This blog will help you navigate the health care system as a patient or caregiver. After 30 years of nursing I am still astonished at how many individuals end up like lambs headed for slaughter when they undergo surgery. Today's topic will be how to schedule an intelligent and successful surgery:

1. Get a second opinion. Yes, you've heard that before and it is still true. This allows you to gauge the necessity and urgency of the procedure. Remember, surgeons get paid for booking operations. Be a cautious consumer.

2. Look into your anesthesia options. Do not say 'I just want to go to sleep'. Yes, anesthesia is very safe, but why undergo a general anesthetic if you don't need to? With the intravenous drugs available now you can have a regional (one part of your body numb) and you won't remember anything anyway.

3. Write down a list of questions before you go to the doctor. You will likely learn of the surgery at your internist (primary doctor) who will refer you to a surgeon. This means you will have time to research the surgery and the side effects before you go to the surgeon. Make sure you educate yourself. You are the person with the most invested, if you don't find yourself worth the time and effort no one will. By preparing a list you ensure that you will get your questions answered. Time in front of your surgeon when your aren't asleep is extremely brief, do not waste it.

4. Ensure your surgeon of choice has an medical assistant that you can reach easily and that is receptive. This may seem strange, and you may ask 'why would I care about his lackey?' Well, because this person holds the keys to your communication with your surgeon, your insurance company and your pain prescription refill. They will own your ability to access the surgeon, get timely insurance approval and treatment. Sadly, this person is often unpaid, overworked and resentful. You cannot solve those issues and you do not want them to take out their passive aggressive behavior on you and your care. You can have the brightest and best surgeon possible, but if you can't get through to them what good are they?

5. Ask if there is anything you can do to to contribute to a successful outcome. If you are scheduled for a knee replacement and you are 20 pounds overweight then this should be obvious. However, most surgeons no longer feel it is politically correct or worthwhile to risk offense and tell you to lose weight. If you smoke stop. In most cases you should stop taking aspirin or non steroidal anti inflammatory drugs (Advil, Aleve) for 2 weeks before surgery to ensure good clotting time (and eliminate unnecessary bruising and bleeding). Again, ask if this is appropriate for you and your surgery. Ask if there are supplements that you should take or a special diet you should follow. This lets your surgeon know you are motivated and you are willing to partner with them to ensure a successful outcome.

6. Think about the recovery period and what you will need ahead of time. Many surgeries are on an out patient basis now. Who will stay with you and help you? Will you need assistance devices (shower chair, toilet riser) to help you perform activities of daily living? Do you need physical therapy and where will you get it? What nursing tasks will you or your helper be expected to do? Research them ahead of time so you won't be handed a urinary catheter and bag and be told how to care for it while you're still dazed from anesthesia. Written instructions are often woefully inadequate and confusing.

7. Ask for your prescriptions ahead of time. You do not want to be in pain post surgery waiting in the car while someone attempts to fill them for you. There is no reason you can't get them at the time you schedule the surgery so they are there waiting for you when you get home.

I wish you a good outcome and by following the above you will have eliminated some of the risks associated with every surgery. A parting thought: be completely honest with your surgeon. If you aren't forthcoming about your medical history you are asking your surgeon to operate blindfolded. If you drink 3 glasses of wine a night say so. Being less than completely honest may make you look better on paper, but will decrease your chances of success.