Surgery for an Aged Mother

[delatorrea]

I am writing in behalf of my 75 year old mother who has Baker's cyst on both knees, causing her lower extremities to swell. To relieve her pain, both legs had to aspirated once a month. Almost 10cc of fluid per leg is extracted at each time.

She was referred to a surgeon who said that work to be done is quite "extensive", thus, requires general anesthesia. However, her Cardio believes general anesthesia is risky for her age (75 yo). We are at a loss because we do not know what to do.

I do not know what "extensive" means. (I live in Port-au-Prince while she is in the Philippines.) I assume that the cyst does not look good.

Would not a local anesthesia suffice to remove Baker's cyst?

Can you please suggest other alternatives to address her condition considering her age?

Thank you in advance.

[John Kenyon, CNA]

Hello -

Normally Baker's cysts can be removed under a local, but if they are well-developed and their roots entangled in the mechanics of the popliteal area, then work can be "extensive" and require something more than a local.

What concerns me is that your mother is 75 years old and the cardiologist is basing his concern over the general anesthesia solely on her age. Nowadays not only are there many less risky anesthesias, but 75 isn't as "aged" as it once was. If you mother has some chronic health problems or if the cardiologist knows of some heart problem she has, that would be different.

My best suggestion would be that your mother get second opinions on both the surgery and the cardiac clearance. It still seems likely there should be a less invasive and complex way to surgically remove or repair the cysts, and if your mother is in otherwise good health I really don't think her age alone is sufficient reason to rule out the procedure.

I hope this is helpful. Best of luck to you and to your mother.

[Parks P, RN]

Good afternoon,( p.s.t.)

Hi, If more "extensive" surgery is required another option would be to talk with your mothers anesthesiologist about having spinal anesthesia where a needled is placed in the membrane surrounding the spinal cord, and an injection of anesthetic in this space leaves the lower body in an inability to move or feel pain for a period of time based on the length of the surgical procedure. Mild sedation is usually given in combination with the "spinal", this procedure is very common and tolerated well in patients it is something you might want to discuss with anesthesiology. I hope this helps you.
Good luck, Paul