When you need elective surgery, make sure you evaluate your treatment options.

This includes not only how you will be treated, but also where you will receive the treatment and by whom.  Here’s how I viewed my situation – In my case with my multinodular thyroid with an especially large nodule on the right, I was given the option of just having the right side of the thyroid removed.  In that case there was a good possibility I would not have to take daily thyroid hormone replacement, but there was also a small possibility that there might be a cancer in the remaining thyroid.  However, most thyroid cancers are very slow growing.  If I kept the left half of my thyroid, I’d need periodic thyroid ultrasounds and follow-up.  At some point in the future I might need the left side to be removed as well.  Realistically with my cardiac history and advancing age I figured that my risk for surgery will only get worse as time goes by, so I chose to have the whole gland removed.  This way, I will know definitively if this is any cancer in any of the thyroid.  The only downside is that I now have to take thyroid medicine every day, but, since I already take daily medications for my blood pressure, that didn’t seem like such a negative.  Your potential treating physician should be able to help you understand the pros and cons of your treatment options.

Just as important, especially if you are having surgery is how much experience has your surgeon had with the procedure as well as the outcomes of the hospital for that kind of procedure.  I was initially evaluated by specialists at a local community hospital about 20 minutes away from my home.  I considered having my surgery there until I learned that the surgeon does only about 25 of these procedures a year and the hospital had a higher mortality with this kind of surgery than average.  Fortunately I live only 30 minutes away from a national center which also participates in my health insurance network.  Their mortality is better than average, and I had surgery by the chair of the department who does 300 of these a year.  Often your health plan will have some quality information about the hospitals and physicians in their network.  I used the information compiled on www.health.usnews.com to help me make my decision.

I hope these last four posts will prove useful if you are faced with new symptoms that might require surgery.  Please share your experiences with us!

For Your Health – Dr. Bob

When you go to your doctor for some new symptom, realize that there will be a clinical process for your workup that could involve many steps, so think ahead!

I’m not suggesting that you will know exactly what tests will be necessary to evaluate your condition, but you can still think ahead.  In many instances, your PCP will have a pretty good idea what kind of treatment your symptoms will require.  In most cases, the tests he orders are done to confirm his suspicions.  With that in mind, if surgery is a strong possibility and you have a history of a chronic condition such as diabetes or heart disease, you may wish to schedule a pre-op evaluation by the specialist who cares for you for that condition.  Why?  Because these doctors are often very busy and you may have a long delay to get such an appointment.  At the very least check with the receptionist how quickly you can be seen if you need clearance before surgery.  In my case because of my heart history I knew I needed to be cleared by my cardiologist.  I also knew because I hadn’t had a recent stress test, he would probably want me to have that done prior to his giving me clearance. I was correct & getting these done added about two weeks to the process.

Next time I’ll discuss evaluating your treatment options to make sure you get the best care you can!

For Your Health – Dr. Bob