Great Expectations- But Let’s be Realistic

Great Expectations- But Let’s be Realistic

Great Expectations- But Let’s be Realistic

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We see so many patients who have already had surgery somewhere else and are disappointed in the outcome. They have unresolved numbness, pain or weakness after extensive surgery and feel they should be doing much better. Their expectations have not been met.

Let’s talk….

For most of us, if we are recommending surgery to a patient, we want them to feel comfortable and confident going into the operating room. Yes, this is important but it may raise expectations to an unreasonable level. That, and marketing techniques of “back to work in three days” or billboards showing a twenty year old running down the beach, with a band-aid on her back, create an unrealistic goal for both the surgeon and the patient. Trust me, if the patient is not happy, neither is the surgeon, unless he/she is oblivious of their actual outcomes.

Back surgery has made great progress over the last few years. Minimally invasive surgery has led to smaller incisions and quicker recoveries, but it’s still spine surgery. The actual diagnosis of herniated disc, spinal stenosis, spondylosis etc. did not change. Many of these spine injuries, or diseases, cause irreparable harm such as nerve or spinal cord injury that no minimally invasive (or open for that matter) surgery can fix. Sometimes the goal is only to keep things from getting worse. Patients need to be aware of the realistic outcome expected.

Also comes the question of how much a surgeon has to do to make a patient’s life improve. Do you do a big three level fusion on someone who is older, inactive or sedentary; or do you do a simple decompressive surgery that will relieve pain and be easier to recover from? They may never go in a marathon, but that wasn’t the plan anyway.

We need to give proper information to our patients. We cannot give a sixty year old a twenty year old back. There is often residual numbness after a nerve has been compressed for a long time. It might get better the day of surgery, in the next six months, or never. Everyone reacts differently to pain medications and pain itself, so we can’t be sure what we order for you is exactly what you need. You may not need any. There is a chance a second surgery may be needed down the road. We can give you percentages of likelihood but nothing absolute. All we can do is go by the patients history, the seriousness of the problem, the length of time there has been symptoms, and the surgery being done.

As a patient, ASK! What can I expect from this surgery? What is the plan if I don’t get better? Are we making me better or preventing me from getting worse? How long before I can expect some positive results?

Unrealistic expectations don’t do anyone a favor. An informed patient is one who doesn’t expect miracles and has the patience to get better under a realistic timeline.

Citations

  • Cole BJ, Cotter EJ, Wang KC, Davey A. Patient Understanding, Expectations, and Satisfaction Regarding Rotator Cuff Injuries and Surgical Management. Arthroscopy. 2017 May 9; PubMed PMID: 28499920

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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