Operation Nation

By Tawny McCray

May 15, 2009 5 min read


Surgeries are a part of aging, but should you have one?

Tawny McCray

Creators News Service

Getting the news that you need surgery is hard to hear at any age, but the older you get, the more likely you are to need an operation.

"As we age we have accumulation of damage to our joints, so it's very common for seniors in this day and age to undergo hip, knee and other replacement operations," said Dr. Richard Allen Prinz from the American College of Surgeons in Chicago, Ill.

In addition to complications to their joints, Prinz said that as people age they are also subject to developing vascular or heart disease, so an older person may be a candidate for having peripheral vascular or cardiac surgery to increase their blood flow if stenting and medication don't help them. The chance of developing cancer also increases, so a person may be faced with needing it removed.

Prinz said that when deciding on whether to undergo any sort of surgery, no matter what the condition, the patient should discuss it with their surgeon and get the reasoning behind why they need it.

"They should enter this with an open mind, become well informed about what needs to be done and why an operation is being suggested to them," he said. "It should be clear in their discussions with their doctor what the result and outcome is likely to be. The operation is not going to make them a 20-year-old, where they're going to run the Boston marathon, so they have to have reasonable expectations about this."

Prinz added that as we age we're prone to other illnesses that can affect the results of a surgery. You should consider having a thorough pre-operative evaluation by an internist or cardiologist.

"The surgeon should want to be sure that there are no surprises and the patient is in the appropriate condition to have the operation and doesn't have to worry about other issues," Prinz said. If the medical adviser thinks that the patients' risk is too great due to underlying conditions, they shouldn't proceed.

Dr. Walter Pofahl, chief of laparoscopic, gastrointestinal and endocrine surgery at the Brody School of Medicine at East Carolina University, said that some major things to consider when contemplating an operation are whether it will improve your quality of life, increase longevity and diminish pain.

He added that age in and of itself is a minor factor in determining whether a person should go ahead with surgery and agreed that the underlying factors play a large role in making the decision to operate.

"There are plenty of 80- and 90-year-olds that are exceptionally healthy, fit and active," Pofahl said. "And conversely there are plenty of 50-year-olds who physiologically are much older, who have severe heart and lung problems."

There is a big difference between how older patients and younger patients handle elective surgery versus emergency surgery.

"The percentage of operations that are performed as an emergency operation amongst elderly patients is much higher than it is in younger patients," he said. "And the rate of complication and death in emergency operations is much higher. For most elective operations, elderly patients do almost as well as younger patients, so from that standpoint it's always good to try and do an elective operation."

Prinz said that the number of seniors having surgery has increased over the past two decades due partially to the great strides in the medical field.

"The medical field has been willing to operate on seniors more because we have better all-around care -- the pre-operative care, the anesthetic care, the post-operative care and the intensive care are all much better than they were," he said. "Surgeons and seniors have seen seniors do well after their operations and consequently the surgeons are willing to recommend it and the patients are willing to accept it."

The rate of seniors undergoing surgery has also increased, Prinz said, because seniors expect to live a longer, more fulfilling life.

"As our population has aged they become more active, they expect more from their life. They want to enjoy their retirement, not sit at home with a hip or other joint pain that prevents them from getting around," he said. "And if they develop a cancer they want the best possible treatment so they can have a chance for a cure."

Prinz concluded that seniors are also often inspired to have surgery done after hearing about someone else in their age group having it done.

"They'll be with their peer group and someone will say how much better their life is now that they've had this operation and their cancer was cured by removing their colon or this, that and the other," he said.

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