"I have had patients ask me if I drank alcohol, used drugs, or was physically fit. I never was intimidated by any question. I felt that my patients had a right to know whether I was competent. As long as you ask the surgeon questions in a nonconfrontational and nonoffensive manner, you should expect an honest answer. If a surgeon is defensive about answering your questions, does not seem forthright, or is unwilling to take the time to answer your questions, you may need to look for another surgeon!"
"Before my recent gallbladder operation, I frequently communicated with my surgeon by e-mail, which worked well for both of us. The fact that he took time to answer my questions about the procedure helped me build a trusting relationship with him. You should work out a means of communication with your surgeon that suits your preferences and the surgeon's schedule, whether that is by phone, fax, e-mail, or in person. The surgeon's communication skills, ease of contact, professionalism, and staff are all important factors in deciding whether a surgeon is right for you. But the bottom line is: Would you trust your life to this surgeon?"
"Be aware that if you schedule your operation right before a holiday, the hospital may be short-staffed during the holiday. Your surgeon may even go on vacation after performing your operation! Ask about the surgeon's availability at that time. If you will be at a teaching hospital, bear in mind that a new group of first-year house staff (physicians in training) arrives July 1, and the senior house staff graduates and leaves. If you are planning on having an operation at an academic medical center, you may want to ask your surgeon if it is an appropriate time to schedule the procedure. When you schedule your operation, ask to be the surgeon's first case of the day to avoid having your procedure delayed."
"Throughout the United States, there is a nursing shortage. If you plan a hospital stay, find out what the patient-to-nurse ratio is. Ask your surgeon or a nurse manager at the hospital. Studies have shown that patient safety suffers when nursing staffing is low, because nurses have too many patients to take care of adequately. Nurse ratios typically depend on multiple factors, including the number of patients in the unit, the patients' care needs ( postoperative recovery, intensive care, general inpatient, and so on), and the nurses' skill level and experience. Ask your surgeon if the ratio of nurses to patients is appropriate and adequate for the type of procedure you are having and for your needs. The ratio should be adequate, not just during the day but also at night."
"A time-out is a final safety check in the OR before the operation begins. Once you are on the operating table, a surgical team member states the name of the patient, the type of procedure to be performed, and the surgical site. The operation should not start until the surgeon and other team members agree that this information is correct. They will make sure that the name on your ID bracelet matches the one on the consent form and any medical images, such as X rays, are available in the OR. Similar to the safety inspection pilots do before flying, a surgical time-out also allows the OR team to ensure they have all the needed equipment in place. During the pause, the surgical team also discusses the patient's special needs, if there are any. This verification process may happen before or after you receive anesthesia. Ask your surgeon if there will be a time-out to discuss your case and whether he or she will participate in the time-out. I made sure to ask my surgeon about this procedure before my gallbladder operation!"
"Abnormally low body temperature in the OR may increase your risk of an infection developing at the surgical site. Warming a patient before the operation can prevent body temperature from going too low in the OR. Surgical facilities use warming systems or heated blankets to keep patients warm. So if you are cold in the preoperative area, tell a nurse. Make sure the surgical team will keep you warm during the operation if it will last more than an hour. Ask if they will monitor your temperature. If you are diabetic, make sure that the OR staff will monitor your blood glucose (sugar) level. If it becomes too high, a surgical-site infection could develop. Blood glucose control is important!"
"To prevent infection, make sure that all care providers wash their hands before, or wear gloves while, they check, wash, or bandage your surgical wound. Feel free to ask them to wash their hands if you don't see them do so, or to wear gloves. Protection against infection is especially important if your immune system is compromised—for example, if you have received chemotherapy."
"My advice, if you need a hospital stay, is to have realistic expectations about the loss of privacy and personal control in the hospital. Some hospitalized patients feel like they've been stripped of a part of themselves by this lack of control. In the hospital, you have constant reminders that you are not at home. You're told when to eat, you may not have much of a choice in what to eat, and it's not fine dining, to be sure! You are awakened several times during the night to have your vital signs measured, so you can't sleep when you want to. Hospitals try to control noise levels, but a hospital is still a noisy place. You're treated by a lot of people you don't know. You wear a hospital gown with your back exposed, and you may lose your modesty quickly. It helps to accept that there are some things about the surgical experience that you cannot control. But you can regain some of your personal control by actively participating in your recovery. Try to eat properly, move around as instructed, and do your deep breathing and coughing. After all, you want this operation to succeed, so you won't have to go through it again."
"Be prepared for the postoperative blues. Feeling down or sad after an operation is common. There is often a letdown after all the energy devoted to coping with the stress of a surgical procedure. Plus, you may hurt and not be able to sleep well. You may feel vulnerable. Or you may have a sense of loss about your health or your appearance (because of a scar, for example). Worry about finances can be an added cause of anxiety at this time. Talk to friends and family about your fears and feelings during this difficult time. It also helps to have realistic expectations before you have the operation. Most people cope well with the emotions arising from having an operation. Sometimes, however, patients become depressed. Postoperative depression occurs more often after the patient is home or back at work, rather than right after an operation. Depression needs to be treated. If you feel sad or depressed for longer than two weeks or you are having thoughts of hurting yourself, tell your doctor. You may need an antidepressant or psychotherapy (talk therapy)."