Elective Surgery Smarts

Two centuries ago, Ralph Waldo Emerson said, The first wealth is health, which is still true for most of us today.

Facing the prospect of surgery and the possibility of complications causing death scares nearly everyone. Yet, nearly everyone eventually faces surgery themselves or a loved one’s operation. The American Medical Association says over 60% of doctors over 55 have been sued at least once.

Commentary from Doctors’ Statements That Surprised Me
Doctors realize few patients these days view them as gods but also know that patients and their families expect perfection from them each time, every time.
Patients retain less than half of what doctors tell them; that’s why it is so important to have a loved one with you in meetings before and after surgery.
In teaching hospitals, from the first year through the fifth year, surgical residents perform nearly 1,000 operations while they are learning, making it important to make sure you know and trust who will be holding your surgical knife.
Trusting your surgeon is vital to your surgical success and recovery.

Post-Operative Infection is one of the greatest risks. Doctors are people who care about their patients and want every surgery to go perfectly, and some don’t. Be reasonable about complications.

Doctors have alcohol and drug problems, so it is important to pay attention to the telltale signs while you are meeting with them before you go under their knives

Doctors rarely call the discharge shots these days. Discharge Planners, mostly Registered Nurses, and insurance company guidelines grease the skids that slide you out. Surgeries, like car repairs, have predictable timelines that can get followed whether you think you are ready or not. State Departments of Health keep tabs on patient care problems. For example, if a patient ends up back in the operating room within thirty days of surgery, it must be reported to the Department of Health in New York.

How do you react when a sudden pain comes on you? If you choose to do nothing right away, how long do you tolerate a pain that does not go away, or gets worse? What is your general attitude about visiting doctors?

If you are older, men, especially, are known for being sheep to surgeons, questioning nothing, just following along the surgeon’s surgery street. Women, especially, are known for keeping their pains to themselves, avoiding doctors as long as tolerable, and some older women have a high level of tolerance.

My father’s reasoning was man-simple, I wouldn’t trust my doctors to run my business, why would I expect them to trust me to run theirs? He had few words to say in conversations with doctors, rarely contacted doctors between appointments, toughed out complications and side effects.

Does his argument sound spot-on to you? Sharpen your sword of logic instead of letting a medical degree rob you of your common sense. Who did he put in control of his health? The doctor! Certainly, up to a point, we all must do this, but not by totally relinquishing control.

Mom, who hated visiting doctors and taking medicine, went more to being creative and toughing it out when she had pain. In fact, like me, in her sixties, she had never taken prescription drugs regularly throughout her life. Eventually, she believed pain should go away, just like it came. She never complained, because then people would tell her to go to the doctor, especially my father. There was more. She didn’t want to hear that there was something seriously wrong with her that would put her on what she called The Medical Merry-Go-Round. Like my father, she rarely asked questions.

If you are a middle-aged or younger man or women, you are likely to feel too busy and put off getting necessary medical attention. When you cave and go, you are likely to ask more questions and do much more research into your malady than your parents ever did. Use caution with Internet information!

Be timely in responding to your body’s messages: toughing it out when your body is screaming for attention by giving you pain, growing lumps, developing rashes, weakens you. The longer you tolerate the pain or abnormal eruptions, the more tired you feel, the weaker you get. The pain makes you feel like you are fighting a blizzard 24/7.

Of course, even my Mom, who toughed it out all the way to Stage 4 Lung Cancer, eventually went to the doctor, living only four months post-diagnosis.

Here’s a primer to advocate for yourself or someone you love through surgery, health and, hopefully, healing.

• Choosing a Surgeon—You want to have the best surgeon holding the knife. Your Primary Care Physician will likely recommend a surgeon in the specialty you need, probably part of a surgical group, who may be a stranger to you. You don’t have to use that doctor. Find others who have had similar surgery successfully. Get some names. Then, check all possible surgeons out by asking people who work at the hospital you will enter. See if your state’s Department of Health has a consumer site where you can find out if the doctor has been in practice trouble. Ask the surgeon’s Complication Rating that hospitals keep. Make sure the surgeon you choose is Board-Certified in the specialty.
• Making the Most of Your Doctor Visits—Doctors are busy and 15-20 minutes of one-on-one time is what you can hope for. You need to make the most of that time and bring a loved one with you. Keep track of your symptoms, like a diary with dates, times and short statements of what’s going on, what you found helps, what doesn’t. Take index cards and make a list of your concerns and the questions you have about them. Always carry a list of any medications you take and the dosage and frequency. When the doctor speaks, listen, ask questions and take notes. Keep focused so that nothing that concerns you is forgotten.
• Ask Questions About New Medications Being Prescribed, Changes in Current Medications and Surgical Recommendations—It’s your body, your health, and your life, you need to know the reasoning behind the doctor’s recommendations, a known side effect of any new medication and compatibility with current medications. Ask for copies of the results of any tests taken. Get the full picture. Ask the doctor what is likely to happen if you do not choose to take the new medication or get surgery. You have a right to make an informed decision.
• Get Specific Heads-up Information—Understand why you need surgery now and why medication can’t solve your problem. Ask exactly what kind of procedure the surgeon plans. Ask if the surgeon will be holding the knife. If not, why not? Ask who will be your anesthesiologist and how you will be anesthetized. Ask about possible complications and your chances of getting them or dying under the knife. Ask about post-operative care and who will do it. Ask about rehabilitative care, who will do it and how long it will take for total recovery.
• Get a Second Opinion—Why? You want to make sure you really need this surgery, that the surgeon’s plans are the best way to do the surgery. What if one says “yes” and the other says “no” or recommends another type of procedure? Get a third opinion. You want the best surgeon, the best method to get the best results.
• Ask About Giving Your Own Blood or a Family member’s Prior to Surgery—Why? It likely to be a safer bet than a blood bank. What if it is never used? Maybe it will be life-giving to another.
• Best to Ask if Your Operation Can Be Performed Early Rather Than Late in the Week—Why? Complications from Friday’s surgery will be looked at by whoever is on over the weekend.
• On Medicare? Know Your Discharge Rights—remember the discharge guideline people. Medicare pays based on average number of days for surgical procedures. The hospital gets the same payment when you stay less than the recommended number of days, so booting you out early is profitable. You have recourse. If you do not feel ready to leave the hospital, tell the nurse that you want to appeal your discharge through Medicare. This gives you up to three days from the time you contact Medicare until Medicare makes its decision.
• Recovering from Surgery—Just trust the process of people who recover surgical patients every day as their careers. Recovery can be painful, tedious, time-consuming, and frustrating. Be obedient, but, still, let caregivers know your discomforts, drug side-effects, what movement hurts too much.

It is just not smart to be intimidated by a medical degree or a sheep behind medical people. That doesn’t give you the right to be the patient from Hell, either. Thousands of people go through successful surgeries. It is your job to do everything under your control to be one of them.

Why not clip out this article and file it away for future reference when you or someone you love faces surgery?  

Have questions? Give me a call. I have been a proactive, mostly happy patient for many decades, practicing what I have shared about win/win medical treatment and recovery.