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Get Answers to Make an Informed Decision About Surgery

Photo of doctorWhen your doctor suggests surgery, it’s ultimately your decision whether to have it. Ask questions and learn as much as you can about any surgical treatments that your doctor suggests. Consider the following the next time you speak with your doctor about surgery.

Because most of the more than 100 million inpatient and outpatient surgeries Americans undergo annually are not emergency procedures, you usually have time to determine if any recommended surgery is right for you. Making an informed decision includes weighing all your options—including doing nothing—and making sure you are comfortable with both your surgeon and the hospital.

A meta-analysis of 21 different studies in the journal Clinical Orthopaedics and Related Research found that patients are increasingly involved in shared decision-making regarding orthopedic surgery. Being involved in these decisions with your surgeons can enhance communication and improve surgical outcomes, increase your satisfaction as a patient, and improve your compliance with your doctor’s postoperative directives.

What to Consider

Often, the first suggestion that you may need surgery comes from your primary care physician (PCP). Your PCP will then refer you to a surgeon. Your surgeon will give you an opinion on treatment for your condition. You may want to get a second opinion from another surgeon to make sure the procedure is appropriate for you and your condition, according to the Agency for Healthcare Research and Quality (AHRQ).

If surgery is recommended, the AHRQ advises asking both your PCP and your surgeon the following questions:

  • Why do I need surgery? You want to understand how the procedure will improve your health.
  • What kind of operation are you recommending? Have your surgeon explain in detail how the surgery is done. Ask about surgical options. For example, according to the National Cancer Institute, women diagnosed with breast cancer have three main surgical options: breast-sparing surgery, followed by radiation therapy; a mastectomy; and a mastectomy with breast reconstruction surgery.
  • Are there any alternatives to surgery? Surgery may not be your only option. Medication, treatments, or lifestyle changes, such as special exercises or diet modification, might be just as or even more effective than surgery. For example, according to the AHRQ, surgeons can treat torn rotator cuffs by using one of three surgical procedures, ranging from minimally invasive arthroscopic surgery to open surgery, which involves cutting a larger opening, or a combination of the two procedures. Nonsurgical alternatives include physical or occupational therapy, steroid pills or injections, or oral medicines, such as acetaminophen. Although all the options can be effective, older or sicker patients often fare better without surgery, the AHRQ says.
  • What are the operation’s benefits? For example, a hip replacement could enable you to walk again without pain. It’s also good to ask how long the surgical benefits should last. In some cases, the benefits could last for the rest of your life. In others, the procedure ultimately may need to be repeated.
  • What are the risks? All surgeries involve some risk, so you need to balance out the benefits with the danger of potential complications or side effects. Complications can include infection, excessive bleeding, accidental injury, or reaction to anesthesia. In addition to these, if you are undergoing heart surgery, for example, the National Heart, Lung, and Blood Institute notes that other possible risks include arrhythmias (irregular heartbeats), stroke, memory loss, and damage to tissues in the heart, kidneys, liver, and lungs. The risk for heart surgery complications are also greater if you suffer from other conditions, including lung, kidney, or peripheral arterial disease or diabetes.

    During an operation, death is also a possibility, although more likely for patients who are severely ill before surgery or who are having surgery in an emergency situation.

    Regardless of your type of surgery, you should talk with your doctor about what side effects you can expect, such as swelling or soreness around the incision site. You should also ask about the necessary steps doctors will take to control any pain you might experience after the surgery.

  • What happens if I don’t have this operation? When you add up the benefits and risks, you might decide that surgery is not right for you. It is worth asking your surgeon what you might lose, or gain, by not having the procedure now. If you don’t choose surgery, you should ask the following questions: Will my condition get more painful? Could it get worse? Could it get better?
  • How much will it cost? Call your health insurer before you have surgery. Even with health coverage, there may be costs you have to pay, including to your surgeon, the hospital, and other doctors who care for you while you are in the hospital.

No matter what you decide, remember that being informed about the costs, outcomes, risks, and benefits for each option helps you choose which treatment (if any) is right for you. When doing research on your own, be sure to have your surgeon verify that the information you’ve gathered on your surgery options is accurate.

By Bruce E. Beans, a feature writer for Vitality. For more information, visit the Agency for Healthcare Research and Quality’s website at www.ahrq.gov. Search for its “Having Surgery? What You Need to Know” booklet.

STAY INFECTION-FREE AFTER SURGERY

Surgical site infections are one of the most common hospital-acquired infections. To reduce your chances of developing an infection following your surgery, ask your doctors about the safety precautions they follow. According to the Centers for Disease Control and Prevention (CDC), your doctors and nurses should adhere to various safety steps, including:

  • Cleaning their hands and arms with an antiseptic before the operation
  • Wearing hair covers, masks, gowns, and gloves to keep your surgical area clean during the surgery
  • Cleaning your surgical site with soap
  • Giving you antibiotics shortly before your surgery starts, when warranted

You can also help prevent infections. Before your surgery, tell your doctor about other medical problems you have that could affect your surgery and treatment, such as diabetes. If you smoke, you should quit before your surgery because smokers get more infections.

Also, because shaving can irritate your skin and make it easier for infections to develop, don’t shave around the area where you are going to have surgery. And don’t let anyone on the medical staff shave you. The CDC recommends that health care professionals use electrical clippers to remove hair around the surgical site.

Afterward, make sure your family and friends wash their hands before and after visiting you. Don’t allow them to touch your surgical wound or dressings. And make sure you understand how to care for your wound. Always wash your hands before and after you do so.

If you do develop an infection, it most likely can be treated with antibiotics, although in some cases another surgery may also be needed.

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