Q. My doctor is recommending I have surgery, but I am not sure I want to. Do I have to go ahead and do what he says?
The decision of whether or not to have surgery is yours. Be sure to make it an informed decision.
Keep in mind that approximately one-quarter to one-third of all surgical procedures performed in the United States may not be necessary. Getting a second opinion before deciding to have any kind of elective surgery is almost always a good idea.
When you are hospitalized for elective surgery, a number of health care personnel will become involved, including the surgeon, the anesthesiologist, the radiologist and others. You will spend time in a number of different hospital environments that will likely be unfamiliar and confusing: the operating room, the recovery room and possibly the critical care unit.
Choosing a surgeon is within your control. Sometimes your personal physician helps by recommending a surgeon, but you are ultimately in charge of this decision. Having family meet with the surgeon and discussing your choice with loved ones also can help.
You should find out the surgeon's experience in performing the specific operation you need, and what he or she considers acceptable quality of life for a person before and after the surgery. Do not hesitate to ask your physician and the surgeon these questions.
The risk associated with surgery generally increases as we age. However, surgical risk for older adults in the United States has steadily declined over the past 40 years because of medical advances. In fact, elective surgery on people more than 80 years old was safer in the 1990s than the same procedures performed on younger people in the 1960s.
Multiple medical problems and the urgency of the procedure are far more important factors than age in predicting possible complications. People over the age of 80 can generally undergo even major surgery without undue risk of death.
Problems with the heart and lungs are the most serious postoperative complications. Narrowed arteries that reduce blood flow to the heart, previous heart attacks, congestive heart failure and disturbances of heart rhythms are serious problems that increase surgical risk. Other conditions, such as stable heart pain (i.e., angina pectoris), compensated congestive heart failure and well-controlled high blood pressure do not contribute unduly to the risk of heart complications.
As we age, our lungs lose some of their elasticity (ability to expand and contract) and their ability to move air. To reduce the risk of lung complications after surgery, especially pneumonia, you must be able to generate enough airflow to expel mucus that can accumulate in your lungs during surgery. Preoperative testing occasionally includes a test of lung function.
Get in touch
NANCY TURNEY received a bachelor's degree in social work and a certificate in gerontology. If you have a specific question you would like answered in this column, e-mail it to firstname.lastname@example.org or call Turney at the Crescenta-Cañada YMCA, (818) 790-0123, ext. 225.