I was not told of the complications: Botched Lasik Surgery

Caprice’s story:
I went to the eye center to see if I would be a candidate for Lasik. I was not told of the complications other than the obvious, I was never told of the permanent side effects (reading glasses). I was assured that I could attain 20/20 with the surgery. After my first surgery the doctor left "debris" under the flap of the right eye, and my eye became infected. I had excruciating headaches and the antibiotics did not help.
I went back in, they had to lift the flap and remove the debris, I was not told this would change the prescription of the eye. After removing the "debris" he left behind in the initial surgery my eyesight in my left eye was 20/40 and it became 20/100 in the right. I was not allowed to use any kind of corrective lenses at this time, again I was suffering severe headaches due to the disparity between the vision in both eyes. Unable to see adequately I subsequently lost my job. I went in to have the right eye corrected again.

After this surgery both eyes were 20/40 and I failed my eye exam for my drivers license. I was told I would have to wait a year before they could go back in and "enhance my vision. One year later I received a notice in the mail advising me it was time to come in and have my eyes checked. I returned to their office only to be told I would be charged for the visit. I was indignant and told them it was a follow-up from the previous surgeries, that they had not given me 20/20 and I would not pay. I was escorted back for more tests on my eyes. I was told they could get me 20/20 this time and i asked would this affect my near vision I was assured by two technicians it would not. I was scheduled for the "enhancement." After the "enhancement" surgery I discovered the doctor not only had left "debris" in the right eye he had also left some in the left eye as well. The field of vision in my right eye was greatly obstructed.

Not wanting to allow this "doctor" to touch me again I went to a specialist in Dallas only to discover not only had the doctor left "debris" in my right and left eyes, he had left creases in the flap of the right and ruined the lens in that eye as well! I got astigmatism in the left eye and I have to permanently wear reading glasses all the time. The specialist spent 45 minutes cleaning out the "debris" and "ironing" out the creases. I want to tell the world what they did to me!

Read another story about elective surgery. Thanks to Caprice for sharing her story.

No need for a bag: Informed consent for treatment of rectal cancer

Denise Grady's story:
Six years ago, a relative of mine found out that she had rectal cancer, and would need surgery, radiation and chemotherapy. She lives in a small town, and consulted a local surgeon at a community hospital.

He was pleasant and kind, and clearly explained her condition and the operation he would perform. He was also painfully honest, and said that because the tumor was large, he doubted that he would be able to save the sphincter muscles that make bowel control possible. She would very likely need a colostomy, a procedure to divert wastes out through an opening cut in the abdomen, and would have to wear a colostomy bag for the rest of her life.

She thought it over, and decided that, instead, she wanted a doctor who operated on patients like her all the time. She found a surgeon who specialized in rectal cancer, and today she's in good health, with no need for a bag.

Practice makes perfect for surgeons too. Hospitals and surgeons that perform a higher number of a certain kind of procedure are better at it. It’s not just the surgeon's skill; outcomes are better if nurses, intensivists, respiratory therapists, and physical therapists are more experienced at treatment of a given condition.

This goes beyond "informed consent," which sometimes refers only to a perfunctory explanation and an unquestioning patient. Patients should insist on a "well-informed consent" based on their active weighing of pros and cons.

Advice: If surgery is really necessary, have it done at a high volume hospital by a surgeon who has performed many of the procedures you need.

Read a story about well-informed consent.

Thanks to Denise Grady for the source article in today's NY Times.

He was more concerned about my health: Elective breast surgery

Knowing that her mother had had breast cancer at 49, Kerry Herman of Brooklyn, New York had her first mammogram at 38, just before her first full-term pregnancy. She was told her breasts were cystic and very dense but otherwise healthy. When she stopped nursing her daughter, she had a second mammogram, at 41, and then annually after that.

She was in her early 50s when the mammograms started to show calcifications. By then sonograms were readily available to supplement her breast exams. At age 55 her mammograms revealed a different pattern of calcifications in her left breast. Though the radiologist and surgeon told her they did not think this was worrisome, a biopsy was recommended and done in three locations. It revealed very early cancer called ductal carcinoma in situ, or D.C.I.S.

Faced with removal of her left breast and biopsies of the right, she said in an interview, "I decided to be more proactive. After consulting my husband, who said he was more concerned about my health than my breasts, I had a bilateral mastectomy and reconstruction."

"I have never regretted my decision [about the elective surgery], she said. "For me, having to go through this every year and wondering if I would beat the Grim Reaper was agony."

A friend of hers with the same findings chose to wait and see, Kerry said. She ended up with an invasive cancer that had spread beyond the breast by the time of her next exam.

Advice to people with a friend at risk of breast cancer: Help her consider all the options, and be supportive of her tough choice.

Read about another woman's very difficult decision on elective surgery

Thanks to Jane Brody for the source article in the New York Times of Oct. 21.

He got it for free: A decision by Mariano Rivera on elective shoulder surgery

Mariano Rivera stepped out of the visitors' clubhouse in Boston's Fenway Park on Friday to get a soft serve ice cream cone. It cost $4.25, but he got it for free. At 38, after a long career, he is well known, and being the greatest closing pitcher in baseball history has its perks.

He is weighing the merits of shoulder surgery for inflammation caused by a calcification in his right shoulder. It causes him periodic irritation and pain, intensifying when he pitches frequently, but has not prevented him from having 38 saves in 39 chances this season, with 76 strikeouts and only six walks.

He had an MRI (magnetic resonance imaging) test, and saw two doctors this week, who have given him the options of cortisone injections to dull the inflammation, or surgery. The surgical procedure would be a minor one, requiring only a few weeks of rehabilitation.

He is weighing his dislike of needles against the low risks of surgery, and is leaning toward surgery.

Advice to athletes considering surgery: Keep in mind that the team physician and other employees of the team have the team’s best interests at heart, not necessarily yours.

Read another story on a baseball pitcher.

Thanks to Tyler Kepner for the source story in today's New York Times.

Thrilled to be a pitcher and not a patient: Carl Pavano's shoulder misdiagnosis

The scar still looks fresh, 15 months later, on the inside of Carl Pavano's right elbow. Usually, after Tommy John surgery, it settles into a flesh-colored zipper, visible but not so obvious. Carl is actually progressing quite well.

As he comes to the end of his four-year, $40 million contract, Carl is thrilled to be a pitcher and not a patient. But he also has wounds from a bitter comeback trail that are hard for him to forget.

Carl said he was bruised by the belief among fans, reporters and some teammates that he was not dedicated to his craft. When he reflects on four lost seasons, he said he thought it could have been different if the Yankees' team doctor had recommended reconstructive elbow surgery sooner.

Carl shares some of the blame. He said he should have reported his back problems early in the 2005 season, when he made 17 starts through the end of June. Those issues brought about everything else, he says.

"I wish I had been smart enough to just get it right," Carl said. "Say something, make sure something was taken care of, instead of just keeping pitching and thinking it was going to get better."

A daily massage at his apartment helped for a while, Carl said, but pitching with back pain affected his arm. He went on the disabled list that July, and the Yankees announced that he had right shoulder tendonitis.

He made two rehabilitation starts after a month of rest and was re-evaluated by the team physician and a doctor whom Carl had known and trusted for years. The new diagnosis was rotator cuff tendonitis and associated pain in the humerus.

"When they reported I had rotator cuff tendonitis, I actually had a stress fracture in my humerus bone," Carl said. "It wasn't rotator cuff tendonitis. It was just misdiagnosed."

By May, Carl was back on a minor league pitching mound, but he left a start for Class AA Trenton with elbow discomfort. This, Carl said, was a pivotal point.

Six years earlier, when Carl pitched for Montreal, a doctor had removed bone chips from his elbow. He did it again in May 2006, removing a chip the size of a marble. (Carl kept is as a souvenir, he said, until it turned to mold and dust.) The procedure was a temporary fix. It helped for a while, but when Carl broke his ribs in a car accident that August, he aggravated the elbow by trying to keep pitching without telling the Yankees about the injury. In hindsight, Carl said, he could have had Tommy John surgery that summer, but the Yankees did not recommend it.

"I think I could have, but we'll never know," Carl said. The doctor "was told not to. He was told to take the bone chips out and rehab it."

Two starts into the 2007 season, the elbow pain returned, and Carl insisted on major surgery as the only way to heal everything. It took four doctors to find one who agreed definitively. That was the Mets team doctor.

"They had to go through all that red tape; that's why I had to go get all these opinions," Carl said. "It was crazy. And I had to walk around with my heart in my throat: 'Are you serious? You're messing with my career here.' You think I wanted to have Tommy John surgery? But I knew I needed it and I knew I could come back from it. That's why I was all for it."

The Mets team physician told Carl he had done everything he could to come back from the 2006 operation. His only choice was Tommy John surgery, in which a tendon from Carl's knee was used to replace an elbow ligament.

It took place June 5, 2007, nearly two months after he had last pitched a game. Carl said he wished he had the operation sooner.

"I would have been back seven weeks earlier this year," Carl said. "That would have been a considerable amount of time to help the team."

Advice: If you don't agree with a doctor's diagnosis, ask what else it could be. If the answer and the recommended treatment are still unsatisfactory, consider getting another doctor's opinion.

Read another Yankee pitcher's misdiagnosis story.

Thanks to Tyler Kepner for the source article in yesterday's New York Times.

The team physician provided a third opinion: Elective surgery

Boston Red Sox pitcher Curt Schilling has a record of 11 wins and 2 losses in the post-season, the best record of any pitcher with at least ten win/loss decisions. Now at age 41, he has not pitched this season because of a shoulder injury.

After his problem was diagnosed as a tendon injury, the team physician recommended rehabilitation. Curt has been receiving rehabilitation since spring training. Since then, he got a second opinion from another doctor, who recommended surgery. The Mets' team physician provided a third opinion, agreeing with the team physician.

Curt has chosen surgery. It is likely to take him about six months to recover fully.


Advice to people considering surgery: Get additional opinions from a variety of doctors if you're not sure.

Read another second opinion story.

Thanks to Jack Curry for the source story in the New York Times of June 21.

Doing handstands on my walker: Elective amputation

Bonnie Denis was only three years old when a rare virus, transverse myelitis, attacked her central nervous system. It left her temporarily paralyzed below the waist. But she bounced back quickly, and by age five, "I was doing handstands on my walker." But as she grew, the muscles in her feet atrophied, and the bones grew crooked.

Now, when she walks, it feels "like there are a bunch of knives stabbing me," she says.

Even so, she has lived a very active life, dabbling in acrobatics. She keeps an active and quirky sense of humor. Now at 30, she has made a difficult and rare choice, after many operations and years in a wheelchair. The decision is as personal and unique as her custom-painted, raspberry-pink crutches.

She decided to find a doctor to amputate her excruciating right foot.

The decision follows a series of operations. While she was in high school, surgeons invented a series of procedures to reshape her feet. They broke bones and reset them. They implanted metal pins and took them out again. They augmented her own bones with bones from cadavers. Once horrified, she came to think it’s cool: "I'm part zombie," she says.

Bonnie knows the trade-offs; she knows surgery, and wheelchairs, and what it feels like to walk. She is making her own choice – maybe not the one you or I or her doctors would make for themselves – but none of us has walked a mile in her shoes. It's a well-considered decision, and it's hers.

Advice: Explore your choices thoroughly, and make your own choice.

Thanks to S.I. Rosenbaum for the source story in the June 16 issue of the Boston Globe.

He doesn't make mistakes: Cadaver grafts for ACL knee surgery

An orthopedic study, released yesterday, found a 24% failure rate in operations on young athletes who get a cadaver graft [from a dead person] in knee surgery to repair an ACL ("anterior cruciate ligament"). Many have discussed whether Tiger Woods should have this surgery. Here's the story of Keith, an avid amateur soccer player in California:

Having played an awesome game of soccer on Saturday the 15th, on Sunday July 16, 2006 I decided to help out a teammate and play for his team since they were short. The league that I play in have artificial turf fields. The league my teammate played in used various grass fields. On this particular day, it was an awful field of a junior high school. I had just recovered from a mild Achilles tendon strain to my right heel, so jokingly I stated "there's a hole out there w/my name on it, watch." 

Unfortunately, I was right, but had no clue what was in store for me. With maybe 10 minutes left in the game, the other guy playing forward w/me was on a breakaway. I was running with him, wide open, so he crossed the ball to me leaving me 1v1 with the keeper (who sucked btw). It was a simple setup that I've played through many times before: a quick cut to the side and pass the ball in. That's all I had to do. So, I did just that. 

Or attempted.

What happened, to my recollection, was that I tried to cut to the left w/the outside of my left foot. Somehow in my footing my left leg got stuck as if I couldn't lift it up quick enough. Maybe I stuttered in my steps while trying to quickly change my direction or something, but my leg was firmly planted as the rest of my body moved over it. Before I knew it, I was on the ground, my knee having bend backward and to the inside a bit and having heard a pop. I was in the most excruciating pain I've ever felt in my life, and as I was literally digging out clods of dirt and grass from the field I could only say two things, "f***" and "oh s***!" I didn't even move for a few minutes (from the ground that is). When a teammate shouted to the sideline "get some water" I blew up. "I DON'T NEED ANY F***ING WATER, WATER ISN'T GONNA HELP ME!" 

And it figures, because with my Achilles tendon strain, I bought and brought a bag of ice from Ralph's every game. The one day I don't do that is the day I tear my ACL, and some ice would have been nice initially. Anyway, when my teammates helped me up, I tried to walk and immediately my knee buckled. It was as if it were jelly, just no stability at all. The fact that somebody else said they heard a pop was a bad sign, but for the time being I had hoped that it was just a severe hyperextension. In high school I hyperextended my knee a few times and may have had Osgood Schlatter's disease (it was a debate, I had a lot of the symptoms but currently show no sign of ever having it).

My 1hr+ drive home was nervewracking because I started analyzing what could be wrong and what it could mean for the rest of MY season (screw my teammate's season!), and where the heck should I drive to. The urgent care I had intended on going to was apparently closed even though they have "24hrs 7 days a week" posted on their window. In tears from the pain, I made it to the hospital (having never been there before) and apparently parked the furthest distance from the urgent center as possible. In time I got a wheelchair and X-rayed, and 4 hours later (it was a long wait) was told to see an orthopedic surgeon. My leg/knee was in an immobilizer brace and a friend picked me up and took me home.




THE SURGEON

The next day, Monday July 17th, 2006, I went to Blue Cross' website and found the closest orthopedic surgeon to me and called. They had an opening if I could get there in 1/2hr, so I lucked out. The surgeon asked me a series of questions and prodded around my knee for a bit, injecting a giant needle into my knee and pushed out a TON of blood. The needle felt like it was going so deep so as to hit the bone, but it wasn't. Definitely painful while it lasted. I wish I could say the amount, because it was a lot even for an ACL tear, but must have been 4-6 CC's worth. He sent me off to get an MRI as it was the only way to tell for sure what was wrong. I had my fingers crossed for a "best of" situation, meaning I didn't want it to be an unhappy triad (torn ACL, MCL, and torn meniscus), but I wasn't gonna be happy with an ACL tear either. During this time, I had not only the immobilizer brace but was on crutches too. Anyway, a few days later I got the MRI results and sure enough...ACL complete tear. Unfortunately, my stupid surgeon was going on vacation to the Caribbean for THREE weeks! I wanted the surgery right away and this wasn't going to help. So, I painfully had to wait nearly a month in order to have it. At some point I got a hinged immobilizer brace which was a lot better than what the hospital gave me. This new brace had hinges which you could lock into various degrees of flexion and would be key mostly for after the surgery. So anyway, let's get to that already shall we?



THE SURGERY

Finally, the big day came: Friday August 25th, 2006. The process I was told would take about 1hr 15 minutes, which I found surprising, but I guess it's not that long for a non life-threatening surgery, heh. The method of surgery was an allograft: a cadaver graft, meaning some dead guy's Achilles tendon was used as opposed to a hamstring (or patellar tendon) autograft. My surgeon explained he preferred this method because it doesn't require cutting into your own body. Why heal from 2 places when you can do it from 1? Fortunately, despite his jackassery of leaving for 3 weeks, he's a very good surgeon in LA. I got extremely lucky by finding him at random!

 The morning of the surgery, I wrote a giant "NO" on my right knee as it is my healthy knee. The docs later laughed at me for doing that, because "he doesn't make mistakes." But hell, why take the chance? Anyway, I was told that after the surgery I would be sent home: an outpatient. I found that cool because who wants to be in a crappy old hospital? BUT, the surgery didn't go quite as planned. Apparently my surgeon's assistant was also assisting another surgery, so rather than 1hr 15 min, it was 4 friggin hours! But, it was a success. I woke up and they wheeled me out of the recovery room and into a room in the hospital...so, rather than being an outpatient, I was an inpatient and had to spend a night in the hospital. 

That night was the longest friggin' night of my life. I knew that surgery would be painful, but I figured that knee surgery was small in comparison to hip replacement, shoulder surgery, etc...WRONG! Sorry to say but you're gonna have pain and it's gonna be extreme. I was asking for morphine every 4 hours on the hour and didn't sleep for s***...kinda sucked. I didn't eat nor drink much while there either. The next morning was quite a task as it was time to go home. Time to go home after going through traumatic surgery and having no food in my stomach. It also meant moving with a recently-operated knee. A therapist-type guy came in and helped me out of bed (painful) and showed me how to go up and down stairs w/crutches. After a long process of getting me into a wheelchair, into and out of my mom's car, and into my bed...I was home. Aside from moving, there really wasn't much pain...from surgery and on I only took 3 Vicodin pills and honestly didn't really need them. This is to say that while laying on my back all day I wasn't experiencing pain. Getting in and out of bed (basically, when my leg wasn't laying in bed) hurt, but that's to be expected. Maybe 3 inches below my knee was, and still is to this day, numb because apparently they have to cut through a nerve, but the area is only 4x3 inches? Its not bad, but it's one of those things that I'd like to have back just because I'm supposed to. 

There are some other side effects of the surgery such as lightheadedness. Considering you're stuck on your back for such a period of time AND a loss of blood/traumatic surgery AND your usual eating habits have been changed temporarily, it's entirely natural, but I tried to sit up when possible to read, etc. 

So, my surgery was Friday Aug 25th, right? Well, Wednesday August 30th I was back at my surgeon's office for a followup, and my first day of physical therapy. I guess this leads us to our the next point...



THE RECOVERY

The goal of therapy is to achieve full flexion (bending) and extension. When I saw the therapist the first time, he just did some electro-pulse type stuff on my knee. I've done it before back in high school so it was nothing new. Because a little more than a month passed between injury and surgery, my leg muscles atrophied pretty bad. If there's one thing I've always had pride over, it was my muscular soccer legs, heh. My right leg hadn't changed, but my left was kinda chicken-legged. Most notably, my quads. 8 months later, my quads are still diminished...better than post-op, but still not to where they need to be. I'd like to say that my therapist didn't have me work on them in the early stages of therapy. He stressed that the hamstrings are really important because they're the muscles that aid flexion. But, I still feel like he neglected them when it was key because I'm only doing 15 lbs on my left leg...it's not that my muscles can't handle the weight, it's that the ACL is still weak at this point. Which is normal.

Advice: Look into other patients' stories thoroughly before choosing elective surgery.

Read a more grim story of a young athlete's knee surgery.

Thanks to Keith, and to Drs. Kurre Luber and Gene Barrett for their presentation at the 2008 American Orthopaedic Society for Sports Medicine's Annual Meeting.

Different kinds of healing: Elective surgery for quality of life

Question: My patient, a devout Catholic, is considering a risky radical abdominal surgery that can't cure her condition but may extend her life for a year. She says she's okay with either outcome, living longer or dying in the Operating Room. I believe she's sincere, even though her daughter feels she's being talked into the procedure by the surgeon. Now the daughter has asked me to tell her mother how horrible the surgery is and that most patients suffer greatly.

I'm sympathetic to her concerns because I've cared for several patients who underwent this surgery and none of them fully recovered. But it's not my place to explain the risks and benefits of surgery to the patient or to intrude on her relationship with her physician. How should I handle this? -S.N., Wisconsin


Answer by Joy Ufema, RN, MS:
This doesn't sound like a patient who's being coerced into doing something she doesn't want to do. Ironically, if she were to choose an intervention and died soon, the daughter could do a complete turnaround and worry that her mom gave up without pursuing all options.

Explain to the daughter that you can't discuss the odds for recovery because every patient is different. Instead, encourage her to talk with her mother in depth about her beliefs and goals. Offer to sit in on the conversation if they wish. Let the daughter hear her own mother discuss her position as a patient with a serious illness. Then support them both, regardless of the outcome.

Advice to family members who are patient advocates: Educate your loved one about the choices, then let them make the important decisions that affect their lives

Browse for related stories in the index at the very bottom of this page, or read an elective surgery story.

Thanks to Joy Ufema for the source article in the January issue of Nursing 2008.

She used her retirement savings: Gastric banding surgery

"I weighed 424 pounds in May 2004, before losing 250 pounds [from gastric banding surgery],”"said Sandi Henderson, a dark-haired woman in her 50s. Gastric banding restricts food intake through an elective surgical procedure in which a surgeon wraps a silicone band around the upper stomach. This creates a small pouch that limits food intake. After it's installed, the doctor makes periodic adjustments depending on the patient's weight loss, food craving, and physical reaction to the band. Patients typically need four to six adjustments in the first year, and two to three in the next two years or so.

Sandi swims every morning and has tossed out her old medications. "I put my food-addiction money toward shopping and exercise," she laughed. Since her insurance specifically excluded bariatric surgery, Sandi says she used some of her retirement savings to pay for the procedure.

Like any major surgery, gastric banding patients have a risk of infection and even death. The silicone device can shift after surgery, causing it to lose effectiveness, or erode into the stomach. No one knows how long it will last inside the body, so patients may eventually need another operation to replace or remove it. And some surgeons say the banding causes a smaller weight loss than do other procedures.


Advice to people looking to lose a lot of weight: Exercise will help keep off the pounds, even if surgery helps you lose a lot of weight quickly.

Browse for related stories in the index at the very bottom of this page, or read a gastric bypass story.

Thanks to Rhonda Rundle for the source story in the March 31 issue of the Wall Street Journal, "Industry Giants Push Obesity Surgery."

I feel like I will be the most educated patient: Bariatric surgery

From “Aquameliza,” age 38:
My PCP has given me a referral and I have my first appointment with my surgeon (Dr T at BWH in Boston) on 2/27/08. I cannot wait, but am terrified of not getting insurance approval. I have Harvard Pilgrim HMO - the plan and my employer allow for bariatric surgery and do not appear terribly strict on the requirements, but becuase I want this so badly, I am sure that something will prevent me from getting approval.

I have been thinking about this surgery for more than 5 years. A girlfriend went to Mexico to have it done then and watching her lose weight effortlessly made me soooo jealous. However, I also watched her gain weight back because she did not get fills or follow any program or get any real support. I learned from her that the only way to do this is to do it all the way and follow whatever they tell me to do. Another friend had it done at the same hospital with insurance coverage 2 years ago and looks great. Finally, my father was banded in January and for a man who could never lose weight- he has lost 26 pounds.

I feel like I will be the most educated patient - I read everything there is to read, have watched the surgery on the web and have discussed this with my therapist. Honestly, I do not know what I will do if I am turned down. I can't even think about it - the idea of starting ANOTHER diet makes my stomach hurt and my head ache. I cannot walk into another Weight Watchers Week one meeting - or eat any more cabbage soup or try any more pills - I have even bought ones not approved by the FDA from Hong Kong - how crazy is that???!! Diets have been nothing but bad for me- I lose 20 pounds only to gain back 25. Aurgh!!!!

I guess I am writing to see if anyone else went through this or is going through this same thing now. I feel a little obsessive and do not like that - I wish I could stop thinking about it, but I feel like the next stage of my life is on hold until I get the thumbs up and have a surgery date.

Anyone else ever feel like this??

Advice: Become a thoroughly educated patient before undergoing any elective surgery.

Browse for related stories in the index at the very bottom of this page, or read another _elective surgery story.

Thanks to Aquameliza for the source, her comment at lapbandtalk.com

She was the inspiration for "Hey Mama:" A death after cosmetic surgery

Donda West, mother of hip-hop mogul Kanye West, may have died because of complications from surgery, the Los Angeles County Coroner's office said Monday.

An autopsy may make clear the cause of death. West's publicist, Patricia Green, told CNN earlier Monday that West died after undergoing a cosmetic surgery procedure.

Publicist Jo-Ann Geffen said West contacted the surgeon again two weeks ago to say she was ready to go forward, but the surgeon said he needed a medical clearance before he would perform the surgery.

"I always insist on a medical clearance for women over 40, and in this instance it was particularly important because of a condition she had that I felt could have led to a heart attack," the surgeon said, according to Geffen's statement.

Geffen said she was scheduled to see an internist for the appropriate tests, but never made the appointment.

Donda West was a major influence on her son's life, as the music producer-singer-songwriter has often said -- including in lyrics to some of his songs. She regularly attended her son's concerts, and was at his performance at the MTV Video Music Awards in September.

Earlier this year, she released a book she co-authored called "Raising Kanye: Life Lessons From the Mother of a Hip-Hop Superstar." She retired from her post as professor and chair of the English Department at Chicago State University in 2004 to become her son's manager, according to the Kanye West Foundation Web site. Donda West was the inspiration for the song "Hey Mama."

Advice to those thinking of cosmetic surgery: Be sure to consult your regular doctor first.

Read a very different elective surgery story, or read CNN's source story by Karen Bonsignore, K.J. Matthews and Lola Ogunnaike.