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To operate or not?

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February 26th, 2013

Modern medicine and technology have brought many wonderful advances and opportunities. Procedures, evaluations, and surgeries previously performed on a limited basis such as coronary artery bypass or knee replacements have now become routine. While this is good news for us all, these opportunities also come with some risk. Are these procedures being done too frequently and are the complications that can occur being overlooked? This is particularly relevant to seniors, who face higher risk in the operating room due to age and the presence of chronic medical conditions such as diabetes or lung disease. Before undergoing any medical procedure whether it is a test as innocuous as blood work or a much more intensive surgery such as joint replacement you and your doctor should be able to agree upon the compelling reason for proceeding. Of course, a decision about a blood test requires much less discussion as there is little risk and it may simply be needed to monitor the safety or efficacy of a medicine such as a cholesterol-lowering agent. Surgery, however, requires careful consideration of potential risks, complications, length of rehabilitation, and the likelihood of the procedure producing the desired effect. It may be relatively straightforward if you need cataract surgery to restore vision in an eye that is essentially blind, or it may be quite complex when considering a carotid artery procedure to prevent a stroke.

Weigh all options

Knowing your alternatives and adequately exploring those options with your physician is an important step because there are often a few choices. For instance, prior to having a vascular procedure, it s important to discuss whether lifestyle changes, lowering cholesterol and blood pressure levels, and exercising are viable alternatives. Can a procedure be done laparoscopically? Generally speaking, the less invasive the surgery, the better the recovery with a quicker return to normal and often fewer complications. Finally, if you have to have surgery, make sure you understand the procedure and anesthesia risks thoroughly. Have someone be your advocate if you have to be hospitalized, and have your aftercare well planned in advance. Find out if you are in the best condition possible to have surgery, and if there s anything you can do beforehand to prepare. In 2013, we have a wealth of treatment options and opportunities like never before. This is why it s more important than ever to have that discussion with your provider and agree upon the compelling reason to proceed with a clear understanding of the associated benefits and risks. Together you will make a great decision. In good health, Matt Narrett, M.D.

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