Health Organization for Pudendal Education

Dear friends,

It has been almost three months since my Laparoscopic PN decompression surgery with Dr. Tibet Erdogru.I was operated by on the 24th of September, 2012 at Memorial Hospital in Istanbul, Turkey.

The surgery was seven hours long and was filled with Complications right from the beginning. I developed severe thrombosis in my lower right leg and foot. Besides thrombosis, I had damage to my tibial nerve, sural nerve (branch of the tibial branch) and sensory peroneal(fibular) nerve in my right leg and foot. In addition, Hemoglobin level fell from 12 to an 8 gr/dl after the surgery. My whole stomach, intestinal and testicular area were covered with internal bleeding.Dr. Tibet wanted to do a redo surgery, but the MRI showed no major pathologies according to them. I was given 5 units of blood transfusion after my mother intervened and was really concerned that these were my last moments. I have never endured so much pain in my whole life and I really thought that my life was over.

After three days, It was determined that the dropping of my hemoglobin and internal bleeding was due to heparin, which I was put due to thrombosis. It seemed that I am allergic to heparin and on the 5th day of the surgery, my hemoglobin level rose again to 11.6 gr/dl and I was discharged on the sixth day on a wheel chair. Heparin was replaced with Coumadin.

Ironically, Dr. Eduardo Quesada gave used heparin in my PN injection back in 2007 which led to the sitting pain on both sides. Before that fateful block by Dr. Quesada, I never had any issues on my right side and no sitting pain at ischial tuberosity on either side.
I left Istanbul after 12 days with major pain, complications, disappointment and a complete state of shock. I wanted to flee Turkey. I was unable to travel back to the USA .instead, it was decided that I would fly to my parent’s house in Islamabad, since it was only 4 hours flight and I was in no condition to fly back to the USA in such a state.
Dr. Tibet and his associates never figured out in Istanbul that I also developed major nerve damage in the foot and leg. My foot was completely numb and thrombosis never causes numbness.

It was only later when I had a clear thrombosis Ultrasound that the doctors became concerned In Islamabad that I had foot and leg neuropathy. A Nerve Conduction Velocity, EMG test and physical examination clearly determined that I had tibial nerve , sural nerve and sensory peroneal nerve damage in my right leg and foot. I have sent those results to Dr. Tibet and he has a hard time acknowledging nerve damage. Ironically, a female patient from Utah developed similar peroneal nerve damage ten days after my surgery in both legs. She is still trying to recover till this day.
I got my detailed surgical report about a month ago from Dr. Tibet Erdogru and it said that I had no complications.

I haven’t seen any improvements in my PN symptoms. Unfortunately, I have developed SIJD on my right side as well. The thrombosis is totally gone, and I am off Coumadin (blood thinner).Although, I am off crutches, it is still difficult and painful for me to walk because of the pain in the calf of my leg, Achilles tendon and the sole of my foot. I was able to put on a shoe on the right side about three weeks ago, but it’s very uncomfortable and very painful.My right hip also tenses up when I walk Sometimes, I get electric shocks in the foot and they are terrible. This foot and leg pain is ten times worse than PN PAIN.I have never endured so much pain in my whole life.

I also suffered from insomnia and was unable to sleep for more than two hours during the night for about a month and a half because of traumatization. Even 10 mg diazepam didn’t help. Reluctantly, I was put on 25 mg of anti-depressant and I was finally able to sleep like normal people. I am doing PT, but further foot surgery may be required if the situation doesn’t improve. I am not sure whether I can walk normally again. Neither can I walk properly nor can I sit now.

Dr. Tibet came on Facebook forum to defend himself, accusing me of being overweight and writing my whole Medical History on Facebook. He also said that he doesn’t want to communicate with me on email but rather on Facebook. I am very disappointed with his unprofessional attitude. Since it has become apparent that he caused me so much damage, he has stopped communicating with me.

Most of these complications were caused by negligence because I was kept in the lithatomy position for about seven hours and the patients aren't supposed to be kept in that position for than four hours.

http://www.corexcel.com/courses3/html/b ... _page4.htm

I had one failed PN surgery with Dr. Bautrant in 2010 and another dorsal nerve surgery with Professor Oskar Aszmann in Vienna, Austria in2011.Both were without complications and I had an excellent experience with both of them .Both are very professional,sophisticated,kind and had excellent bed manners regardless of the outcome. I have been left with a major foot and leg complication to deal with now and it was a total nightmare in Istanbul, Turkey.

Kind Regards,
Ali

PS

The total cost of the surgery was US $10,000,but I had to pay another US $1,200 for the blood transfusion.Any complication during the surgery has to be paid by the aptient.

I am so sorry to hear of your continued problems. It does sound you have made small steps in the right direction in that you can wear a shoe now. Many prayers and hugs sent your way.

What a nightmare, Ali! I'm so sorry this didn't work out for you.

AliPasha1 wrote:I got my detailed surgical report about a month ago from Dr. Tibet Erdogru and it said that I had no complications.

AliPasha1 wrote:I developed severe thrombosis in my lower right leg and foot. Besides thrombosis, I had damage to my sural nerve (branch of the tibial branch) and sensory peronial nerve in my right leg and foot. In addition, Hemoglobin level fell from 12 to an 8 gr/dl after the surgery. My whole stomach, intestinal and testicular area were covered with internal bleeding.Dr. Tibet wanted to do a redo surgery, but the MRI showed no major pathologies according to them. I was given 5 units of blood transfusion after my mother intervened and was really concerned that these were my last moments.

How is it possible this wasn't documented?????
I'm encouraged by the progress you're making with PT and remain hopeful that your tibial & peroneal nerve are irritated from the prolonged lithotomy position, and not entrapped. Still ... I feel these were unnecessary complications, due to negligence.
I wish for better days and further improvement for you.
Warm regards,
Karyn

Hi Karyn,

Thank You for reminding about the prolonged lithtomy position.I have added it in my Post. .Another issue is that I had no DVT socks after I was brought in the room.After they saw the trhombosis,they put them on me.My mother can testify to that and so can I, because I was shouting to Tibet when I came to my senses that I want my leg back,because I had so much pain in my leg at that time like somebody was cutting my leg with a saw and I noticed no DVT socks on.

Although, Dr. Tibet completely denies that.

Kind Regards,
Ali

Dear Ali,
I know I probably should wait to discuss this with you during one of our private conversations, but I'm just beside myself. With all of the horrifying things that happened to you in Turkey, this is right up there on my disturbed list:

AliPasha1 wrote:I got my detailed surgical report about a month ago from Dr. Tibet Erdogru and it said that I had no complications.

Please don't accept this, Ali. Unless things are waaaaaaay different in Turkey, I would think the hospital who is treating an admitted patient for DVT and replacement blood would have to have that documented somewhere! If it's at all possible, please request your records from the hospital, IN ENGLISH. If you're able to obtain them, attached them to the back of your OP report.

These are the last three lines of your Op report - word for word:

"There was no bleeding around the trocar sides. Estimated blood loss was less than 100 ml. There was no complication during surgery".

So, OK. Maybe the DVT "complication" occurred after the surgery? I don't know enough about his blood loss statement to comment, but again - you required FIVE bags of blood. Maybe not during the surgery, but the hospital HAS to have a record of it! After all; they did charge you an additional $1200!!!!
And they prescribed blood thinners for you. There has to be documented justification for that!
It appears to me that Dr. Tibet is either lying by omission; or he got cute with his wording by saying "no complication DURING the surgery".

AliPasha1 wrote:I got my detailed surgical report about a month ago from Dr. Tibet Erdogru

Your surgery was 09/24/12. I'm aware that you were asking Dr. Tibet for a copy of your report since you got released from the hospital. We were wondering what was taking so long.

AliPasha1 wrote:.Another issue is that I had no DVT socks after I was brought in the room.After they saw the trhombosis,they put them on me.My mother can testify to that and so can I, because I was shouting to Tibet when I came to my senses that I want my leg back,because I had so much pain in my leg at that time like somebody was cutting my leg with a saw and I noticed no DVT socks on.

Although, Dr. Tibet completely denies that.

I can testify to that, too. Ali, you probably don't remember talking to me while you were in the hospital and what you said, but I do. I also remember very clearly hearing your mom chatting away in the background! I got this stuff fresh from you (and your mom!), while it was still new and current.
This is the very first line of your Op Report:

"Under general anesthesia, after tromboembolic socks and intermittent air pump wrapping of both legs, low lithotomy position, the surgery has been started".

It used to annoy me that Dr. Conway was evasive and said he didn't have the resources to track his surgical results, but at least he didn't lie.
Unfortunately, I think you're up the creek without a paddle as far as getting any kind of documentation from the hospital about the lower extremity neuropathies. They're not acknowledging it and they didn't provide you with any type of treatment for it. However, I wouldn't leave Islamabad without those records from your PT and the neurologist you've been seeing.

Warm regards,
Karyn

Ali,
The whole thing sounds like it was a nightmare and I am so sorry.
I'm glad that you are off crutches and wearing a shoe; prayerful that someday this will be only a nightmare from the past and that you will recover from PT alone.
I guess one of the worst things about international travel for surgery is that in order to hold a doctor accountable for negligence and fraudulent documentation, you have to learn to navigate a foreign country's legal system. I would think that the laws in Turkey offer some protection or compensation, but it would probably be quite challenging for a non-native to figure out how to approach the matter. At least you are being outspoken on the internet, which is the same forum Dr. Erdogru uses to promote himself internationally. I am sure people trying to pick a surgeon appreciate that while you are not well yourself, you are taking time to share your experience.

Hi Karyn and Hermajesty.

I do have the records right after the surgery which states complications and blood transfusion which I got right after the surgery.Dr. Tibet wanted to post on facebook right after surgery that my surgery was a success and he was asking me if he could disregard the complication part.My mother told him politely that it isn't possible and there is no reason to lie.He replied immediately "Yes ofcourse Madam".He did make a small post on facebook about me and did mention the thrombosis part.

I also declined an interview with a popular Turkish newspaper.The sole purpose of that interview was to glorify Laproscopic PN decompression surgery and publish that Dr. Tibet and Memorial Hospital is getting international patients especially from the USA.No one in the right mind could ask me such a favor at that time.

I was in so much pain laying in the hotel bed unable to walk ,intestinal spasms and with one of the stitches bleeding on and off.I think that he should have concentrated more on my complications rather than the interview.

I don't see any reason for him to lie on the Medical report as well.The report was sent after I have sent him the Peroneal nerve and tibial nerve damage report.I really don't know what his issue is.

HerMajesty,I have been pretty vocal about my complications on facebook.Although,there are some people who believe that he will bring them "instant relief" are upset about it.One Eastern European woman became pretty aggressive and wanted to shut me up.So,I guess people who don't have insurance in the USA will probably go to Turkey irrespective what you tell them.

I doubt that I will go for any more Pn surgeries after this horrible experience.I think more surgeries will bring more complications and financial ruin.It was a bad decison on my part to go to Turkey,but I guess that Dr. Tibet did play a part by painting a very rosy picture.I had never imagined that such complications could occur.

The bottom line is that laproscopic surgery does carry major risks of complications and Memorial Hospital in Istanbul isn't eqquipped to handle them as yet.

Kind Regards,
Ali

AliPasha1 wrote:Dr. Tibet wanted to post on facebook right after surgery that my surgery was a success and he was asking me if he could disregard the complication part.My mother told him politely that it isn't possible and there is no reason to lie.He replied immediately "Yes ofcourse Madam".

I also remember, before he agreed to comply with your moms request, he stated to her that "your complications were irrevalent" and there was no need to disclose them.

Hi Karyn,

You phrased it better than I did.

Take care,
Ali

Ali I would like only to express the feelings of empathy to you and to engourage you to fight further on, there are surely some better days ahead of you.
When I had my terrible flare up after ECSW wave, I also though that my life is over, but after 4-5 months the pain got back to baseline values and this year I enjoyed maybe 5 months of only mild pain, manageable with low dose of baclofen, amytriptylin etc.
I trully appreciate, that despite your difficult situation, you shared your experience with laparoscopic approach in full detail and thorough analysis.
We should not enter this laparoscopic approach of dr. Erdoglu lightly. 1 year ago it seemed to be a safe alternative to classical TG approach...Today I got the feeling that it is far more dangerous than dorsal nerve decompression of prof. Aszmann. We still need more experience from other patients, but it seems to be blind alley in PNE treatment.
Wishing you the strength to keep figting and some better days ahead than those you are experiencing now.
Few of the forum members did more for all the suffering crowd than you did.
Matt