Surgery? Risk? Alternatives...

[imoldernu]

Since this is so much a personal matter, opening the subject for open discussion and your thoughts on this health defining issue.

This AM, went to the Friday AM coffee with my older friends in our CCRC, and the discussion turned to the general feelings about how we handle situations where "choice" has forced us to make decisions about our healthcare. More directed to cases where the choice came down to the alternative of surgery, or other means such as diet, physical therapy or medication.

Of course there are situations where there is no choice, but often there's a fine line, where risk/reward comes in to play. In our own case, we very much respect our doctor's advice, but this has always been after an in depth analysis wherein he brings the surgery option down to a percentage of risk... as well as the expected downsides of the alternative options.

There is no "right" answer here, and no one can definitively say today, what decision may be made tomorrow, but I was somewhat put off, in todays discussion, to find that some of my friends totally abide by their doctors' recommendations.

Because some choices come upon us unexpectedly... as in cases where a medical test gives unwanted results, medical decisions are often made in haste. Because we have seen this, our resolve is to (at least) sleep on any final decision.

Would you share your thoughts on this? Have you been faced with this type of decision, and what influenced your choice?

 

[Teacher Terry]

We always weigh all the options, get second opinions and sleep on things before deciding. I would never blindly follow one doctor's advice.

 

[Brat]

My husband, who had just turned 79, had shoulder replacement surgery recently. Kaiser did a through workup to assess his ability to survive this experience successfully. Maybe they were looking for a reason not to proceed...

Based on my experience as a caretaker arrange for help for the first few days after discharge from the hospital. A caretaker can't safely care for a patient with little sleep. The other is to come to an agreement that if the nursing staff suggest you extend your stay don't decline the offer. In my husband's case it was a matter of pride that he was discharged after one day. That wasn't wise.

 

[MRG]

A neurosurgeon wanted to whack on my c-spine. Two surgeries a year apart, if I survived the first one and wasn't paralyzed he'd do the second. He didn't know which of the two to do first.

He talked at length of the risks, death, paralysis. The words that got me were "of course the surgery could be successful and you could still be paralyzed". At that point I asked about alternatives! He suggested physical therapy as a treatment. I chose that.

 

[CountryGal]

We always weigh all the options, get second opinions and sleep on things before deciding. I would never blindly follow one doctor's advice.

I totally agree!! I have seen studies that showed PT worked about the same or better than knee surgery for some people. Personally surgery would be my last resort. Good luck!

 

[Amethyst]

As my Dad used to say about his osteoarthritis pain, "If I found out that eating horse [manure] would make me feel better, I'd eat a plateful."

It makes absolutely no sense to me to opt for the knife, if reputable medical professionals believe that changing your lifestyle (exercise, food elimination, losing weight) would fix or nearly fix the problem at hand. Gosh think of the people with permanent disabilities, autoimmune disorders, etc. who have no alternatives except suffering. Would they leap at the chance to make a lifestyle change, if it really could help them? I bet they would.

 

[MRG]

Spot on for changing lifestyle. Ten+ years ago my DW was told she needed a knee transplant. They wanted her to put it off, she did. Then after losing 55 pounds her knees fine. She doesn't take the anti-inflammatory drugs anymore.

 

[foxfirev5]

Spot on for changing lifestyle. Ten+ years ago my DW was told she needed a knee transplant. They wanted her to put it off, she did. Then after losing 55 pounds her knees fine. She doesn't take the anti-inflammatory drugs anymore.

Personally I've had carpal tunnel, Achilles tears , and variety of structural issues. I've never elected surgery but rather worked it out over a period time. Wise or not I do not know.
Exercise, resistance training (weights) and weight loss have personally helped me. However I certainly could not give advice to anyone regarding their situation. But I will say that ER has undone a lot of damage related to work!

 

[Meadbh]

A friend of mine was having severe knee pain. It was recommended that she have a knee replacement. She went on the waiting list, and started physiotherapy. She also had some steroid injections. She is already very active and does not need to lose weight. When she received the call to go for surgery, her symptoms had improved so much that she declined. There is something to be said for waiting lists.

 

[Alan]

I've had 5 different joints operated on (no replacements), and each time I first spent a couple of years at least doing physiotherapy or chiropractor, pills and injections. 3 years ago I thought I was going to need surgery again but the physiotherapist did a fantastic job and I don't expect to need surgery anytime in the foreseeable future.

 

[braumeister]

A surgeon will look at a problem and think about ways he or she could alleviate it through surgery. When all you have is a hammer, everything looks like a nail.

But there are other tools besides hammers. Problem is, many patients don't want to consider their situation and just blindly do what their doc tells them.

 

[Car-Guy]

I guess I've been lucky. While I've had my share of physical problems/injuries over my life, and a few that last for years, they all have eventually gone way without a doctors intervention. I have no doubt that most doctors would have given me pain pills, steroid injections and/or possibly even recommended surgery for one or two my more serious injuries. Today, everything seems to work ok, and all injuries have healed on their own (albeit some took a while).

I'm sure the day(s) will come that this aging body won't be able to fix what I hurt and I'll need medical intervention, but so far so good. IMO, surgery would be my last resort. But that's me.

I'm also one of those that don't believe in "a lot" of PM (preventive maintenance). But that's another discussion.

 

[Car-Guy]

I would never blindly follow one doctor's advice.

+ A bunch

 

[JoeWras]

Absolutely try all alternatives, but they don't always work.

After 20 years of continuing pain, I finally elected surgery. It was life changing positively.

 

[nuke_diver]

A surgeon will look at a problem and think about ways he or she could alleviate it through surgery. When all you have is a hammer, everything looks like a nail.

Depends on the surgeon I think. Not all do. The last knee surgery I had was my choice. My first few visits with the surgeon we decided not to do the surgery and to see if there was any worsening of symptoms first. After 3 years I decided to get it done because the symptoms had gotten worse and I was going to retire and I wanted the work done on the company's dime not mine. But certainly his first choice was not surgery.

 

[mamadogmamacat]

Always give at least some consideration to alternatives. I am very happy so far with both PT and topical treatments (as well as an occasional OTC pill) for my knees. My hope is that with time even more alternatives, such as stem cells perhaps, will become more common and hopefully also gain a good track record, will be available and I can avoid joint replacement altogether. On the other hand, thirteen years ago, alternatives ultimately did not work for pain or provide adequate mobility restoration for my wrist tendonitis, and I did, after about three months of no improvement opt for the surgery and it was successful.

 

[mamadogmamacat]

agree it does depend on the surgeon. Perhaps also on the type of practice. Recently attended a mtg at the local senior center where the speaker was a hand surgeon and spoke on "the aging hand". I was impressed with the amount of time he spent on describing and on QA about PT, saying that 95% of his patients only require PT, some short term medication usage and often custom braces short term also. Now, the practice employs several PT professionals as well as a half dozen doctors each specializing in various body parts. So, suppose it is true it all looks like a nail, but that can be OK if one uses a practice with people expert in a variety of hammers.

 

[grasshopper]

My urologist suggested a whole range of options when I was dx with prostate cancer. I opted to watch it as it was a low risk indolent type of PCa. 5 years later my PSA is in the range of a 40 yo and I am 66. my doc has me on a one year exam and quarterly PSA tests, if I didn't chose to watch it a wonder if I would have a prostate today.

 

[Meadbh]

My urologist suggested a whole range of options when I was dx with prostate cancer. I opted to watch it as it was a low risk indolent type of PCa. 5 years later my PSA is in the range of a 40 yo and I am 66. my doc has me on a one year exam and quarterly PSA tests, if I didn't chose to watch it a wonder if I would have a prostate today.

It is now recognized that low risk prostate cancer is extremely common and that the PSA test has been responsible for a lot of unnecessary worry and treatment.

 

[Amethyst]

Age matters, too.

In my 30's, I developed a benign breast tumor and was referred to a surgeon, who wanted to remove it just in case. But he also said, "I'm a surgeon, and we like to remove things." So I declined. Over time, the lump went away.

If I got one now, at this age, though, I'd be more fearful and would want it out.

 

[Mr._Graybeard]

My urologist suggested a whole range of options when I was dx with prostate cancer. I opted to watch it as it was a low risk indolent type of PCa. 5 years later my PSA is in the range of a 40 yo and I am 66. my doc has me on a one year exam and quarterly PSA tests, if I didn't chose to watch it a wonder if I would have a prostate today.

From my experience I'm skeptical about the justification for some prostate surgeries. Yeah, a lot of men who get it need it, but in my case the urologist was (IMO) overly eager to get me under the knife after a biopsy turned up 5% cancer in one of nine cores taken during a prostate biopsy. I got a second opinion from another urologist and a third from an oncologist who specialized in prostate cancer. They both told me that surgery was premature in my case, and I should just watch the cancer's progress.

I can't help but think about that big-ticket Da Vinci surgery robot at Urologist No. 1's hospital and the financial pressures to keep that thing humming!

 

[eytonxav]

This made me think, at what age can we safely stop getting colonoscopies?

 

[Ronstar]

This made me think, at what age can we safely stop getting colonoscopies?

Don't know for sure, but MIL didnt need one at 87

 

[REWahoo]

I'll spread a little Mayo here...

Colon cancer screening: At what age can you stop? - Mayo Clinic

 

[Fedup]

This made me think, at what age can we safely stop getting colonoscopies?

Colonoscopy is not useful after age 70 and my husband's doctor agreed with me.