Before surgery: Getting information and making a decision

Surveys have shown that most people don’t feel they have enough information before surgery. As a result, many don’t feel confident about the decision they have made, and they may have doubts.

The amount and type of information people want varies a lot from person to person: Some people want to know exactly what is going to happen during and after a procedure or operation. Others would prefer to be told about what they will see and feel. Many would like advice about how to cope with these situations. So it may be important to consider the following beforehand:

• Get information: Knowing what will happen during the operation can reduce uncertainty.
• Plan: You might want to talk with your doctors and nurses about the type of pain therapy and follow-up care you will have.

Having enough information can help you feel safer. Knowing what other treatments are available and how they compare with the planned procedure may also be helpful.

Anyone can seek a second opinion from another doctor – that is, to get advice from them. They may recommend having recent, more involved tests – such as a CT or MRI scan – repeated. So it's a good idea to bring all your previous medical records with you to avoid unnecessary testing.

In Germany, you even have a legal right to a second medical opinion for certain non-urgent surgeries – like some back, hip, or heart procedures. In other words: If a doctor recommends one of these surgeries, they must inform you of your right to discuss the decision for or against the procedure with another specialist at no additional cost.

One of doctors’ responsibilities is to inform patients about what will happen during a procedure and explain the risks. When preparing for doctor’s appointments, it’s a good idea to make a list of questions you may have about the surgery. Having some pre-selected questions to guide you can be helpful.

Because it isn’t always possible for the doctor to answer all of the questions, many people end up looking for more information afterwards. There are many different sources of medical information – including websites, leaflets, books and videos – but the information is often contradictory, confusing or simply wrong. Some of it may even end up scaring you or making you feel even more anxious.

Decision aids are available for some diseases. These usually contain information and questions that can help you find out what is important for you, personally. Decision aids concerning surgery may, for instance, present the advantages and disadvantages of an operation and help you realize how important they are to you. Studies show that decision aids can increase your level of satisfaction with a decision.

Once you have a clear idea of your own wishes, values and expectations, it can be easier to make the right decision – or to reassure yourself that you have made the correct decision. The information “Gathering information and making a decision” offers tips and on how you can make the decision that is right for you involving a health issue.

Having a talk with the doctor before surgery can also give you the opportunity to discuss and make arrangements concerning things that may be on your mind, such as:

• Which medications you should stop taking before the operation, such as medication for chronic diseases
• How long before having the anesthetic and after surgery you shouldn’t eat, drink or smoke
• How surgical wounds and pain are treated after the surgery
• What should happen if the operation leads to the discovery of a certain illness, such as cancer
• Whether specific requests are recorded in the medical record – for example, that certain treatments should be avoided
• Whether and how much medical information is allowed to be shared with family members and friends
• Whether you have, or have to make, arrangements for written documents like an advance health care directive or power of attorney
• How soon after surgery you can return home, and how you will get there
• When you can return to work
• Whether you will need help at home after the surgery, for instance with household chores or looking after children

It can be helpful to write down any questions you have before you talk with the doctor, and take the list along to the appointment.