need to be done but that the doctor giving the second opinion will often review the tests that have already been given. Patient should check with their insurance company before having a second opinion performed. The second opinion should be done by a qualified surgeon who is qualified in doing the surgery as well and can give the patient an informed choice as to whether the surgery is necessary.
Preoperative Testing There are several tests necessary in cases of an upcoming surgery, particularly if the surgery is to be a major surgery. The tests are present to help identify if the patient is healthy enough to undergo major surgery. If the surgery is minor, only a few tests are done during the preoperative period. The various tests necessary before a major surgery include the following: •
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A CBC, blood sugar level, and bleeding studies are done to make sure the patient’s blood count is normal, that they don’t have anemia or diabetes, and that their kidney and liver are functioning normally. If blood transfusions are anticipated, the blood type may also be checked in case the patient requires blood during the procedure. A urinalysis is done to check for an occult urinary tract infection and to make sure the kidneys are producing urine that is normal in character. A Chest x-ray is done to evaluate the patient’s lungs and is done for major surgeries and in patients older than fifty years of age. An electrocardiogram is done on older patients who may have occult evidence for heart disease that only shows up on an electrocardiogram. Other tests directly evaluate the reason for the surgery and include a CT scan, MRI scan, PET scan, and other x-rays that evaluate a tumor, if this is the reason for the surgery. If an area of the body needs to be closely examined before the operation, the surgeon will do these tests before performing the surgery. A history and physical examination will be done by the patient’s internist, family doctor, or the surgeon. Things that are examined include the blood pressure, questions related to having heart disease, a diabetic check, the history of the patient’s drug and alcohol use, and any other health issues that could affect the outcome of the surgery. This needs to be done about one week before the procedure and no further out than that. A complete medication list is determined and written down as part of the history and physical. Prescription medications, vitamins, herbs, and prn medications are listed in this list. Any allergies to medication should be written down in the history and physical. Tobacco use needs to be discussed at the time of the history and physical. Tobacco use causes constriction of the blood vessels and decreases the supply of nutrients and oxygen to crucial tissues involved in the surgical procedure. It is recommended that the person stop smoking at least two weeks before having major surgery. Certain blood thinning medications and alcohol should be stopped before having surgery. If there is time, the surgeon may recommend a weight loss of a few pound before surgery, which will improve the surgical risk. The patient will most likely be given a medication for anesthesia during the surgery. In such cases, the patient will have a visit with an anesthesiologist. This individual will examine the
