While I’m a spine surgeon, the ideas I talk about in this blog post work for all kinds of surgery, whether it’s a colonoscopy or a broken bone. Anytime you’re having a significant invasion of your body, you want to talk with your doctor to make sure that you get all your questions answered and you can be the best advocate possible for yourself.
Types of Surgeries
There are three main types of surgeries.
- Emergent procedures: Must be done within hours to a day
- Urgent procedures: Need to be done very soon, but it can be within a few days
- Elective procedures: Need to be done, but you can schedule them
Your first question to your physician is to determine if you are having an emergent procedure, an urgent procedure, or an elective procedure. I will be discussing elective procedures, but you can use the same principles for emergent or urgent procedures as well.
The Top Three Questions to Ask Your Doctor Before Surgery
- What is the procedure’s name and a general outline of the technique?
- Why exactly do I need this?
- What are the goals of this surgery?
Procedure’s Name and General Outline of the Technique
You don’t need to study the procedure to know every action that is taken during the surgery memorized, but ask your doctor general questions. When you’re first offered surgery, you may be a little shaken and not really hear what happens during the office visit. With my patients, I give them a handout with a website where they can get more information on the surgery I am suggesting. They’ll be directed to videos of the procedure so they can watch it, and see some commonly asked questions about the procedure.
The Reason You Need This Procedure
Ask your physician to show you the x-rays, the lab results, or anything that they’re using to make the determination that you should have surgery. They should explain in layman’s terms what is going to happen. For example, with a disc herniation, I will describe generalities of the anatomy to a patient. I will point out what normal anatomy looks like and then I will point out abnormal anatomy. I will use the patient’s images, like x-rays and MRIs, to show the patient what I am talking about.
After your surgeon explains what is abnormal, ask them how it is affecting your body. What are the symptoms the abnormality is causing? Abnormal results or abnormal findings on a test, a lab result, an MRI, a CT scan, etc. don’t always mean that you have symptoms and need treatment. For example, you may have disc herniations that show up on imaging, but that are not causing any pain or other symptoms.
Surgery Goal
Surgery of any kind, injections, even colonoscopies all carry risks. You want to make sure that the goal that you have in mind and the goal your surgeon has in mind match and that you’re going to have the right kind of procedure for your needs. If you have a little bit of pain once a month, a very invasive procedure is probably not the right choice for you, but it may be the right choice if you’re in constant pain and using high-level pain relief.
You want to have a goal agreed upon by both you and your doctor. It may be to go back to playing golf or to simply walk around the mall, or it may be getting back to high intensity exercise.
For example, I had a patient in his 50s who was a CrossFit trainer who had a back issue. Physical therapy wasn’t helping him so we discussed surgery, but our goals didn’t match so I didn’t end up agreeing to the surgery. He wanted to proceed at a level of physical activity that I thought was unrealistic given his age and the type of surgery he needed. On the other hand, a 30-year-old with a disc herniation and severe leg pain, who was not helped by injections or physical therapy, it is a reasonable goal to have him going back to doing triathlons.
You want to know how you and your physician will measure success after the procedure. For some of my very old patients, the goal has been to get off narcotics. It may seem like a low bar, but the narcotics can cause dizziness and other undesirable side effects in the elderly. My patients in their 20s and 30s, however, may want high intensity activities and that may be a reasonable goal depending on the type of procedure that they need.
Additional Tips
If you get a notebook, you can take notes during your office visits and at home, and write down your questions so you don’t forget to ask them.
Frequently Asked Questions
Should patients ask safety questions about the procedure?
Yes, you should. Consent forms are not waivers of liability, like you sign if you go skiing. Consent forms are an educational tool so that you as a patient can better understand what is going to happen and what the risks might be. You learn more medicine as a patient by going through your consent forms carefully and asking questions about things you do not understand. For elective surgeries, the consent process should happen ahead of time in a physician office, not in a hospital right before surgery.
If a patient had a poor reaction to an anesthetic during a previous surgery, how would they handle it if they have an upcoming surgery?
You should tell your doctor that you would like to consult with the anesthesiologist or anesthesiology team before your procedure. For elective procedures, there is time to have this consult. It’s important to get your records from the previous surgery so the anesthesiologist can see what you were given and what the bad reaction was so they can plan for the upcoming surgery.
Is it OK to ask my doctor if I can talk to their previous patients who have already had this surgery?
Yes, your doctor should be open to you talking to previous patients. There are health information privacy restrictions involved, so your doctor can’t just give you the numbers of 5 people to talk to immediately. But they should be willing to talk with their previous patients and get the right permissions to connect you to someone who has had this procedure before. I find that these types of discussions are helpful for the patients.