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ind Body Health
 

Rx: Preparing for Surgery

© David S. Sobel MD

The following is one in an ongoing series of columns entitled Mind Body Health by David S. Sobel MD. View all columns in series

If you get conflicting opinions, have the doctors talk to each other to clarify their recommendations. Or get yet another opinion. Then weigh the opinions and make the decision for yourself.

Questions to Ask Your Doctor
Experts estimate that one in five operations are not necessary at all, and that many more could be prevented if we changed our lifestyles.

So ask your surgeon:
Why do I need this operation now?

Are there any other alternatives?

Can something less invasive be tried first?

What will happen if I don't have surgery now?

How is this surgery supposed to help me?

What is the success rate?

Is the gain worth the risks and costs?

[sidebar] Know Your Coping Style
When it comes to coping with stressful situations like surgery, most people fall into one of two basic styles - avoidant or vigilant. Both styles have useful elements. Both taken to extremes, can be harmful. The key is to know your style so you can do what works best for you to feel more relaxed, confident and in control.

Avoidant Copers don't want to be overwhelmed with information or to be asked to make too many decisions. They distract themselves, concentrate on pleasant thoughts, don't ask too many questions. If this is your style, immersing yourself in details of surgery may raise rather than relieve your anxiety. Some information you need to know, but you may want to spare yourself the details. Your best strategy may be to put your trust in the surgical team and believe that all will work out for the best.

Vigilant Copers feel more comfortable and in control when they ask a lot of questions and get detailed information. If this is your style, go for it - get as much information as you can. If there are choices to be made, you be the one to make them, and base your decision on carefully weighed information.

[sidebar] Tips for Communicating with Your Doctor

What to tell your doctor:
Along with your medical history, you should discuss the following with your doctor.

Do you smoke?
Smoking greatly increases the risk associated with anesthesia. Quitting at least two weeks before surgery is extremely important.

Do you have concerns or fears about surgery?
Express your concerns and your hopes for the outcome of the operation. This will alert the surgeon to your needs and set the stage for better communication.

What to ask your doctor:

How often have you performed this operation?
In general, the more often a surgeon performs an operation in a particular hospital, the lower the rates of mortality for that surgeon and that hospital.

What are the risks, including risk of death and of non-lethal complications?

Will I need blood, and should I donate and store my own?

What are my options for anesthesia?
Find out what kinds of anesthetics are available and appropriate for you, and choose your preference. As a general rule, select the least invasive and risky type of anesthesia that produces the desired results.

Can I do this as an outpatient?
There are a number of advantages to having surgery as an outpatient, including reduced stress, cost, risk of hospital-acquired infection, and disruption to family life. Some 30 percent of all surgery now falls into the outpatient category, including breast biopsies, cataract surgery, dilatation and curettage, sterilization, some plastic surgery, some orthopedic procedures, and some hernia repairs.

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About The Author
David S. Sobel, M.D., M.P.H., is a practicing physician in adult medicine and Medical Director of Patient Education and Health Promotion for Kaiser Permanente Northern California. He is physician lead for the national initiative in Self-Care and Shared Decision-Making for Kaiser Permanente. He is coauthor of Living a Healthy Life with Chronic Conditions, The Healing Brain,......more
 
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