Artikelen

9) Second opinion Daniel den Hoed (December 2002-March 2003)

In December we took contact with Daniel. The first impressions were good: there was a special second opinion consultations and we could quickly find an initial consultation. It noted that there are practical problems: not all requested data were available in Nijmegen during the consultation. We explained our problem to the ENT specialist and informed our need for a second opinion to. We expected a specialist clinic may be alternatives that could wait and see policy, especially for patients such as Peter, with a little something-from-around good condition. We were somewhat alarmed   by the observation of the ENT doctor that the hospital was basically the same offer as the hospital in Nijmegen, so we still have some to expect. The ENT doctor promised to go back all the files, then to see if he under the scheme to a second opinion might be, or that further investigation was needed.

Further investigation and came out again was initially a consultation with ENT doctor in training. For an ultrasound and puncture and a CT scan and MRI scan of neck and chest at two different dates we had to come back. On January 22, 2003 took place an ultrasound and a biopsy was taken from a suspicious spot on the left side of the neck. In retrospect, we wonder whether it is justified that there was a biopsy taken. Those suspicious spot on the left side of the neck was at that time because an estimated at 0.8 cm. The file from the Radboud Hospital is to make this place all based on physical examination two suspicious nodes were noted. In October 2002, the amount of respectively 1.5 and 2 cm   and 1 cm estimated. So pretty stable. But after that puncture the suspect began to grow quite place. Afterwards   we wonder whether the doctor concerned on the basis of history should not have to take decisions not to puncture. And if the history is sufficiently known.

On February 5 found the scans of chest and neck position. The ultrasound led to the conclusion that the metastasis on the right side of the neck had disappeared. That was very good news. The bad news was that on the left side of the neck tumors were small. A laparoscopy is considered necessary to assess whether now in the ENT-area primary tumor was manifested. The idea behind it, so we understood later, it was only when it was out of the suspect halsklierdissectie glands may be a sensible procedure would be.

Who taught us again laparoscopy special things about the patient-friendliness of the organization of health care. Before we were again in Rotterdam are expected to talk with the anesthesiologist. Hundred kilometers away (and back too!) To answer the question of anesthesia in earlier cases, sometimes never caused problems. That gave a hangover feeling. Or was there a connection with the transmission of Tacks, in which just the weekend before the story was discussed by the man in whom the anesthetic did not work?   In any case, we know that later in Frankfurt very different experiences in health care have gained. There are scientists succeed in all sorts of studies on a single day and also at the end of the day to give the result.

Another special experience with health care in the Netherlands, the use of questionnaires by nurses. Both in Rotterdam and Nijmegen, the patient questions that you wonder what the point of it now is. In Nijmegen in the week that the probe is placed was asked: What do you expect from this recording? Peter's answer that he hoped the surgery for some time longer to live by the nurse was wrongly interpreted as a signal of gloom. In Rotterdam, too many questions that were unrelated to any organization and purpose of the exploratory operation.

On the other hand, our experience is that transfer of information between nurses who are important enough place. Among the youngest hospital in Nijmegen found that things that were important for Peter, which he always had to be repeated. So the approach of the nursing records is also a thing to improve.

What a very big compliment deserves is the Family that the Daniel den Hoed Clinic connected. This is a comfortable guesthouse for both patients and relatives. Partly due to the financial support of sponsors and the unpaid meticulous efforts of a large group of volunteers, participants stay for cheap. A very nice feature for when you are at half past seven in the morning fasting in a distant hospital to be ..

On 28 February the keyhole surgery in the ENT-area location. When the doctors were reporting the results (in the ENT area is nothing special to see) we were surprised by the demand of one of them: "What are you doing here?" After our story, he concluded that a careful special case as that of Peter, a young person with a generally very good physical condition may be considered a halsklierdissectie was.   A week later, a "vision" rather than the head and neck group of doctors from the Daniel den Hoed Clinic and Hospital Dijkzigt. A strange surreal event. First, over 100 km away. Then more than one hour wait. Called inside in a small room, where an estimated thirteen doctors stuffed together. Again the same question: "What, you doing here?" A doctor-in-training just remember to say that the question now is whether the metastasis in the left neck mobile. The metastasis in the two months that elapsed between this vision and puncture increased in size to a diameter of about 3.5 cm. Two or three doctors feel equally. And then we are out five minutes later with a hung-over feeling. A week later we go for the advice. Hours later than planned we are welcomed by the doctor in training. A young guy with a great sense of responsibility that despite the trouble waiting to file through it. Suspiciously, we wonder whether another doctor already has taken the trouble to do that. And whether the dossier is complete.

The conclusion of Daniel was that the tumor on the left side of the neck was resectable. This is passed to the Radboud hospital. It recommends to first PET scan. This advice was passed on March 13, 2003 at the Radboud hospital.