April 24th, 2012
01:43 PM ET
Dick Clark died a day after prostate surgery
The Empowered Patient is a regular feature from CNN Senior Medical News Correspondent Elizabeth Cohen that helps put you in the driver's seat when it comes to health care.
Hollywood producer and television legend Dick Clark died of a heart attack a day after having prostate surgery, according to a death certificate obtained by CNN.
Clark died last Wednesday at St. John’s Health Center in Santa Monica, California. The day before his death, he had an operation to relieve “acute urinary retention,” an inability to urinate.
“It’s a very painful condition,” says Dr. Kevin McVary, professor of urology at Northwestern University’s Feinberg School of Medicine in Chicago.
The operation is “exceedingly safe” according to McVary, a spokesman with the American Urological Association.
“The mortality rate is less than one in 1,000. That’s very low risk,” he says.
Patients with this kind of health history are usually screened by a doctor to test whether their heart is strong enough to withstand surgery, McVary says.
The surgery, known as transurethral resection of the prostate, is considered lower risk because it doesn’t involve an external incision. Instead, doctors insert a surgical tool through the tip of the penis and into the urethra, and then cut away prostate tissue to unblock the flow of urine.
It’s not known why Clark had a heart attack after this procedure. Surgery can be risky for cardiac patients. Anesthesia, for example, can be difficult on the heart, and so can blood pressure fluctuations that occur during surgery.
“Having surgery is a stressful event,” says Dr. Kenneth Rosenfield, an interventional cardiologist at Massachusetts General Hospital in Boston. “It might have been enough to tip him over.”
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Too bad...he could have lived much longer. Unfortunately, these things happen sometimes. I'll miss him.
Maybe. Or maybe it was just his day whether or not he had surgery. We cannot know. The guy was a vasculopath and an old man. Scores and scores of 82 year old diabetics with history of strokes die of heart attacks every day. This is all monday morning QBing.
From the sounds of the operation it would give anyone a heart attack.
Prostate cancer rates are skyrocketing, but all FUNDING goes to breast cancer and AIDS.
He could very well have lived much longer...had he not had a heart attack. Just because he had a heart attack the day after surgery does not necessarily connect the two.
Richard, I assume you were wanting to make a point, but like mommajam, you stated unrelated facts, which basically means nothing.
While you're somewhat correct about where the money goes, you obviously know next to nothing about prostate cancer. Since I do, let me suggest that there are a couple of major differences. First, in most cases, prostate cancer is VERY slow growing, and in men much over 70, they will typically die with the disease but not from the disease. In fact, the standard of treatment is often just to watch. Second, the 10 year survival rates for those younger who have treatment, either surgically removing the prostate or the implanted radiation alternative, are excellent...amongst the very best for cancers as a whole.
So...since most women (and men) with breast cancer will be dead in ten years without treatment, and since the treatment for breast cancer is far more involved and dangerous, I'd say, setting aside my thoughts about Komen, that it's a much larger risk. If you wish to comment in the future, at least bother to learn something about what you're talking about!
Dick Clark had a heart attack just a day after having prostate surgery, a procedure that an expert says is “exceedingly safe.”
WELL I GUESS APPARENTLY NOT!!!!!!!!!!!!
WHAT ABOUT THE MONEY. WHO GETS IT ALL.
It seems like that he would've died from heart problems eventually. Apparently his heart disease was like a ticking bomb waiting to go off.
"Anesthesia, for example, can be difficult on the heart, and so can blood pressure fluctuations that occur during surgery" Garbage he had underlying coronary disease and the stress of surgery ,which anesthesia mitigates but does not eradicate, caused a myocardial infarction it happens . No fault ,but comments like blood pressure fluctuations as a cause that is primary school thought I wonder at the people you choose to get quotes from they wouldnt be my Physician!
I agree with the premise that it's dangerous to view physicians as founts of unfailing wisdom. In a similar vein, Mike, the world is full of armchair blowhards who love to make definitive-sounding comments on events and situations for which they have no direct knowledge.
Wondering why he wasn't given a stress test.........
Actually, anesthesia doesn't reduce the "stress of surgery", anesthesia is a big part of what CAUSES the physiologic stress of surgery. Basically, you are putting someone into an unnatural state between awake and dead, using various drugs, and this creates physiologic stress. So it is correct that the anesthesia process itself, plus/minus blood pressures going high and/or low, are the main causes of heart attacks intraoperatively and postop (of course in combination with the patient's underlying medical status BEFORE surgey, such as age and diabetes, etc.). Momma – that is a good question about the need for preop stress testing, but there are scientific guidelines for that – with this type of relatively minor urologic surgery, stress testing is not medically indicated because the risks do not outweight the benefits. In this case also, the patient had acute urinary retention and if you do a stress test and find an abnormality, then the next step is a cardiac cath (and if you do that and find a blocked artery that needs a stent, then the patient would need Plavix and aspirin for months, which would delay or make impossible his urologic surgery). A lot of factors have to be considered when deciding about preoperative stress testing – we don't want to do them just to make ourselves money, but only if it will benefit the patient.
Have to agree with Dr. Aly.
In addition, the folks writing this don't know whether a stress test was done. It very well could have been and he was deemed fit enough for the surgery. A lot of times with older folks, there is a whole constellation of things going on medically and a decision has to be made regarding risk vs. benefit. My father, who had a past history of heart attack (MI) and related problems died a couple days after a medical procedure. He was suffering from a condition that put him at very high risk for stroke – so a decision was made based on all the medical data to do the procedure. He did not want to risk a stroke and he and his docs decided the procedure was the best course of action. Unfortunately, when they gave him the anesthesia, he had a second major MI. He was revived but it was clear that he would not survive. I know that we were given all the data and made an informed decision. It didn't work out the way we hoped but I have no doubt that we did the right thing.
In Mr. Clark's case, did they risk him having a bladder rupture and a major infection or do a procedure? They opted for the latter and it didn't work out. Life is a risk/benefit deal.
My father-in-law, age 90, had the same issue. He couldn't get off of a catheter. They were to do the procedure only without any cutting involved – only heat to shrink the prostate. He was certified as a high-risk for even this low risk procedure. He had a pacemaker and low blood pressure and of course, was compromised in his coronary ateries. What was the alternative.....he developed a terrible urinary infection, he contracted aspiration pneumonia, and died anyway.
Ouch!! Sorry but nobody will do something like that to me, sounds like it hurts like HELL
But did you ever consider how much it mist hurt if you couldn't pee?
If not, use a rubberband for 2 days, that is if you are male.
abeatle, you know what hurts more than that procedure? Urinary retention causing your bladder to eventually rupture. Hope you never have to experience it but if you do, take the lesser of two evils.
FYI...If you live to 80..there is a big chance you will undergo a cystscopy atleast once...and they do it under sedation. I suggest you search till you find a doctor who will knock you out completely during this exam. If he wont..move on ! As for the procedure, you will be out..but you will have a catheter for a week..they wont put you under to remove it..It takes 3-4 seconds...seconds you wont want to remember.
I had one in my 40s. They should use it in Guantanamo instead of waterboarding.
I can attest to that. A day after having surgery in that general area, I was released from the hospital, but found myself unable to go. The next morning, I'm in the ER having a tube shoved up my whohoo. While that hurt like hell, the relief literally brought tears to the eyes. Had around 1500ccs backed up.
How long can you live not being able to urinate?
That was a reply to mommajam, which obviously, didn't work. Epic fail, CNN. Get a better blog provider.
Typically until your eyes turn yellow.
Not long. A hospital can empty your bladder thru other means, but that is only a temporary solution.
Sometimes people just pass away. The surrounding events don't always contribute to the final result. He lived a full and productive life and passed when it was his time.
Less tha1 in 1000 dies, and this is low risk!!! not to me! 1 in 100000 would be low risk
I hope you never get into a car or cross a street then.
In medicine risk / benefit is weighed with every decision. In this case, I suspect (but cannot know because we don't know, nor should we, what his private conversations with his doctors entailed) Mr. Clark wanted to be able to urinate without having permanent catheter (foley or suprapubic) so he opted for a TURP. Had he done NONE of the above, he would have ultimately died of kidney failure due to obstructive uropathy (with a ton of pain from urinary pressure in the process).
So, 100% risk of death doing nothing.
0.1% risk of death from TURP.
Proabably lower immediate risk with a permanent catheter (but also the inconvienience and constant risk of infections).
Nobody said life is risk free, especially for 82 year olds with cardiovascular disease. His risk of having a heart attack and dying even without any surgery on any given day was MUCH higher than 1 in 100,000.
Isn't this a HIPAA violation to talk about procedures and medical records and conditions of patients, dead or alive?
The first line of the article says the information came from his death certificate which is public record. Mr. Clark's doctors are not quoted or on record anywhere here in this article.
@Doug It's only a violation for someone who got that as a result of patient confidentiality (anyone working in the hospital or lab). A reporter is under no obligation from HIPAA to keep it private, nor is a family member, publicist, co-worker, etc. In this case, the info was on the death certificate which in most states is a matter of public record that is independent of HIPAA rules.
@duh and in reference to the comment by "doug". this looks like someone exagerated the details of what was actually public info on the death certificate but clarification on this with regard to HIPAA. it would be a primary HIPAA "violation" so to speak on behalf of the person that actually accessed a paitients PCI, "if" in fact they did not actually have "legitimate" need, and then another violation if that same person were to disclose that patients PCI to a third party who also did not have legitimate need. the person that may potentially recieve the PCI is not necessarily bound to any HIPAA regulations. so the only person liable in this situation would be the person that accessed the PCI and then disclosed, not the person receiving it or repeating it......
Man, that is WAY too much information. Do we really need to know this? Is it ANY of our business?
You win intelligent comment of the day!!
It might. Who knows?
Personally, I'd rather know. Everything.
"Anesthesia...difficult on the heart" Really? If that were the case, then we should stop having anesthesia to risk our heart risks associated with surgery. But try having surgery without it and see how your heart does. One day following the procedure, the increased vascular load and change in electrolytes due to the fluid used to do the TURP probably stressed out his bad heart. He could also have suffered a fatal embolus (air or clot) due to positioning and/or the procedure itself or immobilization that contributed to the heart attack. But please, don't even suggest that the anesthesia may have caused it.
That was an insightful response with the caveat that you are dead wrong.
You sir, are an idiot. Anyone who has ever had surgery is informed that anesthesia can be risky.
I really hope you're not a physician. Anaesthesia leads to vasodilation when the smooth muscle of arteries relaxes. The resulting increase in the volume of the cardiovascular system leads to a drop in blood pressure, and the heart works harder as a result. In a patient with CAD, this can be the event that directly leads to an MI.
Ummmm, being in his 80's may have had something to do with it......
Answerrs to a few points above:
1) How long can you live wityout being able yo void your bladder...maybe a day or so before rupture or serious kidney damage. If it ruptures you've got all sorts of big bad issues like infection and such to deal with – you're in a far bigger problem at that point than the proceudre used to fix it.
2) It hurts like **** – well that's why they use anesthetic that's it's purpose. As they mention though its not without risk – ANY anethesia is a risk there is no 100% safe option. These are exceedlingly powerful drugs and have correspondingly bad potential side effects.but its better than the alternative of surgery without it. As was stated problems area rare but they do happen.
3) As they stated he had numerous other health issues which can turn any routine procedure into some hing far more involved. He has a privious history of cardiac issues, stroke and diabetes among other things plus he was 70+ years old that alone complicates things. With all of these, he'd be a higher risk for anything involving anesthesia or surgery..
4) Another thing to consider is with diabetic patients often if a heart issue occurs is can be a "silent MI" where the patient has little to none of the customary pain associated with a heart attack so diagnosis and treatment quickly become more of a challenge with no major symptoms.
When will these morgue chasers ever stop!, Why do we have to know all of these details? Let the man rest in peace and go find a real job that actually is of some use to humanity!
My buddy had bladder cancer a few years back, they treated him by applying a chemo paste to the tumors. And there's only one way to get into a guy's bladder. When I remarked how horrible that must have been, he said it wasn't as bad as one would imagine. Seven years later, he's doing just fine.
So an 82 year old stroke survivor with diabetes, prostate problems, glaucoma and coronary artery disease passes away and CLEARLY it was the anesthesia or the doctor's fault? Wow on some of the comments here.
It's true, but surgery at any age is risky – especially for someone who's already had a stroke, has heart disease, and diabetes...
My Aunt had open heart surgery 10 years ago for an aortic tear and had a stroke the next day – and was also near 80, so surgery especially in the eldery is often risky...
Still – he lived to a fine age – the actress Dana Hill died at age 21 of a stroke related to Type 1 diabetes so complications of heart disease and diabetes can affect anyone, at any age...
Ouch! Sounds horrendous!
No kidding. I wonder how many guys had heart attacks just reading about this procedure.
That's terrible. Poor guy!
Good old ol' age, just lying in wait to present us with a grab bag full of surprises. Luck and good preventative measures
like exercise and eating right may stave off some stuff, but overall, Dick Clark seemed to live a wonderful, full, rewarding
Ms. Cohen's accompanying image looks inappropriately amused.
Anytime you have surgery and go under anesthesia there is a risk, no matter what age! Dick we loved you! RIP!!!!
I love all the "Doctors KILLED HIM!" comments. Especially since there is not nearly enough info to even form an opinion.
Urinary blockage is bad, not just painful. If not relieved it can be deadly. Here are some things the blamers with TV show medical degrees forget (or don't know).
I bet they tried medication and other methods before deciding surgery. This would explain why the Drs. took the risky road.
Clark was 82 with diabetes. Diabetes is far worse than many people realize. Before insulin shots, people dropped from it in large numbers.
All surgery, no matter how simple, can lead to death. Given Clarks' health, the risk was higher and I'll bet both the medical team and the man himself knew it could end up badly.
Maybe it was incompetence, however, like I said at the top, there is not enough detail known by us, the unwashed masses, to come to any conclusion.
Truth. The guy was just too fragile.
You got it right.
Man... New Years is gonna suck.
From the surgeon point of view, there is no risk at all. They get paid whether he lives or dies.
Since deaths are matters of public record, I would assume that HIPAA rules would not apply. Cause of death would be listed on the death certificate.
Had bladder cancer diagnosed about 1992 the Dr. went in and removed the tumors. Knock on wood no return of the cancer since. The worst part was the catheter they put in to drain the bladder. Have since had the same prostate surgery and the worst part is the catheter. Feels like they're shoving a 3inch tube up your penis.
Based on the description of that surgery, I'm reasonably certain I would have had a stroke as well!
If someone stuck that machine up me I would have a heart attack and I am healthy.
We want more dick!
Ground-breaking reporting here: Old guy with a history of coronary disease dies of a heart attack.
Dick Clark died from being 82 yrs. old...it happens all the time
Dick you will be missed. You are the greatest. I just wish that Ryan Seacrap was not trying to steal your spotlight. Seacrust is a jerk and I've not watched his new years program since he took over as the show's miserable headstone.
How many time do we see this happen o people? Each one of us know a story. They killed him with their ignorance! When a car mechanic fixes a car and it breaks down, weather its the mechanics fault or not the customer stops payment and down raps the mechanic. When a patient dies in the care of a doctor, they say, sorry he did not make it, he was not strong enough" and the family gets the full bill anyway. How dare they not take responsibility. They tortured my dad for ten days, tied his hands so he could not take out the tube in his throat and tapped cotton balls over his eyes so he could not signal them. We tried to stop them but they convinced my Mom saying " do you want him to die?" They popped a hole in his colon and after ten days he finally died. When the call came in the doctor said, "he did not make it" We were actually relieved that he passed and was not suffering at the hands of these so called professionals. Western medicine is a sham and these doctors should be held accountable!
I had retention back in November, at the ER they inserted a catheter in the penis (ouch!!) I saw the urologist a few days later and they removed the catheter and all was OK. Three days later, it was back to the ER and another catheter (ouch again!) I wore a catheter until they did Major Surgery March 2. After a 7 week recovery i am finally back to normal.
What Dick Clark got is considered non invasive but the aftermath of it can be very painful. I am 72 so they did a lot of testing to make sure surgery was safe to do. Guys, if you get your prostate checked regularly you probably won't have to go through what Mr Clark or I did. Tests prior to surgery, Urodynamics, Cardiogram, Echo Cardiogram, Digital exam, Ultrasound scan of prostate, Cystoscan, Cystogram. u
Ultrasound scan of prostate, Cystoscan, Cystogram whew!
Are any of you who are here offering your learned medical opinions actually physicians?
OMG that surgery sounds soooo painful!
i still think a lot of inflammation is from yeast infections (or any other infection, could be streps) and allergies that look like infections. i don't think health care understands low flying infections, blood sugar, or inflammation from allergies very well. seems more often than not they are doing the wrong things.
No surgery is minor.......... Don't let them fool you.
Was he in the hospital when he died? Strange you could die of a heart attack in the hospital. I thought you did not even need a heart to survive in a hospital...they could keep the blood flowing.
Well, you thought WRONG.
It was enough for us to know that he died of a heart attack. We REALLY don't have the need-to-know about his other delicate medical history. Why is this article here? What about patient privacy? Why do you feel this is everyone's business to know?
Because CNN is trying to stir up controversy along the lines of Conrad Murray and Michael Jackson – should the doctors have operated on Clark? Should this, should that? The man was 82, had suffered a massive stroke and resulting vascular damage and had an acute need for surgery, which he received to alleviate his suffering. What CNN is doing is pure garbage, the most disgusting thing I've read here in a long time.
If you cannot urinate then you need surgery, it's not a question of "if". This procedure is very safe but Clark already had blood vessel damage due to his major stroke; it caused brain damage and so was not "mild" as reported. Raising questions about whether the doctors should have screened him or performed the operation is nonsense, very unprofessional on the part of CNN. I understand the need to generate controversy but this is garbage and CNN should be ashamed.
I would be curious to know if Propofol was used during anesthesia. That stuff should be banned from surgery.
And what is your rationale for banning the use of Propofol?
Propofol should be banned from use in a non accredited healthcare facilities without proper equipment, anesthesiologists and other trained health care professionals. Despite its positive benefits and good safety profile, it should also be banned as a sleep aid used along with other powerful sedatives especially in pop stars who have a history of drug addiction.
You can wear a catheter and a leg bag indefinitely, at least according to my Urologists nurse who said she's had patients been wearing them for 2 years. Men just need to get the actual catheter changed once a month for infection prevention. He could have done that until the doctor said it was safer to do surgery But maybe the Dr determined is was best then. He may have had cardiac testing pre op. See my last post.
Doctors messed up, plain and simple. Lawsuit.
you guys are ignorant ! the stress is caused by the surgery ! not anesthesia ,in a patient with disease it comes to a head because of that disease if they have non then the risk is negligble and anesthesia is very safe ,if you anesthetize and dont do an operation say for pulmonary veins it is very safe ,it is the surgery that is the problem it causes alot of stress --you guys are not bright
One way to prevent prostate cancer is to actually keep it functioning. That means USING it! You don't hear about the old Hugh Hefner having issues. Some people just lose functionality early. Maybe he should have dumped his old wife and got a new one! All rich guys do that, they know how to keep their prostate healthy and without surgery!
First, it wasn't cancer. Second, a huge majority of men have enlarged prostates by the time they're 83, and having lots of sex does nothing to stop it. Your post is uninformed and idiotic.
jmsent is an idiot and your right! you have an enlarged prostate because of fluid buildup and until you get a prostate massage or use it alot you will still have problems. jm needs to educate himself as that prison cell is probably closing in........................
You surely don't know squat about what you are talking about. Prostate enlargement verses, engorgement, what you are talking about has little to do with having intercourse. BPH,( Benigh prostatic hypertophy) occurs in older males idiopathicly, (,unknown reason), and has nothing to do with sexual activity. One thing of note, a mortality rate of 1 out of 1000 is not a very good set of odds in a predictible operation. D. Clark must have had a delayed reaction to the medication used during the proceedure or he had some sort of embolic event.
My guess - poor pain management - lawsuit and hopefully more awareness
I am a nurse, and while pain management is a soapbox of mine, people do not have heart attacks from poor pain management. Dick Clark was very weak and sick when he went into this surgery. It seems to have been a palliative procedure. That is to say, it was done to keep a man who was already in morbid health as comfortable as possible. I don't understand the lawsuit mentality in healthcare, when we are talking about a man who was very old, very weak and had already suffered multiple strokes. People die 100% of the time. That is an undeniable fact of life. The doctors undoubtedly told the family of all the risks, and that he was at a greater mortality risk because of his health. They most certainly decided, as a team, to go ahead to try and give him a little more comfort at the end of his life. I see nothing unethical with their decision or the outcome. It is sad. I wished that he had pulled through surgery; make no mistake about that. However, his death was probably a foreseen risk to surgery. It is not a matter of a lawsuit. If the choices were death, or another six months in excruciating pain from urinary retention (which can cause severe dementia, believe it or not), death is not the worst thing. Death is not always the worst outcome that can happen to someone who has lead a full life, who is extremely ill, and who is suffering from severe pain. Just because someone dies, it doesn't always warrant a lawsuit. You people scare the hell out of me. It's people like you that make me scared to death for my license and my ability to support my family. You come in at the last days of your 98 yr old grandmother's life. She is eaten up from head to toe with cancer and she is in pain all the time. You haven't been around for any of her surgeries or her chemotherapy regimen. Then you want us to stop giving her so much pain medication because "it is making her too confused/sedated" (I hope someone makes that decision for you when you are old and eaten up with cancer) Then you insist that the other family go home to rest. They do because they are so sleep deprived because _they've_ been at the hospital for weeks because people like _you_ were no where to be found. Then, in the middle of the night, grandma's heart stops beating and even though she is a DNR you want us to brake every rib in her chest doing a full cardiac code on the poor woman, you want us to put a tube down her throat to breath for her and keep her in this horrible existence of pain and confusion. Then, when she inevitably dies because she has TERMINAL CANCER and she is 98 YEARS OLD, you want to sue us and have the nurses stripped of their licenses. American's need to deal with the concept of death. We will all face it at some point, no matter how many lawsuits people file.
There is a time and a place to litigate malpractice, to be sure. This is not it.
lawsuit – that'll fix it ::rolleyes::
I'm nurse as well. I am with Emily. Dick Clark was elderly, anytime you do surgery on older patients there is a high chance of complications. The reason's for doing the surgery are private, but probably palliative and not without risk. There is no reason to sue and the mentality in this country about suing is really about ignorance. I have never liked the "Empowered Patient' or Cohen's point. I feel that it is very narrow minded and not a good perspective about health care. CNN please get someone that actually understands the medical aspect for the issues you are trying to report on.
TO NURSE EMILY: Read the New England Journal of Medicine and get enlightened...the #1 cause of death is the US is medical errors.
unowhoitsme, The #1 cause of death in the U.S. is NOT medical errors–it's heart disease. Continuing with the top ten: cancer, chronic lung disease, stroke, accidents (trauma), Alzheimer's, diabetes, influenza/pneumonia, kidney disease, and suicide. Medical errors not even in the top 15. You're the i-d-i-o-t. Emily is absolutely right.
Emily is 100% correct and, as someone in the medical field too, I have seen precisely that scenario more times than I care to remember. Absent relatives assuaging their own guilt by treating their own consciences, not their loved one, and then looking to blame someone for the natural course of life.
Everybody gotta die someday. Whats wrong with that. What did cavemen do when they couldn't take a pee. They probably just walked out in the wilderness and died a painful death.
I am a long time lurker on many sites, enjoying the unbridled comments. Emily's post is one of the very best comments I have read.
Right on! Best comment read in a long time!!! Kudos.
I am sick and tired of lawsuite mentality(suing everyone for everything) in this country. That is why medical costs are sky rocketing in this country. All the trial lawyers should be sent to prison.
@unowhoitsme The number 1 cause of death is medical errors? What a hoot! Not that they don't occur and not that medical error reporting is not a problem but the number 1 cause of death? So we dismiss ALL medical personnel and we'll all live longer, right?
Y'know, I'm an ICU nurse, and people die. Every single day. In fact every one of us is going to die, just like every human being who has ever lived has died. The man was in his 80s, he had multiple comorbidities that had an effect on his heart, he had known heart disease, and he underwent anesthesia. That's about six strikes against him. Lawsuit? Seriously? That's what's wrong with our medical system mess. Too many lawyers involved.
We need more Nurse Emilys in this world – thank you so much for your insight, logic, and heart.
I had chest pains just reading about the prostate surgery....eesh!
Do NOT take "surgery" so lightly, folks. People nowadays (stupidly) act as if it's as "routine" as a haircut. THREE THOUSAND people die EVERY YEAR die just from ANAESTHESIA–not from the disease that put them on the table in the first place. Just the anaesthesia can kill you. Being "knocked out" so someone can "perform a procedure" on you is VERY serious business, and YOU COULD VERY WELL DIE. That's why you "sign away any blame" before it's done.
That's exactly right. Then add to that the thousands of people who die from hospital-acquired infections and it's clear that there is no such thing as a "routine" or "simple" surgery,
Thank you for your military service and may God bless you with a long life.
That's entirely true. Surgery is *never* "routine". It may be uneventful, but it's never routine. However... that doesn't mean surgery is to be avoided at any cost. Sometimes surgery actually does save and extend lives. In fact that's the case far more often than not. Do people die in surgery? Sure they do. But more people die in car accidents getting to the hospital to have surgery than who die during the procedure. Remember *that* as well. Life is about managing and understanding relative risks. Unless you want to live in a glass bubble, it's risky. And even then somebody could burst your bubble and kill you.
Sad to see Dick Clark go...such an icon.
Why sad? Everyone dies and moves on. it's like graduating and should be a time of happiness. Death is only a bad word for closed minds.
Clark had an outdated prostate surgery procedure. He should have had the current gold standard in prostate remediation, "Green Light Laser Surgery." It is performed the same way but uses a laser device to heat the tissue blocking the urethra until it "explodes." This surgery both removes the blockage and cauterizes the wound so that there is minimal bleeding afterward. I had this surgery and it was a simple outpatient procedure. It would also be more easily tolerated by someone of Clark's age and with his health implications. The procedure he had is a barbaric procedure to which no patient should be subjected.
Wrong. TURP is still the gold standard.
Where's your randomized controlled trial that compares heart attack risk for green light laser vs TURP. He died as a complication from palliative surgery. The type of procedure likely made no difference. It was likely either a surgical procedure or a morphine drip. Older patients sometimes die as we try "to do something."
There comes a point when the saying should really be, "Don't just do something...stand there!"
In response to Jeff Taylor's comment about TURP being the gold standard for prostate surgery I must disagree. If you have the choice between TURP and Green Light Laser, you would be a fool to have TURP. TURP is the procedure that was common before Green Light was developed and now Green Light is replacing TURP as the procedure of choice in most major medical centers and in progressive urology practices. TURP uses a blade to cut away the blockage, leaving a substantial area of raw tissue and bleeding capillaries. The TURP process is far more prone to infection and scarring which can cause additional blockage and the need for an additional procedure. Recovery takes much longer with TURP and is more prone to complications. Certainly in Dick Clark's situation there were a number of contributing factors that may have played a role in his death, most of which would be equal regardless of which procedure he had, but the brutality of the TURP procedure elevates the risk. The only other option was for him to be on a permanent catheter in order to keep the urethra open to allow urine to exit the bladder. That isn't a good option. Green Light Laser is the gold standard and the quicker it replaces TURP in all urology practices the better the outcome is likely to be for all related prostate procedures.
Are you his physician? Do you know everything about his condition prior to the surgery? Is it up to you to recommend what someone should or shouldn't have? Please don't presume to tell *my* doctor what to do to *me*, thanks all the same. TURP is still very much the "gold standard" throughout the developed world, btw.
Ken – are you a urologist? Or perhaps a sales rep for AMS (company that makes the green light laser)? You are misinformed and you stance against the TURP is uneducated and unfounded. TURP is still the gold standard. Have you ever done either a TURP or a green light PVP? I have done both – and I can tell you unequivocally that the TURP is not unsafe nor is it barbaric as you would have yourself think. To address a few of your comments....
"If you have the choice between TURP and Green Light Laser, you would be a fool to have TURP." Not necessarily – don't forget the person performing the surgery. Would you rather have someone who's done 300 TURPs, do a TURP on you or someone who's done 1 or 2 green lights (believe me, there is a learning curve to everything including the green light). The key isn't the tool, but rather who is using it.
"TURP is the procedure that was common before Green Light was developed and now Green Light is replacing TURP as the procedure of choice in most major medical centers and in progressive urology practices." TURP is still quite common and is still being performed at many major medical centers (including major academic centers) and by many "progressive" urology practices – whatever that means.
"TURP uses a blade to cut away the blockage, leaving a substantial area of raw tissue and bleeding capillaries." True the TURP cuts away tissue. Bleeding is cauterized to stop it. FYI – you can get bleeding with a green light too – believe me I've seen it. The green light leaves "raw" tissue as well.
"The TURP process is far more prone to infection and scarring which can cause additional blockage and the need for an additional procedure." – Simply not true. In fact, the secondary procedure rate is higher for green light than for TURP. Also the risk for persisent or recurrent urinary retention is higher with green light than TURP (look up the data).
"Recovery takes much longer with TURP and is more prone to complications." Recovery can be shorter with green light (pts usually go home the same day), but most pts go home the day after surgery for TURP. TURP is more prone to some complications (blood transfusion), less prone to others (persistent or recurrent urinary retention – incidentally the problem you are addressing in the first place), and about the same as green light for others (post operative incontinence).
So long to a good fellow, He was always a class act.