Most surgeries are not life-or-death situations, which gives you the opportunity to ask important questions well ahead of time—and weigh the risks and benefits. "The answers can help patients be sure they are comfortable with the plan and know what to expect in terms of outcome and recovery," says Zachary Litvack, MD, assistant professor of neurosurgery at George Washington University School of Medicine in Washington, DC.

Prepare to Ask

When consulting with a neurosurgeon, bring along a friend or relative, as well as a pen and paper to jot down information, advises Dr. Litvack. "It's a lot to take in when you're talking about neurosurgery. If you have someone with you, he or she can help you ask questions and remember the answers," he says. Here are nine questions to get started.

1. What is your experience with this operation, what is your success rate, and what is your complication rate? 
   "The surgeon's experience was the top question on my list," says Miriam Suldan, 54, a health care consultant in Baltimore who had temporal lobe surgery for epileptic seizures several years ago. "I also wanted to know what his patients reported about recovery and outcomes," she says. Her surgeon put her in touch with some of his patients, and she found those conversations reassuring.
   While it might be uncomfortable to ask about complications, Dr. Litvack notes that surgeons are used to it and should be willing to provide the details of how many operations they've done and what their outcomes were. "If the surgeon is evasive, that's a potential red flag," he says.
2. How is the operation performed? 
   Knowing what the surgery entails will help generate other questions. If the surgeon says she will be operating on your skull, for example, you may want to ask what kind of pain you might experience post-surgery and how to manage it, and what wound care is involved.
3. What are the risks, benefits, and possible complications for this operation?
   Understanding the risks and benefits helps manage expectations, says Michael Lim, MD, associate professor of neurosurgery at Johns Hopkins School of Medicine in Baltimore. Suldan hoped the surgery would eliminate her seizures completely, but her neurologist explained that the operation may not prove 100 percent effective. When the surgery ended up reducing the frequency of her seizures but not eliminating them completely, Suldan was prepared. "Even if surgery is 100 percent successful, there can be residual pain, numbness, or some other lost neurologic function," says Dr. Litvack. "That's why it's so important to ask what is considered a success and what could go wrong."
4. How long will I be in the hospital, and where will I recover? 
   Patients sometimes ask when they will be discharged but forget to ask about the rest of their recovery, says Dr. Litvack. "Finding out you're headed to a rehabilitation facility to regain strength instead of going home can be disappointing if it's unexpected," he says. It's also good to know if you'll be spending a night in the intensive care unit so you can prepare for the noisy and bright environment, he says.
   Also, be sure to ask your doctor how long it will be before you can return to work or resume regular activities such as driving, says Dr. Lim—and be sure to follow those directions so you don't impede your recovery.
5. How fast and fully will I recover?
   Poorly managed expectations are the most common cause of tension during the course of surgery and recovery, says Dr. Litvack. Review all possible complications and outcomes of surgery beforehand, including not achieving maximal results, so your expectations and your doctor's are in sync, he says.
6. Do I need to stop taking any of my drugs before surgery?
   Expect your doctor to review the list of routine drugs you should or shouldn't take. Some drugs, such as aspirin and clopidogrel (Plavix), both of which help prevent blood clots, may need to be stopped a week or more before an operation, says Dr. Litvack. Some supplements and vitamins such as vitamin E can cause clotting and other problems, so review everything you take with your doctor. Also, find out how long before surgery you have to stop eating and drinking, and ask if you can drink a sip of water with the medications you are allowed to take on the day of the surgery.
7. How can I contact you and anyone else in your practice to answer my questions?
   Ask your doctor whether he or she is accessible by email or by phone for follow-up questions, and whether anyone else in the practice can field questions. Practice coordinators, often specialized nurses, can review specifics of surgery or recovery and can answer some questions or refer them to the doctor.
8. How long will the surgery take?
   This is especially important for family and friends, says Dr. Lim. If possible, ask a friend or relative to stay at the hospital during the surgery. If not, arrange ahead of time for the doctor's staff to call a designated person.
9. How much will it cost?
   This is a question for someone in the doctor's business office and the hospital's financial services department, says Dr. Litvack. Find out beforehand if the doctor and the hospital are covered by your insurance. You should also inquire if radiology and pathology departments participate in your plan.
   If your doctor does not participate in your insurance plan, find out if your insurance plan allows out-of-network benefits. If it does, ask the doctor's office if you will be expected to pay the difference between what the provider charges and what your insurance covers or to pay the charges in full. If you have no out-of-network coverage, ask your doctor what the full physician costs would be—and if the cost is prohibitive, ask him to recommend someone on your provider list.

Consider All Your Options

Keep asking questions until you feel comfortable, says Dr. Lim. "There's no stupid question." If the surgeon is evasive or gives vague or incomplete answers, Dr. Litvack recommends scheduling a follow-up visit or phone call for any additional questions. "Sometimes, this can be done by email, at the surgeon's discretion," he says. "If you still feel like you're getting the runaround, then a second opinion may be in order."