INTERESTING
The specialty of Orthopedics is often thought of as a trauma based area of medicine, dealing with broken bones and accidental injuries. A lot of what we do, however, is management of chronic medical conditions like osteoarthritis, and the debilitating pain and impact on quality of life associated with it. Definitive treatment for many of the conditions we care for can often be some type of surgical intervention. So the question becomes, what is elective surgery, and when is it right for the patient? The basic definition of elective surgery lies in the fact that it is planned in advance, and is not an emergency situation. But how does one decide it is time for surgery?
Speaking from experience, there is often never a “good time” to have surgery, elective or otherwise. I struggled with pain in my foot for many years due to a bunion, but delayed any definitive intervention based on convenience, or rather, the inconvenience of surgery. I had tried every conservative measure on the market, and had worked closely with my physicians to delay surgery as long as I possibly could. At some point though, I realized that I could no longer live with the pain in my foot as it was. I finally decided the summer between graduating from Physician Assistant School and beginning my career at OrthoRI in the fall was likely going to be my best bet, despite not wanting to spend my summer in a walking boot. There was not going to be another more convenient time in my life for years to come, and I could no longer live with the pain. It simply had to be done.
The decision to have elective surgery needs to factor in many aspects of the patient’s life. Often, the conversation is centered not only around the anatomy, pathophysiology, and treatment options, but on work schedules, family and living situations, and even vacations. We will discuss surgical risks and benefits, but also recovery goals and expectations. How soon can the patient expect to return to work? Will they be able to get back into their workout regimen? Will they be able to take that trip to Europe? How will they know when the time is right? My best answer to that last question is always: you will know when you are ready. I always ask each patient on a scale of 1-10, how bad is your pain? And more importantly, on a scale of 1-10, how bad is your quality of life?! When the pain and limitations begin to affect your way of life, it may be time to seriously consider elective surgery.
More often than not, patients will come back to me and say “I wish I had done it sooner”. Having spent a summer on the beach in a walking boot, I can also now say I’m glad I did it. It may not have been the most convenient time, and I did have a funky tan line for a while, but it was the right time for me. It’s important to be able to express to your provider where you are in that journey, and when you feel you are ready to move forward with surgery if it is appropriate for your disease state.
