Weight loss, quitting smoking might reduce odds of complications, expert says
By Randy Dotinga
FRIDAY, March 14, 2014 (HealthDay News) -- Before agreeing to have surgery, ask questions about your condition and the treatment options, an expert says.
You might want to bring family members or friends with you to ask questions of their own, especially if they'll be helping you recover, said Dr. Robert Cima, a colon and rectal surgeon.
"It's your body, it's your disease," Cima, chairman of the Mayo Clinic's surgical quality subcommittee, said in Mayo news release. "You should feel comfortable asking those questions before you enter into something as major as surgery."
Here are his suggested questions for physicians:
Are you board-certified to perform this procedure?
Board certification means surgeons are considered qualified to perform a specific type of operation.
"They are recognized by the institution as well as the national organizing body for that specialty as having met all the important standards for practice, competency and background," Cima said. "It is a marker of someone ... who is trying to stay abreast of the knowledge and the changes in health care in their specialty."
Will it help if I lose weight before the operation?
Extra pounds can boost the risk of complications, Cima said, although exercise isn't advisable for all patients scheduled to undergo surgery.
It can also be helpful to build strength before a procedure. "Just like an athlete, you're going to perform better if you're in better shape and your strength is better," Cima said. "Surgery is a major event -- a physiologic injury -- and you have to be able to respond to that."
Does it matter if I'm a smoker?
Smoking can increase the risk of complications from surgery, and quitting smoking just a few weeks before an operation can make a difference, Cima said.
"Smoking has significant negative impacts on almost all surgical procedures we've looked at," Cima said. "The nicotine and many of the compounds in tobacco smoke constrict the small blood vessels. You need those blood vessels to be open to bring blood down to the level of the healing wound."
What if I have sleep apnea?
Make sure your surgeon knows if you have sleep apnea, because the sleep disorder has been connected to higher rates of complications after surgery, Cima said. If you use a continuous positive airway pressure (CPAP) machine, you might be advised to bring it with you.
"A lot of institutions now, including Mayo Clinic, are so concerned about sleep apnea that we actually screen for it in the postoperative period in the recovery room," Cima said. "If [certain patients] are at high risk for undiagnosed sleep apnea, we have protocols in place here to admit them overnight for observation in a more intense care area, such as monitored care. Or we'll have them evaluated in the hospital for sleep apnea and intervene earlier."
Is there anything you can do to shorten my hospital stay?
You might be able to undergo a less invasive procedure with less recovery time, Cima said. And improvements in care, such as less catheter use and limited use of painkillers, might help patients recover more quickly in the hospital room.
"We try to get your body back to its normal state as soon as possible," Cima said.
The Agency for Healthcare Research and Quality has more on what to ask before surgery.
SOURCE: Mayo Clinic, press release, March 10, 2014
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