Contemplating a surgery

June 10, 2013

Considering a surgery is usually a difficult decision. Sometimes it helps to get very logical about it because often our emotions make us want to avoid the risks or perpetually delay the inevitable.

With joint pain problems, the surgical option under consideration can be as committing as a total joint replacement. Think knees and hips. In my experience working with patients who live with a joint that is progressing towards replacement, the pain will eventually become severe enough to disturb sleep and significantly limit your ability to do what you want physically. Many people delay addressing very painful joints because they continue to cope sufficiently enough with their limitations.

Sometimes the decision is about protecting a joint and its cartilage for the future when the joint pain isn’t really that bad at the moment. An example of this is a ligament repair for an ankle joint that has such insufficient ligament support left after too many bad sprains. Here it is a good idea to stabilize the joint as a protection against wearing out the ankle cartilage. You can be losing a lot of cartilage depth and health and not feel any pain until its quite worn through. (Ankle surgery can sometimes be avoided by sclerosing injections also called prolotherapy which can restore stability.)

Sometimes its a realignment of bone to salvage as much comfort and function as is reasonable to expect. The outcome may be shades of better. The idea of a full recovery and restoration of lost motion really may be unrealistic. I had a joint revision in mid April for my big toe joint that’s quite arthritic. It fits this category. Yes, it was hard to “decommission” myself for the 3 month recovery period.

I did have a fabulous last day of the ski season, in powder, at Vail the day before. As I skied that day, my mind was torn between the idea of canceling surgery for more skiing and secondly the strange idea that I could ski with another degree of wild abandon because if I got hurt, the week off was already planned, and I could have a different surgery if it came to that.

As I currently face another breast cancer scare, I am trying to logically think through the possibilities if I am lucky enough to not be in the category of essential surgery due to cancer. The other options are 1:) the ostrich mode of putting my head back under the sand and hoping I never face this again. Hah, this seems unlikely as I’m confronting this for the 5th time. 2:) The Angelina Jolie. My emotions get pretty strong when I consider losing my breasts by choice versus necessity. I can emotionally say I really don’t want to make any choices because it’s too hard. But, logically, I am ready to say I never want to be in this place again.

The idea of surgery for a joint improvement seems so much less stressful than this but its all a matter of perspective I suppose.

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