Monday, June 02, 2008
Don't rush to the surgeon
…Ranit Mishori, MD, writing in Parade (USA Today Weekend, May 25, 2008), says more than 70 million Americans face the knife each year. Not all of those surgeries are necessary.
…”There is always the possibility that something can go wrong when someone sticks a sharp blade in your body,” notes Mishori, with a colorful flair for the turn of phrase that HA cannot help but admire.
…Sometimes less-invasive (knifey) options should be tried first.
…Take knee surgery, the doctor says. More than 13 million Americans suffer from osteoarthritis of the knee. Many doctors try ani-inflammatories, physical therapy or injections into the joint.
…But, alas, one in four will still be candidates for surgery. This is successful sugery—90% of patients are helped.
…But Mishori is no fan of arthroscopy—the less invasive form that does not replace the joint or parts of it, but smooths off the bone surfaces. Here, he says, the placebo effect may lead patients to think their knee feels better. He even talks about “sham” surgery in which only one little cut is made and basically nothing is done. (Please bring whoever does that over here so HA can start the slapping.)
…Back surgery is another tricky one. Ninety percent of “slipped disk” people will get better over time. It may take 6 weeks to 12 months of rest and medication, but it will happen.
…Surgery may be required for spinal stenosis, in which the nerves of the spinal cord get squeezed.
…Sinus surgery is another one that gets recommended all the time. Surgery for inflamed sinuses is controversial. If you are a mess for 12 weeks or more, it might be an option.
…Your eyes and brain are close to those sinuses, Mishori notes. Check out your surgeon very carefully.
…This is elective surgery. You are electing, or deciding. Find out, at very least, what the downside of waiting is.
…No one is exactly the same after surgery. Stuff has been cut, even thrown out (HA has no lens in her eye now). Ideally, what is left works better. Try to be sure it will.