Should I have surgery or not?

Here’s a question from our reader: “I am 68 years old and I have a problem with my left hip which is very painful when I walk. I have seen several doctors already in the past three years. One doctor said I should undergo surgery while the other one said I should wait. What should I do?”

First of all, since I have not seen all your records, what I can only do is help you make a better decision on whether     to undergo surgery or not.

Here are some tips our patients can follow:

1. Play an active role in decision making.

Patients now have access to the Internet and can help their doctor decide what is best for him or her. Your values and outlook in life often play an important role when choosing surgery or not. 

2. Is the surgery an emergency or is it elective?

Emergency surgeries leave you little choice to decide and you probably have no time to explore your options. A ruptured appendicitis, a vehicular accident, a dissecting aortic aneurysm all need immediate care. Luckily, this only happens in a few instances. The majority of surgeries are elective, for which you still have time to decide. 

3. General rules when surgery is needed.

Surgery is appropriate when it is needed to: a) relieve or prevent pain, b) correct a deformity, or c) save or prolong a life. However, even if the surgery is appropriate, there may be other treatment options available which is non-surgical. Ask your doctor about other options, too. If you feel pressured or uncomfortable, then get a second opinion on the matter. 

4. Decide with a calm mind.

With doubt, there arises fear. Fear of the unknown. Fear of making the wrong decision. Fear of choosing the wrong doctor. Knowing the pros and cons of the operation will help you feel more calm and confident in whatever treatment you decide on. 

5. List down the questions to ask your doctors before surgery. 

It’s best to list your questions down before you visit your doctor. Otherwise, you might forget about it because you may suddenly panic or your doctor is busy. Basic questions to ask are the following:

a) What is the surgery called and how is it done?

b) What’s the reason for the surgery?

c) What results can I expect after undergoing this procedure?

d) What are the risks involved and how often do they occur?

e) How much time do I need before I can go back to work?

f) How much money should I prepare for the hospital bill and your professional fee?

g) Are there cheaper options available for me? What if I get a semi-private room or stay in a ward?

h) Will the costs be covered by PhilHealth and/or my health card? 

Now, the next two questions should be handled skillfully and with care: “Doc, how many times have you performed this surgery before? How frequently is this surgery done in this hospital?” These questions assess the skill of the surgeon. There’s no harm in asking around. Ask other patients, too.

6. When to ask for a second opinion.

Now, you might feel uncomfortable asking for a second opinion, but that is your right. A doctor who gets angry or refuses to cooperate with you (not allowing you to photocopy your laboratory results) may not be the best doctor for you.  To get around this problem, always have an extra copy of all your lab tests. File it in a folder.

There are some instances when it’s wise to seek a second opinion: a) The surgery is risky or still experimental; b) Your symptoms are not severe and the outcome of the surgery is not clearly beneficial; c) There’s controversy about the need for the procedure, for example, tonsillectomy, hysterectomy, Caesarian section, coronary bypass, balloon angioplasty, orthopedic surgery, gallbladder removal, and plastic surgery.

I’m not saying that these procedures are not needed, but I just want you to know that there is a wide range of opinions on the matter. There are doctors on the conservative side (no surgery) while others are on the aggressive side (early surgery). Both doctors are still correct within the bounds of acceptable practice.

Now, if the second doctor disagrees with the first, find out the reason why. You might find that one doctor’s philosophy may be more in line with your own values. Then choose which doctor you prefer. 

7. Pray that you find the right doctor.

Now, some people might wonder about this suggestion, but there’s some luck involved, too. Prayers and a positive attitude help the patient find the right doctor and make the right decision.

Find a few doctors whom you can trust. Doctors who’ll give you the leeway to be yourself, to listen to your questions and will only have your best interests at heart. With the added help of the Great Physician, our Filipino doctors can really alleviate your pain and prolong your life. Good luck!