After explaining all of your symptoms, giving your history, reviewing your physical exam and diagnostic studies, a diagnosis will be arrived at. For every diagnosis, there are a number of general options that are possible. Some options are more appropriate than others. If non surgical options are the most reasonable for your situation, we will be happy to recommend that course of action and facilitate the necessary appointments. Surgery can be risky and difficult, but sometimes after careful consideration, it's clearly the best option. Other times, alternatives to surgery are the wisest choice.
Learning to ask the right questions -- and getting the right answers -- is vital to helping you decide whether or not surgery is right for you. Being a responsible health care consumer starts with getting involved in decisions about your health. That way, you're more likely to feel calm and confident about whatever course of treatment you choose.
Deciding Which Option is Best
So how do you decide about surgery? The first step is to find out whether the surgery being recommended is emergent, urgent, or elective.
When surgery is needed to save a person's life (such as to remove or decompress a large brain tumor with swelling or hematoma causing coma) or must be done immediately to prevent permanent disability (such as to decompress an injured spinal cord, or repair a fractured spine), it is considered emergent. That means there is little or no choice but to have the operation or risk serious consequence to a person's future health. There is usually little to no time to explore other options and surgery is performed within minutes to hours of diagnosis. Fortunately, few surgical procedures are truly emergent.
When performing surgery prevents the occurrence of, or progression of serious dysfunction it is considered urgent. These circumstances may allow for plans to be made, schedules to be adjusted while preparations for surgery is made. Preparations may include medical clearance or further preoperative testing. These procedures are performed within days of diagnosis.
Most surgical procedures involve some degree of choice for the patient. In some cases, alternatives to surgery exist, such as medications, interventional procedures or other ways of dealing with the problem. In other cases, surgery may be the only option for correcting a particular problem, but the symptoms don't merit the risk of surgery. For example, many people with radiculopathy have no weakness and only intermittent pain.
Surgery is appropriate when it is needed to:
- Relieve or prevent pain
- Restore or preserve normal function
- Correct a deformity
- Save or prolong your life
Even if surgery is appropriate, it may not be the only choice of treatment. It's always best to investigate all other options before choosing surgery.
If you feel anxious or nervous, take a friend or relative along for moral support. Then assess the information and decide what you want to do. It is usually appropriate to come to a decision after the appointment is over and you have had a chance to consider the information you were given during the visit. Make sure it's your own decision. Don't let yourself be pressured into having surgery.
Asking for a Second Opinion
Getting more information can help when you're deciding about surgery. One way to do this is to get a second opinion, also called a "review of treatment". A second opinion can help you make a more informed decision. Some health plans require second opinions before they will cover certain procedures, but others may not cover it. Check with your health insurance to learn whether a second opinion is covered.
You might feel uncomfortable asking for a second opinion, but most doctors today are used to this and are very cooperative. A doctor who responds with anger or refuses to cooperate with such a request may not have your best interests at heart. Dr. Barry frequently performs second opinions for patients and other surgeons. Likewise, he would be glad to recommend other physicians or surgeons in the area and nationally.
Questions to Ask Before Surgery
- Why is this surgery recommended?
- How will this procedure help my condition?
- What are the benefits?
- What other treatment options are available?
- What will happen if I don't have the surgery?
- Is no treatment an option?
Name and Procedure
- What's the operation called?
- What will be done?
- How is it performed?
- How long will it take?
- How serious is it?
- What's the typical recovery period?
- How long will I be unable to care for myself?
- When can I return to work and my normal activities?
- How soon should I have the surgery?
- How soon must I make a decision?
- What will happen if I postpone the operation?
- What are the risks involved?
- What percentage of patients die from this procedure?
- What complications may occur?
- Which complications are common for my age and state of health?
- How often do you perform this procedure?
- How often is this surgery done at your hospital?
- What will be covered by my health plan?
Except in certain emergencies, we must get your informed consent before performing a procedure such as surgery. In doing so, we will explain the risks and benefits of the procedure, alternative treatments, and the likely outcomes of not having the procedure. A form will be used to reinforce information given orally and to document that consent was given. If you do not understand any part of the consent form, do not sign it until we have addressed your concerns.