The questions to ask your surgeon are:
- Are you about to go on holiday?
- Have you had a death recently?
- Are you moving house?
A strange way to start a blog post you may well ask. Indeed it is but it does relate to an effective health lifestyle.
The Times [newspaper] Saturday supplement I read last week had an interesting interview with heart specialist Samer Naschef. He is not only quite handy at fixing problematic hearts but he is also a leading expert on surgical risk. He’s written a book called The Naked Surgeon: the Power and Peril of Transparency in Medicine.
He captures and and analyses surgical data. Some interesting findings are that patients operated on the day before a surgeon goes on holiday are twice as likely to die than those operated on the first day the surgeon returns from holiday, due to a slight alteration in the risk taking behaviour of the surgeon.
Surgeon’s not as careful as they could be
How Jehovah’s Witnesses, who do not for religious reasons permit themselves blood transfusions, not only fare no worse than other patients in heart surgery, but actually lose half as much blood. Nashef’s hypothesis for this curious ﬁnding is that the lack of access to blood transfusion means surgeons take more care than usual to control bleeding. Which, in turn, highlights a theme that may be disconcerting for anyone about to go under the knife: surgeons are not always as careful as they could be. This does beg the question: if it is possible to take more care with Jehovah’s Witnesses, should surgeons not take more care with everybody?
Apparently the majority of surgeons (86 per cent) and anaesthetists (95 Per cent) have encountered at least one death on the table. Cheery statistics are they not?! One surgeon in Scotland made headlines a few years ago when he suffered an almost incredible misfortune: two deaths on successive operations on the same day. And it is unnerving to read that, while patients who are operated on by surgeons who have just lost a patient in theatre have no difference in survival rates, they have more complications and spend longer in hospital than their peers, and, somewhat counterintuitively, patients operated on after a death that was somewhat to be “expected” have a higher mortality rate than those operated on after a surgeon had experienced an unexpected, low—risk death.
But the most shocking thing, from the patient perspective, is the lack of guidance for surgeons on the topic. Armed police ofﬁcers involved in deaths are routinely required to step down from duty, but apparently just over half of the surgeons (53 per cent), and only around one in five anaesthetists (22 per cent) actually stop work immediately after an intra—operative death.
The flip side to this mortality statistic transparency is that there should be more care and attention provided by surgeons however that is not always the case. The flip side has a flip side; increased transparency can lead surgeons to avoid high-risk procedures in order to protect their ratings.
My sum up
You should be more informed when it is proposed that you go under the knife. If you are in that unfortunate position ask the questions at the start of this article. Out of politness maybe you can’t ask if they have had a martial break-up or determine other things that can affect their performance; but maybe you should as they are taking your life into their hands.
Another way is to try and avoid surgery all together, taking away all surgical/medical risk, by undertaking an effective health lifestyle. Many surgery options are presented to us as a consequence of chronic disease associated with smoking, drinking, being overweight and sedentary.
Look after your life support system by generally moving more (include effective movement) and eating healthier.
Even Naschef’s health advice (backed by data naturally!) is “not to smoke and not get fat; as for the rest of it – enjoy life as much as possible.”
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