Preparing for Surgeries: Questions to Ask, Understanding Risks, and Post-op Care
Author: Lauren Wheeler, MD, BCPA
Purpose of this guidance: Whether you’ve just been told you might need surgery, you’re considering a second opinion, or you’re recovering at home; get answers for how to advocate for yourself around surgery. This post will follow a typical patient experience with surgery, from before the first meeting with a surgeon to after leaving the operating room.
Considering Surgery: Preparing to Meet With a Surgeon
If you have a medical emergency that needs surgery – imagine a stab wound and lots of blood – your surgical experience will mostly depend on which surgeon is closest to you. After all, delaying an emergency surgery could cost you a limb, an organ, or even your life.
However, most surgeries aren’t done during emergencies. They are planned in advance and called planned or elective surgeries. Surgery can be performed for lots of reasons, including:
- To diagnose a problem (like taking a biopsy)
- To relieve a symptom (like pain)
- To improve or change how the body functions (like making a permanent feeding tube)
- To change your appearance (like a breast implant)
In these cases, you get to decide whether or not you want surgery, which surgeon you want to see, and more. Deciding to have surgery can be simple for some people and a big decision for others.
Before you even go to your first appointment with a surgeon, it may help to think about your choices and what’s important to you. Using a decision aid can help. For example, what do you hope the surgery will do? What are you most afraid of about surgery? What do you know about the surgery and what do you want to know?
Surgical Consult: What Questions Should You Ask Your Surgeon About Risks and Benefits?
At a minimum, legally speaking, you need enough information to make an informed choice about surgery. You will need to understand:
- What the surgery is for
- What benefits are expected from surgery
- What risks are involved
- What alternatives there are to surgery – for example, what is likely to happen if you do nothing, or if there are non-surgical options for treatment.
You have the right to have this information explained in a way you understand.
There are other questions you may want to ask, based on your own values and preferences, for instance:
- How many times have you done this surgery?
- How much will this surgery cost? What will insurance cover? Are there any ways to reduce the cost?
Lists of questions are available from the American College of Surgeons, the Agency for Healthcare Quality and Research, and MyHealth Alberta. Pick which ones are important to you. If you need more time to talk to the doctor, say so.
You are responsible for making sure your questions are answered before you sign any informed consent documents that give the surgeon permission to operate. If you don’t feel 100% certain that you want to have the surgery that the surgeon described, ask for a second opinion. Second opinions are common and paid for by Medicare.
After the Decision is Made: What Should You Know About Surgery Ahead of Time?
After you decide to move forward with surgery, you will likely need more information. This can happen in the first meeting with the surgeon, or it can happen in a second appointment, or even over the phone. You will want to know:
- What kind of anesthesia will be used? (This is medicine to make you feel comfortable)
- Where will the surgery happen? (which hospital or surgical center)
- How long will it take to recover?
- Will I need any tests or doctor’s appointments before surgery?
The surgeon will want you to be as healthy as possible before surgery so that you have the best chance of healing well. That means they may ask you to stop smoking, if you do, or visit other doctors for a “tune-up,” like a cardiologist.
PAC or Pre-Anesthesia Clinic
Sometimes, your doctor will ask you to go to a special checkup before surgery at a place called the PAC or pre-anesthesia clinic. These professionals will ask lots of questions about your health, and may draw blood or do other tests. They help make sure anesthesia is as safe as possible for you.
(Because anesthesia makes you deeply unconscious, you may not be able to breathe on your own. That means it's more dangerous for people who already have issues with their heart, lungs, or circulation.)
The PAC nurse or anesthesia doctor is often the best person to ask about which medications (and substances like alcohol or marijuana) you should stop taking before surgery. If you don’t have their phone number, call your surgeon or the place where you are having surgery with questions like:
- When should I stop drinking alcohol before my surgery?
- Can I take Tylenol the day of surgery?
- When is it safe to resume smoking after surgery?
Tip: Be sure to ask about your anesthesia options. Even though something may be common, you may have other options. For example, in the US, most colonoscopies happen when people are “put under” by anesthesia, but they can also be done safely while the person is awake, which is generally cheaper.
What Happens Before Surgery? How Should You Prepare?
The day(s) before surgery, you will have special instructions to follow about what to eat, which medications to take, when to shower, and when to stop eating. If you have questions about what to do or why it’s important, ask. You will also need to make sure you have an adult to drive you on the day of surgery.
What Happens on the Day of Surgery? How Do I Stay Safe?
On the day of surgery, you will need to arrive at the hospital or surgical center as instructed. This may be very early, but that’s to make sure there is plenty of time to handle any situations that arise.
The nurse in the pre-op (before surgery) area will help you change into a hospital gown and remove things like jewelry or dentures. They will also make sure you are warm enough and may place an IV tube in your arm. Someone will ask you about your health and make sure you aren’t feeling sick.
Before surgery starts, you will meet two important people:
The anesthesiologist who will take care of you during the surgery. This person may ask you questions about when you ate or what medicines you take and your life may depend on answering honestly.
The surgeon will see you again briefly before going to the operating room. They can answer any last-minute questions (though things can be pretty hectic), and they will mark the side of your body where the surgery will happen.
If you are a parent preparing for your child’s surgery, things are mostly the same. You may want to bring a favorite stuffed toy or blanket for comfort; and you’ll need someone else to watch your other children.
Staying safe in the hospital, especially during surgery when you aren’t awake, is a valid concern. There are many steps in place to make sure that all surgeries happen on the right patients, on the correct side of the body, and at the right time. Safety measures can be annoying, but they do help. They may include:
- Asking for your name and birthday many times
- Marking the body part to be operated on
- A special time-out in the operating room
Care After Surgery: Questions to Ask After Surgery
After surgery is complete, the anesthesia will take a while to fully wear off. You may feel confused or groggy. Children often cry. This is all normal. As you wake up more, you may be able to drink clear liquids or eat some crackers.
Some important questions at this time include:
How is my pain going to be treated? If you are in pain after surgery, someone must help you alleviate it.
When can I lift objects, begin exercise, start having sex again, or go back to work?
When is my follow-up appointment with the surgeon?
How should I wash the wound from surgery?
Do I have new medications to take?
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC-BY-SA-4.0), available at https://creativecommons.org/licenses/by-sa/4.0/. SPDX-License-Identifier: CC-BY-SA-4.0
Signed-off-by: Lauren Wheeler