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Thursday, 17 April 2003


What if it doesn't work out?
I want to share my experience of two years ago making a rather important decision, and how I went about making it. I was suffering from a heart problem (atrial fibrillation)to the point where it was extremely tiring just to walk to the end of the block or to do the normal functions of an office job at work. The first-line treatments had been tried and didn't work. So I had to make a decision about what to do next.

I could have had an ablation procedure done, which is sort of likely an angioplasty in that they snake a device up and to your heart. But that wasn't a very effective procedure, from the results I'd seen. But minimally invasive.

My other choice was to have the full-bore open heart cut-the-sternum procedure called the "Maze procedure" done. Very, very effective, but very very invasive. They actually make incisions into the heart muscle itself to create scar tissue which acts like an insulator which causes the spurious electrical signals to follow a path rather like a maze, hence the name of the procedure.

At the time, this wasn't a very common procedure at all, with only one doctor, the originator of the procedure, having done very many of the operations. But he was getting up in years, something I was hoping to do also!

I found a local heart surgeon with thousands of heart operations under his belt, and who was highly recommended. My wife is a nurse, and through her network was able to get the straight dope on him and not the marketing fluff that's of no value whatsoever in this situation. Everybody she talked to only had good things to say about him. I liked him when I met him, and all those little signals you get when you meet someone told me he was a competent surgeon.

But here was the rub: He had only done one other Maze procedure a couple of weeks earlier. He didn't share this but I didn't ask him point blank either, since I already knew.

So, what to do? Try the ablation, which was effective so little of the time as almost to be a waste? Or be the 2nd Maze procedure of an otherwise accomplished heart surgeon?

I used two approaches to making my decision. The first, kinda the opposite of the saying "Screw-ups screw up", was my experience that competent people somehow found ways to be competent, even if they didn't have the experience. In other words, there are some people who always seem to get the job done, no matter what, and my potential surgeon seemed like one of those people.

The other approach was to ask myself "What could I live with if it doesn't work out?". Phrased in that way, I decided I could best live with trying the Maze procedure, even if it didn't work out. I couldn't say that about the ablation.

Cut to the chase: I had the Maze procedure, and it worked just fine. It's like I've come back from the living dead. And my surgeon, by the way, e-mailed the originator of the Maze procedure and asked him specifically about my case. So I ended up with the best of both worlds: The older surgeon's experience with a younger surgeon's hands.

So my advice to anyone making a really important decision: Of all the alternatives, which would be the easiest to live with if it didn't work out? Ask yourself that question, and it will help you make your decision.

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