Cut Naked, continued ...

Excerpt: Finding your Surgeon, Your Pre-Op Evaluation

As promised, here’s another excerpt, pages 8-12 …

That being said, the vast majority of surgeons take pride in their craft and work to keep their skills up.  Rest assured that the staff at your chosen facility will know the docs who are of this ilk.   They can spot those of other ilks from the next county.  In other words, these days everybody and their hamster are going to know if a doc has a significant complication rate, conflicts of interest, or skunks in the closet. 

Ask around.  It’s free. Your primary care doctor will typically be the one to refer you to a surgeon. If there is any choice in the matter, let them know the surgeon you want. If there’s not, find out what you can about the one to whom you are being referred. The internet can be pretty handy for this research, especially the medical boards as previously noted.

I guess the bottom line is … if a doc is well educated, experienced, handy with a knife and likeable face-to-face, you’re probably ready to schedule your surgery. Conversely, if the doc comes across as arrogant or has some other personality trait you don’t like, ride on. Let your primary care doctor know that you want someone else. You can tell them why, but you don't necessarily have to. When you’re the Boss you don’t need a reason.

Pro tip:  If your surgery is elective (not an emergency), schedule your operation early … early in the day and early in the week.  The earlier in the day you get operated upon, the sooner you can eat.  By the time you’re able to eat again, you’ll be starving, having been NPO (nothing per oral) since last night’s pizza. Another plus is that your doc will be fresh, as opposed to worn out, as can happen later in the day.

Early in the week is better because your doctor is more likely to be around after the surgery.  In fact, many docs will not operate later in the week if they are planning on leaving town and know they won’t be around for their patients in the important post-operative period.

Regarding your initial consult with the doctor, expect some medical jargon that may sound a lot like blah, blah, blah.  You may not understand the full gist of things, let alone the gritty technical details.  Be sure to record the session, take notes and bring a note-taking friend or family member.  Don’t worry about spelling; most docs can’t spell all the words they’re saying.   

Ask at least one question.  If you don’t ask about anything, they are going to assume you know everything you need to know.  You probably don’t, so ask away.

What’s wrong up in here, Doc?

For proper perspective, it’s worth a mention that most health problems are not something that require a surgical solution.  In fact, the vast majority of things that go wrong with the body can be healed with time and benign neglect.

The human body has such an amazing capacity for healing itself that many things for which patients seek medical attention would have fixed themselves anyway, without the help of a doctor.  During my pediatric internship, one of the instructors liked to say that the kids usually got better in spite of what we did for them.

That being said, the unfortunate fellow with severe belly pain may not know whether he has a self-limited disorder such as a viral gastroenteritis or the life threatening monster known as a ruptured appendix.  That’s where the expertise of the doctor comes into play.

Based on your physical signs, symptoms, lab tests and x-rays, the doc will determine if you need surgery, medication or something else. If you need surgery, what comes next is a sequence of events involving many people and many steps.

Early on there is the clinical history questionnaire.  If possible, get copies of these forms from the doctor’s office before the  visit.  Many offices will email or fax them to you.  There are typically several pages of questions and it’s just easier to do in the comfort of your home, where you can take your time, be more thorough and have a cocktail.    

Always be completely honest in your answers to these questions.  If you guzzle a six pack of beer every day, say so.  This could be important should you need certain drugs that might interact with alcohol, for example.   A single baby aspirin can affect your blood’s clotting ability for several days, thus precluding surgery.

Plus, there is no penalty for telling the truth!   A nurse doing a questionnaire once asked,

“Do you drink?

“Yes.”

“How much?”

“A lot.”

She stopped writing and looked at me.   With a nervous pause, the deer in the headlights said, “Uh, well, uh ok, uh … the doctor can discuss that with you.”  Clearly she had never heard that answer before.   Tell the truth.  Sometimes it’s fun.

After the history and physical (H & P) examination by your doctor, there will usually be testing … to determine not only the nature and extent of your problem, but also your overall health status and level of fitness for the stress of the surgical experience.

The pre-operative testing is very important, so it’s best to go into it well prepared, armed with a positive attitude and a big smile, ready for any number of needle sticks, x-rays or claustrophobic CAT scans. It’s a party not for the timid.

Next Chapter:

Let the testing begin:  Are you healthy enough for surgery?

~~~~~

For the free copy of the entire book, shoot me a request at …

doc115@pm.me