Injury Medics - Levi in for surgery

[BigCharlie]

Possibly a surgeon??? Definitely a surgeon. Who else would you go to to get a surgical opinion.

Why go to a surgeon for advice to rest? A surgeon isn't qualified to judge whether an injury will respond to rest/bracing/controlled reloading - they are qualified to offer an opinion as to what is involved in a surgical procedure and the pros and cons of such.

The whole episode - and all of the others - smacks of someone at the CFC not having the knowledge and/or courage to make a decision as to the best course of action.

Being able to diagnose and manage appropriately is the cornerstone of surgical training. If you can't do that then just give up. However once surgery becomes a consideration the surgeon will be the driver of the diagnosis and management. No one other than the surgeon can make the surgical call. Thats the essence of the surgeons job.

Sorry, that's just plain incorrect. You only have to look at the number of failed spinal fusions/laminectomies/discectomies etc that surgeons diagnose and manage for back pain, yet result in no or scarcely any improvement in pain and function to realise that, in many instances, surgeons should have no place in the diagnosis and management of injury. Neither should GPs, just in case you think I have it in for surgeons.

 

[jackcass]

Why go to a surgeon for advice to rest? A surgeon isn't qualified to judge whether an injury will respond to rest/bracing/controlled reloading - they are qualified to offer an opinion as to what is involved in a surgical procedure and the pros and cons of such.

The whole episode - and all of the others - smacks of someone at the CFC not having the knowledge and/or courage to make a decision as to the best course of action.



Sorry, that's just plain incorrect. You only have to look at the number of failed spinal fusions/laminectomies/discectomies etc that surgeons diagnose and manage for back pain, yet result in no or scarcely any improvement in pain and function to realise that, in many instances, surgeons should have no place in the diagnosis and management of injury. Neither should GPs, just in case you think I have it in for surgeons.

What a crock.

 

[jmac70]

Why go to a surgeon for advice to rest? A surgeon isn't qualified to judge whether an injury will respond to rest/bracing/controlled reloading - they are qualified to offer an opinion as to what is involved in a surgical procedure and the pros and cons of such.

The whole episode - and all of the others - smacks of someone at the CFC not having the knowledge and/or courage to make a decision as to the best course of action.



Sorry, that's just plain incorrect. You only have to look at the number of failed spinal fusions/laminectomies/discectomies etc that surgeons diagnose and manage for back pain, yet result in no or scarcely any improvement in pain and function to realise that, in many instances, surgeons should have no place in the diagnosis and management of injury. Neither should GPs, just in case you think I have it in for surgeons.

Unless I’m mistaken, GC is actually a surgeon, so his medical opinion does carry weight. Would you mind posting your background so we can gauge your medical expertise?

 

[Saintly Viewed]

Surgeons, doctors, all fallible. Ofcourse.

But this idea that the less expert you are, the more chance you'll get it right, is very very very strange.

 

[left at home]

Surgeons, doctors, all fallible. Ofcourse.

But this idea that the less expert you are, the more chance you'll get it right, is very very very strange.

This type of stuff is that you need to trust the people with the expertise in the field.
And not doctor google.

 

[Bad Horse]

This type of stuff is that you need to trust the people with the expertise in the field.
And not doctor google.

I trust Doctor Tia. Do Yoooooooou?

 

[Gone Critical]

Why go to a surgeon for advice to rest? A surgeon isn't qualified to judge whether an injury will respond to rest/bracing/controlled reloading - they are qualified to offer an opinion as to what is involved in a surgical procedure and the pros and cons of such.

The whole episode - and all of the others - smacks of someone at the CFC not having the knowledge and/or courage to make a decision as to the best course of action.
.

Sorry I haven't been here much today. Unfortunately your post shows you have no understanding of how this works. I don't want to be condescending but a surgeon who can't prescribe conservative treatment has no place in the field. Diagnosis and appropriate management from there is vital, if you can't do that your career is over.

 

[whiskeytown]

Surgeons..? Glorified Jim's handymen

http://www.telegraph.co.uk/news/uknews/1581896/Surgeon-uses-DIY-drill-to-remove-brain-tumour.html

 

[Gone Critical]

Sorry, that's just plain incorrect. You only have to look at the number of failed spinal fusions/laminectomies/discectomies etc that surgeons diagnose and manage for back pain, yet result in no or scarcely any improvement in pain and function to realise that, in many instances, surgeons should have no place in the diagnosis and management of injury. Neither should GPs, just in case you think I have it in for surgeons.

This is quite a change in direction from what we started discussing and one of the more radical ideas I have seen put forward on Big Footy. Are you going to suggest to the next Collingwood player to do an ACL , break a bone, tear a hamstring off the bone etc etc that a surgeon should not be involved in their management and diagnosis. Again I don't want to be condescending but this post just shows you don't understand how the system works.

I will agree with you that there has been plenty of bad surgery performed over time. For all sorts of reasons. Still that's not even in discussion here.

All I have ever said, and with my own surgical background I understand this implicitly, is that we on BF have no ability to judge whether the decision to try rest with Levi initially was good bad or otherwise. We just don't have the knowledge or information to be able to do so. That's no defence of the surgeon just a recognition of what we don't know in this situation.

To me this is fairly self explanatory because I know what you need to make a judgement in this setting and we just don't have anywhere near the information needed. There is just no dispute about that and if you don't accept that it only shows how little you do understand how this area works.

 

[Gone Critical]

Are you saying GC that surgeons are the experts in post surgery rehab?
It seems to me they often just hand off the patient to a physio or similar rehab professional and are then largely oblivious to the program used.
Only to then review progress after set intervals - say monthly.

So I'm not sure that I surgeons do much more after surgery than passively monitor progress.

I wasn't making a comment about post surgical management rather overall management

Breaking it down the sequence of events for Levi or anyone else would involve

History
Examination
Clinical diagnosis
Investigations
Combined Diagnosis
Management- non surgical
-surgical
Follow up.

Follow that algorithm and the initial H&E and clinical diagnosis would have been done by club doctor/physio . Investigations e.g scans may have been ordered and a diagnosis confirmed potentially. If a surgical opinion was needed that would be arranged. The surgeon would do their own H&E and possibly order further investigations, confirm or refute the current working diagnosis and work out whether surgery or a more conservative non surgical plan were options.

The surgeon would then discuss with Levi the benefits of each option and the downsides. Including chances of success of each option, risks involved , the chances of complications causing other issues etc etc. Armed with that info Levi, and this is really important because Levi not Collingwood is the only one who can consent to any treatment, would then decide what treatment to undertake.

Sometimes it will be fairly clear cut, an ACL rupture in an AFL footballer will always have surgery as the first consideration. With Levi though, whatever the specific advice he was given initially about rest and rehab v surgery, he chose rest and rehab. The advice may have been strongly in the direction of R&R or it may have been much less definitive. This is amongst many things we dont know here.

Once you go to R&R the surgeon would communicate with the club docs and physios about what plans he/she had and they would actively take that role on and be the main drivers with, as you note, the surgeon undertaking the role to review progress and ultimately decide if the conservative treatment worked or whether surgical ultimately becomes needed. The surgeon may have even said do the R&R with a plan to recommence the footy pre season and see if the knee was ok without further review by themself.

Post surgically the physio is going to run the rehab under the direction of the surgeon. So rightly the surgeon will have a more passive role there because its the domain of the physio and mangement of these injuries is undertaken by a team approach and the fitness staff will also be informed and involved.

The only bit I would disagree with is your thought the surgeon would be largely oblivious to what post surgical rehab was used. This makes big difference to surgical outcomes and recovery times. The surgeon needs to be right across that as it has been a rapidly changing area over the years. They will clearly stand back and let the physios use their expertise but they need to know about what is involved in the rehab.

 

[Saintly Viewed]

Surgeons..? Glorified Jim's handymen

http://www.telegraph.co.uk/news/uknews/1581896/Surgeon-uses-DIY-drill-to-remove-brain-tumour.html

If I need a tradesman, my luck they'd come 6 hours late, forget some tools, go early due to inclement weather but still bill me the full whack.

 

[Timmy from Thomastown]

What a crock.

Yours seems to be the most direct succinct and correct reply.

 

[Professor Knowall]

http://m.afl.com.au/news/2017-12-19/mid-greenwood-becomes-third-pie-to-go-under-the-knife

Our medics have had a shocking offseason, another that should have been operated on post season...

Absolutely. This situation would never happen at a well run professional club ... like e.g. Geelong. They wouldv'e got any surgery done much earlier ... surely.

 

[Timmy from Thomastown]

Absolutely. This situation would never happen at a well run professional club ... like e.g. Geelong. They wouldv'e got any surgery done much earlier ... surely.

Bang!

 

[neilk]

Absolutely. This situation would never happen at a well run professional club ... like e.g. Geelong. They wouldv'e got any surgery done much earlier ... surely.

Scott Selwood reference? Just had ankle surgery.

 

[Timmy from Thomastown]

Scott Selwood reference? Just had ankle surgery.

Levi had minor medial ligament surgery. Whats your point?

 

[left at home]

Levi had minor medial ligament surgery. Whats your point?

The surgery bit

 

[Saintly Viewed]

Scott Selwood reference? Just had ankle surgery.

What?????

No!!!!!!!


This is Geelong the greatest run club.

Pffft

 

[Timmy from Thomastown]

The surgery bit

Terrible isnt it that Geelong have mismanaged this so badly

 

[left at home]

Terrible isnt it that Geelong have mismanaged this so badly

Here l thought it was only us. Where’s the out rage

 

[McOrist]

Terrible isnt it that Geelong have mismanaged this so badly

In spite of only hearing about Selwood's ankle this evening, I'm convinced they should have put him in for surgery before Christmas. Geelong's medical team is in chaos.

 

[Saintly Viewed]

In spite of only hearing about Selwood's ankle this evening, I'm convinced they should have put him in for surgery before Christmas. Geelong's medical team is in chaos.

The football department is in disarray.
All because they let Balmey go!

 

[Saintly Viewed]

Maybe the player had no faith in the medical team or the football department or the coaching group.

Unable to voice his concerns.
Why didn’t he just go to the captain?
Maybe he thinks the captain is too unapproachable and like the coach too professional.

Something smells in the cattery.

 

[JB1975]

Terrible isnt it that Geelong have mismanaged this so badly

I just took a tour of the Geelong board, and what I find more disturbing than Geelong's obvious medical incompetence is that their supporters seem utterly blind to the relevant issues. Not a pitchfork in sight! Instead they were blathering generalities about the complications of ankle injuries and who might replace Scott Selwood in the midfield, while none of them seemed aware or seemed to care that one of their best 22 had been sabotaged by bad medical advice.