If you or a loved one have ever had an elective orthopedic surgery, you know that it is a huge decision to make. There are many factors to consider, such as age, extent of trauma, and recovery time. However, there are other, often overlooked, questions which will be highlighted in this post! Hopefully, they will help you to decide if having surgery is right for you.
To clarify, elective orthopedic surgery pertains to your bones, muscles, joints, tendons and other connective tissues. It is NOT cosmetic surgery or emergency surgery; in most cases orthopedic surgeries are not emergent or life-threatening. An exception to this is if you fracture a bone and need corrective surgery immediately to aid in the healing process. Orthopedic surgeries are, however, something you may want or need due to a progressively worsening condition or injury, when you are unable to live with the pain, or when you are unable to complete regular activities of daily living (bathing, dressing, toileting, driving, etc.).
Here are some examples of orthopedic surgeries:
Total or partial joint replacement
Rotator cuff repair
Carpal tunnel release
Bone spur removal
And many others!
So, what are some things to consider beforehand? Below are 5 important questions to answer before going under the knife.
1. Can you live with the pain you are experiencing now?
It is generally advised that if you can work through and live with your current pain, you should wait to have surgery. Surgery is a last resort, and should be considered when the pain is severe enough to interfere with your daily activities. Also, consider if you have given up on some of your activities because of the pain. Try to think of the big picture when it comes to this question: over the past year, have things gotten worse or are they staying about the same?
2. Have you explored all the treatment options available?
There are a variety of conservative and less-invasive treatments that are worth looking into, such as using ice or heat, wearing a brace or other support when doing heavier activities, injections (steroids, PRP, gel/hyaluronic acid, stem cells, etc.), and physical therapy (PT). Quite frequently, PT can help you avoid or at least postpone a surgery. Physical therapists assess your joint mobility, range of motion, strength, pain level with certain activities and focus on giving you targeted exercises, stretches, or activity modifications. It can get you functioning to the point where you can at least live with your current level of pain, or get you as strong as possible before surgery! There are many different treatment options available now, and it is important to be your own healthcare advocate and know your options.
3. How will surgery improve your condition?
This is a harder question to answer because there isn’t a clear cut way to answer it. To start, think about how your current discomfort/pain changes throughout the day, throughout the week, and how you are currently managing it. Are you taking medications? Are you just pushing through the pain? Are you becoming more sedentary because of the pain? Then, think about what activities you can and cannot do- can you get your shoes and socks on? Can you sit in the car for 30 minutes? Can you walk for half a mile? These questions are meant to help you with some introspection so that you are better equipped to talk with your healthcare provider about your current level of function. Once this happens, you will have a better idea of how surgery may or may not help.
Before talking to your surgeon, you should also think of some goals you want to accomplish after the surgery and bring those up during your appointment. If you are having horrible knee pain and want to get back to being able hike with your dog for 5 miles, tell your surgeon that and see what kind of response you get. Most surgeons will be pretty straightforward as to how you are expected to recover. For example, when people need to have a shoulder replacement, one of the things they are told is that they are probably not going to regain their full range of motion in the shoulder (this is similar with a knee replacement). Therefore, think about your top activity goals and speak with your surgeon about them to see if having the surgery is a good fit for you in the long run.
4. Does your insurance policy cover the costs of the surgery and the recovery?
This is something you will look into based on your current health insurance coverage. Not only do you need to consider the costs of the surgery itself, you need to think about what is included during your recovery time. If you have surgery for carpal tunnel syndrome, it is possible that you may need occupational therapy and physical therapy. After a rotator cuff repair, some surgeons prescribe physical therapy for 6 months, so it is important to examine what your insurance will cover and if that is feasible for you. Again, it is important to be your own healthcare advocate and know your options!
5. Do you have a support system in place to help during your recovery?
This is one aspect of the surgical process that most surgeons do not discuss at length with their patients. Having a support system is very important because depending on what surgery you have, you might not be able to drive yourself around, you may be on heavy pain medications, you might be in a sling for a month or wearing an ankle boot for 6 weeks. For example, with total shoulder replacements, you are not allowed to actively move the arm for about 4-6 weeks, so your spouse, caregiver or a family member needs to be prepared for this as much as you do. This is a great question to discuss with the surgeon as well and find out if the recovery process will be problematic; that way you will have some time to coordinate and figure things out so you are not blind sighted coming out of the surgery.
Hopefully these 5 questions will help you to better plan for a surgery in the future. As previously stated, it is a big decision and becoming your own healthcare advocate will help you feel more prepared.
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