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October 23, 2013

Consumer Reports: Surgery savvy — lower your risk

If you're facing surgery, you no doubt want to do all you can to prepare. But according to Consumer Reports on Health, many of the things that patients are told to do, including some their doctor may recommend, aren't necessary and can even cause harm.

For example, many doctors routinely order a battery of preoperative tests, including blood analyses, chest X-rays and cardiac stress tests. But when they are done just to "clear" you for surgery, with little regard to the type of surgery, the kind of anesthesia that will be used or your overall health, they're more likely to cause potentially harmful false alarms than keep you safe, current research shows.

Similarly, patients are still often told to avoid food and drink for 12 hours or more before surgery. But revised guidelines are more flexible; they take into account the fact that fasting too long can stress the body and slow recovery.

Consumer Reports on Health recommends the following steps to help speed your recovery from surgery:

Don't get overtested. Ordering preoperative tests when they aren't necessary can lead to trouble. For example, some doctors order cardiac stress tests even for low-risk patients before minor surgery. But abnormal results can lead to angiography, a test that exposes people to radiation. And if that test detects a blockage in an artery, doctors might treat it with a stent, even though the artery wasn't causing symptoms. The stent procedure must be followed by the prolonged use of a blood-thinning drug, which can make surgery riskier or delay it for up to a year. If your doctor can't give a clear reason for a preoperative test, say you want to skip it.

Eat well. Doctors have long advised patients not to eat or drink anything after midnight before morning surgery because of the risk of regurgitating stomach contents into the lungs. But such fasting impairs the body's ability to recover from complications. The American Society of Anesthesiologists says that healthy people can have clear liquids up to 2 hours before most surgeries and a light meal up to 6 hours beforehand.

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