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Hello - My mother has been ill for a year now with abscesses in her abdomen. It started with a bout of diverticulitis that ruptured the colon that resulted in a fistula to the skin surface. She has had 5 surgeries with two different surgeons trying to clear up the internal pockets that would not heal. They kept rupturing up to the surface with fluids. She has even had a wound vac. Her primary has said all along he thinks it still has to do with the colon. The last surgery she had was with surgeon number 2 and he thought it best to operate by fully opening it, cleaning it and sewing it all up. Sure enough one month later, last Saturday she ended up in the ICU with a severe infection the size of a grapefruit in her abdomen almost septic. Sooo, with yet another admission through the ER surgeon number 3 opened it, cleaned it up and put in a drain. He told us he thinks it has to do with the sigmoid colon and that part may need to be removed. That was the last we heard 3 days ago after he did the cleanup surgery. She is now in med-surg in the hospital and they are talking about moving her out to a rehab facility (for the second time). WE STILL don't even know what is going on, or why this keeps happening 5 surgeries later. They keep doing the same thing over and over and getting the same results. All these surgeons know each other and are somewhat connected thru the network or personal relationships. I need some advise as to how to get to the bottom of all of this. We are not even sure who's care she is under anymore. All of this is complicated by the fact that she now has a second bout with CDiff (from the antibiotics from the surgery last month) and is diabetic. Who do we look to as the doc who is watching the bottom line? Now, in the hospital she is under the Hospitlaist Doc. If she goes to rehab she will be under the rehab doc. Who is watching the big picture and making recommendations to heal her? We need somebody that will look at all the pieces and take some charge here. Is there somebody at Medicare we can contact that will help? What if we want to take her into one of the big hospitals in Boston rather than these suburb hospitals? How do you start that? She is the sickest I have ever seen her right now and all we are hearing is that she is off to rehab without any plan!! Please, any help from anybody who has navigated something similar would be helpful and appreciated. Thank you in advance. Michelle

Category: Gastroenterologist, Surgical

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Category: Gastroenterologist, Surgical
 31 Doctors Online

Hello Michelle,

Thank you for choosing DoctorSpring.

I understand how disappointing, taxing and frustrating it can be for you to run between Surgeries and health care facilities without much improvement in your Mother's condition.

Ideally at this stage it is better if she is under the care of a Intensivist (who looks after ICU) or Hospitalist (an Internal Medicine Specialist). As she is currently with a Hospitalist it is fine. She will need additional consultation from Surgical Gastroenterology, Infectious Disease, General Surgery and Critical care team.

I would not recommend shifting her at this stage to a suburb hospital as she might need further interventions. Moreover your current Doctor know her medical and surgical history well. It might appear that they only know bits and pieces and a holistic picture is missing. But in reality it will not be the case. i am afraid they might not have conveyed your mother's health status well and hence the confusion.

If you can share some of the medical reports (imaging /ct / surgical notes etc) I might be able to give you a specific opinion regarding her treatment strategy.

Hope this helps
Feel free to ask followups
Thank you

Dr. Lokesh HM
Category: Gastroenterologist, Surgical
Fellowship: Minimal Access Surgery (FMAS)
Fellowship: Pancreato-Biliary surgery (FPBS), SGPGI Lucknow, 2012
Senior Residency: MCh, Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI) Lucknow, 2011
Junior Residency: MS, PGIMER, Chandigarh, 2008
Medical School: MBBS, MS from Post Graduate Institute of Medical Education and Research (PGIMER) Chandigarh, 2007
Dr. Lokesh HM and 4 other Medical Specialists are ready to help you

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