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A doctor evaluates symptoms , age , and the person 's general state of health when considering whether to recommend surgery . This is easiest to administer , and makes sense when there are n't many people . They grew up at a time when layoffs and divorce were hitting families hard . In our day , when the perfunctory initials " L. S. " have replaced the heraldic devices , the law is conscious of its own absurdity when it preserves the rubrics of a vanished era . In Texas , mat formation occurs at any time during the year , but is most common in late fall and winter when the weather is cooler and wetter .