Posted by Bill Sandweg on 13 February 2023.
Many patients have wondered what to do when the surgeon tells them they need surgery. One thing you should not do is just say, “OK” without first asking some questions.
Of course, not all surgeries are the same. Some are necessary and must be performed right away to save the life of the patient. Some are elective and are not essential to the health of the patient at all, such as most cosmetic procedures. Except in the case of the life-saving surgery which must be performed immediately, take the time to ask some questions.
How necessary is this surgery?
If I do not get this surgery, what is likely to happen to me? Will the problem get worse or will it pretty much stay the same? How is the problem likely to affect me, if I don’t choose to have the operation?
What are the risks of the procedure and how likely are they to occur?
No surgery is without its risks. Depending on your age and health status, a surgery may be extremely routine or it may have a lot of risk associated with it. Some risks, such as infection, are present in every surgery. Some are procedure specific and apply only to that kind of surgery. Risks will include minor problems such as a little extra bleeding and can go all the way up to death. How often one of these adverse events occurs is important too. Only one in 10,000 patients having this surgery may die during the procedure but that is of little comfort, if you are the one. You can pretty reliably expect the surgeon to play down the risks.
What are the benefits of the surgery and how likely am I to see those benefits?
The expected benefits are the whole reason for the surgery. What are they and how likely is the surgery to provide them? Is it a 50-50 chance or a 90% chance that things will go well and the surgery will be a success? If the surgery is a success, how will it improve my life or my condition?
If the surgery is not successful, what can I expect?
Even the best of surgeons doesn’t always get a great outcome. Sometimes matters are beyond her control or she finds something unexpected during the course of the procedure. Sometimes the surgeon makes a mistake which can harm you or result in an unsuccessful surgery. Before you agree to have a surgery which is not life-saving, you need to know what will happen, if the surgery is not a success.
The balancing test.
Whether to go forward with a surgery is always a question of balancing the risks of the surgery with the expected benefits. The surgeon is supposed to have already compared the risks with the benefits before recommending the surgery to you. It is unethical for a surgeon to recommend a procedure when she thinks the risks outweigh the benefits but it happens and you need to be aware of it and protect yourself against it.
If I don’t need the surgery immediately, what can I do to get ready?
When surgery does not need to be done right away, you need to ask if there is anything you can do to increase the chances the surgery will be successful. For example, if you have not yet stopped smoking, this is a perfect excuse for doing so. Smoking affects your lungs and your ability to heal after surgery. Make sure your blood sugars are under control. If you are carrying extra weight, try losing some of it before surgery. It is never too late to begin a walking program to improve your cardiovascular status. Your surgeon may have other suggestions for you.
Good luck with your surgery.