Surgery Today - Apprehensions about surgery

Most people feel anxious when faced with the need for surgery. This is to be expected. After all, a certain amount of anxiety normally accompanies any prolonged or incapacitating illness or infirmity. When surgery is the recommended therapy, it's natural for the patient to feel some anxiety about the surgery even if he's optimistic about a favorable result.

Factors That Reduce the Risk of Modern Surgery

Much of the risk of surgery these days is eliminated through the careful preoperative screening examinations reviewed earlier. A patient with a chronic disease who might have been a surgical risk a generation ago may have one or more options not available in past years, such as regional anesthetics that allow surgeons alternatives to general anesthetics that would be less than satisfactory. Antibiotics and other backup medications are available to control possible complications after surgery. Recovery room techniques and intensive care units with electronic monitoring of vital life systems provide added insurance of safe recovery. And, of course, surgeons today have the added experience of many millions of successful operations involving a range of procedures such as kidney and heart transplants, open heart surgery, and replacement of important organ parts with plastic substitutes. These and other procedures, including the implanting of electronic heart pacemakers, were beyond the dreams of surgeons of past years.

Surgery for the Older Patient

With the rapid increase in the proportion of older people in the population, the surgical patient is more likely to be an older person with problems associated with aging. An older man who underwent surgery to remove his prostate gland before World War II had a life expectancy of a few years after the operation. Today, such procedures in older men are considered routine cases with little or no effect on longevity. It is not unusual nowadays to find men and women in their 70s and 80s who have undergone five or six major operations since reaching the traditional retirement age and without any significant restrictions on their physical activities.

Part of the reason for the greatly improved outlook for surgery on older patients may be that older persons today are simply in better health because of the improved medical care available. Thus they are better surgical risks than their parents would have been at the same age. Advanced preoperative and postoperative care has also improved the outlook for the older patient. He may be admitted to the hospital a few days earlier than the younger patient for more intensive examinations, and he may remain a few days longer for postoperative care. Convalescence for the older patient may take longer, and in some instances the recovery may not be as complete as that of a younger person. But in general, modern surgical techniques are likely to offer a safe and effective therapy for people of advanced age with complaints that can be corrected by an operation.

In addition to the physical benefits, surgery may improve the mental capacity, personality, and sensitivity of older persons who had been depressed about a disorder before surgery. The patient who complained that he is no longer the person he used to be physically may have assumed that his medical problem was simply a result of growing old and overlooked the possibility that the complaint was due to a disease that might respond to treatment.

Surgery for the Child

A child, on the other hand, may have his own reasons to be apprehensive about the trip to a hospital for surgery. Most children seem to worry that the operation will hurt or that other procedures, such as taking a blood sample for testing, will be painful.

Telling the Truth

Many surgeons recommend that the child be told as realistically as possible, in terms he can understand, what can be expected. The youngster should not be given a sugar-coated story about the operation which might give the impression that he is embarking upon a happy adventure. At the same time, the child should not be frightened by suggestions that he may be given drugs to make him unconscious while he is strapped to a table so that strangely masked and gowned strangers can cut him open with sharp knives.

Children are more likely to appreciate surgery if they are told that a friendly person will help them go to sleep; that the operation will hurt a little but the pain will go away after a while; and that the operation will make them feel better or help correct a problem so they can be more active like other children. A small child should always understand that he may have to remain overnight at the hospital without his parents, but that he will have other adults to take care of him and there probably will be other children at the hospital to keep him company.

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