What are some of the good questions to ask a surgeon prior to surgery, and what are some questions that are still relevant after your surgery?
Welcome back to The Hip Replacement Podcast. And today, we're gonna talk about questions to ask a surgeon before your surgery.
Now whether it's actually before your surgery and you need to go in and talk to a surgeon or it's after your surgery, it doesn't really matter because these questions and the answers are still relevant to you and can still help you as you move forward through the surgery process and your initial recovery.
Now when I went into my surgeries, my first surgery, I was absolutely terrified. I've talked about that in length before, but I had all kinds of questions. To me, I was in unchartered territory because I was so young and because I really didn't know anybody who had hip replacement surgery.
So I was pretty scared, and I went to see three different surgeons. Alright? And then after seeing three different surgeons, I circled back and went to the first one for another appointment and asked another round of questions. So I essentially had four bites of the apple. Three different surgeons that I saw to explore having hip replacement surgery or to get second and third opinions as to whether or not I needed a hip replacement surgery.
So I asked all these questions of three different surgeons, and then I went back to the first one, and I asked them again and probably asked different questions. So I had a lot of things on my mind and a lot of things I needed to get as comfortable as I possibly could before actually moving forward.
And it's not about, if you're past surgery and you didn't ask these questions, it's not about asking the questions that gets you the results that you want. These are just words. These things that you have with the surgeon, they're just words. It's just a conversation. It doesn't impact the long term outcome of your hip.
So if you miss these questions, don't worry about it. It's your approach to the whole process that makes the difference. What you do after the surgery, not what you talk about. And you have a lot of control over the outcome. And because you have control over what you do after and what your approach is, you can still have great outcomes regardless of you asking these questions and getting these answers.
So don't worry about it if you didn't get these when you were talking to your surgeon.
And even if you still have these questions, maybe it's a few days, maybe it's a few weeks, maybe it's a few months after your surgery. If you still have some of these questions, go back and ask the surgeon. Call them. Hopefully, they'll give you the time that you need to get your questions answered.
And even if it's been a long time since your surgery, some of these are still gonna be relevant. And addressing them may boost your health and the ability to enjoy your hip and have the best lifestyle following your hip replacement surgery.
So don't worry about missing the questions initially when you first talk to your surgeon, not your surgeon, when you first talk to a surgeon, because the information can come later. Or if it doesn't come at all, it's not really gonna change the outcome of your hip replacement surgery and your initial recovery. So don't worry about it.
But a couple points first before we get into all of these questions.
In the US and a lot of other countries, we have a choice of doctors. We have a choice of surgeons. And when you visit a surgeon, and this is what a lot of people get wrong, when you visit a surgeon or any doctor, you are interviewing that surgeon or that doctor.
You're not only going in to see the surgeon or the doctor for that person to diagnose your issue and give you a treatment plan, this is a two way street in most countries. You have the opportunity, and you're there really to interview that person, interview that surgeon, interview that doctor to make sure this is what you want, to make sure the treatment plan that they suggest is something that you agree with, that you want to go forward in.
And if they're not giving you the answers that you need to hear or the answers that make you feel comfortable, you can simply go and get another opinion, or go interview another doctor or a surgeon. You have that power.
Now, again, in some countries around the world, you don't have that choice. You simply get told you're on a surgery schedule, take it or leave it. But, again, a lot of countries, you have that ability to go and check out which surgeon you really want to use.
And notice what's really going on here. When you go in and talk to a surgeon and you decide whether or not to move forward with that surgeon, you have an incredible amount of power because you are controlling almost the whole process.
You're deciding based on your decision to go with a certain surgeon. You're deciding on which approach they take, which materials are used, and your level of physical therapy. Because when you select a surgeon, all of those other decisions are then followed up with the surgeon. Because a certain surgeon will use this approach, they'll use this material, and they'll have this belief on physical therapy.
But if you control which surgeon you use, you are indirectly deciding all of those. So that initial conversation with the surgeon, that initial meeting where you should be interviewing the surgeon, you decide all of this stuff.
And that can have a lasting impact on the rest of your life.
So it's incredibly important to when you go in to see a surgeon, note that this person, this surgeon is not your surgeon. This is a surgeon you are going to see. Maybe you hire them to do the surgery, maybe you don't. But don't have the mindset that you're going to, you have to use the first surgeon that you go see and that this is your surgeon because that is not the case at all.
And let me give you an example. Of course, I went to see three different surgeons before my hip replacement surgery, and I could have gone with any one of them. But I went back to the one who was seemed the most interested to get me back to the most active lifestyle I possibly could. And he used the materials that I thought would give me the best opportunity to have the active lifestyle that I wanted.
Let me give you another example. Years before I did my Ironman triathlons, I went to see a heart doctor just to get my heart checked out, do the stress test, do further tests, and it was a series of multiple visits to the heart doctor. Alright?
And after the first visit, I did the stress test on the treadmill and, you know, they put the EKG on me and looked at my heart, and I was supposed to come back a few weeks later.
And during that initial visit, I didn't really like that doctor. He had all kinds of diplomas on the walls. He had news articles about how highly rated he was, but still the decision to go with that doctor was mine. I didn't like his bedside manner. I didn't like his attitude. I didn't like his arrogance.
So when I went in for my next visit and he was an hour late, I simply asked my medical records. I walked out with a folder, and I went to see a different doctor. It's that simple.
The doctor doesn't control the relationship with you. You control the relationship with the doctor. So keep that in mind. Alright? Ask as many questions as you want.
Now third thing I wanna address just overall about this episode is that I'll go over questions to ask, helpful questions to ask, but then I'll also talk about a few what I would consider useless questions at the end of this episode.
Sometimes we ask these questions. I see a lot of these questions pop up on social media, but I think they're useless questions, and I'll talk about those at the end.
But first, let's talk about helpful questions to ask a surgeon when you go in for your initial meeting or consultation or whatever you wanna call it.
Okay. Question one. What's the difference between posterior and anterior surgeries? That's a big question. You should know where you're gonna get cut.
A follow-up question to that is, what is your preferred method, mister or missus surgeon, the posterior or anterior, and why?
Each of the surgeons is gonna use a different approach. They're not gonna use two different approaches on you at the same time. They're going to use one. Why is that?
Each has different recovery periods. Each has different risks. Understand which surgery you may have with this surgeon, and you make the decision.
Next question to ask. How much of your practice, mister or missus surgeon, is hip replacement surgeries? And approximately how many hip replacements do you perform each year?
You're basically asking, how experienced are you in this particular area, in this particular field of medicine, in this particular joint? Are hips their full time practice, or do they do them occasionally? Do they mostly do shoulders and they do hips on the side, or are they one hundred percent hips?
Also, you're getting at the question of, does this surgeon have a reputation for doing hips that they want to protect? That is their bread and butter. That is what they do and what they're a specialist in.
I would prefer to go to a surgeon who has a specialty in this particular thing rather than a surgeon who does a lot of different things and also hips.
Next question. What are some of the complications and what are your revision rates for hip replacements?
So you're basically asking, do you see a lot of infections, dislocations, blood clots, leg length differences, fractures during the surgery, fractures of the femur during surgery? And how many of the surgeries that you do have to be redone? Basically asking if they make mistakes or what kind of complications they see.
Next question. This is a big one. This is the one you have a lot of control over by selecting a specific surgeon.
What implant components do you plan to use on me, and why are you choosing those components?
Maybe they're using those components because they've always used those components. Maybe they use those components because they're cutting edge. They're stronger. They're more reliable. They have a steady supply. They're easy to get replacement parts for in the future.
All important questions to ask about what type of components are going to go into your body.
And by the way, I mean, this might scare you, but if you were to do an Internet search about how many different companies make hip replacement components, you may be a little bit shocked to find out how many that there are dozens and dozens of companies that make components used in hip replacements.
Some of them have to be better than the others. They have to use different materials. Otherwise, why have so many if they're all gonna be the same?
Asking that question about what types of components are going to be used is important to your long term health.
Another question to ask is, what are some of the biggest risks for me as a patient, and what can I do as a patient, or what can you do as a surgeon to help reduce those risks?
There's factors such as smoking, diabetes, weight, and overall health that the patient can control if they're made aware of, and maybe the surgeon will advise you on reducing those risks that you control.
But also the surgeon can do things or their process can do things like making sure the area is disinfected, making sure you take antibiotics when you need to take them, making sure that you have pain medication. Okay?
So there's a lot of things that both sides can do, the surgeon and the patient, to help reduce risk factors.
Next question. What should I realistically expect to be able to do after this hip replacement?
Whatever the activity is. Walking? Can I do stairs? Can I exercise? Can I golf? Can I cycle? Can I do yoga? And to what intensity level are we talking about?
So ask the surgeon about the activity that matters to you and talk about that intensity level.
If you used to do yoga on a scale of one to ten, where ten being the most active, the highest level, will you only be able to do yoga to a four or five?
Maybe you ride motorcycles and you can only ride bikes after that. Maybe you're a bull rider. Can I still ride bulls to a level of ten intensity, or do I have to ride cheap to an intensity of two?
That's a basic question to really understand what the surgeon would have in mind for you after your surgery.
Next question. How long am I gonna be in the hospital after surgery? And if I'm not staying overnight, why not? Isn't that a safer place for me to be for the medical team to keep an eye on me?
Some surgeons like to send you home the same day. Some like to keep you overnight. Understand which one the surgeon would prefer for you and why.
Next question. What is the pain management plan after surgery? And who do I contact after hours if the medication isn't working or if I have a problem?
This is a major issue for me. I needed to change my pain medication the day I came home from surgery. The day I stayed overnight in the hospital and I came home the next day, but that night, the medication, the prescription that they gave me wasn't working for me, and I had a phone number to call to get a different pain medication prescribed.
You need to understand if you're gonna have that possibility of changing your pain medication if needed.
Next question. When am I coming back for a follow-up appointment? Or are you sending me home for a month or two months or never gonna see me again?
When I got home, when I left the hospital, I did not have an appointment with the surgeon for a week. And then a week after that. So I had two appointments within two weeks. One week and then one week later.
Now I thought that seemed like an awful long time. Maybe that was standard. But being at home for a week wondering if everything was okay seemed like a long time to me. It seemed like those seven days took a long time before going back to see the surgeon to get his approval or confirmation that everything was going fine.
So just know when your appointment's gonna be.
Next question. What's your approach to physical therapy? When would it start? How long? And if you don't prefer physical therapy, if you don't prescribe physical therapy, if you don't like physical therapy, why not?
Every surgeon is gonna have a reason why they like physical therapy for their patients or why they don't. So just ask them why they don't, or when can you start, and how long it will be.
Next question. How to break up the scar tissue?
Because the tissue around the incision is gonna get stiff. It's gonna feel awkward. It's gonna feel like it's maybe taped or glued together on the inside.
How can you break that up over time so that the muscles and tissue become more flexible and I don't know, malleable or subtle?
How to break that up?
Next question. Are there any vitamins, nutrients, or other supplements I should be taking before surgery or after to help my body heal?
The body's gonna go through a huge amount of stress in the surgery and in the initial recovery. What types of vitamins and nutrients or supplements should I be taking?
It's possible your surgeon doesn't recommend anything. It's possible they do. Ask them.
When can I start to drive?
You're probably gonna wanna get out and be mobile, or you're gonna need to get out and be mobile. How long is that gonna take?
Probably all depends on which leg had the surgery and which country you're in because what side the accelerator or the gas pedal is on and the brakes are on.
Next question. How long will the bandage or the dressing be on?
My dressing was on for two weeks, and I did not replace the bandage until I went for my first appointment at the surgeon a week later.
It felt like a little bit long to me. I wanted to take it off and see if everything was okay before I went to the surgeon, but I was advised not to. So ask how long the dressing or the bandage will be on.
Next question. When can I take a shower and how to take care of the dressing or bandage while in the shower?
I was advised that the bandage or the dressing was totally waterproof and to take a shower.
I didn't really believe him, so I covered it up with plastic wrap and waterproof tape because I tell you what, after the surgery, when you're at home or wherever you are, it's the little things that make a huge difference.
The little things that just give you a boost of hope, a boost of sunshine, if you will.
And taking a shower is one of those things that could give you a major boost in your attitude, in your mood, in the way you feel about how things are progressing.
So ask about taking a shower and how to do it safely with the dressing and also how not to slip and fall.
Next question. Will I have any pain after my hip replacement? What about months or years later?
So a lot of people have pain, and it could be coming from a lot of different areas. The muscles around the hip, the back, the other side, the other leg, the other knee, the other hip, the knee on the same side.
And maybe the surgeon will give you some ideas about, hey, you may have these pains, and this is how you would address it, or this is who you would need to contact when you have those aches and pains come up.
I think it's probably a little bit unrealistic if you're advised that you're not gonna have any pain whatsoever anymore ever in your life because of the hip replacement surgery.
So ask about pain from the hip, the muscles, or other joints, or your back in the body.
Alright? So we covered those were seventeen total questions that we covered to ask a surgeon when you're having your initial consultation. Maybe you cannot get to them all, but getting some of those answers will help you.
Now I just wanna briefly address a couple questions that people may ask. Either ask their surgeon or ask on social media, and I'm not really sure that they have a lot of value. Okay? Unless you have a further, a deeper conversation.
Let me give an example.
Here's a question I don't think is really relevant or really helpful. Can I return to my activities?
Well, this is a deep discussion. This is not a short answer. I think you'd probably get an absolute yes. You can return your activities.
But you need to understand, the surgeon needs to understand what activities are we talking about, and what's the surgeon's risk tolerance.
Does a surgeon believe in skydiving, rowing, riding motorcycles? If they have that approach, then they may be more willing to say, yeah, go ahead and do it. Live your life on the one hand.
But if they're conservative, if they're risk averse, they may advise against that.
There's no right or wrong answer. People live their lives.
So having a discussion of can I return to my activities is probably needed rather than a simple question of can I return to my activities because there's a lot more to talk about.
Because you need to understand the context of what activities, what the risk tolerance is, maybe your age?
So when I went into my first surgery, I was in my late thirties. I was in a much different position than somebody who would be, let's say, in their seventies because I need to take care of my hip. Let's be honest. I need to take care of my hip a lot longer than someone who is in their seventies.
So maybe I need to be more risk averse than someone else. Maybe not be the best answer, but it's realistic.
Next question that I'm not sure is really relevant or really an accurate question to help a decision being made.
Which method is better? The anterior or the posterior?
Every surgeon is going to do the surgery a different way, whether anterior or posterior or some other method. They're going to pitch what they do, which is reasonable.
Imagine you have two restaurants. You have a restaurant that serves steak, and you have a restaurant that serves seafood.
If you were to go into the steak restaurant, they're going to pitch steak. If you go into the seafood restaurant, they're going to pitch seafood.
So by going into a surgeon who does the posterior approach, we should expect them to talk up the posterior approach. If you go in to see a surgeon that does the anterior approach, we should expect them to talk up the anterior approach.
So just understand that the question of which method is better, the anterior or the posterior, may depend upon the surgeon you're talking to, your age, your location around the world, a lot of different factors. What you expect from a hip replacement surgery, the surgeon's specialty, the surgeon's expertise.
Alright. So that's a deep question. The initial question of what's better posterior anterior may not do that ultimate question justice.
Third question, maybe a little bit irrelevant or needs a longer discussion.
How long is the recovery? How long is this going to take?
And if you think about it, that is the equivalent of if you've ever gone on a road trip, and you have kids in the back seat, and the kids are asking, are we there yet? Have we reached our destination yet?
The answer is probably no. We're not there yet. We still have a ways to go.
So the question of how long is the recovery is really an open ended question because we need to understand what do you mean by recovery, and what do you want out of your new hip?
Do you simply want to be able to walk half a mile, or do you want an incredible recovery where you're pain free, you want full mobility, you want to do everything that you could do if you never had or never needed a hip replacement in the first place?
Those are two different recoveries by far.
So when you say how long is it gonna take, we need to identify what you want. If you want less, you'll get there faster. If you want more, it's going to take more time.
Make sense?
Next question. What type of anesthesia are you gonna use?
Now the surgeon's job is to replace the damaged joint, and most of them are incredibly good at that.
There is another doctor in the room, the anesthesiologist, that controls the anesthesia. And the specific question of what anesthesia are you going to use belongs to the anesthesiologist.
So I had a general conversation with the surgeon that I went to see who is going to perform the surgery about anesthesia. And he said, probably this, but we're gonna leave that to the specialist, the anesthesiologist.
I didn't find out what would be used until the morning of surgery when I'm laying in the bed, the IV is in my arm, and the anesthesiologist walked in and told me what he was going to use.
And since I had two different surgeries a year and a half apart, I had two different anesthesiologists who used two different methods.
And if I would have asked the surgeon that during my initial meeting with him, he would not have been able to answer.
So the question of which anesthesia is best served to the anesthesiologist the day of the surgery, or if you can talk to them before, you could have that conversation with that doctor.
So I hope these questions help. We talked about questions to ask, questions maybe not to ask, or you need follow-up because the discussion's bigger than a simple question.
But overall, don't just walk into a surgeon's office with the mindset that you're only there for the surgeon to evaluate you. It's not a one way street. It's a two way street. You're also there evaluating the surgeon.
When you think about it, you're potentially giving the person, the surgeon, permission to cut you open, remove part of your body, and install an artificial joint that you'll probably live with for decades.
So it's completely reasonable to ask tough questions before you say yes to this, before you commit to this.
So I hope these questions were helpful, and I wanna hear from you.
What's one question you're gonna ask a surgeon or one question that you wished you asked a surgeon prior to your surgery?
If you're watching on YouTube, tell me your answer in the comments below. And if you're listening on the podcast platform, go to the show notes, click on the link to the podcast page, and send me a message through the contact form.
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Thanks so much for tuning in to The Hip Replacement Podcast. Until next time, I wish you the best recovery possible. Take care.
