So you’ve been told you need surgery.
Now what? Here is a general overview of the first step of surgery: the consent. There are questions you need to ask your surgeon before you consent to “going under the knife.”
First, understand your time frame. There are a few different ways to refer to the timing of surgery but generally speaking there are elective, urgent, and emergent procedures.
Elective surgery is what it sounds like it is: not required. Elective surgery is an invasive procedure aimed at improving quality of life but not necessarily maintain life itself. This quality of life may be improved body function or decreased pain. These procedures are scheduled at the convienence of all involved.
Urgent surgery is a surgery that is aimed at treating a condition that, if left untreated, will likely continue to worsen or even turn into an emergent situation. The timeframe for these types of procedures is usually hours to days depending on other factors involved in your situation.
Emergent surgery is an invasive procedure aimed at resolving a threat to life, organ, or limb. These procedures need to be completed within minutes to hours after identifying the need.
Whether or not a surgery is classified as elective, urgent, or emergent isn’t just about the procedure itself but also has a lot to do with other pieces of the your story (such as other conditions that may complicate your overall health). There is an extremely wide spectrum of complexity within the surgery world. Each surgery within a specialty requires specific skills that vary greatly from other specialties. Regardless of the surgery or the surgeon each procedure warrants a thorough chat with the doctor that is performing the procedure. Before signing your name on the consent make sure you have a general understanding of:
1.) What will be done.
2.) The alternatives to surgery.
3.) The most common side effects or complications of the procedure.
4.) Recovery time.
1. What will be done:
What is the technical name of the procedure being recommended and what is that translated into normal English? This not only helps educate you but helps you inform other care providers later in your healthcare journey. Ask the surgeon what exactly will be done and the main tasks to be accomplished during the procedure. You should not try to understand all the nuances of a highly technical surgery but your surgeon should be able to communicate the highlights of the technique in simple terms. Ask about pain control and anesthesia. There are quite a few options for pain control and anesthesia in a 21st-century operating room. Ask what your options are and what usually works well for patients who have been through the same process.
2. The alternatives to surgery.
Emergent surgery rarely, if ever, has an effective alternative. There are also not many alternatives for urgent surgery but you should still ask what your options are in an attempt to understand the situation. Elective surgery, however, almost always has some sort of alternative. These alternatives cannot always provide relief from pain, improve quality of life, or prevent a condition from getting worse as well as surgical treatment can. But sometimes patients are able to find success with alternatives such as medications, physical therapy, or lifestyle alterations and can effectively avoid or delay an elective procedure. Ask specifically about alternatives and what the expected outcome (and risk) would be with each of them. Also ask about the risks to your health if you do delay or decide against the procedure.
3. The most common side effects and risks of complication.
All surgeries have a long list of fairly alarming risks. The reality of these risks vary greatly by patient and procedure. Ask what your specific risks are, how likely those risks are in your circumstance, and how your other chronic conditions and medications affect those risks. Experienced surgeons will be able to tell you the common concerns of the procedures that they perform. They will also be able to inform you of what side effects can be expected afterwards: incision pain, sore throat, muscle cramping, nausea, and constipation are all fairly common . Also ask about any permanent lifestyle changes that will be necessary once the immediate recovery period is over.
4. Recovery time.
Most surgeries require a period of rest and recuperation. This may include: restrictions (such as physical activity, lifting, or driving), a period of resting, care of bandages (dressings), managing medications at home, physical therapy, or a potential hospital stay. Specifically ask about what recovery will need and make sure you have the time and help to abide by recovery guidelines. Not respecting recovery instructions greatly increases your risk of complications and could even land you back under a surgeon’s scalpel for a second procedure.
Surgery can be scary and daunting but having a basic understanding of what will be done, the possible alternatives (if any), common side effects and risks, and the recovery time necessary will give you the necessary knowledge to navigate the process well. The more you understand the better you can engage with the process and participate with your healthcare team in moving towards everyone’s goal: the best possible outcome for you.
Next step in the surgery process: talking about anesthesia.
https://www.facs.org/for-medical-professionals/education/for-your-patients/medical-professionals/informed-consent/ Assessed and Endorsed by the MedReport Medical Review Board