CONSIDERING SURGERY

http://www.adhesionrelateddisorder.com/adhesion3.html If surgery is recommended for you, it's important to know what your options are and what questions to ask your primary-care physician and surgeon. If you learn all you can, you'll be sure that you're making the right decision.
Jason Bodzin, M.D., F.A.C.S., director of the Inflammatory Bowel Disease (IBD) Institute at Sinai Hospital in Detroit, advises you to follow a four-step process:

• Examine your options. 
• Talk to your surgeon. 
• Talk to patients who have had the operation. 
• Weigh all the factors in making your decision. 

Knowing What to Ask
Before consenting to surgery, the first question you should ask is: "Is this surgery necessary, or are there other medical options that I can try?" For instance, many people with IBD have avoided surgery by combining total parenteral nutrition (intravenous feeding) with medications. 6-MP, an immunomodulator drug, often successfully heals fistulas that once required surgery.
You'll also want to know:

• Are there other surgical options? 
• What risks will I face by having the operation? 
• How will the operation improve my condition? 
• How long will my recovery take? 
• Will I require medications following surgery? 
• Whom do you recommend as a surgeon? As anesthesiologist? 

Choosing a Surgeon
Many sources can help you find a surgeon: 

• Friends, relatives, neighbors 
• Your primary-care physician 
• American Board of Medical Specialties (ABMS): (800) 776-CERT. (The ABMS can tell you whether a surgeon is board-certified.) 
• American College of Surgeons: (312) 664-4050, Ext. 391 
• The American Society of Colon and Rectal Surgeons: (708) 290-9184 
• Your local CCFA chapter 
• Your health insurance carrier 
• Your local hospital, or your state or county medical association -- all can provide lists of board-certified surgeons. 

Once you've compiled a list of two or three possible surgeons, ask the following questions about each one: 

• Is he experienced with the particular operation you need? (This is particularly important if you are undergoing a fairly new procedure, such as an ileoanal anastomosis.) 
• Does she treat many IBD patients? 
• Is he affliated with the hospital you want to be in? 
• Is she affiliated with a medical school or is she a member of its clinical faculty? 

You'll also want to know: 

• Where the surgeon trained, what his specialization is, and whether he belongs to any professional organizations or has published any professional articles. (To get this information, ask the surgeon directly or go to the library.) 
• Whether the hospital frequently performs your kind of surgery and whether the staff is well-versed in IBD.

Getting a Second Opinion:
It is always wise to get a second opinion. In fact, many insurance companies require it. Before seeking a second opinion, you may want to get copies of all your medical records. However, any physician can request these for you.
If you receive conflicting opinions, visit a third surgeon or review the situation with your primary-care physician. Though this process can be frustrating and time-consuming, it will give you peace of mind.