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Evaluating the Risks of Surgery

Evaluating the Risks of Surgery

| February 28, 2020

In our financial planning process, we start with the client's ultimate goal in mind; work through potential actions and consequences; and ultimately help our client choose the path with the highest probability of success. I'm so comfortable with this approach that I apply it to virtually every important decision that I need to make.

But when it comes to medical decisions, there is often hurried communication from medical professionals who are pressed for time and may offer advice that conflicts with the last doctor you saw. There is also terminology and verbiage that is hard to remember; no shortage of tests; a pressing need to make one's pain go away; well-intentioned friends who eagerly share their stories; and of course, Mister Internet, which contains lots of information for the masses but who knows if any of it pertains to you.

When I began to suffer nerve pain in my neck during the 2018 Labor Day weekend, I was determined to find conventional treatments that could relieve the pain and help me avoid surgery. I have great faith in my chiropractor, so I turned to him as the quarterback for my care. When he could not get the pain to go away through treatments, he referred me to various practitioners skilled in pain management, orthopedics and physical therapy. Ten months into this journey, when we determined that none of the conventional approaches worked, he forthrightly recommended I seek out a surgeon. I then turned to my trusted general practitioner, who concurred with my chiropractor and provided names of neurosurgeons.

Two doctors had recommended a spinal fusion procedure, so I booked the surgery for the end of August 2019. But something inside was telling me to get a third opinion, which I did 12 days before the scheduled procedure. I assumed he would rubberstamp the prior opinions. However, he presented a different, less intense option. And then I was stumped. How could I know if he was correct? What if it turned out I was making the wrong decision? My neck was on the line—literally.

With little time to make such a big decision, I quickly assembled a think tank of six people whose opinions I trust. My food scientist daughter Ilana reminded me that in science simple comes first. My friend Shelly was able to find research from a spine website comparing the procedures. The other four concurred that I should consider the new recommendation, because, as the neurosurgeon said, I could always have fusion later if the simpler procedure did not work. I asked two of the medical professionals in my thinktank why the other two doctors did not even mention the simpler procedure. They replied, "The other two probably don't do that surgery."

How is a regular person supposed to know this?

The upshot: Three weeks later, I underwent the simpler procedure (cervical foraminomity), and I am happy to report that it worked.

Here are my takeaways from that decision-making process:

  • I could not have made the important decisions without relying on medical practitioners I could trust, meaning they related what they knew and let me know when the decisions were beyond the scope of their expertise.
  • I was fortunate to surround myself with a thinktank I could trust. They did not tell me what to do or frighten me with stories of botched surgeries. They simply offered ideas and questions for me to consider.
  • While the surgeons were generally pleasant and patient with me, the one I chose has a knowledgeable nurse practitioner who was available whenever I needed guidance, before and after the surgery. (Try getting a doctor on the phone these days.)
  • The best doctors not only have the best technologies, but they are able to blend the technology with their academic knowledge and clinical experience.

The entire experience has reminded me that while there is no shortage of information in the Information Age, it is imperative that we find knowledgeable, empathetic professionals and friends who can help us reach our ultimate goals.