Can you be a surgeon if you have trouble standing for long periods?

[GH253]

---

Members do not see this ad.

Suppose you have trouble standing for long periods due to joint issues. Can you still be a surgeon? Is it possible to perform surgery while seated if necessary? Or should you look into a another speciality?

 

[GeraldMonroe]

How would you get letters of recommendation from surgeons if you can't scrub in and hold retractors for a few hours? Just wondering, the practical obstacles seem pretty insurmountable.

 

[DHT]

How long are we talking about. You could potentially pursue some surgical specialties that generally have shorter OR times (Ophtho).

Hand surgeons sit a lot in the OR, but you have to make it through Ortho or Plastics first (both have their share of long cases).

To get a good view of the field (and close enough to the patient), you will need to be standing for most cases.

 

[Winged Scapula]

How long is "long"? And what do you mean "can't" stand for long periods? Can't do it at all (ie, a legitimate disability) or don't want to because its uncomfortable (which the case for nearly every one of us)? Can you take an NSAID to get through those times?

As others have noted, you have to actually get through medical school which also requires long periods of standing. I was much more tired during rounds of indeterminate length on IM and Peds (got chided once for leaning against a bassinet in the NICU during rounds) than I ever was in the OR.

There are fields with shorter surgeries, Ophtho is certainly one of them but nearly every other surgical field ahs its share of lengthy cases.

 

[Samoa]

Suppose you have trouble standing for long periods due to joint issues. Can you still be a surgeon? Is it possible to perform surgery while seated if necessary? Or should you look into a another speciality?

How badly do you want to be a surgeon? Enough to stand for long periods of time despite the discomfort? Or a lot, but not that much?

It's a question you'll have to answer for yourself. Just know that:

1. there will be long operations where sitting is not a reasonable option
2. long operations are more prevalent in some specialties than others (ortho, neuro at some places, and plastics reconstructive cases come to mind)
3. there are numerous shorter and mid-length operations, which can become very long if things go wrong, where sitting is not a reasonable option (most of general and CV surgery, endovascular cases, neuro/ortho spine)
4. for those operations where it is a reasonable option (anything involving the head or extremities), you will not be the one to decide whether you sit or stand until you reach the final year or so of your training
5. requiring people above you to adjust to your need/desire to sit will likely be accommodated if required medically, but will also likely be a Pyrrhic victory for you.

If you can get through training while handling the above obstacles (i.e. avoid entirely, circumvent or suck it up, as indicated), there's no reason you can't be a surgeon.

 

[LovelyRita]

Don't forget that it's not just standing in the OR. General Surgery residency is 5 years of rounding/walking all over the hospital quickly, THEN standing in the OR potentially all day, and then if you are on call possibly rounding/walking all over the hospital again.

Attendings don't have the 80-hr workweek, and if they stood all night in the OR, they may have to go to their clinic the following day, walk around the hospital, etc., maybe do more surgeries.

I highlight these things because I know what it's like to have an injury and try to do it all. Doable, but not ideal. I wish I had a "sit down" job right now. Good news is for me it's not permanent.

Not to discourage, but this is what it is, and if you can save yourself, you might want to.

 

[GH253]

I have early OA in all of my weightbearing joints- hips, knees, ankles and feet. Right now I have no mobility limitations and can stand all day, but I'm thinking about down the line. I have no idea how bad it's going to be in 5 or 10 years.

 

[Preop]

besides standing all day, seems that you guys have to be in nearly the same position all day. your operating in a small space and its not like u can stretch your arms out. so doesnt your shoulders and neck get sore too? i'm just curious because mos tpeople just mention the feet/knees getting sore.

 

[Winged Scapula]

besides standing all day, seems that you guys have to be in nearly the same position all day. your operating in a small space and its not like u can stretch your arms out. so doesnt your shoulders and neck get sore too? i'm just curious because mos tpeople just mention the feet/knees getting sore.

Yep, my neck and shoulders hurt much more than my back and knees/feet every have.

The first few times you wear a headlamp and loupes is a real tiring day.

 

[GeraldMonroe]

I have early OA in all of my weightbearing joints- hips, knees, ankles and feet. Right now I have no mobility limitations and can stand all day, but I'm thinking about down the line. I have no idea how bad it's going to be in 5 or 10 years.

If he got through training, are there specialties where one could limit their scope of practice to surgeries that can be performed seated? Hand, maybe. Or urology if he used nothing but a robot for major cases.

What do you think, Winged Scapula?

And, OP : do you have some kind of degenerative disease that is going to spread to your smaller joints (like fingers)? Would it progress to the point that you would be wheelchair bound? Or could you have your joints replaced when the degeneration becomes too severe?

 

[GH253]

And, OP : do you have some kind of degenerative disease that is going to spread to your smaller joints (like fingers)? Would it progress to the point that you would be wheelchair bound? Or could you have your joints replaced when the degeneration becomes too severe?

It's not going to spread to my other joints but I expect it to progress to the point that I will be wheelchair bound. I can get my hips and knees replaced, but not my feet.

 

[GeraldMonroe]

It's not going to spread to my other joints but I expect it to progress to the point that I will be wheelchair bound. I can get my hips and knees replaced, but not my feet.

Would one of these help you?

http://www.scientificamerican.com/b...rouble-walking-try-hondas-new-exos-2008-11-10

How long will this disease take to progress? If you have 20-30 years then perhaps much more practical and sophisticated walking assist exoskeletons will be available.

 

[GH253]

Would one of these help you?

http://www.scientificamerican.com/b...rouble-walking-try-hondas-new-exos-2008-11-10

How long will this disease take to progress? If you have 20-30 years then perhaps much more practical and sophisticated walking assist exoskeletons will be available.

if it gets as much worse in the next three years as it has in the last three years then I'm giong to be a very unhappy mother****er by 2012. plus, i don't really wanna be seen wakling around with a faggy exoskeleton anyway

 

[GeraldMonroe]

if it gets as much worse in the next three years as it has in the last three years then I'm giong to be a very unhappy mother****er by 2012. plus, i don't really wanna be seen wakling around with a faggy exoskeleton anyway

Well, I would assume you're on immuno-suppressants now to reduce the speed that you lose cartilage, right? And while that exoskeleton does look a little gay, it sure beats a wheelchair. Not to mention the model in 2030 would probably boost strength and speed over a person without an exoskeleton.

 

[Samoa]

Immunosuppressants don't help osteoarthritis. It's due to wear and tear--either from overuse, poor body mechanics or inadequate repair and maintenance, not autoimmune destruction.

 

[GH253]

Well, I would assume you're on immuno-suppressants now to reduce the speed that you lose cartilage, right? And while that exoskeleton does look a little gay, it sure beats a wheelchair. Not to mention the model in 2030 would probably boost strength and speed over a person without an exoskeleton.

Immunosuppressants are for rheumatoid arthritis, not osteoarthritis...

 

[GeraldMonroe]

Wait, so why is he losing cartilage so fast, then? If it isn't autoimmune, then does he have some sort of mutation that weakens his cartilage and makes it wear down faster? That would make perfect sense, I sat through a lecture once on how collagen mutations can make a person much more vulnerable to developing aneurysms.

 

[Samoa]

Any joint that is used a lot is prone to OA. Runners and cyclists are prone to hip, knee and ankle OA. People who type a lot, play piano or operate are more prone to develop OA of small joints in their hands, usually the distal ones. Walkers' hips (i.e. all of us bipeds).

Perhaps the OP was a competitive runner. Or maybe just has poor joint protoplasm.

I'm not sure we know why anyone gets OA, definitively.

 

[GH253]

Wait, so why is he losing cartilage so fast, then? If it isn't autoimmune, then does he have some sort of mutation that weakens his cartilage and makes it wear down faster? That would make perfect sense, I sat through a lecture once on how collagen mutations can make a person much more vulnerable to developing aneurysms.

It was caused by the treatment I recieved from an incompetent podiatrist.

 

[GH253]

Any joint that is used a lot is prone to OA. Runners and cyclists are prone to hip, knee and ankle OA. People who type a lot, play piano or operate are more prone to develop OA of small joints in their hands, usually the distal ones. Walkers' hips (i.e. all of us bipeds).

Perhaps the OP was a competitive runner. Or maybe just has poor joint protoplasm.

I'm not sure we know why anyone gets OA, definitively.

False. Primary OA is not caused by joint use. Just the opposite, it's caused by cartilage weakening secondary to inactivity. A sedentary lifestlyle causes the cartilage to lose its viscoelasticity, which in turn makes the tissue suceptible to damaging mechanical stress. Running keeps the cartilage strong and actually reduces the likelihood of OA.

 

[GeraldMonroe]

It was caused by the treatment I recieved from an incompetent podiatrist.

Wait, so why is the degeneration continuing?

 

[Samoa]

False. Primary OA is not caused by joint use. Just the opposite, it's caused by cartilage weakening secondary to inactivity. A sedentary lifestlyle causes the cartilage to lose its viscoelasticity, which in turn makes the tissue suceptible to damaging mechanical stress. Running keeps the cartilage strong and actually reduces the likelihood of OA.

Interesting. And completely the opposite of what I've always been told about the disease, and have observed in those I know who have it.

 

[GH253]

Wait, so why is the degeneration continuing?

Once the joint surface fails, the degenerative process is in motion.

 

[GH253]

Interesting. And completely the opposite of what I've always been told about the disease, and have observed in those I know who have it.

The medical community is totally ignorant about OA. I've never met a doctor who understood the disease and I've seen 20+ in the last three years. They all believe the archaic notion that OA is caused by "wear and tear" on the joints- exactly the opposite of what is true.

 

[Winged Scapula]

The medical community is totally ignorant about OA. I've never met a doctor who understood the disease and I've seen 20+ in the last three years. They all believe the archaic notion that OA is caused by "wear and tear" on the joints- exactly the opposite of what is true.

Hmmm...all I know is that I've seen plenty of former athletes with OA while a sloth like me can pretty much do anything I did at age 20.

 

[deleted263296]

-