Pre-surgery questions could save you some pain

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Pre-surgery questions could save you some painStory Highlights

All surgeries, no matter how small, carry risk of complications

First step in cutting complication risk: Take care in choosing a

surgeon

Make sure surgeon knows all your pre-existing conditions, medications

Follow all post-surgical directions to the letter

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Every year in the United States an estimated 15 million people have

surgery and every one of them runs the risk of complications.

Patients who ask a lot of questions before surgery are more likely

to have better outcomes, one expert says.

" You have a risk every time you go into the operating room, " says

New York-based surgeon Dr. Rose. " Every surgery, whether it

is hangnail surgery or brain surgery, has potential complications. "

Some of the most serious problems reported by the American College

of Surgeons include reaction to anesthesia, severe bleeding, blood

clots, pneumonia, infection and accidental injury during surgery.

Before you reconsider any medical procedure, the group wants

patients to know that something going wrong during surgery is fairly

rare.

" Surgery is much safer than it used to be, " says Dr. Clifford Ko,

director of the quality division for the ACS. " We have become very

good at assessing risk in patients before operating. New technology

and gadgets are also making surgery safer. "

Ko's organization tracks information on patients through the

National Surgical Quality Improvement Program. He estimates the rate

of major surgical complications in the United States is less than 5

percent.

Still, Ko, a colorectal surgeon at the University of California, Los

Angeles, tells patients to protect themselves by doing their

homework before and after the operation.

" Patients should not go in blind and say, 'Doc do whatever you

want,' " Ko says. He suggests they'll get a better outcome if they

ask a lot of questions. Ask your doctor these questions before

surgery

Experts agree that the first step in reducing the risk of

complications is picking a qualified surgeon you feel comfortable

with. Surgical risks may be amplified if a doctor isn't properly

trained and accredited. The American Board of Medical Specialties

provides information on its Web site that allows the public to check

a doctor's certification.

Dr. Grant Carlson of Atlanta, Georgia, advises, " Talk to friends and

others who have gone to a doctor and see what their feelings are and

if they're satisfied. "

Once you've chosen a surgeon, be honest about revealing any

medications, underlying medical conditions or issues that could

affect the outcome of the operation. People with pre-existing

medical conditions may have greater risk of complications.

" Patients are embarrassed or afraid or forget about medical problems

they take for granted, " Rose explains. For instance, doctors need to

know before a patient is being wheeled into the operating room

whether they smoke or have illnesses such as diabetes or heart

disease.

Common surgery risks: Reaction to anesthesia, Accidental injury,

Severe bleeding, Blood clots, Pneumonia, Infection

Patients should also provide a list of current prescriptions, over-

the-counter medications and vitamin supplements.

A patient's job doesn't end there. Carlson admits it's difficult,

but the patient really needs to ask the surgeon some hard

questions: " How many of these [operations] do you do in a year?

Where is this being performed? What would happen if I ran into

complications? "

The Agency for Healthcare Research and Quality, which falls under

the government's Department of Health and Human Services, goes one

step further.

It suggests patients ask " what they'll gain by having the operation

and how long the benefits will last. " Doctors should be able to

provide written material or links to Internet information to learn

more about a procedure and the expected results.

Ask about the risks and side effects of an operation. Find out how

much pain can be expected after the surgery and how the pain will be

controlled.

Medical experts say it is OK to ask a doctor what would happen if

you didn't have the operation. Will the condition get worse or could

it one day go away? Could you be in more pain without the operation?

Finally, patients are warned to follow their doctor's instructions.

Most offices provide written directions to be followed after surgery

that cover everything from wound care to level of activity.

" Patients really need to follow the directions of the doctor, " Rose

says. " A lot of patients don't, and they pay the price. "