They should have good familiarity with what their past medical history is. They should
know what their significant illnesses are and have been in the past. They should know
what operations they’ve had. That is a little bit of the homework that patients should do
before coming to the doctor’s office to discuss their surgery.
They should know what their allergy profile is. There are so many medications that are
used around the time of surgery and the preoperative preparation during surgery or after surgery.
Whether it’s antibiotics, whether it’s pain medication controlled, whether it’s
medication to control acid in the stomach or whatever. There’s just a myriad of medications
that are necessary. We want to avoid any of those interactions that would be deleterious
to the patient’s recovery and operation, and knowing what their allergy profile is
ahead of time helps us prepare the medications that we’re going to administer to them to
help them recover from their surgery.
They should particularly know their medication list and it’s very helpful to have that
written down so the surgeon can advise the patient which ones to continue, which ones
to even take the morning before they leave the house to come into the hospital even though
they’ll be instructed to fast after midnight the night before. Probably one of the biggest
items in the medication list is where the patient is on some type of blood-thinning
medication; whether it be formal anticoagulation or in the way of anti-platelet type of medication,
it’s really important for the surgeon to know that and not find that out the morning
of the surgery (and the patient forgot to tell them that). Because that could result
in cancelling of the operation. Some of those medications need to be stopped several days
prior to surgery and it’s best to know that ahead of time, rather than too late.
First of all, they should know that no question is a dumb question. Anything that comes into
their mind they should ask. Because what they’re going to do is they’re going to go home
if they didn’t ask and then they’re going to stew about it and then they’re going
to think, “Gosh, I’d have asked it.” And there’s no reason to have that type
of angst and it’s just better to ask their questions. But in particular, I think they
should make sure that they get a good description of the surgery that’s being discussed, what’s
involved in the operation; that kind of goes hand-in-hand with that. I think it’s very
important that they ask the surgeon what’s their personal experience with the operation;
is it something they do reasonably frequently? There are some surgeries that are not done
with a great frequency just because they’re unusual types of operations, but still I think
there has to be a comfort level there with the experience of the surgeon and it’s a
good question to ask and patients feel like “maybe I shouldn’t be doing this”, but
they should feel empowered to do that because it’s very important.
One of the other items they should always ask about, if it hasn’t been offered by
the surgeon is: what are the potential risks (what are the potential side effects)? Usually
most surgeons will use that in the description of their operation and explain what the more
common risks are. And then I think it’s important (if the surgeon doesn’t discuss
it) is to ask, “Are there any alternatives to not having this operation? What happens
if I don’t have this surgery?” I don’t think patients should feel like they’re
going to come into the surgeon’s office and feel like they’re going to get a lecture.
They should feel like there should be a dialogue and that their contribution is every bit as
important at the preoperative setting as the surgeon’s contribution. If both are forthright
and both are informative with each other, then I think the outcome is going to be a
good one.