Pre-surgical Optimization – How We Ensure You Have the Best Possible Outcomes
Consultations often involve frank discussions about the potential surgical risks that you as an individual face. Our aim is to help you understand the possible issues and work with you to minimize them. Fifteen years ago we used to talk about clearance for surgery – which essentially focused on ensuring that you were deemed low risk. Today we talk about medical optimization. That means that we aim to help you minimize any risk as much as possible so you are going into surgery in the best possible shape for it.
That means that, when you come in for a consultation, we’re going to talk about what we call modifiable risk factors – essentially your daily habits that may or may not impact directly on surgical care.
We are very proud of the excellent outcomes we get for our patients, and much of this is down to the fact that we do a really good job of optimizing them before surgery. Unfortunately this means that sometimes we have to have uncomfortable discussions on topics including: –
- Smoking. We know that nicotine impairs blood flow, increases the rate of infection, and reduces healing rates.
- Weight – we’ll often see issues such as diabetes with heavier patients. One of our pre-surgical tests is the hemoglobin A1C analysis- this shows how good your control of your blood sugar is over time. Higher A1C rates are associated with increased rates of infection. That means that, if appropriate we’ll talk to you about steps you can take to lower those levels.
- Current medications – if you are currently taking a large amount of pain medication, then it is likely to be more challenging to control your pain after surgery. We also want to know which other medication you are taking, as some should be paused before surgery.
This doesn’t mean that we can’t take care of you in these sorts of cases – in fact, we pride ourselves on taking care of all people. However, if there is an opportunity to reduce the risks you face, we will address it with you to get the very best outcome for you.