A lot of women walk out of the appointment where surgery first comes up with a folded handout and very few answers. The questions show up later, usually in the car or at two in the morning. Sharon Breit, MD, FACOG, has been on the other side of that conversation for 34 years as an obstetrician-gynecologist in Wichita, Kansas, and she’d much rather patients ask them in the exam room.
Dr. Breit performs laparoscopic and hysteroscopic procedures and is trained in robotic surgery, including robotic hysterectomy. She doesn’t expect patients to know the vocabulary. She does expect them to ask until the plan makes sense. Here are the questions she thinks are worth bringing to that visit.
Start With the Diagnosis
Before anyone talks about how to operate, it helps to know exactly what’s being treated. Ask your doctor to explain the diagnosis in plain language and to tell you what it’s based on. Was it an ultrasound or a biopsy, or is it an educated guess that still needs confirming?
That last one matters more than people think. Some conditions are confirmed before surgery. Others are only fully understood once the surgeon can see inside. If you’re in the second group, you’ll want to know what might change once the procedure starts, and what your doctor would do if the picture turns out different than expected.
Ask What Happens If You Wait
Not every gynecologic problem needs an operation right away. Some can be managed with medication or monitoring, at least for a while. So ask it directly: what are my options other than surgery, and what happens if I wait six months?
Sharon Breit takes an individualized approach to treatment, and this is where it shows. The right answer depends on the patient’s symptoms and whether she’s thinking about a future pregnancy. A good surgeon won’t flinch at the question. If the honest answer is that waiting is reasonable, you should hear that. If waiting carries real risk, you should hear that too.
Get Specific About the Approach
If surgery is the right call, the next question is how it’ll be done. This is the part where the vocabulary gets thick, so here’s a rough guide.
Hysteroscopic procedures use a thin, lighted instrument passed through the cervix to view and treat the inside of the uterus. There’s no abdominal incision at all. Laparoscopic procedures use a few small incisions in the abdomen and a camera that guides the surgeon’s instruments. Robotic-assisted surgery is a form of minimally invasive surgery in which the surgeon controls robotic instruments through small incisions, and robotic hysterectomy is one example. Some cases still call for open abdominal surgery with a larger incision.
Ask which approach your doctor recommends for you and why. If a minimally invasive option isn’t on the table, ask what rules it out. And it’s completely fair to ask how often your surgeon does this particular procedure. Most surgeons expect that question. The good ones don’t mind it.
Talk Through the Risks and the Benefits
Every operation carries some risk. Your doctor should go over the general ones, like bleeding or a reaction to anesthesia, and then the ones that apply to your procedure and your health in particular.
The benefits deserve the same attention, and they’re easy to skip past. Which symptoms should improve? Is this likely to fix the problem for good, or could it come back? Patients who know what to expect tend to feel better about the decision afterward, even when recovery is slow.
If the procedure could affect fertility or hormone levels, bring that up yourself. For women approaching or in perimenopause, an operation that involves the ovaries can change the timing and feel of menopause. Helping patients through perimenopause and menopause is one of Dr. Breit’s clinical interests, and she treats those questions as part of surgical planning from the start.
Find Out What Recovery Will Really Look Like
Recovery is where people tend to feel the least prepared. Before the day of surgery, ask whether it’s an outpatient procedure or an overnight stay. Ask when you’ll be able to drive and when you can go back to work. Ask about lifting limits, since that one catches a lot of people off guard when they try to pick up a toddler or a laundry basket.
It also helps to ask which symptoms mean you should call the office right away and when your follow-up visit is. Knowing that ahead of time makes it easier to line up rides and time off. It also makes the first few days at home a lot less nerve-racking, because you’ll know what’s normal.
Bring Your Own History Into the Room
Some of the most useful information in that appointment comes from you. Your surgeon needs your full medical history, including any bad reaction you’ve had to anesthesia in the past. Bring a list of your medications and supplements, too, because people forget the ones they take every day.
Family history counts too. Identifying women at increased risk for hereditary breast and ovarian cancers is another of Sharon Breit’s clinical interests. If close relatives have had either cancer, say so. It can change which tests make sense and, in some cases, the surgical plan itself.
How Sharon Breit Approaches the Conversation
Dr. Breit’s path to medicine started at the bedside. She earned her nursing degree from Wichita State University and worked as a labor and delivery nurse at Wesley Medical Center in Wichita and later at Lawrence Memorial Hospital before earning her medical degree from the University of Kansas School of Medicine in 1988. She finished her residency in obstetrics and gynecology at Washington University in St. Louis in 1992.
Those nursing years shaped how she listens. Ask her what she’s proudest of and she’ll point first to being a caring and compassionate physician, which probably sounds like a stock answer until you notice how much of her approach depends on patients feeling free to ask the awkward question.
If you leave a pre-surgical visit still unsure why surgery is the recommendation, schedule another visit or get a second opinion. Surgeons hear that request all the time, and a decision you understand is worth the extra week.
Readers can learn more about Dr. Breit’s practice at SharonBreitOBGYN.com and through her profiles on MediFind, HealthLynked and F6S.
Dr. Sharon Breit, MD, FACOG, is an obstetrician-gynecologist in Wichita, Kansas, with 34 years of experience and more than 8,000 deliveries. A former labor and delivery nurse, she now practices as a locum tenens physician.