Jeanette Bullock had already been diagnosed with osteoporosis when a doctor told her she might need surgery for aneurysms of the thoracic aorta – the largest artery in the chest. Her cardiologist told her the surgery would be very serious, very invasive and required a lot of recovery time.
Like many of us suddenly facing surgery, Jeanette left the doctor’s office with concern about what might be ahead. She consulted with her primary care doctor who suggested she seek a second opinion at Froedtert & Medical College of Wisconsin and then review all of her options.
"My doctor said to me, 'If you were my mom, I'd want you to get a second opinion, and I'd suggest going to Froedtert & Medical College of Wisconsin because they have excellent doctors there,'" said Ms. Bullock.
Ms. Bullock, a woman in her seventies with several fractured bones due to osteoporosis, had the type of case that stood to benefit from the specialized expertise in the Cardiac Second Opinion Program at Froedtert & Medical College of Wisconsin.
Ms. Bullock went to see G. Hossein Almassi, MD, a cardiothoracic surgeon at Froedtert & Medical College of Wisconsin, who did a CAT scan and found that the aneurysm did not merit surgery but should be monitored over time.
"She was high risk," says Dr. Almassi. "Her left arm was in a sling, and she could have been put at unnecessary risk of opening the chest, bleeding, stroke, heart attack, infection or even paralysis from the waist down. It is a major operation and a complicated surgery with many potential adverse consequences."
In his evaluation, Dr. Almassi also identified an abdominal aortic aneurysm and recommended that Ms. Bullock have that condition, known as AAA, monitored by another doctor specializing in AAA. He communicated his analysis to Ms. Bullock's primary care physician, so that together they could ensure the best possible treatment.
"I was relieved," says Ms. Bullock. "And now the records show that the aneurysms have hardly changed in a year since my first appointment, so it was good that he didn't recommend the surgery.
"By seeking a second opinion, Ms. Bullock minimized the amount of risk involved in treating her heart condition. That's the ultimate goal of the Cardiac Second Opinion Program at Froedtert & Medical College of Wisconsin, which was formally initiated after many instances such as this.
David Rutlen, MD, chief of cardiovascular medicine and director of the Heart and Vascular Center at Froedtert & Medical College of Wisconsin, says that a second opinion is especially important in cardiology and cardiothoracic surgery because of the wide variety of treatment options and their associated risks. According to Dr. Rutlen, the specialists – cardiologists and cardiac surgeons – in the Heart and Vascular Center can offer very precise evaluations for all heart conditions, which works to the advantage of patients seeking second opinions. "We all function as private cardiologists and cardiothoracic surgeons,” says Dr. Rutlen, “but we're all part of the Heart and Vascular Center, so we practice as a group. We don't all do everything. At another practice you might see one cardiologist who does the initial evaluation, performs a stress test, does a diagnostic catheterization and performs the angioplasty on the coronary artery. That same cardiologist might even implant a permanent pace maker if needed. At Froedtert & Medical College of Wisconsin, we have physicians who are highly trained in their particular subspecialties of cardiovascular medicine. These specialized physicians perform a larger number of procedures which lead to better results. We offer a full evaluation, and if someone can be treated more minimally and achieve the same or better outcome we're all here to accomplish that."
This fall, one year after first seeking a second opinion at Froedtert & Medical College of Wisconsin, Ms. Bullock went back to Dr. Almassi to check the status of her thoracic aortic aneurysm. Dr. Almassi gave her a 90 percent assurance that she would not need surgery at any time for her condition. Ms. Bullock says she felt reassured and would highly recommend getting a second opinion.
"I don't think doctors feel insulted if you say you want to get a second opinion," says Ms. Bullock. "Some doctors will even advise you to get a second opinion, and it’s a very good idea.
Last Review Date: January 26, 2005
Online Editor(s): Frank Lococo