Surgery during residency?

[lemonlove]

Hi,
I have been diagnosed with an anal fissure that is so severe that I am contemplating having surgery done. I am in my third year which is all outpatient but I am having a difficult time getting my program to give me vacation time in the near future. Right now I am so miserable that I am unable to focus on my work as I have to go to the restroom 5-6 times a day. I would like to get the the surgery done in the next week or two. The soonest my program is willing to give me vacation would be towards the begininng of September.

In these scenarios, is there any medical leave I can pursue/ask for? I don't want to put my program in a tough bind and I can see that some people may not think this is an urgent procedure.

Appreciate any advice. Thanks

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[rokshana]

Hi,
I have been diagnosed with an anal fissure that is so severe that I am contemplating having surgery done. I am in my third year which is all outpatient but I am having a difficult time getting my program to give me vacation time in the near future. Right now I am so miserable that I am unable to focus on my work as I have to go to the restroom 5-6 times a day. I would like to get the the surgery done in the next week or two. The soonest my program is willing to give me vacation would be towards the begininng of September.

In these scenarios, is there any medical leave I can pursue/ask for? I don't want to put my program in a tough bind and I can see that some people may not think this is an urgent procedure.

Appreciate any advice. Thanks

do you not have sick days?

 

[lemonlove]

do you not have sick days?

Yes I have sick days but I'm not sure if this something I can use them towards. Sick days are usually you get sick and can't come for a day then reutrn the next day.

 

[Hakuna Matata]

Use your sick days. Otherwise FMLA might apply here?


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[AdmiralChz]

If you're so uncomfortable that you are contemplating surgery and it's affecting your job performance, you can and should use your sick days.

 

[bannie22]

i think its obscene that hte program is not giving you time off for something that is obviously affecting your wellbeing and performance...

u can always just go to the ED and c/o lots of pain and demand ur surgery be done in the AM...

 

[hamstergang]

Yes I have sick days but I'm not sure if this something I can use them towards. Sick days are usually you get sick and can't come for a day then reutrn the next day.

Having surgery is a situation in which you are physically unwell and can't come to work for a number of days. It's ridiculous that you're even asking this.

 

[surgonc2017]

You can not come to the ED and demand surgery for a fissure. You will be discharged with creams and likely never see a surgeon and made an outpatient follow up appointment to schedule elective surgery.


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[LucidSplash]

Have you told your program that you need to have a surgery? I'm not clear from your post if you've told them that vs just trying to schedule vacation.

Typically these are outpatient procedures. You don't have to be specific about what is going on, simply tell your program that your doctor is recommending an outpatient procedure that will require you to take a day or two off work. You can even schedule it for a Friday when you have the weekend off if you have to.

 

[LucidSplash]

You can not come to the ED and demand surgery for a fissure. You will be discharged with creams and likely never see a surgeon and made an outpatient follow up appointment to schedule elective surgery.


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Ignore bannie. He's a regular font of ridiculous suggestions.

 

[bannie22]

You can not come to the ED and demand surgery for a fissure. You will be discharged with creams and likely never see a surgeon and made an outpatient follow up appointment to schedule elective surgery.


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your general surgeons are weak. if the ed declines to consult surgery (which never happens)
i would demand transfer to another hospital. if they discharge u, just walk to the next ed.

just do your research figure out who you want, whether they are on call. (try to find a colorectal)
then just walk in man. a true general surgeon will take care of u.
or have their residents take care of u until they come in.

fissures hurt a ton but this is same day surgery brah. dude i can even do it for u. what wud u like? do u want some botox or do u want a sphincter release? do u want it open or closed?
u cant even code this bloody this as an operation. its only a procedure! lol

also depends on why u have a fissure right? and whether u want to keep it tight.

anyway. trust me. and no program can deny a resident for presenting to the ED and say they were not sick enough to take a sick day.

all the best! hope u get well soon

 

[Smurfette]

your general surgeons are weak. if the ed declines to consult surgery (which never happens)
i would demand transfer to another hospital. if they discharge u, just walk to the next ed.

just do your research figure out who you want, whether they are on call. (try to find a colorectal)
then just walk in man. a true general surgeon will take care of u.
or have their residents take care of u until they come in.

fissures hurt a ton but this is same day surgery brah. dude i can even do it for u. what wud u like? do u want some botox or do u want a sphincter release? do u want it open or closed?
u cant even code this bloody this as an operation. its only a procedure! lol

also depends on why u have a fissure right? and whether u want to keep it tight.

anyway. trust me. and no program can deny a resident for presenting to the ED and say they were not sick enough to take a sick day.

all the best! hope u get well soon

Didn't realize (pre-)podiatrists did so many anal operations. Is the presence of a foot the cause of the fissure?

To the OP: depending on how much time off you need, use sick days (if you have them) or do FMLA. You don't need to give details as to why you need off, although telling them a surgery is involved and the surgeon feels you will be ok to work by [date] is reasonable.

 

[bannie22]

Didn't realize (pre-)podiatrists did so many anal operations. Is the presence of a foot the cause of the fissure?

To the OP: depending on how much time off you need, use sick days (if you have them) or do FMLA. You don't need to give details as to why you need off, although telling them a surgery is involved and the surgeon feels you will be ok to work by [date] is reasonable.

got to make ends meet man. this era just prepodiatry procedures are not enough to keep the food on the table

 

[ThoracicGuy]

your general surgeons are weak. if the ed declines to consult surgery (which never happens)
i would demand transfer to another hospital. if they discharge u, just walk to the next ed.

just do your research figure out who you want, whether they are on call. (try to find a colorectal)
then just walk in man. a true general surgeon will take care of u.
or have their residents take care of u until they come in.

fissures hurt a ton but this is same day surgery brah. dude i can even do it for u. what wud u like? do u want some botox or do u want a sphincter release? do u want it open or closed?
u cant even code this bloody this as an operation. its only a procedure! lol

also depends on why u have a fissure right? and whether u want to keep it tight.

anyway. trust me. and no program can deny a resident for presenting to the ED and say they were not sick enough to take a sick day.

all the best! hope u get well soon

There is so much nonsense in this post.

 

[Light at end of tunnel]

Hi,
I have been diagnosed with an anal fissure that is so severe that I am contemplating having surgery done. I am in my third year which is all outpatient but I am having a difficult time getting my program to give me vacation time in the near future. Right now I am so miserable that I am unable to focus on my work as I have to go to the restroom 5-6 times a day. I would like to get the the surgery done in the next week or two. The soonest my program is willing to give me vacation would be towards the begininng of September.

In these scenarios, is there any medical leave I can pursue/ask for? I don't want to put my program in a tough bind and I can see that some people may not think this is an urgent procedure.

Appreciate any advice. Thanks

It shouldn't be that hard to get the time off you need to address this medical matter. Have you told your PD directly about the matter? Does the program know about the medical issue and why you are requesting "vacation"?

 

[Raryn]

Schedule an appointment with a surgeon. Find out when he would have openings. If you have a primarily outpatient schedule right now, you should have at least some flexibility with getting a clinic visit in sometime.

Then ask for a doctors note. Go to your chiefs (or whomever is in charge of the schedule) hopefully at least a few weeks ahead of time, state I have an upcoming surgery that needs to be done (don't have to say what), these are the possible times, but my doctor says it should not be delayed further.

Every program I'm aware of will work with you to give you the sick leave off. The only reason I say do it a few weeks ahead of time is it gives the program flexibility to arrange coverage or reschedule the patients to a different clinic, which is a courtesy to the program for an elective procedure.

This shouldn't use up your vacation time (though for it to count as sick leave, they may actually request that doctors note you got in paragraph 2), and it shouldn't effect your ability to graduate on time unless you're out for an excessively long period (like measured in weeks, not days). The only exemption would be that there do exist boards that have no flexibility and the most time off you can have is a flat-out maximum of 30 days. If your program already offers 4 weeks of vacation and is butting up against that max, your options if you are in one of those specialties would be to either cannabilize vacation time or graduate a few days late. That's unfortunately not up to your program as much as to your certifying board.

 

[dermmom17]

I have no advice other than what others above have said. But having had that same issue 30 plus years ago after my first child, I empathize with you and know the pain you're going through. Find a great colorectal guy and get it fixed asap. It's not going to get better on its own.

 

[rokshana]

your general surgeons are weak. if the ed declines to consult surgery (which never happens)
i would demand transfer to another hospital. if they discharge u, just walk to the next ed.

just do your research figure out who you want, whether they are on call. (try to find a colorectal)
then just walk in man. a true general surgeon will take care of u.
or have their residents take care of u until they come in.

fissures hurt a ton but this is same day surgery brah. dude i can even do it for u. what wud u like? do u want some botox or do u want a sphincter release? do u want it open or closed?
u cant even code this bloody this as an operation. its only a procedure! lol

also depends on why u have a fissure right? and whether u want to keep it tight.

anyway. trust me. and no program can deny a resident for presenting to the ED and say they were not sick enough to take a sick day.

all the best! hope u get well soon

‍♂️ ‍♂️ ‍♂️

While that anal fissure may hurt, unless there is a river of blood it's not going to kill you and even IF the ED doc did consult gen surg... gen surf is going to give the pt the phone number to their office and recommend that they call the office to schedule the surgery...
And frankly I'm not even sure you are even remotely involved in medicine, even podiatry, if you would actually recommend ER shopping ...

 

[Bryan O’Blivion]

Use sick days, it's not unreasonable. Realistically, it may take until September to be seen by a surgeon and get an outpatient appointment. Taking vacation afterward is prudent.

I had an elective surgery during residency, and it took a month or two to schedule it and work out the time off. But it was the best option. Your situation sounds less severe, but taking time for recovery is important.

 

[dpmd]

On a side note, who diagnosed you with the fissure? Chronic diarrhea can cause a fissure but would not be solved by surgery for a fissure. Sounds like you need a workup to determine the source of the diarrhea.

 

[EKGdoc]

Talk to your employer's HR department they will be able to give you all your options and rights. Even though u r a resident you're still an employee as well. You should easily qualify for the time u need.


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[d2305]

Sitz baths and antibiotics should keep you going. Pilonidal cysts do need surgery.

 

[lemonlove]

On a side note, who diagnosed you with the fissure? Chronic diarrhea can cause a fissure but would not be solved by surgery for a fissure. Sounds like you need a workup to determine the source of the diarrhea.

My Gastroenterologist did. I actually have chronic constipation and was taking an intense bowel regimen of colace and miralax as well as fiber.

I am doing topical treatments with sitz baths and It is still painful. I still have days when I cannot have a bowel movement. I am dreading surgery but am entertaining the possibility. My program will need to let me use my sick days.

 

[dpmd]

My Gastroenterologist did. I actually have chronic constipation and was taking an intense bowel regimen of colace and miralax as well as fiber.

I am doing topical treatments with sitz baths and It is still painful. I still have days when I cannot have a bowel movement. I am dreading surgery but am entertaining the possibility. My program will need to let me use my sick days.

There is a lot more to the treatment of fissure than sitz baths. Surprised the GI or your PCP hasn't tried medical management which a surgeon is going to require before considering surgery. Have you even seen a surgeon yet? If not, I don't understand why you would be pressing your program for time off. Or did you think surgery would happen immediately at the first visit (which is false)?

 

[anbuitachi]

My Gastroenterologist did. I actually have chronic constipation and was taking an intense bowel regimen of colace and miralax as well as fiber.

I am doing topical treatments with sitz baths and It is still painful. I still have days when I cannot have a bowel movement. I am dreading surgery but am entertaining the possibility. My program will need to let me use my sick days.

you must go to a really **** program if they wont let you off for 1 day for a procedure. its not like you need time off after the surgery to recover..

 

[dpmd]

you must go to a really **** program if they wont let you off for 1 day for a procedure. its not like you need time off after the surgery to recover..

Sounds like op asked for vacation not medical leave. Also sounds like medical management hasn't even been tried yet and the op probably hasn't even seen a surgeon so asking for time off is pretty premature.