DermHelpCentral

About Frailty

Deciding When Older Patients Should have an Operation, by Paula Span, NY Times, October 31, 2017.

Full NY Times Article

In geriatrics, frail is not merely an adjective. A syndrome marked by slowness, weakness, fatigue and often weight loss, frailty tells doctors a lot about their patients’ likely futures. It can, for example, predict how well older patients rebound from physical stresses — like surgery.

The “timed up-and-go,” test measures how long it takes someone to rise from a chair, walk 10 feet, turn around, walk back and sit down again. This is a simple and important test.

A study that Dr. Seib and her colleagues published in JAMA Surgery (October 2017) shows that frailty is associated with increased perioperative morbidity in common ambulatory general surgery operations, independent of age, type of anesthesia, and other comorbidities. Surgeons should consider frailty rather than chronological age when counseling and selecting patients for elective ambulatory surgery.

Even for out-patient surgery, it is important to take frailty into account for any operation, big or small. One should screen for frailty before any procedure.

Here is a free online article from the Journal of Gerontology (11/2015) Frailty in Older Adults: A Nationally Representative Profile in the United States.

Music and Surgery

Musick has Charms to sooth a savage Breast.
William Congreve

The use of music before, during and after surgery has been employed for years and there are many disparate studies in the literature.  Recently, a group from London, England has collected these studies and reports on a meta-analysis of music as an adjunct to postoperative pain.

Here is the article:  Download Music Surgery Lancet
"Music could be offered as a way to help patients reduce pain and anxiety during the postoperative period. The timing and delivery can be adapted to individual clinical settings and medical teams."

There was a 2 minute NPR piece on this study (it's a good introduction).

Here is a piece we published in OJCPCD on this topic:  "Music as a Complement to Surgery."  Or see full essay from OJCPCD.