Picking a surgeon

Hi, I am in a similar boat - I have my first consult with Dr. Finlayson scheduled for week after next.  J-pouch surgery seems likely, since I have failed to respond to other treatments.  Dr. Mahadevan at UCSF is my GI and I have been happy with her, but I want to make sure I am doing enough research prior to choosing a surgeon.  Curious to hear if you found out anything interesting about Dr. Finlayson, or found other recommended surgeons in the Bay Area? 

Thanks

Hi- I had my first of two step jpouch surgery with Dr Finlayson on aug 8. I was supposed to be released after about five days but ’m still here at UCSF hospital on dat 10! I had a few issues with my small intestines being slow to wake up after surgery- that’s what lengthened my stay.  Hoping to go home this weekend. I’ve had a good experience so far with dr Finlayson. She was patient with me in our consultation. (I had a loongg list of questions!). I found her down to earth and quite knowledgeable.i also have dr Mahadeven as my GI and trusted her judgement when she referred me to Finlayson.  And of course, UCSF is among the best hospitals. 

Good luck! Let me know if I can answer anything else. 

Shannon

Hi Shannon, thanks for the reply.  Nice to find someone else who's had experience with Drs Mahadevan and Finlayson. I too am working on my long list of questions before my consultation appt with Dr. Finlayson on 8/28  

Any wisdom to share, now that you've made it through the first surgery?  Things you wish you'd known beforehand, questions to ask, etc...? 

Hope you can get home this weekend, and that the rest of your recovery goes smooth! 

Brian

Some of the things that surprised me: the importance of starting liquids and food very slowly post surgery. Also the importance of walking after surgery to get the small intestines moving. 

Not sure if everyone gets this post surgery- but I had a drain coming out of one of my incisions  

The other thing that surprised me was how I reacted to the illeostomy. I thought I would be traumatized but I really wasn’t. It wasn’t nearly as bad as I had feared.  

Hope this helps! 

Good to know, thanks for the info. 

Hi Shannon, I just had my consult with Dr. Finlayson this afternoon.  My first impression of her was very good, she seems very knowledgeable and experienced, and has a great bedside manner/sense of humor.  Looks like I will likely be scheduling a three-step j-pouch procedure with her, probably starting with step 1 in November (supposed to hear back from scheduler tomorrow). 

Is your procedure also being done in 3 steps?  How is your recovery going? 

Hi Brian- 

Glad you liked Dr Finlayson. I liked her too and was told by a few nurses that Finlayson was quite good and that I was in good hands. She came to see me most days I was in the hospital which was reassuring. 

I had 2 step. Hoping to have the takedown surgery in mid-November. 

I was in the hospital 11 days. It was supposed to be 5-7 days so I wasn’t quite prepared for such a long stay. As I mentioned above, I think I started solids too soon (day after surgery.) so that’s what kept me in the hospital  I’ve been home for  about a week and a half  and I’m slowly getting back to normal  just doing little things around the house and running a few local errands. At first I got tired really easily but I’m getting stronger every day.

Dr Finlayson told me to plan on 2 steps but she wouldn’t really know if it would be 2 or 3 until she got in there. Did she tell you for sure that you’ll have to do 3 steps. 

UCSF is great. The  hospital is modern and new and the rooms are all private with huge tv’s! Lol

Shannon

That's good to hear that things are progressing well.  Today I talked to one of Dr. Finlayson's j-pouch patients, Lauri, and she mentioned that she had also talked to you!  San Francisco J-pouch club, woo!  Lol. 

Dr. Finlayson didn't say definitively whether I would get a 2-step or 3-step.  After my consult, I realized that I am still a little unclear on the reasons you would have one or the other, but here's what I *think* she said are the reasons to opt for a 3-step:

(1) After Step 1 of the 3-step procedure, you would have the opportunity to test drive the ileostomy, and could choose to keep a permanent ileostomy, rather than go to a j-pouch.  I don't think this applies to me; I am pretty set on not having an external bag long-term if I can avoid it.

(2) After Step 1 of the 3-step procedure, you can have time to taper off of steroids and get healthy before they go in and create the J-pouch.  So maybe the J-pouch would have a better chance of healing smoothly. 

I would prefer to get it all done in 2 steps if possible, but if doing it in 3 increases likelihood of an issue-free j-pouch, I would go that way.  I sent Dr. F a message to get more info on this because the more I think about it the more confused I get, but would be curious if you have any insight...

From the way I understood it- if you’ve been on steroids or other medications (biologicals maybe?) for an extended period, then the tissue becomes friable prompting the surgeon to hold off on creating the jpouch. I guess the aim is to give the tissue more time to get stronger. The jpouch is created in the 2nd step. Then  the “takedown” where the plumbing is all reconnected is 3rd step. 

My tissue was fine. I had been on prednisone for a few months—two years ago. I was on biological in and off over the last three years. 

By the way- I used my chart to email Dr Finlayson but never got a response... so I called the office to get my question answered. You might have better luck. 

I thinks it’s funny that you also spoke to Lauri. She was great and made me feel more at ease going into this. 

Good to know, maybe there is some hope for me getting it done in 2 steps after all, depending on the state of the tissue.  Maybe I'll give their office a call if I don't get a message back on MyChart in a couple of days.  Thanks Shannon, hope the rest of your recovery goes well!  I'm scheduled for Step 1 the week after Thanksgiving, so have plenty of time to mentally prepare and do my research, but it's good to know that I'll be in good hands at UCSF. 

Yes, UCSF is great. Keep us all posted on your progress!

Will do, and you too!