Experts call them "never events" — surgical errors that should never happen, such as performing the wrong procedure or leaving a sponge or tool inside a patient's body after an operation. Yet they are surprisingly common, with a Johns Hopkins University study estimating 4,000 preventable surgical errors occur every year.
The good news is you can greatly reduce your odds of becoming a victim by asking your surgeon several key questions before going under the knife. Robert Cima, M.D., tells Newsmax Health that it's critically important to take steps to understand the specific details about your medical condition and treatment before surgery, and ask about your doctor's background and training.
"As in all things, setting realistic expectations and active engagement of participants is a key component of success. With each type of surgery there are specific items that are important," says Dr. Cima, a colon and rectal surgeon and chair of the Mayo Clinic's surgical quality subcommittee.
To help patients "improve their transition into and out of surgery," he has devised a list of five questions to ask before undergoing any surgical procedure, based on his clinical experience.
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Are you board-certified to perform this operation?
In addition to receiving state medical licenses, surgeons must be board-certified to perform certain procedures — essentially qualifying them to do particular types of operations, such as heart surgery. Dr. Cima, for instance, is board-certified in general surgery and colon and rectal surgery.
He explains that certification is granted by national medical organizations for those specialties to surgeons who meet critical standards for practice, competency, and training.
In many cases, recertification as often as three to four years, so that surgeons maintain their skills and keep up to date with advances in their fields, Dr. Cima says.
In addition to asking your surgeon about certification, it's a good idea to check his or her profile on the American Board of Medical Specialties website or your state medical licensing board.
Should I lose weight before surgery?
Obesity can increase the odds of surgical complications, so maintaining a healthy weight — or shedding some pounds before an operation — is usually a good idea, Dr. Cima says.
In addition, building up strength before a surgery — what he refers to as "prehabilitation" — can be as important as losing weight, he adds. This is particularly important for older patients and those with diabetes, who should take care to get their blood sugar under control before an operation.
Should I quit smoking before my procedure?
You already know the answer to this question. But Dr. Cima advises that smokers still ask their surgeons about specific tobacco-related complications for particular procedures. For example, smoking is a known risk factor for surgical infections and it can slow healing, increase the odds of developing pneumonia, and lead to cardiovascular problems.
Quitting tobacco even a few weeks before surgery can be beneficial, he says, noting that tobacco has significant negative impacts many surgical procedures, many of the compounds in tobacco (including nicotine) constrict small blood vessels, which need to be open to bring blood to healing surgical wounds.
He adds that patients who sneak a cigarette before certain surgical procedures run the risk of having their operations canceled or postponed.
Can sleep apnea lead to surgical complications?
Obstructive sleep apnea — a breathing disorder that strikes up to 20 percent of older surgical patients — can increase the risk for post-surgery complications. If you have sleep apnea, Dr. Cima advises telling your surgeon ahead of time. If you use a continuous positive airway pressure (CPAP) device when you sleep, bring it with you to the hospital to use in recovery.
Many medical facilities, including the Mayo Clinic, screen patients for sleep apnea in the postoperative period in the recovery room, Dr. Cima says. Some patients with apnea will be admitted overnight for observation in a more intense care area such as monitored care.
What can I do to shorten my hospital stay?
Several strategies — before and after surgery — can reduce your risk of complications and speed your recovery. Showering with an antiseptic cleanser the day before and the day of surgery can reduce the risk of surgical-site infections — a major cause of prolonged hospitalization.
Minimally invasive procedures, which have shorter recovery times, are also an option to consider in many cases. You should also ask your surgeon about what — and when — you should eat and drink before surgery (usually the night before is recommended, but not the day of). It's also wise to ask how active you should be immediately following surgery. Many surgical patients should be out of bed and walking, perhaps with help from a nurse, the same day they have surgery.
"We try to get your body back to its normal state as soon as possible," Dr. Cima says, but adds: "The most important thing from the patient's point of view is to come into the surgery as 'optimized' as you can."
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