After your ACL tear diagnosis and recommendation of surgery, the next step is to find a surgeon you can trust. I cannot stress enough the importance of having a doctor you're comfortable with operating on you, especially if the operation will inherently affect your career.
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*Disclaimer: This article is not meant to substitute professional medical advice. It is based on my own experiences as a 22-year-old dancer who's had ACL reconstruction and meniscal repair surgery. If you have questions or concerns about your condition, please see a licensed practitioner in your area.
The initial place I went to for a diagnosis was Cleveland Clinic. They specialize in sports medicine and physiotherapy. My teacher recommended them. It's where she found her doctors for her two ACL operations back in the day.
(Fun Fact #1: She now has two artificial knees, not because of failed operations but simply due to age and being a professional dancer for decades.
Fun Fact #2: In her days they had "over-the-top procedures" for ACL surgery, which results in this huge, long gash all down the leg. Trust me, I've seen them. My teacher showed both of hers to me proudly (great!), but also be grateful that we live in an age where the operation is now minimally invasive.)
Cleveland Clinic has a pretty long history. They have a home base in Cleveland, Ohio (USA) and another junction in Toronto, Ontario (CA). If anything, Cleveland is a solid place to find your doctor.
Why didn't I go with them, then?
The reason for that has something to do with bedside manner.
bedside manner: a doctor's approach or attitude toward a patient (Google)
Doctors and surgeons are not known to always have their best faces on.
When I first went to Cleveland, I had to go through one doctor first before he set me up with his partner doctor, the surgeon. Both of them had pretty curt attitudes in general. I get it; they're busy. It was to the point, though, that I wondered if they even gave an ounce of care for me. I mean, why would they? I'm just another random patient who's busted her knee and is in need of medical attention. All in a day, right?
Well.
Nothing against them at all, but I just couldn't justify to myself how I could put my life in their hands if they didn't even seem to pretend to care.
When I asked about the surgery initially, I couldn't help but shed a few quiet tears. The surgeon didn't say anything or offer me a tissue but sat there with his arms crossed. I suppose this might've been his way of silent respect. On the other hand, soon after that he started talking quickly again, still with his arms crossed, and generally giving off a sense of please-let-me-leave. He was practically halfway out of the room already before I could ask my last question. Follow-up appointments were much the same.
It felt like he didn't have time for me.
I understand that no one is under any official obligation to be extremely nice or gentle, but if I'm going to let you put a knife to my body, I'd at least appreciate you give me the time of day to sit down properly and talk-walk me through whatever questions I may have.
Now, many patients don't care about bedside manner, and that's fine. Does your surgeon's skill live up to the hype, and you decide to go with them? All good. It's just a matter of personal preference.
For me, being as it was my first ever surgery, I couldn't help but feel anxious. This surgery would greatly determine if I still had a career in performance dance. The long wait didn't help either. Imagine waiting for an MRI and surgery for an entire year. Yeah. When it's finally going to happen, you can't tell what to feel about it. Couple that with negative social support from the people who are supposed to support you most (peers, teachers) and concerns of whether or not it's been too long since the accident -- are my cells dead? Is everything still working? -- and you've pretty much got a recipe for Grade A Anxiety.
His ratings on RateMDs.com didn't do much to settle my nerves. Overall his score was pretty average for medical professionals, but most of the complaints were about his bedside manner. Some claim he botched their surgeries (be warned: many patients also don't continue with the necessary rehab afterwards, affecting their recovery). Know that this is a public website, and anyone can post anything, but it's a starting point if you want to know more about a professional. Don't be ashamed -- even my physiotherapists use it.
In such a situation, I wanted a surgeon who would hold my hand a bit more. I also wanted a second opinion. Did I really need surgery?... The answer is yes. I just needed someone else to reaffirm that and shake off any doubt I still harboured.
I went back to Google and RateMds.com. It wasn't hard to find the #1 orthopedic surgeon in Toronto, according to his ratings. Amazingly, he has almost all 5-star ratings on his profile. That's a welcoming start.
My mom took the time to look through the site and listed for me the top three active orthopedic surgeons in the city. I then took that list and tried to get my family doctor to set me up with appointments.
He refused. At first. He asked if I didn't trust the original surgeon I found.
By that point I was so frustrated and sick with anxiety that I involuntarily started crying in his office. I told him I just wanted a second opinion, and finally he relented and wrote off a referral to #1. Nothing else. He refused #2 and #3. That was alright. As long as I could see #1, that was all that mattered to me.
I'm not sure if perhaps doctors get called out for referring a patient to several different specialists, and that's why they're reluctant to do that for you, but you have to remember: this is your life. This is your body. And this is indeed a case of getting the best money can buy. You don't want to risk going with a surgeon you're not comfortable with only to regret the surgery for whatever reason and potentially derail your future.
Trust your guts.
All of this happened during the coronavirus pandemic. Before I'd even searched #1, I'd tried making a surgery date with Cleveland as soon as I finished the school year, but all the hospitals had just cancelled nonessential surgeries due to the virus.
It wasn't until another month or so later that I heard back from #1's clinic, Nguyen Sports Medicine. I let them know beforehand that I'd already seen a previous surgeon, so everything was transparent. We had an online meeting first, then I went in person to their clinic for the second assessment. This doctor too recommended I get surgery, only he suggested the hamstring graft. Depending on what type of dance you do, utilizing the hamstrings will reduce the risk of pain in the frontal knee area when you kneel.
What I discovered from seeing another doctor is that I had more faith in him. He was more comfortable for me to be around, he had a gentler demeanour, and he didn't give off an I-have-no-more-than-10-minutes-for-you vibe. Oh, he was still extremely busy, but he conducted himself with politeness and respect. Plus, he has a sense of humour. and a load of certificates. All this increased my faith in him because I felt he would take care to do his best and repair what once was mine, a torn ACL.
Their clinic, in conjunction with PhysioPlus, is cozy and quiet. They take good measures to separate patients from each other and sanitize everything. The assistants, as well, are very personable and kind. I felt secure and safe assuming my rehab and physiotherapy activities there.
He also offered me choice. I had to decide whether I wanted a hamstring or patellar tendon graft, which was torture for me, but at least it showed his all-around expertise. My struggle with hamstring vs. patellar tendon is another story.
And your original clinic? When they call to set up an appointment, just tell them you've got it sorted out already. They'll be fine with it. They already have a list of people waiting to get through the operating room.
Caring.
This is what it amounts to. This is why I went with a different surgeon from my original. Whether or not it matters, I think we all breathe a bit better when we feel the people around us care. Find a doctor you can entrust with your life.
Find a doctor who cares.
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