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Pre-surgery questions could save you some pain

  • Story 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
  • Next Article in Health »
By Judy Fortin
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ATLANTA, Georgia (CNN) -- 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. Kenneth 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." Video Health Minute: Watch more on the risks of surgery »

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

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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

Source: Department of Health and Human Services, American College of Surgeons

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." E-mail to a friend E-mail to a friend

Judy Fortin is a correspondent with CNN Medical News.

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