Get to Know Your Physicians
Before making a decision about surgery, find out whether it’s really necessary and what benefits it will provide. You also should talk to the anesthesiologist prior to surgery. Consider scheduling a consultation with a geriatric anesthesiology specialist, particularly if you are taking multiple medications. A geriatric anesthesiologist has specific experience caring for the elderly both preoperatively and postoperatively.
Please note that if you are depressed, it can be helpful to see a psychiatrist and seek treatment prior to surgery. This is extremely important because depression has been tied to higher mortality rates in surgical patients. The psychiatrist, in consultation with other members of the surgical team, may also recommend minimizing the use of sedatives, especially long-acting drugs such as benzodiazepines.
Don’t Be Afraid to Ask Questions
Having a surgical procedure can bring up a lot of questions. You should bring a list of all your questions to your preoperative appointments, and don’t be afraid to keep asking until you feel you understand the answer. Some questions you may want to ask are:
- What are the benefits of this procedure?
- Where will the surgery be conducted?
- What do I need to do before the procedure?
- Can I continue to take my prescribed medication before the procedure?
- Is there any medication I should not take?
- Are you a geriatric specialist? If not, can you recommend one that I can consult with about my current medications and how they could affect my procedure?
- At what point in the procedure will anesthesia be administered?
- What type of anesthesia will I receive?
- What are the advantages and disadvantages associated with the type of anesthesia I will receive?
- How will the anesthesia be administered?
- When you administer the anesthesia, will it hurt?
- Who will be my anesthesia provider?
- When can I speak with my anesthesiologist?
- Are there any risks associated with anesthesia?
- Will I wake up during the surgery?
- As a senior citizen, are there any specific complications associated with anesthesia and this procedure that I should be aware of?
- How long will the entire surgery take?
- Are there risks to mental function with surgery anesthesia?
- When will I wake up?
- Will the anesthesia make me nauseated after the procedure?
- Will I be in pain when I wake up from the procedure?
- After the surgery, is it possible for me to be placed in a recovery room with a window?
- When will I be discharged from the hospital?
- What drugs should I avoid taking in the postoperative period?
- How long should I wait before becoming mobile after my procedure?
- Will I need someone to drive me home?
- What do I do if I don’t feel well after I’m discharged? Who should I call?
- When will I be completely healed?
- Are any follow-up appointments necessary?
List Your Medications and Other Regularly Used Substances
You must provide your physician with a comprehensive list of all medications you take, including prescriptions, over-the-counter and herbal supplements, as some of these can affect your anesthesia and surgery. Sleeping pills, anxiety medications and alcohol withdrawal have been shown to increase the risk of postoperative complications in the elderly. Download and fill out the ASA’s Checklist of Emergency Contact Information and Current Medications. Be sure to have it with you at all times.
Learn Your Anesthesia Plan
Ask your anesthesiologist about the type of anesthesia that will be used during your procedure – general, regional or local, as well as potential effects of the medication. He or she is your partner in the operating room, so feel free to ask as many questions as you need to in order to feel comfortable.
Get Your Support System in Place
Surgery can be an overwhelming experience, and family and friends can be an invaluable resource. They are especially important during the recovery period by doing such things as:
- Ensuring your eyeglasses, hearing aid, etc. will be made available as soon as possible following the procedure
- Placing a calendar in your room so you know what day of the week it is
- Putting photos of your family in your room
- Requesting a recovery room with a window, if possible, so you know if it is day or night
Stay Vigilant for Complications
After a successful surgical outcome, it is easy to fall back into a daily routine and forget to watch out for post-surgical complications, which may include cognitive problems or issues with mental function. Some suggestions to minimize this are:
- Request that your physician conduct a cognitive exam during your preoperative interview. This will serve as a baseline for your physician to evaluate your mental function after surgery.
- Ask your caregiver or support person to monitor your physical and mental activity closely following surgery. He or she should report any troubling behavior to you or your physician. Avoid taking drugs with long-acting central nervous system effects, such as benzodiazepines, which are frequently used to treat insomnia, anxiety, seizures and muscle spasms.