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Advice
Steps to Safer Health Care
1. Ask questions if you have doubts or concerns. Ask questions and make sure you understand the answers. Choose a doctor you feel comfortable talking to. Take a relative or friend with you to help you ask questions and understand the answers.
2. Keep and bring a list of ALL the medicines you take. Give your doctor and pharmacist a list of all the medicines that you take, including non-prescription medicines. Tell them about any drug allergies you have. Ask about side effects and what to avoid while taking the medicine. Read the label when you get your medicine, including all warnings. Make sure your medicine is what the doctor ordered and know how to use it. Ask the pharmacist about your medicine if it looks different than you expected.
3. Get the results of any test of procedure. Ask when and how you will get the results of tests or procedures. Don't assume the results are fine if you do not get them when expected, be it in person, by phone, or by mail. Call your doctor and ask for your results. Ask what the results mean for your care.
4. Talk to your doctor about which hospital is best for your health needs. Ask your doctor about which hospital has the best care and results for your condition if you have more than one hospital to choose from. Be sure you understand the instructions you get about follow-up care when you leave the hospital.
The points listed above will help you understand what will happen if you need surgery. Make sure you, your doctor, and your surgeon all agree on exactly what will be done during the operation. Ask your doctor, "Who will manage my care when I am in the hospital?" Ask your surgeon:
Exactly what will you be doing?
About how long will it take?
What will happen after the surgery?
How can I expect to feel during recovery?
Tell the surgeon, anesthesiologist, and nurses about any allergies, bad reaction to anesthesia, and any medications you are taking.
12 Questions Before Surgery
1. What operation are you recommending? Ask your surgeon to explain the surgical procedure. For example, if something is going to be repaired or removed, find out why it is necessary to do so. Your surgeon can draw a picture or a diagram and explain to you the steps involved in the procedure. Are there different ways of doing the operation? One way may require more extensive surgery than another. Ask why your surgeon wants to do the operation one way over another.
2. Why do I need the operation? There are many reasons to have surgery. Some operations can relieve or prevent pain. Others can reduce a symptom of a problem or improve some body function. Some surgeries are performed to diagnose a problem. Surgery also can save your life. Your surgeon will tell you the purpose of the procedure. Make sure you understand how the proposed operation fits in with the diagnosis of your medical condition.
3. Are there alternatives to surgery? Sometimes, surgery is not the only answer to a medical problem. Medicines or other nonsurgical treatments, such as a change in diet or special exercises, might help you just as well or more. Ask your surgeon or primary care physician about the benefits and risks of these other choices. You need to know as much as possible about these benefits and risks to make the best decision. One alternative may be "watchful waiting," in which your doctor and you check to see if your problem gets better or worse. If it gets worse, you may need surgery right away. If it gets better, you may be able to postpone surgery, perhaps indefinitely.
4. What are the benefits of having the operation? Ask your surgeon what you will gain by having the operation. For example, a hip replacement may mean that you can walk again with ease. Ask how long the benefits are likely to last. For some procedures, it is not unusual for the benefits to last for a short time only. There might be a need for a second operation at a later date. For other procedures, the benefits may last a lifetime. When finding out about the benefits of the operation, be realistic. Sometimes patients expect too much and are disappointed with the outcome, or results. Ask your doctor if there is any published information about the outcomes of the procedure.
5. What are the risks of having the operation? All operations carry some risk. This is why you need to weigh the benefits of the operation against the risks of complications or side effects. Complications can occur around the time of the operation. Complications are unplanned events, such as infection, too much bleeding, reaction to anesthesia, or accidental injury. Some people have an increased risk of complications because of other medical conditions. In addition, there may be side effects after the operation. For the most part, side effects can be anticipated. For example, your surgeon knows that there will be swelling and some soreness at the site of the operation. Ask your surgeon about the possible complications and side effects of the operation. There is almost always some pain with surgery. Ask how much there will be and what the doctors and nurses will do to reduce the pain. Controlling the pain will help you be more comfortable while you heal, get well faster, and improve the results of your operation.
6. What if I don't have this operation? Based on what you learn about the benefits and risks of the operation, you might decide not to have it. Ask your surgeon what you will gain--or lose--by not having the operation now. Could you be in more pain? Could your condition get worse? Could the problem go away?
7. Where can I get a second opinion? Getting a second opinion from another doctor is a very good way to make sure having the operation is the best alternative for you. If you get one, make sure to get your records from the first doctor so that the second one does not have to repeat tests.
8. What has been your experience in doing the operation? One way to reduce the risks of surgery is to choose a surgeon who has been thoroughly trained to do the procedure and has plenty of experience doing it. You can ask your surgeon about his or her recent record of successes and complications with this procedure. If it is more comfortable for you, you can discuss the topic of surgeons' qualifications with your regular or primary care doctor.
9. Where will the operation be done? Most surgeons practice at one or two local hospitals. Find out where your operation will be performed. Have many of the operations you are thinking about having been done in this hospital? Some operations have higher success rates if they are done in hospitals that do many of those procedures. Ask your doctor about the success rate at this hospital. If the hospital has a low success rate for the operation in question, you should ask to have it at another hospital. Until recently, most surgery was performed on an inpatient basis and patients stayed in the hospital for one or more days. Today, a lot of surgery is done on an outpatient basis in a doctor's office, a special surgical center, or a day surgery unit of a hospital. Outpatient surgery is less expensive because you do not have to pay for staying in a hospital room. Ask whether your operation will be done in the hospital or in an outpatient setting. If your doctor recommends inpatient surgery for a procedure that is usually done as outpatient surgery, or just the opposite, recommends outpatient surgery that is usually done as inpatient surgery, ask why. You want to be in the right place for your operation.
10. What kind of anesthesia will I need? Anesthesia is used so that surgery can be performed without unnecessary pain. Your surgeon can tell you whether the operation calls for local, regional, or general anesthesia, and why this form of anesthesia is recommended for your procedure. Local anesthesia numbs only a part of your body for a short period of time, for example, a tooth and the surrounding gum. Not all procedures done with local anesthesia are painless. Regional anesthesia numbs a larger portion of your body, for example, the lower part of your body for a few hours. In most cases, you will be awake with regional anesthesia. General anesthesia numbs your entire body for the entire time of the surgery. You will be unconscious if you have general anesthesia. Anesthesia is quite safe for most patients and is usually administered by a specialized physician (anesthesiologist) or nurse anesthetist. Both are highly skilled and have been specially trained to give anesthesia. If you decide to have an operation, ask to meet with the person who will give you anesthesia. Find out what his or her qualifications are. Ask what the side effects and risks of having anesthesia are in your case. Be sure to tell him or her what medical problems you have including allergies and any medications you have been taking, since they may affect your response to the anesthesia.
11. How long will it take me to recover? Your surgeon can tell you how you might feel and what you will be able to do or not do the first few days, weeks, or months after surgery. Ask how long you will be in the hospital. Find out what kind of supplies, equipment, and any other help you will need when you go home. Knowing what to expect can help you cope better with recovery. Ask when you can start regular exercise again and go back to work. You do not want to do anything that will slow down the recovery process. Lifting a 10-pound bag of potatoes may not seem to be "too much" a week after your operation, but it could be. You should follow your surgeon's advice to make sure you recover fully as soon as possible.
12. How much will the operation cost? Health insurance coverage for surgery can vary, and there may be some costs you will have to pay. Ask what your surgeon's fee is and what it covers. Surgical fees often also include several visits after the operation. You also will be billed by the hospital for inpatient or outpatient care and by the anesthesiologist and others providing care related to your operation.
For additional information, please visit the following sites:
U.S. FDA Center for Devices & Radiological Health
MedlinePlus
U.S. Department of Health & Human Services
American College of Surgeons
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