Decisions, decisions, decisions: Measure twice, cut once

Today someone asked me a great question, and I felt like it warranted a blog post. So, it's getting a blog post!

"Burt, what's your decision-making process for having surgery?"

My decisions on whether or not to have surgery are based on a few things.

First, can my body handle it?

• I am trying to be very in touch with myself. This is one of the lessons I've learned over the past year. Even as my surgeon says, My body and I know better than anyone what's right for me and when

• I actually ask my body (literally), and think a lot about it - does this feel right?

  • Try asking yourself and really listening to your body, it's pretty amazing and life-changing. I owe Krista (my wife) a lot for teaching me to do this and how.

• Quick examples

  1. Example One - Internal Bleeding

     1. Last summer when I was in the hospital I had a lot of procedures to try and figure out why I was bleeding and to stop it. I had upper endoscopies, Interventional radiology, and other types.

     2. One day, a generalist (or a Hospitalist) came in and told me they wanted to order an upper endoscopy (UE) to see if my bleeding had stopped. I felt my body tense and felt myself screaming on the inside that getting another UE was a horrible idea, would do more damage than good, and would be a real risk

     3. I told the hospitalist "no". The next day, a GI Specialist came into the room and confirmed that the test was a bad idea for me

  2. Example Two (current) - Getting the Pancreas Surgery

     1. I had liver surgery on June 9. They were going to do the liver and gall bladder (they did both) and if I could handle it, remove the tumor on the tail of my pancreas and my spleen. I lost too much blood from the liver part so they didn't do part two

     2. When I saw my surgeon post-op, he told me to call him when I was ready for the pancreas surgery

     3. Again, I asked my body. My body screamed "not now" at me. I have had two surgeries since April (and the june one had complications) and have gone through a ton in the past year. My body can't handle another surgery right now. It told me and I am listening.

     4. Will it happen in the future? Most likely. But not til I feel like I can handle it. The risks of having a procedure that my body is not ready for are greater than the risks of waiting (as far as I know now, that can obviously change)

Second, are there alternatives?

• Does my medical team feel like I have to do this and why? I kind of need them to "sell" me on why I need to get it done. I don't do things just because and I need to understand the whys.

• Can I get radiation, localized robotic procedures, or go back on chemo instead of surgery? Are there other existing treatments that we can use instead?

• If I make a list of XX number of options to help me solve my problem, what's on the list and what # is surgery on the priority scale?

• Can I get into a clinical trial? Or try a newer treatment method?

Third, will it extend my life or improve my quality of life?

• This is a big one and maybe the hardest to answer. They can give you broad guesses based on "most people" but we are all individuals and what works for one might not work for another.

• What will I lose or gain from having it?

Fourth, What are the risks besides the objective of the surgery itself?

• For example, if I have a pancreas surgery that has its own risks to the pancreas.

• But, surgeries carry risks for blood loss, heart attack, stroke, IV issues, hospital stay issues, etc

• Are all of those risks worth it? People generally only discuss risks with the procedure, not the general risks that come from having surgery

Fifth, is the financial impact due to insurance coverage

• If I get the surgery this calendar year, is it covered?

• If I get it next year, am I still paying for it with my deductible?

• I hate that we have to think about this but we do

So overall, thanks to the person who asked me the question. It really made me think about my process, what matters to me, what's important to me, etc. At the end of the day, like anything else, you know best. Trust yourself, do the research you need to do to make your decisions, and remember that you are always in control!