Oh it says "durgery". That's an honest typo, but I think I'll leave it.
What are the aspects that no one tells you?
After you're asleep from the anesthetic? They slice you open with knives. No lie!
It has been a long time for me, but I remember that it sucked.
Durgery is when they use Gregorian chant as an anaesthetic.
All I remember is waking up in a hotel bathtub full of ice with a note saying to call 911.
After my hernia surgery, I felt weary and lethargic for a couple weeks. The dr. said it was a common reaction to the anaesthetic, but it seemed to me to be going on far too long. So I spent time on pubmed until I found an article that essentially said "Patients who experience post-operative fatigue are either depressed or malingering." This gave me the kick I needed to get myself back in gear.
Surgery is fine, if they don't give you a post-op infection. I've had two operations, plus a couple of investigatory things done under a general. The actual process, apart from the boredom of being in hospital was fine. The post-operative infection sucked, though.
re: 2
In my case, they [he, the surgeon] also sliced me open with knives when I was awake. No anaesthetic.
7.2 Are you sure that was the surgeon and not some random Glaswegian who had wandered into the hospital thinking it was a pub?
I initially read durgery"as a portmanteau of drudgery + surgery.
The part that I've witnessed is the unending boredom of recovery. You're too fuzzy or hurt too much to concentrate to read--even TV shows may be too much at first.
Good luck with it!
Depends on what they cut, of course, but moving around is going to hurt and you'll generally feel beaten up and tired. When you first wake up, you might have nausea from the anesthetic, but that passes eventually. If there are painkillers that you prefer, maybe discuss with your doctor and husband beforehand so you can ask for them / have them prescribed. Be nice to your nurses, but have someone around who can be insistent if necessary.
Never heard of the fasting thing, although you can't eat before surgery anyway.
Good luck!
6 makes a good point. If your doctors and nurses think you should be up and about, get up and about--it's easy to get deconditioned quickly and think you're still suffering effects from the surgery when it's really the effect of not having gotten out of bed for twenty hours.
Clarification - I'm not having surgery any time soon. (Probably in December.) Just in early stages, and thought it was something to post, for lack of anything else.
Fasting for 12 hours is pretty common because they don't want you vomiting anything.
Nope, I'm talking about fasting for 3-4 days. Different thing.
One of the bigger sources of medical error in surgery is when the surgeon gets mixed up and performs the wrong surgery or (even more often) performs it on the wrong part of the body. So if, e.g., you're having surgery on your leg it's a good idea to get a sharpie and write "OTHER LEG" on it so they don't find out later on and end up embarrassed.
Actually, given what I know of Doctors and have read about medicine generally it's probably a good idea to just go nuts with that marker: "THIS IS TORSO. LEG IS OVER THERE."
re: 8
Sadly, no. I've told the story before, but basically he decided on the spur of the moment to open and drain the infected neck wound [thyroid surgery].
'Nurse, have you got a suture kit?'
'Yes'.
[sound of package being opened]
'Sit still.'
[sliiiiiice - gouting]
Me: 'WTF? No anaesthetic, no gloves?'
'The nerves there are all dead from the surgery, and you've already GOT an infection. No biggie.'
At which he wandered off. The whole thing took about 5 minutes. I was a bit stunned.
Thanks, Knecht, for reminding me in 9 of something I'd managed to forget. I once found myself lecturing on Victorian anesthesia (it takes students so long to finish Middlemarch that one ends up filling the lecture time with all kinds of hastily-researched things), and I said something like, "In the late nineteenth-century, doctors didn't actually know how to anesthetize people: they simply prevented patients from moving and then erased their memories afterward." At the end of class, a student came up to me and said, "My dad's an anesthesiologist, and I think that's still how it works."
...and you've already GOT an infection
Tell him that infections come in different flavors.
I've had more surgery than you've had hot dinners and my take is that the surgery is OK because unconscious, but the immediate recovery bit is not much fun.
1. Depending on the seriousness of the operation they may starve you for 6-12 hours beforehand. This is to prevent you vomiting while unconscious if you react badly to the anaesthetic. Vomiting while unconscious is bad news, see Tommy Dorsey, Dinah Washington, Jimi Hendrix, etc.
2. If you're under for long you will be dying of thirst when you come round and they will likely refuse to give you enough to drink. This is to prevent you vomiting while not unconscious if you react badly to the anaesthetic mixed with stuff in your stomach. They don't want to have to change the sheets.
3. You may have a headache like you've been on a 4 week bender. Suck it up.
4. You may wake up attached to a blood transfusion and/or other intravenous drip. Try to work out where they enter your body before turning over.
5. These days they want you out of the hospital asap for many excellent reasons. They will therefore make you get up and start moving around long before you're ready. You will hate them but they are right.
6. Write down a list of questions to ask after the surgery before the operation, because you won't be in a good mental state to think of them after it.
7. If American hospital kitchens are anything like British ones, arrange for all your friends who are good cooks to bring care packages daily.
If I think of anything else I'll let you know.
14: I never heard of that but in general I'm pretty sure that not eating for four days isn't a good idea.
I've mentioned it before but it hasn't come up yet so: Crap as early as possible after surgery. The pain meds are also smooth muscle relaxants so your bowel sits inactive for a while, just soaking up the water from your poop until you have a big chunk of adobe to crap out. I swear I'm not kidding when I say I nearly cried from the pain. I waited like three days after surgery before hitting the head. Never again.
Also Chris Y gives good advice.
Oh god. Will you remind me of 21 when my surgery is closer?
If you are having abdominal surgery, the shock and the anesthetic may cause peristalsis to stop, ie your stomach to stop doing anything. If they send you home before this is resolved, you will throw up repeatedly when you try to drink or eat and then get dangerously dehydrated, probably while receiving bad advice from the surgeon's office about how this is just a reaction to the pain pills, until someone panics and takes you back to the ER, where you will be readmitted for several additional days.
This is easy to prevent - all they need to do is, like, use a stethoscope to listen to your stomach to make sure it's burbling away before they discharge you. Make sure they do this - it is in both your and their best interests...not to mention the best interests of the person who is caring for you post-surgery, who will still get shaky remembering how scary it all was.
By which I mean, peristalsis restarts naturally within a day or two of surgery, but it's important to be receiving IV fluids until it does.
This is probably not relevant for you, but the thing that nobody told me before my appendectomy is that they'll shave you if you're hairy where they're cutting. I was rather surprised to wake up and discover that I'd been given half a Brazilian.
I was rather surprised to wake up and discover that I'd been given half a Brazilian.
Only half? I concede that I'm hairier than Esau, but last time I had surgery on my body rather than head or limbs, they shaved the whole damn thing.
21 gives what looks to me like a good reason to do some fasting beforehand (probably not three or four days of it, though).
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Hey, can everyone tell me firmly to get lost if I comment for the next three weeks? Things are extremely busy, and I'm digging myself a hole.
|>
Girls are so bad at time management! I'll get baa to guest post while you're away.
It's a self limiting problem, righ? If you dig deep enough you might not get WiFi.
Oh it says "durgery". That's an honest typo, but I think I'll leave it.
I saw the post title and thought, for a minute or two, that Kevin Drum was going to need surgery . . . It didn't fit the tone of the post (and I realize that you have obvious reasons to plan surgery as well) bit it did give me a scare for a moment.
One of the bigger sources of medical error in surgery is when the surgeon gets mixed up and performs the wrong surgery or (even more often) performs it on the wrong part of the body. So if, e.g., you're having surgery on your leg it's a good idea to get a sharpie and write "OTHER LEG" on it so they don't find out later on and end up embarrassed.
If your hospital is following best practices error avoidance protocols, they will ask you themselves to do this during pre-op. They will also ask you about 4,000 times to state your name and date of birth and the procedure for which you are in the hospital.
IMX, 19, 21, and 23 have it right. A four day fast is nutty.
32: And if you jokingly say "castration" even once, off they go.
Has anyone here ever heard of fasting for a few days before surgery to get your body into healing-mode?
Incidentally, I knew that I'd seen this come up before on unfogged, but it turns out you were the source last time.
Honestly, it's a research oncologist that I know very well who has collaborated on some of these studies. There is actually a body process that is understood, but all I recall are analogies.00 And specifically told my mom to fast for 4 days before she had her hip replaced, which she did because she is crazy, and according to her doctor, "healed like a 30 year old". She was two years post Stage-4 cancer, and still recovering from that, and healed much faster than the post-op predicted schedule, by weeks. And healed much faster than when her other hip had been done, pre-cancer.
My only in-patient surgery maybe in my life was for appendicitis. I noticed the pain around 11 a.m. on a Monday, went to the hospital around noon, sat around and was shuffled from line to line and had various tests for hours, they finally put me under after 6 p.m., I woke up the following morning in a hospital bed, feeling very weak but ultimately functional. I spent Tuesday and Wednesday in bed and worked roughly half-days (less than that overall) Thursday and Friday.
Hospital food was pretty bad, but not as terrible as anecdotes make it sound - I've probably paid for worse in college or at a cheap hotel's continental breakfast. I had a sore throat for a few days afterwards from being intubated during the surgery, so they gave me some kind of industrial-strength aerosol throat anesthetic. Tasted like novacaine but it worked better than cough drops. Over the following days I was surprised now and then to find which muscles I really used for certain things, but that's probably not relevant unless you're having the same surgery. Speaking of which, I wouldn't expect the wait time to be so long for something planned, and it probably didn't help that I wasn't at a great hospital, so don't worry about that either.
38: Is there a pseudonym problem here?
Choose the person who drives you home from the hospital carefully. If you are thinking of getting a ride from someone whose driving nauseates you on a good day, pick someone else.
I had several sores at the back of my throat after my hernia surgery. I hope it was from the intubation.
I'm curious as to why they are right in 19.5.
22: They'll prescribe a stool softener, most likely. No one mentioned the first post-partum poop ahead of time to me. Yikes.
Heebie, I'm both curious and skeptical. I'd also want to know how much of an effect fasting has.
I've also been left really queasy after all my surgeries. (I too have had several, between the cancer and the bad shoulders and getting my tubal ligation.) I concur with the advice to choose carefully who drives you home.
IDK about the advice to fast so long before the surgery. It sounds like dicey advice to me. You won't have much of an appetite after the surgery -- as in, you won't want to eat for probably two or three days afterwards. So that will be, what, a week without much nourishment? While your body is dealing with a major trauma?
I can't think that's a good plan.
Tasted like novacaine
Which ranks surprisingly high on the list of most unpleasant aspects of dental surgery.
My surgery was a week ago. No talk of fasting, other than the 12 hours before. I'm not sure they actually made it to 4,000 times asking me which foot, but with one all wrapped up in bandages and then swollen and seriously discolored up to the knee, it seemed kind of silly.
They wanted me up and out faster than they should have; my ability to carry on simple conservation when they wake me doesn't say anything at all about my ability to navigate the stairs into my house with crutches -- where keeping weight off a foot is a big damn deal, they were awfully casual about how loopy I actually was.
The block (whatever that actually is) wearing off the next day was pretty unpleasant.
I'm still elevating and icing a week later -- I'll get a more serious cast in a few days, and hope to be more mobile after that.
Find out ahead of time what you will be physically connected to after the surgery. I expected an IV and a catheter, but totally was not expecting an IV into my jugular vein (very distant from the place of surgery) in addition to one in each arm. They may have told me in advance, but I want't feeling very well and didn't pay close attention at the time.
Surgery while parenting toddlers is especially challenging, because they like to hug, and sometimes also punch and scratch their parents, and have difficulty understanding that these are contraindicated for regions of incision. They also might not understand that you're unable to do much of anything for a few days when you get home. On the plus side, to the extent you can show them the wounds, they will think it's really cool and may ask if they can have one of their own.
Relatedly, if relatives or babysitters are watching over them for more than a few days, don't be surprised if they talk alot about how bedtimes, snacking, and rules in general were much easier while you were away, and they wish you were gone longer.
Ask lots of questions of your surgeon in the presurgery meeting. "Doc, will I be able to play the violin afterwards" is always a good one.
47 -- My surgeon told me I'd never have a shot at an Olympic medal in any of the distance running events.
Other unanticipated consequences: Switching work calls etc from my office line to my cell means I've gone way over my minutes. And I really don't feel up to the math for changing plans.
My doctor told me that if I had tendon surgery, I wouldn't be able to run for at least six months. I forgot to ask him if I can run now, then it got cold so I didn't email him.
"you've already GOT an infection"
Good thing there's only one kind of infection!
Talk of healing always seems to involve lots of talk of being well-nourished. It's hard to see how fasting would help. It may depend where the surgery is? In times of want or crisis, the body will concentrate on the core organs, so if you were having heart/stomach/liver surgery maybe? But skin-healing is quite far down the list of priorities (hence pressure ulcers being so serious), so I don't see how fasting would help with wound healing at all.
Honestly, it's a research oncologist that I know very well who has collaborated on some of these studies.
If you know the name of someone involved in published studies, it should be a relative cinch to track down the actual publications, no?
32: Related risk: surgery on the wrong patient. One of my nurses divulged that her ultimate nightmare is a mixup involving a husband/wife kidney transplant. Two patients both going in for surgery on the same organ on the same day, and frequently they have the same last name. To limit the risk they kept me waiting in pre-op until the Mrs. was confirmed to be out of surgery (although we don't have the same name).
The long wait in pre-op brings to mind another unexpected experience: The screaming baby in the next bed in pre-op, directing anger at her poor mother. The nurses explained that the baby's surgery wouldn't be all that serious and the baby was not in particular pain, but she's just not used to waiting 12 hours before its next meal. If your whole life you screamed a little bit and the person holding you gave you a boob or a bottle but today she's holding out, you'd be angry too.
it should be a relative cinch
Or at least could be, I should say.
The spinal tap nerve blocker thingie they gave me pre-op "to help you deal with the pain after the operation better" for my kidney harvest was the most painful thing I've ever consciously experienced.
Not sure it helped with the pain afterwards; nothing to compare it to.
Speaking of consciousness, that operation was the only time I've really had a discontinuity of consciousness, very different from being asleep: suddenly it's several hours later with no memory between going into the operation room and waking up in the recovery room.
Recovery was fast afterwards, though the first two days had no strength whatsoever, but was out of hospital by boxing day, having gone in on th 23rd iirc.
Real recovery at home took a lot longer, as the wound got infected, I kept vomiting up the anti biotics and it all was a bit unpleasant.
Also had to deal with a very annoying and misplaced low level feeling of horniness in the first month post-surgery, no idea where that came from.
Major take-away lessons from a close family member's surgery last year:
Try to have complications IN THE MORNING, so they can be handled during the day. The day shift is usually better at dealing with problems than the night shift. Make sure there's a phone in your room, and have a friend you can call in case you need help understanding what the doctors and nurses are telling you.
And, yeah, the problems with dehydration and getting your bowels to move after surgery... I don't remember exactly what one was supposed to do about this, but try to eat and drink like normal, even if you don't feel hungry or thirsty.
It finally occurred to me that I could just email my Special Scientist and ask them to point me towards some of the papers.
Since apparently my swearing up-and-down isn't good enough scientific proof for you mongrels.
40: thanks for asking, I fessed up at some point.
They do slice you open with knives, and in my case, I retained some subconscious awareness of that. Twice within a week of having abdominal surgery, I had related nightmares. The similarity in each was that I was going about my mundane business, and, all of a sudden, I was sliced open.
One of them, I don't remember anymore, except that I was just walking down the street, tripped and got sliced open.
The other, I was having a dinner party and was at the stage where I was still cooking with friends all just hanging out in the kitchen, drinking, talking, helping, etc. I reached across the counter for something just as a friend reached for a big chopping knife, and he sliced me open.
Both times, I woke in a panting cold sweat about this idea that you could just be minding your business in a routine but pleasant way and get sliced open. It was only later that I connected it with the surgery. It didn't seem connected, ie, didn't make the surgery come to mind, but it seems the most plausible explanation for having those particular dreams right then.
56.last: That is a side effect of certain anesthetics, I believe. My aunt had been at a veterinary conference where the phenomenon in dogs had been discussed (IIRC) right before her husband had some routine surgery, and she horrified the doctors by asking if friskiness was a common response in humans too. I believe her that she was just curious!
my family is extraordinarily tolerant of anaesthetics for some reason one can only guess, and thus my mom has come fully awake under surgery, conscious and able to feel but unable to talk or move. I say arrange some fucking blink signal with the anaesthesiologist. she was drinking then, though. in her recent brain surgery she had the experience of being in a kiva in the american southwest, one of an endless circle of marchers around a central depression with a circle over it opening to the sky, everything dry as dust, and colder than the earth when the sun is dying and huge and red, and there were wrapped bodies in part of the kiva that she passed by with the other marchers, shuffling endlessly past, conscious that if she lay down to rest or even stopped for one moment she would die like the others. I think this was quite right and that if she had, in her dream, decided to lay down with the wrapped bodies she would have died in surgery.
they won't give you water because they're dicks, but they have these little sponges on sticks now that they put in ice water and then you can chew/suck on them. the retrograde amnesia works on most people so probably it'll be fine and you'll only remember them putting valium in the line to calm you down (TELL THEM YOU'RE ANXIOUS) and then wake up in post-op. but yeah, don't leave the hospital until you've taken a shit, for real.
When I had my wisdom teeth out, I was under general. I paid extra. It was bliss.
al-- how are things w/your mom and the rest of the family? How's your sister holding up?
Al, are you still in the DC area? I hope your mom is doing better.
I think a long fast would work against getting that key pre-discharge bowel movement.
45: How is your wife responding to this? My uncle got hurt while working, and my aunt is totally flipping out. I am sure that it is unpleasant and a hassle, but I swear that she is acting like his death is imminent.
I am being selfish about this, but it has really put a damper on my vacation. "No, you can't stay with us the night before you need to go to the airport. We need absolute quiet."
For me the worst part of having wisdom teeth out was coming out from under the general anesthetic--it was one hell of a headache. I had a more recent oral surgery with only local anesthetic and it was a little odd to be awake as they sliced into my palate, but much less painful.
the worst reaction to anaesthetic I've ever heard of is being conscious and maybe feeling but being so disoriented that you don't know why faceless figures are torturing you. Guy I know who had this had two liver replacements, lots of surgery.
the worst reaction to anaesthetic I've ever heard of is being conscious and maybe feeling but being so disoriented that you don't know why faceless figures are torturing you.
We call it "Iatrogenic Fire In The Sky Syndrome".
Surgeons' schedules get very full in the last few months of the year, and patients want to have elective surgeries before a new year and new deductible. if you have your sights set on a December surgery for your own convenience, think about getting on the schedule well ahead of time.
I actually just got back to narnia. I laid off commenting because I did the most asshole thing ever, namely, talked shit about my brother and then left two tabs open on HIS ipad. very thoughtful. I can't tell you how horrible I felt. feel even. I am lucky that he is a thoughtful, forgiving person who was willing to accept my groveling apology with the understanding that everyone has to blow off steam somehow and I didn't want to run anyone down behind their back to another family member, so imaginary internet friends are better, but still. christ, what an asshole. also he found out about his xmas present early.
my mom is doing crazy well. like, she's an ad for brain surgery well. the neurosurgeon said she can drive. she can read libri gialli. she can do physical therapy. oncology is looking good after first round of chemo which wasn't horrible.
my dad is being difficult and putting off going back to the doctor to see exactly where he has colon cancer, which he pretty much mos def has. they had to stop a colonoscopy and need to do another "virtual" one and he's not wanting to go, just like he didn't want to go when I hassled him this summer. he weighs 122 now. the fuck. if this kills him for no reason I'ma be pissed off at him.
Glad to hear that your mom is doing better (and that your brother is so forgiving).
thanks teo! luckily my bro is the type of person who will really for real forgive you after you do a shitty thing. he was also moved by the fact that I didn't try to weasel out of it or make excuses or anything but just said, 'oh my god I'm sure I have felt more like an asshole sometime but I can't imagine when and I am 1000% in the wrong and I am so, so , so sorry, and I don't even think you're that immature person anymore that you used to be PLEASE accept my humble apology please please please.' I was like 'what else could I even have said?' and he said, 'well sometimes people try to turn it around and get mad themselves.' and he even said he was moved in a way that I obviously talk about him so much, just also unnerved by the fact that all these people whom he might really happen to meet sometime if I had people at my house to meetup--which I have, ever--know all these incredibly personal details about his private life. I still have a stomachache just thinking about it, honestly. he said also, 'hey, I'm never going to read unfogged again to check on what you're saying, that's your deal, and I trust you to make kinder decisions.' which, again, he is an incredibly thoughtful, wonderful loving person, and I'm lucky to have two such amazing siblings to rely on in this pretty epically shitty period of my life. and I don't even think those things about him, really! he's a different, way more mature person than he used to be, and a lot of what I was saying was true about the old him but not the person he is now. I was just so stressed out and exhausted that I let my worst side come to the fore. he doesn't even really smoke weed anymore, for example; he just wanted to watch minecraft videos because he was stressed out and exhausted.
Good to hear about your mom. I should probably call my brother. I don't think I've pissed him off, but I haven't called him in a while.
I waited too long by minutes. He texted me, so now I don't get any thoughtful-points.
Assume that during the weeks after surgery, you won't be able to do anything worth anything. 10 days after hip surgery, sitting in a chair and typing an e-mail made me out of breath.
Configure your living situation as much as possible around this.
For many surgeries, a power lift recliner is great, because getting out of a chair/bed will be difficult and/or painful. My friends and I found this to be very valuable for hip surgery, abdominal surgery and shoulder surgery.
Gather all accessories and et cetera for all devices.
Get your payments for things scheduled ahead of time.
Stock up on comfort food, and easy to eat things (protein bars, nutritional drinks, fruit, frozen meals packaged for single servings, etc.).
48: Other unanticipated consequences: Switching work calls etc from my office line to my cell means I've gone way over my minutes
Do you have something where you can designate "Friends and Families" or something similar that does not count towards the plan (or has a higher threshold or whatever)? I was starting to go over until I put a few key work numbers on ours, most notably the 1-800 conference call number for work (I was mildly surprised they allowed a toll-free to be put on the list).
Do you pay for incoming calls?
81. I gather mobile phone charges in the US roughly follow the business model abandoned by European providers around the turn of the century. No idea why.
Seconding recommendations to enlist a gentle driver for the way home. Also, when I drove my b-i-l home after heart surgery, the staff insisted he could not sit in the car's front seat because of the possibility of airbags deploying.
82: They really don't, if you have changed your plan in the past five years.
84. That's a relief. I was going on my American in-laws effing and blinding about their providers every time they turn up here. But maybe the bad feeling is now restricted to the problems with roaming.
81: Yes, you pay the same rate you do when you make a call. I think that in the UK this used to be made up by charging a higher rate for outgoing calls.
I have a plan where I don't pay extra to call Canada, but we do get charged a fee for every text we send to Canada.
I wonder if I should shovel snow. My landlord supposedly pays someone to do it, but it doesn't always happen promptly. On the other hand, no one is really trying to use the sidewalks today.
83. Yes. I was discharged after heart surgery into a minor blizzard. We had a taxi, but it couldn't get into our street, so I had to skid a hundred metres or so on foot to our door. It was scary.
Many years later, Mrs y was discharged after having a gallstone out. This time we had a friend drive us, but it started snowing again, and she kept losing control of the car.
I think what I'm saying is, schedule any invasive procedures for summer.
Even then, you need lots of forecasters.
87: Yes. It will feel good to go outside for a bit, and it's good exercise. Don't overdo it though, and make sure you're all bundled up!
87: Wait for somebody from Greece to come do it. And send the pay directly to Germany. The market has spoken.
I laid off commenting because I did the most asshole thing ever, namely, talked shit about my brother and then left two tabs open on HIS ipad. very thoughtful. I can't tell you how horrible I felt.
ECB talked shit about WCB on an email to my mom, which my mom then included as a forward, when she emailed the entire group. It's not clear if my mom perceived the remark as scathing, or if it just didn't occur to her when she was forwarding, but WCB was pissed. Spouse and I were entertained, but I privately sighed in relief that I hadn't emailed my mom anything sensitive.
Vacation planning has continued to be a clusterfuck, but I think there's a plan.
I think what I'm saying is, schedule any invasive procedures for summer.
In the US you should avoid July if you are going to a teaching hospital. July is when the new residents start. May or June would be better.
but I think there's a plan.
Branson, Missouri, here we come! It'll be like a lapsed Jewish Green Acres.
Immediately reminded me of the controversy around Radio 4 introducing Neil Nunes with his strong Caribbean accent as a continuity announcer.
You may have wanted the other thread.
73/75: I have been in that situation so many times (because I am the slowest of slow learners) that I am cringing in sympathy. I'm so glad your brother was understanding. (Now off the cringe some more and remember what my feet taste like.)