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Each day brings new challenge

July 1, 2007 2:01 am

To give readers insight into the work that area medical professionals do, Healthy Living is launching an occasional series of question-and-answer stories featuring local health care providers.

BY JIM HALL AND JANET MARSHALL

Dr. Victor D'Addio, a vascular surgeon with Surgical Associates of Fredericksburg, is also the part-time medical director of the Rappahannock Wound Healing Center in Massaponax.

He treats people with conditions including carotid artery disease, peripheral artery disease, aneurysms and venous disease. The symptoms of these conditions are often silent. The problems can be severe.

A blockage in the carotid artery can lead to a stroke. A blockage in a peripheral artery can be a sign of widespread arterial problems. A ruptured aneurysm can be fatal.

D'Addio's work ranges from treating varicose veins with lasers to opening blocked arteries with stents to performing emergency surgery on patients with life-threatening ruptured aneurysms.

"That's one of the exciting things about the job--you never know what the day is going to bring," D'Addio said.

D'Addio offered insights about his practice and the medical profession.

Why did you become a doctor?

There's not this seminal event that got me there. It's just something I always wanted to do.

How do you treat the problems that you chiefly see?

Carotid disease is usually treated with an operation called a carotid endarterectomy, abbreviated CEA. That's an operation in the operating room, an incision in the neck, where we go in and clean out the artery and then close it back up. We literally take out the blockage in the artery [and] place a little patch on the artery where we've opened it.

It sounds horrible, but it's really just an overnight hospital stay. There's not a whole lot of postoperative discomfort. It's been a good operation for more than 50 years. That's actually the most common operation that I do.

Tell about some of the advice you give people so they never have to come see you.

Some of the things you can fix and some of the things you can't fix.

The biggie is smoking. Stop smoking or don't start smoking. [Eat a] low-fat diet. Get rid of your sedentary lifestyle. Walk every day. Exercise every day. If you're diabetic, control your blood sugar. If you're hypertensive, control your blood pressure. The basics.

What way does the business side affect the way that you practice medicine?

It's unfortunately a big part of how we practice medicine, and it's relatively new to me. I was in the military and academic settings where you just came to work and operated, and all that just happened. And then I was employed by the practice here for a year before I became a partner.

So really over the last year, I've had to start dealing with human-resource issues. Do we have the right number of nurses and the right front-desk personnel? Is it worth carrying this insurance? And how many patients does it affect if we drop that insurance?

At times you think, gosh, I wish I had gotten my MBA along the way to figure all this out. But we do have businesspeople to help us do it.

What would people, especially those who had thoughts of becoming a doctor someday, be surprised to know about your line of work?

It takes a long time to get where I'm sitting. I don't think I realized that way back when. I guess I had a certain circuitous route with the military. It's many, many years of slaving away, if you will, slogging through the trenches, to get to this stage. I don't think I realized how much training--four years of undergrad, four years of medical school, six years of residency, two years of fellowship, with a five-year stint in the Army in there.

I'm 40 and I do consider myself one of the younger guys. I'm really just starting.

If you could change one thing about the state of medicine, what would it be?

It would be to have us completely blinded and not have to worry about economics.

I don't pick up the chart and look at the insurance card. I don't want to know. I just want to take care of you.

Asked about the high and low points of his career, D'Addio talked about recently losing a patient, who died of a condition other than the one he was treating her for. But he also talked about the joy of seeing the patient's husband and being greeted with a hug.

You realize that patients really appreciate what you do for them, which many times can get lost in the shuffle. You see 50 patients in an office day. You have five minutes at a clip to spend with a patient.

If I have five minutes face to face with you, even if all hell is breaking loose, and people are rupturing aneurysms, [I want to] make you feel important for that five minutes and feel like you have my undivided attention.

Despite all the craziness and the financial, litigation worries, I really enjoy what I do. I drive to work in the morning excited, happy to be coming to work. I'm really lucky to be in that situation.