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Dr Galichia
Joseph P. Galichia, MD is the founder and Medical Director of the Galichia Medical Group, PA. He is an internationally recognized pioneer in the field of interventional cardiology. In the 70's, Dr. Galichia studied in Zurich, Switzerland with the inventors of the balloon angioplasty technique for treating heart disease. As a result of his experience, he was able to bring this historic technique back to the United States where he was one of the first physicians to perform coronary angioplasty here. A noted medical spokesman, he appears on a weekly Newstalk segment on KWCH Channel 12 and has a weekly syndicated radio talk show on KNSS 1330 AM every Saturday live from 11:00 am to noon. Dr. Galichia may be contacted by sending an e-mail to service@galichia.com
Health & Medicine
2007-12-01 10:04:00
What is appropriate surgical clearance?
Answer: Surgical specialists are very adamant these days about establishing that a patient who is about to have any surgical procedure is assessed prior to their procedure regarding surgical risk. Doctors such as urologists, plastic surgeons, orthopedic surgeons, general surgeons and many others feel that it’s necessary to have a thorough evaluation of the patient who is about to have an elective procedure by a physician with sound knowledge and experience in general medicine. In short, specialized physicians are asking for assistance in evaluating the surgical risk of the patient. This has become a standard first step in surgical protocol which did not exist 20 to 30 years ago. Furthermore, the age range in which patients are risk evaluated prior to surgical procedures has fallen greatly and around the country is averaging 40 years of age. Patients below the age of 40 may often have a surgical procedure without a thorough medical evaluation prior to surgery. As we become more sub-specialized in medicine, we also understand the limitations within the specialty. Doctors particularly who are doing elective surgery want to make certain that the patient they’re dealing with is capable of undergoing their procedure. It is not always possible to assure that a patient is well and fine and can indeed have whatever procedure has been scheduled. Nevertheless, knowing what risks one might incur and how to deal with these risks is important for the surgeon. Furthermore, a patient’s family physician should always be informed of what surgeries are being planned since they often have special knowledge about their patients which is critical in preventing complications. An example may be a patient who “feels fine” but really has an underlying cardiovascular problem that needs to be dealt with. Often the patient is not totally aware of the magnitude of the problem or what subtleties may occur during a surgical procedure. At that point, thorough knowledge of all potential problems has to be undertaken. This often will consist of some very basic testing such as a good physical exam, a chest x-ray, an EKG or quite possibly a stress EKG and some basic lab work to make certain the kidney functions and other laboratory parameters are within normal range Long gone are the days when a surgeon would whisk a patient to surgery and “hope for the best”. No physician wants to be part of a medical disaster such as Kanye West’s mother experienced at the early age of 58. Many patients will undergo elective procedures because they are strongly indicated and yet also be at significant risk because of underlying health problems. More and more however, we are able to deal with these problems, minimize the risk and get the patient through surgery. This requires a team effort and may in fact necessitate other consultations leading up to the surgical procedure. The post operative care, likewise, is a team effort and is best accomplished with an “eyes wide open” approach. Through the years, surgical outcomes have improved in virtually every surgical procedure. This is a result of thorough preoperative evaluations and attentive postoperative care of patients who are at risk.
 
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