On deciding to have elective surgery

     I’m 79, had a near-fatal heart attack not that long ago, and now have to decide if I want surgery for a completely different issue.

     It’s elective surgery—that is, I could continue more or less as I am without getting the procedure. The condition could—almost assuredly would—eventually get worse, but it’s not currently life-threatening and for the time being I’m pretty sure I could steel myself, just deal with whatever discomfort arises. I could get by—at least for the immediate future—without heading into the operating room.

     No doctor has yet told me I absolutely need to get it done right now. It could wait, at least a bit. it would be my choice to go ahead with it. Which is what makes the decision so damn difficult.

     According to the University of Michigan National Poll on Healthy Aging, I am not alone in dithering about whether to proceed. Most adults aged 50 to 80, says the poll, have concerns when deciding whether to have elective surgery done.

     Nearly two thirds of respondents are uneasy about potential pain or discomfort related to elective surgery. More than half, like me, are also worried about a difficult recovery. Others are concerned about out-of-pocket costs, exposure to COVID-19 or having someone care for them afterwards.

     In discussing my potential elective surgery with a battery of doctors, I have been told yes, it would be better to get it done now. I’ve also been told there’s a 1 to 5-percent risk of pain or numbness continuing long-term after the operation. There’s a chance that if this pain or numbness is caused by a nerve that’s irritated during the surgery there would need to be another operation to treat it.

     There’s a 2 to 4-percent risk that the problem the operation would address could recur afterwards. There is no guarantee, as well, that the surgery will completely alleviate or even improve the discomfort associated with the problem. There is a 5 to 10-percent risk of postoperative complications.

     And in any case, there will be around six weeks of post-op recovery that would include avoidance of overly strenuous activity.

     Obviously, as a congenital worrier, instead of focusing on the great likelihood that the surgery would alleviate my discomfort and solve the problem that is causing the discomfort, I am instead focusing on the 4 percent and the 5 percent and the possibilities of risk and failure.  

     I’m weighing the potential benefits against the risks and concerns, all of which are greater when you are older. Poor tissue quality, typical among older people, could increase the risk of recurrence of the problem.

     So, I’m trying to remind myself that of those older adults surveyed, including all the ones with serious concerns, most answered that they were very satisfied with the outcome when they went ahead and had the surgery done.

I hope I will be one of them.