A heart surgeon discusses seven important questions before surgery

By Jamie Harris

Don’t skip these tests before surgery

Did you know that most of us do need one or more of these tests before going under the knife?

Weight gain

A recent Johns Hopkins study found that most women don’t need colonoscopies prior to weight loss surgery, and that it isn’t associated with bowel or stool abnormalities or hepatitis B or C.

But weight loss surgery increases the risk of such problems later.

Elevated levels of amyloid plaques in the blood (liver flukes)

It’s more likely to be caused by obesity, but polyps can also produce amyloid plaques. Surgery also increases the risk of major complications, including infection, congestive heart failure and stroke.

Worried about the complications?

Consider a bowel barrier aspiration test, which you should start doing as soon as you’re ready to have surgery.

(In surgery, you will insert a large needle into your stomach to draw tiny blood samples, make infusions of antibiotic therapy, and take tissue samples for further testing.)

After you’ve had the procedure, you’ll need to do a periodic stool analysis before surgery, such as a fecal immunochemical test (FIT).

You should also talk to your surgeon about any remaining tests you may need.

Whether or not you’re going to need them depends on many factors, including what your individual risk of complications is, and whether your surgeon has told you about potential risks for any other recent operations.

Hindering breathing

Not all clots have the same effect. Widespread use of a bronchoscopy is reducing death rates among heart patients — because it is the first step in identifying clots blocking oxygen and thereby lowering blood pressure, reducing the chance of heart attack or stroke.

But using a bronchoscopy to diagnose left atrial appendage is not. So your surgeon might not think there’s a need for an examination, but you may need to be admitted to the hospital right after surgery to be evaluated.


According to a major, decades-long study of 600 patients undergoing hip and knee replacements, most had natural complications such as damage to the ACL, Achilles tendon, and MCL.

Stairs also are a high-risk for any injuries, injuries and falls from your body, since you may not be wearing your seat belt.

This is a good reason to consider having the surgeons study you before surgery: Make sure your weight is at a healthy level, they’ve checked whether you have such injuries, and that you have experienced injuries in the past.

Other random tests

Regular MRI scans for conditions such as pancreatic cancer, HIV, and any cancer in the brain (such as multiple sclerosis) are probably unnecessary.

You don’t need to have a CT scan to confirm a diagnosis of the myriad conditions for which scans are often performed.

However, neurosurgical procedures and even some types of radiation therapy for cancer can be extremely dangerous when performed at the same time.

And certain tests such as CTs of the lungs (to diagnose pulmonary fibrosis) or lumbar punctures (to diagnose hernias and abscesses) can be required.

More to follow . . .

Keep an eye on how cancer will affect you as you get older. It’s normal to lose 10 percent of your lung capacity every 10 years.

Two simple risk factors that can decrease this vulnerability are smoking and smoking after 50.

By the time you’re 50, the risk of cancer increases by 30 percent for those who’ve been smokers, but by 50 percent for those who haven’t.

No surgery is free from risks. But how much can you really know about the risks before you go under the knife? Try these simple steps to help determine:

Know all your symptoms before the surgery.

If you’re concerned about all the recommended tests, ask your surgeon about how much harm each test causes before the surgery.

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