Late today we are visiting Liz's surgeon basically to interview
him regarding his thyroidectomy statistics. After talking with
Orlo Clark's partner in San Francisco, he said that the most
important factor was not whether Dr. Cannon was a thoracic vs.
endocrine surgeon, but the number of procedures he did weekly
and in toto.
Liz's internist will refer her for a second opinion, but since
her operation is currently scheduled for next Wednesday, suggested
we interview Cannon first.

Here are our proposed questions:
1. Statistics
  How many thyroidectomies have you done weekly, monthly, per year,
  in toto? Is there any trend in the number? Will you do the operation
  yourself--no interns?

2. What percentage have complications?
  How are the complications defined?
  (I ask that question since I had a stomach blockage about 3 years
  ago that put me in Stanford Hospital for 3 weeks. If you read my
  discharge papers, you would never know that when I left the hospital
  I continued throwing up for another 6 months)

3.Have you ever operated on a singer before?
  Are you aware that there are 2 factors for concern about vocal
  chords: cutting off the blood supply and nicking the vocal chords?
  Arthur's sister who is a professional musician noticed that when
  her husband had thyroid surgery, the pitch of his voice was
  affected permanently but since he wasn't a singer it probably was
  not reported as a complication

4.Is it unwise to sing after surgery? If so, for how long?

5. Parathyroid complications
  What are the exact details of such complications? Since you
  are not doing a CBC before surgery (which I question) how can
  you see if calcium levels are different?

6. A friend is an opthamalogical surgeon in SF. He suggests a
  possible collaboration with a thyroid surgeon at Stanford Medical
   Group. How would you feel about that?

7. Would you ever refer a patient to Clark's practice? Under
  what conditions?

8. If the operation is delayed to fight with the insurance company,
  could that also cause harm to Liz's vocal chords--i.e. how urgent
  is the surgery?

We are somewhat concerned about upsetting or insulting this guy.
I guess we will be classic petit papier parents. Our friend from
San Francisco said that it would not insult him. As a matter of fact,
he started bragging about how he was either number 1 or 2 in the
city in his stats. If Cannon denies any complications (which his
nurse did with Liz on the phone) I will feel pretty uneasy about
the whole thing. It does bother me that they are not doing any
prelimary blood tests before her operation, but the nurse insisted
they were not necessary. Liz has never had any antibody tests since
her TSH looked normal--but certainly all her symptoms are hypothyroid.
Margaret Snyder