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Have a game plan well ahead of elective surgery

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July 28th, 2017
Woman in discussion with physician

Along with getting a second opinion to find out if there are more conservative alternatives to elective surgery, make sure you talk with your primary care provider, who knows you best.

“The biggest mistake people make when planning elective surgery is not finding out if they need it in the first place,” says Dennis Deruelle, M.D., author of Your Healthcare Playbook: Winning the Game of Modern Medicine (Simon & Shuster, 2017). 

This means a second opinion is in order to find out if there are more conservative measures that could have a similar outcome. “When you consider the high risk of complications with advancing age, surgery may not be your best choice in the long run,” Deruelle says.

Along with getting a second opinion, the best health care provider to discuss elective surgery with is the one who knows you best. “Your primary care provider can help you decide if, based on your personal health and circumstances, you should have surgery,” says Jill Studley, M.D., staff physician at Highland Springs, an Erickson Living community in Dallas, Tex. 

Be prepared before your appointment—whether it’s for a first or second opinion about surgery. “Do not assume that the surgeon will have your medical records,” Deruelle says. “You have a right to your records, so ask for them ahead of time, and carry them to the office yourself.” 

Getting all preop ducks in a row

Find out everything you can about the specific procedure. “The surgeon should be able to tell you, step-by-step in plain language, all about risks, benefits, preoperative care, postoperative care, and exactly what happens to your body while you are in the operating room,” Studley says. 

Same deal regarding anesthesia. The first time some people see the anesthesia provider is when they are prepped for surgery and in the preoperative waiting area. “You need to find out ahead of time what your anesthesia options are, and exactly what the different types mean for your recovery,” Studley says. “Your surgeon should be able to give you much of this information.”

Once you have decided to have surgery, make sure you are cleared for it in advance by the necessary professionals. “You might be surprised to know that medical professionals can drop the ball with this step,” Deruelle says. “Being cleared means, for example, if you are having elective heart surgery, have a cardiologist say it’s okay first.”

If preoperative testing is necessary, such as blood work, an electrocardiogram, or X-rays, have everything scheduled in the proper timeframe, and send results to all pertinent providers.

Remember the business aspect of surgery. “Check with your insurance to see if prior authorizations are in place,” Deruelle says. “Know beforehand how much you will owe. Some hospital business offices will cut you a deal if you agree to pay your portion in cash.” 

Get yourself in shape

Having surgery is a major trauma to your body, so being in the best health possible can improve your chances of successful recovery. “I call it prehab,” Deruelle says, “which means doing everything you can to prepare yourself beforehand.”

“Quit smoking if possible,” Studley advises. “Smoking is associated with pneumonia, heart attacks, poor recovery from anesthesia, and slow wound healing.” Research shows that quitting smoking even just a few days before surgery can help avoid complications. 

“Some plastic surgeons do not want to operate on someone who smokes because of the possibility of poor outcomes,” Deruelle adds.  

Even if you’ve never been active, start now. “Exercise can improve your outcomes, especially with joint replacements,” Deruelle says. “You don’t have to prepare for a marathon, but do as much aerobic and strengthening activities you can in the weeks or months before surgery.”

Ask all providers who prescribe your medications if you need to stop taking any of them. “Blood thinners including aspirin sometimes need to be stopped days or weeks before surgery,” Deruelle says. 

For many procedures, you can expect a period of rehab afterward, so plan for it before you go into the hospital. “Find out how long you will be in rehabilitation and what type of home care or modifications you may need before going home,” Studley says. “Have support lined up for help with daily chores.” 

“Being prepared ahead of time can prevent delays,” Deruelle says. “If you must reschedule because something isn’t in place, you might have to wait a long time for another opportunity to have surgery.”

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