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What's the Best Day to Have Surgery?

By W. Gifford-Jones, M.D.
Sep 10, 2006

POTENTIALLY HAZARDOUS: If possible, schedule your operations during the day and not on weekends. (W. H. King/The History of Homeopathy, 1904)

Can you remain healthy during a hospital stay? It's not as easy as you think. This column is not intended to make you run for the woods rather than seek medical attention. But by being a well-informed patient, you can decrease the risk of falling into hospital traps.

Hospital statistics may make your hair stand on end. Consumer Reports on Health states that in 1999 the Institute of Medicine (IOM) reported that, in the U.S., errors by hospital staff resulted in 100,000 deaths. In addition, 500,000 more patients were injured in hospitals.

Today, contracting hospital infections is high on the list of dangers for patients. But this has always been a problem. In 1846 when the first obstetrical hospital was opened in Vienna, one in eight pregnant women died from puerperal fever. Professor Ignacz Semmelweiss dramatically ended these deaths by demanding that doctors wash their hands after doing an autopsy and before delivering a baby.

Today several studies show that this lesson has not been fully learned. Doctors, even infectious disease specialists, often fail to wash their hands, spreading germs from one patient to another. I admit it requires a brave patient to ask a doctor to wash up before an examination. But doing so could prevent infection.

Cast a wary eye at urinary catheters if you have one following surgery. Since they often set the stage for urinary infection, the sooner they're removed the better. So ask your doctor when it will be removed, and if this is not done, ask the nurse if the order has been overlooked.

Medication errors have always been a problem. Unfortunately, preventing them is easier said than done. For instance, few patients are able to detect that a medication prescribed in grams should have been administered in milligrams. And if you have diabetes or another chronic disease, make certain your drugs are continued, as many hospitals routinely stop all medications when patients are admitted.

Give up smoking if you are scheduled for an operation. This will decrease the risk of complications from anesthesia and post-operative lung infections.

In "Wheels," a novel set in Detroit, Arthur Hailey warned his readers not to buy cars built on Mondays or Fridays. Monday cars, he said, have a bit of the weekend hangover built into them. And Friday's cars often lack nuts and bolts, which were omitted by a worker anxious to get away for the weekend.

Does "Hailey's Law" apply to surgery? If doctors were robots, it wouldn't; but they are as subject to fatigue and other factors as anyone else. So consider yourself lucky if you're assigned a time for surgery on a Tuesday morning at 8 a.m. when everyone is fresh. A Tuesday start also means you will have regular staff looking after your immediate post-operative care. Surgery on a Friday, on the other hand, usually means being cared for by weekend staff that may be short-handed.

Have you ever considered asking your surgeon for his or her autograph on the surgical site before he performs the operation? Probably not, as most physicians are not rock musicians. But this can prevent disastrous errors. Today, amputating the wrong leg or repairing a hernia on the wrong side are very rare mistakes. But it does happen. Asking the surgeon to sign his or her name on the planned surgical site can prevent it.

Don't try to be a hero if you're having post-operative pain. Patients with uncontrolled pain require longer hospital stays and have more complications. Some doctors, however, are resistant to giving adequate doses of painkillers for fear of addiction. Yet addiction does not occur when narcotics are used to ease pain and not for pleasure. Ask the doctor if pain-controlled intravenous analgesia is available. This allows you to administer your own painkiller by pushing a button on a computerized pump.

Get moving after surgery as soon as possible to prevent blood clots forming in your legs. And be kind and courteous to overworked nurses and other staff. They will return the favor.

Dr. Gifford-Jones is a medical journalist with a private medical practice in Toronto.