Sizing Up Surgery
The Value of a Second Opinion -- Is Surgery Necessary? continued...
"A certified pathologist can generally
identify 85 percent of regular tumors," Roscher says, "but if there is
a glandular difference, tumors are difficult to diagnose and often require
second and sometimes third opinions." He adds that even with the small
number of unrecognizable tissue growths, specialists need the availability of
additional resources to confirm or dispute their findings and recommendations,
such as through the California Tumor Tissue Registry, a network of qualified
professionals that was created for such specialized second opinions.
There are, however, instances when emergency
surgery is necessary in order to sustain life, such as when the diagnosis of
acute appendicitis is firmly made. In this case, surgery must be done quickly
and efficiently, and would not warrant a second opinion.
The practice of ordering routine laboratory
tests before admission for surgery is commonplace in most hospitals. Many
doctors believe that urinalysis, chest x-rays, or complete blood counts, for
example, can identify potential problems that might complicate the surgery if
not detected and treated early. Some tests commonly performed before surgery
and the symptoms that prompt doctors to order them are:
-- shortness of
breath, chest pain, cough, fever without other source, abnormal
chest pain, palpitations, arrhythmia, murmur, distant heart sound
hesitancy, discharge, side pain, kidney disease, diabetes, use of drugs known
to cause kidney disease
white blood count
suspicion of infection, use of drugs known to affect white blood cell
-- blood loss,
easy bruising, alcoholism, use of drugs known to affect platelet
-- excessive sweating
with tremor or anxiety, muscle weakness, diabetes, pancreatitis, cystic
fibrosis, altered mental status, alcoholism
diarrhea, congestive heart failure, kidney failure, muscle weakness, tissue
damage, hypertension, diabetes, use of drugs known to affect potassium
-- vomiting, diarrhea,
excessive sweating, thirst or fluid intake, pulmonary disease, central nervous
system disease, congestive heart failure, cirrhosis.
Patients facing surgery need to discuss with
their doctors the necessity of having certain tests performed prior to surgery,
says Mary Pat Couig, R.N., Associate Director for Nursing Affairs at the Food
and Drug Administration.