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If Surgery is in Your Future ...

Darryl E. Owens, Sentinel - Dec, 05 2006

Millions of operations are performed in the United States each year, so chances are good that you or someone you care about will at some point need or elect to have surgery.

Although surgery can provide relief, enhance beauty, and save lives, it isn't risk free.

"Patients should take surgery - - any surgery - - seriously," says Dr. Harrison G. Weed, professor of clinical internal medicine at the Ohio State University College of Medicine in Columbus. "Things might not turn out as planned. People can and do suffer permanent injury and even death as a consequence of surgery, even minor surgeries."

That doesn't mean you should scratch a pending surgery off your calendar or approach it with shaky knees. But it does require having your blinders surgically removed before agreeing to any operation.

You can boost the likelihood of a successful surgery and a speedy recovery by doing your due diligence, experts say.


Investigate, interrogate, and contemplate, suggest Dr. Vicki Rackner, a surgeon, health coach and author of The Biggest Skeleton in Your Doctor's Closet.

"Before you can decide if that operation is right for you, you need to be informed of the benefits and weigh them against the possible risks," she says. "There's no right answer, there's the answer that's best for you."

Increase Your Knowledge

Getting up to speed on your medical condition and the related operation is step one. And the Internet is a good place to begin your research.

"Patients who are the most-informed tend to have better surgical outcomes," says Dr. David C. Watts, a plastic surgeon with the Plastic and Cosmetic Surgery Institute in Philadelphia." They know what to expect regarding the procedure, post-operative course, and have more realistic expectations regarding outcomes. They tend to follow the post-operative instructions in a more-detailed fashion because they understand the significance."

Not that typing random keywords and wading through the tidal wave of Google search results is necessarily the best approach.

"Patients can find some relevant information, but are also often focused on the wrong thing," says Dr. Philip A. Davidson, a board-certified surgeon with Tampa Bay Orthopedic Specialists. "The analogy I use with my patients is that it is like having your car wrecked and only worrying about the taillight."

A better approach, he says, involves navigating the ‘Net guided by insight from your health-care professional.

Consider Getting a Second Opinion

Armed with your crash-course primer on the prospective surgical procedure, you can develop questions for those who might be your surgeon. During your pre-operative visit, Dr. Arnon Krongrad, a prostate cancer surgeon and president of the Krongrad Institute in Aventura, says your decision to pursue surgery should be informed by basic questions such as:

- What is my diagnosis?
- What will happen if I receive no treatment?
- What options do I have beside surgery?
- What are the relative merits of the options before me?
- Who is the most-skilled person to deliver my treatment?

Don't accept any surgeon's answers as gospel. If your medical plan defrays a second opinion, get one, says Watts, who encourages his patients to seek a second perspective "because I believe the more information they have, the more comfortable they will be with me and the surgical procedure they are considering."

Because in the end, consumers must enjoy a comfort level with their surgeons. Studies might suggest that surgical patients fare better at high-volume hospitals, but your successful surgery largely is reliant on who's wielding the scalpel.

"Hospitals do not do surgery, surgeons do surgery," Krongrad says, "The primary focus of any surgical patient should be on the surgeon, not the bricks in which the surgeon works, not the institutional history, not the flavor of Jell-O served, and not the gizmos used in surgery. Ask: "Who is my surgeon?"

Inquire into the surgeon's credentials and experience. Find out if he or she performs the surgery that you need as a specialty or sideline. Check to see if the surgeon is board certified in that field. And ask about protocols to prevent "wrong-site" surgeries (such as amputating the wrong foot).

Detail Your Medical History

After you've lined up your surgeon, the focus shifts to preventing the unexpected from cropping up as you lie on the operating table.

Your medical team will compile your medical history before surgery; histories, however, vary in terms of completeness, experts say. To help quash unexpected complications, chronicle your medical history beforehand for your surgeon.

"Do not make your surgeon become a detective to determine the medical history." Watts says. "Any problem that a patient has should be relayed to their physician, no matter how small or trivial. Anything that is left out could be significant and cause a negative outcome."

If a close blood relative has experienced problems with anesthesia, note it. Weed says. Pack up and bring all the medications, supplements, inhalers and patches you use for our surgeon to review. Don't forget about the infected toenail or abscessed tooth, Davidson says, because "if patients don't make prior or existing infections known, they increase the risk of infection traveling to the surgery site."

It's important to do as much pre-op self-advocacy as possible. It's also important to, if possible, ask a relative or close friend to accompany you on the day of surgery and act as your advocate if you are unable to do so.

After that, the best presurgical strategy is propping up your health.

"If you are healthy before surgery, if you have taken good care of yourself, then you are more likely to make it through safely." Weed says.

Take your medications as instructed and finish off any rounds of antibiotics. Exercise, if you're able. Eat a healthful, balanced diet. Dump the cigs - smoking inhibits healing. And after surgery, faithfully follow your post-operative instructions.

Remember that no surgery is risk-free. But by taking a proactive role in your care, you can boost the odds of a successful surgery and problem-free recovery.
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