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Outdated, unfounded myths hang over heart surgery, rehab

Rochester Business Journal
August 17, 2012

When Peter Roberti had to undergo heart surgery in March, he did not watch many medical television shows or read about the surgery online before the procedure.

Roberti, president of retail sales at Adrian Jules Ltd., wanted to avoid myths and misconceptions surrounding heart surgery. He also had had previous surgeries for different reasons, which helped to cut down on some of the anxiety.
"I really wasn't as concerned going in because I felt I had the best doctor, and I know him, and I felt I had the best cardiologist," Roberti says. "My regular doctor has always taken good care of me. 
"It was like, 'This isn't a big deal. We're going to go in there, do it and be done with it.' I said it's not going to be that big of a deal. I had the best guys in town."
Heart surgery and rehabilitation are serious concerns for patients, and preconceived notions or misconceptions about what to expect can make the entire situation worse. Concerns over the state of post-surgery health, mental acuity after surgery and issues related to age and gender can confuse patients, instill fear and paint an unrealistic picture. Doctors and cardiology experts dispel many of these fears as outdated or simply unfounded.
Ronald Kirshner M.D., chief of cardiac services at Rochester General Hospital, says one of the most common myths surrounding heart surgery is that people believe they will never be able to return to a normal quality of life.
"People always think that afterwards they're going to be somehow debilitated or chronically ill," Kirshner says. "In fact, cardiac surgery is really geared towards getting people back out there, active, getting back to their jobs and being able to live a full, active life afterwards. Rather than being an invalid, it is the exact opposite."
Frank Richeson M.D., director of cardiac rehabilitation at the University of Rochester Medical Center, agrees.
"If somebody comes in with a heart attack, they're pretty convinced that if they survive at all they're going to be impaired, and more often than not the opposite is true," he says.
Rehabilitation after cardiac surgery often sets a patient on the path to normality.
"Most patients feel as though they have been given a second life, after they have recovered to a certain degree," says George Hicks M.D., chief of cardiac surgery at URMC. "It requires getting over the pain of the operation, and a lot of it has to do with the mental aspects of recovering from surgery."
Patients also fall prey to the misconception that they will be less mentally able after undergoing heart surgery.
"People think that once you have heart surgery, your mental acuity will somehow be impaired," Kirshner says. "This may have been the case a number of years ago, and even that is not clear. But nowadays people can have cardiac operations and do well and carry on completely normal cerebral processes."
History also affects the way patients view the prospect of heart surgery. Years ago the risks of such surgery were much greater than they are today.
"There are myths that take origin from our history," Richeson says. "I've been in cardiology for about 40 years. 
"At the beginning of that time it was typical that patients spent three or four weeks in the hospital and were out of work for six months or so, and most of them could not expect to return to a very vigorous life even after six months."
On the other hand, heart surgery is not a common and simple procedure, contrary to what many patients believe.
"Any surgery that you go through is a significant stress to the body," Hicks says.
Given advancements in technology, however, patients might believe cardiac surgery is straightforward. It is not.
"That is a myth. It takes a large team of people, all of whom work in concert with each other," Kirshner says. "But we in Rochester make it look easy. It's kind of like watching a great football player win games; they make it look easy. But it's complicated. It's hard to do. It's so easy to have it not go well."
Another misconception surrounding heart surgery is that there are differences between the genders or that an individual may be too old to undergo such a procedure.
Hicks says some of the age myths stem from the history of heart surgery.
"There's not really a pattern of misconceptions amongst age or gender," he says. "Some of the older patients remember how it used to be, though, and they come in expecting that it will be the same for them, and it isn't."
Kirshner says surgery can be performed on anyone, regardless of age. With the development of modern heart surgery, doctors have been able to push the envelope of age, operating on people in their 90s.
Patients who are ill also are possible candidates for cardiac surgery. Kirshner says no one is too sick to undergo surgery
"The other thing you hear is that people think that they're too sick to have heart surgery," he says. "I've come to learn that no one is ever too sick to get better. We will operate on very sick patients, and the vast majority of them do get better."
The converse is also true: Not everyone gets better, though many people may now perceive that to be true.
"It might be somewhat of a myth that heart surgery can cure anybody," Kirshner says. "It is a very traumatic, complicated procedure, and while most people get better, not everybody does."
Many of these myths have common roots-television shows, the Internet and even the history of the surgery itself.
"Where do myths come about? They come about because we haven't done a good enough job informing the public of what to expect," Kirshner says. "Also, years ago, the operation did have a tendency to leave people debilitated and cause a lot of ill effects."
Says Hicks: "People will hear what they want to hear. Quite frankly, if you listen to a physician tell you about all the risks, it's easier to shut that out because it's painful listening to these risks."
The only way to dispel these common myths and misconceptions about heart surgery, cardiologists say, is to be frank and honest with patients about what they are going to undergo. Dispelling wrong perceptions about a heart attack and its treatment is key.
"There's no other way than being frank with patients about what to expect," Hicks says. "You can't shortcut the dialogue you have with a patient, because it's your responsibility to make sure they understand."
Says Kirshner: "I'm not an expert in knowing how people formulate opinions. It's our job to educate the public as best we can, but as far as where these opinions come from, who knows?"
Being straightforward with patients, doctors find, is helpful.
 "People want you to be kind and considerate and all that, but what I find patients want more than anything else is for you to be straightforward," Kirshner says. "They just want to know what they're heading into; they want to know that you're going to be straightforward and honest with them along the way, and that's what we do. 
"No one ever really knows what's in somebody's mind, what myths they might have or misconceptions, and that's why it's important to talk to your physician about what to expect." 
Katherine Alexander was a Rochester Business Journal summer intern.
8/17/12 (c) 2012 Rochester Business Journal. To obtain permission to reprint this article, call 585-546-8303 or email

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