pass out and my husband said I would talk, but it did not make sense. I also had low Hebagobin (SP) and had to have a Red Blood infusion. Mayo is the best place to have surgery. My surgeon was excellent and had all the qualifications to do my surgery. The surgeon resident that came and saw me everyday didn't do my meds correct. I was only sent home with oxycodone, because I told the nurse I had Tramadol at home and she said my doctor at home could order it for me. They mainly gave me Tramadol in the hospital. My husband called my surgeons assistant and he said, NO, NO, No, I was to also have the Tramadol filled at Mayo. And the way I take it is
is I take tramadol and then 3 hours later the Oxycodone and continue taking the meds that way, They did not tell me that when I was discharge. The surgeon came up to see me the day I was night before I was discharged. He didn't like the way my thing to keep me up right and to protect my back. He did not like it fit, but my husband made it fit better when I got home. Sorry I can't think of the name of it. I hope I didn't give them too many wrong ideas. It was just my surgery and like I said it depends on what kind of surgery they are having. I hope all goes well for them and Mayo is the best place to go.

Jump to this post

@lilypaws that's for sharing your experience!

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@amywood20
Hi Amy,

I'm glad you are here as part of our community! I had PKD too, but I don't anymore… I received a laparoscopic bilateral native nephrectomy (to remove my PKD kidneys) at the same time I had a living donor kidney transplant. I had my major surgery at Mayo and coordinated my recovery and Physical Therapy with my local team. I have been very successful with a blended team effort (some Docs at Mayo and some locally). In your case it would be awesome to have your post care set up and ready to go locally before your surgery takes place. Depending on what computer systems your local teams use you can either share medical records automatically through EPIC or you can have them sent back and fourth in less automated ways.

PS if you have PLD evidence show you should NOT take Estradiol or Estrogen because it causes the liver cysts to grow in volume.

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@amywood20

@colleenyoung I don't have surgery scheduled yet. I am getting a guided injection into my shoulder on the 9th and then am supposed to see the spine surgeon in August as a follow up. He is the one who thinks this is a shoulder issue that was made worse by the cervical spine surgery. Depending on how it goes, I may end up at Mayo for their expertise.

Jump to this post

@amywood20 Only your surgeon can answer if you need to do surgical followups at Mayo, so you may want to ask that when you speak with someone about scheduling. I have had 2 surgeries at Mayo Rochester, cervical spine surgery 4 years ago and orthopedic surgery for a broken ankle just a few weeks ago. With my spine surgery, it was not necessary to come back to Mayo for every followup, until the one year followup, but I liked coming back there. There was a 6 week, and a 3 month followup. The 3 month was done remotely by mailing in X rays. My physical therapist was sending updates. With my orthopedic ankle surgery, I need to return for each follow up. That involves removing the splint/cast at 2 weeks and removing stitches, and in my next follow up, removing the fiberglass cast. My spine surgeon used dissolving stitches, making return to Mayo optional. The orthopedic surgeon used nylon stitches, and return is essential to remove those and place new support dressings for the ankle. I would expect a shoulder surgery might be similar and need a return. Shoulders need to be assessed for proper movement and a surgeon would want to know how that is progressing. One thing I would also ask is if they can evaluate you for thoracic outlet syndrome which is more common among spine injury patients. That is a neck/shoulder problem and I had that along with my spine problem with a collapsed disc. It creates overlap in pain symptoms, and you can have both as sources of symptoms. That is misunderstood by a lot of doctors, but Mayo is a good place to have that evaluated and that was part of my original evaluation to figure out where most of my symptoms were coming from. If you had spine surgery, and TOS was missed, you would likely still have the arm pain. I had carpal tunnel surgery and TOS was missed for a long time. My experience with recovery from spine surgery also caused my neck and shoulders to tighten up making pain a bit worse until physical therapy could be done, and my therapist did a lot of myofascial release to break up the fascial surgical scar tissue. Here is some info on MFR. It may be able to help you.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
I could have found a local surgeon to operate on my ankle, but I didn't want to go to an urban medical center in a COVID hotspot, and I had concerns about infection rates at some of the smaller local hospitals and I didn't have enough information to know which surgeons were better than others. I knew if I came back to Mayo, I would have a really good surgeon and I would be in good hands, and I felt a lot safer at Mayo with the COVID precautions. It cost just a little more, because of lodging, but I think that's worth it for a better qaulity of care and healing. I contacted my spine neurosurgeon and asked is recommendation, and I'm grateful that I can ask that because of the good relationship I have with him and with everyone at Mayo. It matters to me to know that I could trust my care to world class surgeons, and I stop stressing about finding a good one on my own.

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@jolinda

@amywood20
Hi Amy,

I'm glad you are here as part of our community! I had PKD too, but I don't anymore… I received a laparoscopic bilateral native nephrectomy (to remove my PKD kidneys) at the same time I had a living donor kidney transplant. I had my major surgery at Mayo and coordinated my recovery and Physical Therapy with my local team. I have been very successful with a blended team effort (some Docs at Mayo and some locally). In your case it would be awesome to have your post care set up and ready to go locally before your surgery takes place. Depending on what computer systems your local teams use you can either share medical records automatically through EPIC or you can have them sent back and fourth in less automated ways.

PS if you have PLD evidence show you should NOT take Estradiol or Estrogen because it causes the liver cysts to grow in volume.

Jump to this post

@jolinda Thanks for the info and congrats on a successful PKD surgery. In terms of the estradiol/estrogen, none of my medical professionals here seemed to know about that. I was on HRT for three years before learning from others I should not be taking it. I stopped it on my own July 2019. Went to Mayo in October and the PKD/PLD specialists were shocked that my family practice doc, OB/GYN, nephrologist and liver specialist had no clue. Last month I did do a telemedicine appointment with an OB/GYN at Mayo because after six years of not having a period (am not on birth control) and lab work indicating I am post menopause, I have started bleeding again. In my discussion I did mention to the Mayo OB/GYN about my PKD/PLD and the estrogen issue. She wanted to put me on Premarin cream, noting due to how it is administered, it should not be an issue compared to an oral pill. She was concerned about bone health. I have another call with her at the end of the month to go over new lab work she had me do here locally.

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@jenniferhunter

@amywood20 Only your surgeon can answer if you need to do surgical followups at Mayo, so you may want to ask that when you speak with someone about scheduling. I have had 2 surgeries at Mayo Rochester, cervical spine surgery 4 years ago and orthopedic surgery for a broken ankle just a few weeks ago. With my spine surgery, it was not necessary to come back to Mayo for every followup, until the one year followup, but I liked coming back there. There was a 6 week, and a 3 month followup. The 3 month was done remotely by mailing in X rays. My physical therapist was sending updates. With my orthopedic ankle surgery, I need to return for each follow up. That involves removing the splint/cast at 2 weeks and removing stitches, and in my next follow up, removing the fiberglass cast. My spine surgeon used dissolving stitches, making return to Mayo optional. The orthopedic surgeon used nylon stitches, and return is essential to remove those and place new support dressings for the ankle. I would expect a shoulder surgery might be similar and need a return. Shoulders need to be assessed for proper movement and a surgeon would want to know how that is progressing. One thing I would also ask is if they can evaluate you for thoracic outlet syndrome which is more common among spine injury patients. That is a neck/shoulder problem and I had that along with my spine problem with a collapsed disc. It creates overlap in pain symptoms, and you can have both as sources of symptoms. That is misunderstood by a lot of doctors, but Mayo is a good place to have that evaluated and that was part of my original evaluation to figure out where most of my symptoms were coming from. If you had spine surgery, and TOS was missed, you would likely still have the arm pain. I had carpal tunnel surgery and TOS was missed for a long time. My experience with recovery from spine surgery also caused my neck and shoulders to tighten up making pain a bit worse until physical therapy could be done, and my therapist did a lot of myofascial release to break up the fascial surgical scar tissue. Here is some info on MFR. It may be able to help you.
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
I could have found a local surgeon to operate on my ankle, but I didn't want to go to an urban medical center in a COVID hotspot, and I had concerns about infection rates at some of the smaller local hospitals and I didn't have enough information to know which surgeons were better than others. I knew if I came back to Mayo, I would have a really good surgeon and I would be in good hands, and I felt a lot safer at Mayo with the COVID precautions. It cost just a little more, because of lodging, but I think that's worth it for a better qaulity of care and healing. I contacted my spine neurosurgeon and asked is recommendation, and I'm grateful that I can ask that because of the good relationship I have with him and with everyone at Mayo. It matters to me to know that I could trust my care to world class surgeons, and I stop stressing about finding a good one on my own.

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@jenniferhunter So sorry about your ankle! I really wish Mayo was closer, as I love the care I receive there. If the winters weren't so harsh in Minnesota, we might consider moving there. LOL. I suspect I may end up there for this shoulder/spine stuff, as I know they will be able to figure it out.

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@amywood20

@jenniferhunter So sorry about your ankle! I really wish Mayo was closer, as I love the care I receive there. If the winters weren't so harsh in Minnesota, we might consider moving there. LOL. I suspect I may end up there for this shoulder/spine stuff, as I know they will be able to figure it out.

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@amywood20 Mayo is a drive for me too.. 5 hours, but I compare that to driving to Chicago which is about 2 hours with crazy dangerous traffic, then the drive to Mayo through the pretty countyside seems so much better. I also know when I get there I am in a healing environment. it's a bit like a mini vacation and I avoid the over crowded big city. I'll be going back to Mayo in a couple weeks and looking forward to it. I am making slow progress with my ankle and sometimes I can forget what happened and it's not hurting. I'm sorry it happened too, but it was a freak accident that happened so fast when I fell from a horse while on a trip. This is the first time I have ever broken bones, and it has been very painful, even more painful than spine surgery. Moving around the house is a chore, so I plan so I don't have to make extra trips. I am counting the days until the cast comes off. When my ankle hurts, and I can't escape, it seems kind of claustrophobic, but when I keep the leg elevated, I do well because it keeps the swelling down. If you have any questions, I'd be glad to help. Each time I had surgery, we stayed an extra day at the hotel just in case there were issues.

Liked by amywood20

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@amywood20

@jolinda Thanks for the info and congrats on a successful PKD surgery. In terms of the estradiol/estrogen, none of my medical professionals here seemed to know about that. I was on HRT for three years before learning from others I should not be taking it. I stopped it on my own July 2019. Went to Mayo in October and the PKD/PLD specialists were shocked that my family practice doc, OB/GYN, nephrologist and liver specialist had no clue. Last month I did do a telemedicine appointment with an OB/GYN at Mayo because after six years of not having a period (am not on birth control) and lab work indicating I am post menopause, I have started bleeding again. In my discussion I did mention to the Mayo OB/GYN about my PKD/PLD and the estrogen issue. She wanted to put me on Premarin cream, noting due to how it is administered, it should not be an issue compared to an oral pill. She was concerned about bone health. I have another call with her at the end of the month to go over new lab work she had me do here locally.

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@amywood20
I'm glad you were able to uncover the facts you needed, sometimes doing your own research or connecting on a forum like this is the best way to discover cutting edge information. Please feel free to join us in the Kidney Bladder and Transplant groups when you're ready. Best of luck with your shoulder surgery.

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