Surgery when at older age

Q: I’m 82 and could benefit from a hip replacement, but a lot of folks, including some of my doctors, say it’s too risky at my age. I would really like to be able to walk without pain. How do I figure out what’s smart to do — or not do? — Gerald F., Cleveland

A: So many things that affect the outcome have to be taken into consideration. Most important is your physiologic age or what I call your RealAge. Next is your posse (support system), and then your specific health conditions, the medications you take, your history of reaction to anesthesia, and your ability and willingness to do post-surgical rehab.

Around a million major surgeries are done on folks 65+ every year in this country. (Major surgeries are invasive procedures, done in an operating room, using general anesthesia.) And almost one in seven of those folks die within a year of their operation. General frailty contributes to the risk, as does having previous heart disease or increased susceptibility to infection. Older patients with probable dementia are especially at risk — a third die within a year. Having emergency surgery triples the risk.

The reasons for these alarming statistics are, as I said, complex. You and your doctors need to take all this into consideration — and to discuss the remarkable power of physical therapy to ease joint pain and make you better prepared to sail through surgery if you choose to have it.

Harvard Medical School says “The main component of joint surgery avoidance is strengthening the muscles that support your joints,” and suggests exercises that strengthen gluteal muscles in the buttocks and flexors in the pelvis.

Beyond PT, you can make a huge difference in your surgical risks by rebooting your age at GreatAgeReboot.com. At 80, you can become about 30 years younger than your calendar age and that means your risk of surgery would be 1/27 of that of someone whose RealAge is 80.