Seeking Alternatives to Surgery for My Father's Health Concerns

Q: Seeking Alternatives to Surgery for My Father's Health Concerns

Hello： In response to your question, I'm not sure which hospital your father had his surgery at. <br>Generally speaking, if it's a follow-up issue after the first surgery, it's advisable to return to the original hospital for consultation, as all the records and the attending phy

Thank you, Dr. Ko, for your response?

Dear Dr.
Ko,
Thank you for taking the time to respond to this letter.
Recently, my father’s attending physician at Kaohsiung Medical University Hospital informed us that he needs to undergo another surgery.
The explanation provided by the physician mentioned the possibility of adhesions, similar to what you had mentioned.
However, after discussing among our family, we are concerned because my father is unable to eat and has become quite emaciated.
Although the hospital has been administering nutritional IV fluids, we are unsure if his body can withstand another major surgery.
We were hoping to explore other options that might help alleviate my father's bowel obstruction without resorting to surgery.
If surgery is indeed unavoidable, could you recommend a surgeon in the Kaohsiung area who is experienced in such procedures? Thank you!
My father has already undergone a permanent colostomy.
If he has another surgery, is there still a risk of developing adhesions afterward? I would also appreciate guidance on how to contact Dr.
Jian Li-Jian.
Thank you!

A Fang, 20~29 year old female. Ask Date: 2007/08/21

Dr. Ke Fangxu reply Surgery

Hello: In response to your question, I'm not sure which hospital your father had his surgery at.
Generally speaking, if it's a follow-up issue after the first surgery, it's advisable to return to the original hospital for consultation, as all the records and the attending physician are there, which allows for more accurate management of the condition.
However, if you wish to seek a second opinion, you might consider consulting a colorectal surgeon at Kaohsiung Veterans General Hospital or Kaohsiung Chang Gung Memorial Hospital for a more objective perspective.
If you don't have a familiar physician, you might consider Dr.
Jian-Jian Jian at Kaohsiung Veterans General Hospital; he is a classmate of mine and may provide you with more candid advice.

Reply Date: 2007/08/21

More Info

Dear [Name],
Thank you for reaching out with your father's health concerns. It sounds like a challenging situation, and I appreciate your desire to explore alternatives to surgery for his condition. Given your father's history and current state, it's essential to approach this matter with careful consideration.

Your father's situation, particularly with his existing permanent colostomy, raises several important points. Adhesions, which are bands of scar tissue that can form after surgery, can indeed lead to complications such as bowel obstruction. While surgery is often the standard approach to address these issues, it is not without risks, especially for someone who has already undergone multiple procedures and is currently experiencing significant health challenges.

Before considering another surgery, it is crucial to evaluate all possible non-surgical alternatives. Here are some options that might be worth discussing with your father's healthcare team:
1. Nutritional Support: Since your father is unable to eat and is losing weight, nutritional support is vital. While IV nutrition (TPN) can provide essential nutrients, it may not be a long-term solution. Consulting a dietitian who specializes in gastrointestinal issues could help in formulating a plan that may include enteral feeding (via a feeding tube) if appropriate.

2. Medications: Depending on the specific nature of the bowel obstruction, medications may help manage symptoms. For instance, prokinetic agents can stimulate bowel movement, while laxatives may assist in softening stool. Discussing these options with a gastroenterologist could provide insights into whether they are suitable for your father.

3. Endoscopic Procedures: In some cases, endoscopic interventions can relieve obstructions without the need for open surgery. This could involve techniques to dilate narrowed areas or remove blockages. A gastroenterologist would be the best specialist to evaluate if this is a viable option for your father.

4. Pain Management: If your father is experiencing discomfort, effective pain management strategies should be implemented. This can significantly improve his quality of life and may help him tolerate other treatments better.

5. Palliative Care: If your father's condition is complex and his prognosis is uncertain, involving a palliative care team can provide comprehensive support. They focus on improving quality of life and can assist in managing symptoms, regardless of the underlying condition.

If surgery remains the only option, it is essential to discuss the potential risks and benefits with the surgical team. You may want to inquire about the surgeon's experience with similar cases and their approach to minimizing the risk of adhesions post-surgery.
Regarding your question about finding a skilled surgeon in the Kaohsiung area, I recommend seeking referrals from your father's current healthcare providers or contacting local hospitals known for their surgical departments. They can guide you to specialists with expertise in managing complex gastrointestinal cases.

Lastly, it's understandable to feel apprehensive about another surgery, especially given your father's health status. Open communication with his medical team is crucial. They can provide clarity on the necessity of the procedure and discuss any alternative options that may be available.

I hope this information helps you navigate this difficult situation. Please do not hesitate to reach out to your father's healthcare providers for further guidance tailored to his specific needs.

Best wishes for your father's health and recovery.

Sincerely,
Doctor Q&A Teams

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