Pre-op appointments

feisty · 08-05-2008, 07:02 PM

Hi all, nurse etc...

I have a pre-op appointment for surgery tomorrow, the procedure isn't until the 12th- anyway. I haven't met this doctor before. The Doctor who I had my initial appointments with graduated from his residency and I got switched right before my pre-op.

Anyway, since it is an ob/gyn related operation my new md has no history with me or my SCI, I'm not really super worried, but I'm thinking there might be some things I need to inform him/her that are SCI specific when it comes to surgeries. (ensuring my own level of care, lol)

Any thoughts?

For reference, I am getting a rather large Ovarian Cyst removed (12 cm at last check) as well as losing an ovary at the ripe age of 30. womp wommmmmmmmp. I know they are going in through the abdomen, but that's it. Any time I try to contact or speak to my doctor about concerns they just tell me to save it for my pre-op appointment, but it happens to be 5 days (including a weekend) before my appointment and so I just want to be as prepared as possible for tomorrow.

Thanks in advance.
M

lynnifer · 08-05-2008, 07:48 PM

Yeouch! May I ask - do you feel pain from this ovary? Does it happen to be the left one? 12cm - sheesh!

I only ask because I wondered if I was having something similiar and an ultrasound was unable to see my left ovary, and they left it at that. No further investigation.

Good luck with your surgery!

cara_m · 08-05-2008, 08:16 PM

My initial reaction to your post was to check your profile. c5/6. I would make sure your doc was familiar with ad, let him know what your baselins blood pressure is and to keep an eye out more than normal for possible blood pressure elevation during surgery, which may be caused by the ad.

I'm not trying to worry you but I'm very insistent on my docs who aren't familiar with sci to be well informed on ad issues, prior to any surgeries. Good luck and I'm sure everything will be fine.

LaMemChose · 08-05-2008, 08:49 PM

12 cm sounds like a ginormous cyst.

Ditto what Cara said. Take info for your doc about AD. Ask how it will be managed during surgery and post, too. If you may need nitro paste or certain meds, tell your doc so he/she can order what you need in advance.

Make sure your doctor understands that just because you're a quad does not mean you cannot experience pain, whether directly or referred. Let your doc know what your body does when its unhappy from pain or other stimuli.

If you're prone to spasms, make sure the new doc knows about this. I've no idea what happens to us during surgery. I think we're given paralytics of some sort. (Oxymoronic as hell I know.) Anyway, if it matters medically for you to not spasm afterwards, let your doc know it can and does happen if it does.

Also, if this is outpatient, will you need additional assistance not usually required post-op at home? It seems pretty straightforward and sounds as though it could be done laparascopically, but you may need more help than you think.

Tell your doc the assistance you'll need in getting onto gurneys, into your chair, etc., before and after the surgery. I've been surprised at nurses and others who've told me to "hop" onto the bed or a set of scales. Helllloooooo? Read my chart or even looked at me anyone?

If this is not outpatient, make sure to address your bowel program needs in advance. I'm amazed at the lack of awareness with some medical personnel. If you'll be in the hospital, ask your doc to order what you'll need for your program with instructions for it to be done when it should be.

Let the doc know how your bladder is managed, especially if you'll be inpatient for this procedure.

Take a list of any meds you take on a regular basis with you to the appointment, including dosages. Also, tell your doc about any supplements or herbal meds you take. Some can interfere with bleeding.

Have your physiatrist's info handy and give it to your new doc. If she/he has any questions, she/he can call the doctor with anything you don't answer.

If I think of anything else, I'll post it.

I hope the surgery goes smoothly and there are no complications, that you heal quickly and well. I'll be thinking of you, hoping for the best.

Let us know how it goes.

betheny · 08-05-2008, 09:14 PM

My last surgeon had a particular anaesthesioligist she chose to use b/c she was afraid I'd get AD. That was comforting, to know she was paying attention. Make sure, as ME said, that the whole bowel thing is crystal clear. Nursing staff is ignorant to the point on negligence on the subject. As far as I can tell, they firmly believe that ignorance is bliss.

Oh yay, feisty, an opportunity to educate some people, just as you feel like hammered shit! Tell me, does it get any better than that??

Wish you the best.

feisty · 08-05-2008, 10:30 PM

Quote:

Originally Posted by lynnifer

Yeouch! May I ask - do you feel pain from this ovary? Does it happen to be the left one? 12cm - sheesh!

I only ask because I wondered if I was having something similiar and an ultrasound was unable to see my left ovary, and they left it at that. No further investigation.

Good luck with your surgery!

Yes I have an enourmous amount of pain, but after working with my PCP, I have been able to deal with it during the day if I can get a good nights sleep, so we've been managing it with flexeril and naproxin at night as well as my minimal sci meds (10 mg topamax and 1 detrol). I have also not been able to eat much and I keep my bladder extra empty, as both a full bladder and stomach put pressure on it and magnifies discomfort.

Funnily enough it is on my left ovary, the first ER visit was a debaucle as they first thought appendicitis, then kidney stones, then galbladder symptoms, and then after 2 mris and 2 ultrasounds they realized the culprit. Be warned ladies that just because you have an ovarian cyst, it doesn't report the pain properly. I have really good sensation (everything but pinprick/and mild hot-cold), but since the cyst was located on the inside portion of my left ovary, (inhabiting the space where your uterus would normally be) the pain reported centrally and on the right side in the back half of my ribs/kidney and front hip area. The area is also sometimes warm to the touch, which is bizarre.

I also must post, this is something non-SCI specific and probably would have come regardless of my injury, but the pain reporting displacement was different internally and not something that the doctors figured out on their own.

lynnifer · 08-05-2008, 10:41 PM

Ouchie! Sorry, I wasn't familiar with your level of paralysis, etc. I knew if you could feel it, it would hurt like a sonofa!

Again, good luck with the surgery! 12cm is like a grapefruit!

Re: the left ovary. My ultrasound had to be taken with a full bladder to see the left. Difficult to do as a paraplegic using crede .. lol. Regardless, they couldn't see it and nothing further was ordered.

feisty · 08-05-2008, 10:43 PM

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