Pre-op appointment advice

[velvetonion]

ive got my pre op appt next week, as my first lap will be in july, as they think 99% they found chocolate cyst on mri. Ive got a very long list of questions for the appointment about my surgery and what the process will be like on the day as well as a separate set of questions for my surgeon the day of before surgery and just want to be extremely thorough as im a very anxious person. Does anyone know any questions they wished they asked their pre op nurse before their surgery? or anything like that, that i might have missed? ill add my questions so far below if anyone might wanna see what i might be missing, completely ignore it if you want !!

long bit with all my questions below- feel free to ignore, just if anyone is wondering/struggling for questions themselves or if anyone wants to give advice or an answer to any of my Qs

- [ ] can you walk me through what will happen on the day when i arrive so i know what to expect

- [ ] advice on pelvic internal stuff (they're going in my vagina while im under for catheter and uterus manipulation etc), i’m scared im going to wake up feeling violated, can i ask for things like being covered up by a sheet where ever possible while im under, etc

- [ ] should i shave, i know i dont have to of course but i imagine healing might be easier if im having any bleeding

- [ ] anxiety meds before surgery?

- [ ] what sort of things will i have to sign, can i give consent for him to do anything he needs to like my appendix or anything depending on what he finds

- [ ] terrified of throwing up afterwards can i have nausea meds if i need them

- [ ] i think im going to be on my period for the surgery, is this a problem, will i be okay to take cocodamol on the days before my surgery?

- [ ] i don’t want pain meds to make me constipated lol how can i help that not happen

- [ ] nsaids like ibuprofen give me intense stomach pain so no thanks, but if it’s iv will it effect my tummy

- [ ] will i wake up with pain meds already or will i wake up then be asked how my pain is then given pain meds

- [ ] do i need to completely not drink at my brothers wedding two days prior to my surgery, i can not drink thats fine but is it necessary to not have a single drink?

- [ ] help quitting vaping is hard

- [ ] can i always have numbing cream for needles, do you know where my iv will go? hand wrist arm? im terrified of needles

- [ ] how can i help with weeing after surgery, i would truly rather die than have to have a catheter be placed while im conscious you WILL have to knock me out to get that anywhere near me i mean it

- [ ] will my consultant meet with me after surgery to talk through how it went, if so when do you think that might happen, if im not awake will i be woken up/ can i give consent for my partner to talk to him if i am unable

- [ ] im nervous of going under without my partner there, being wheeled off on my own,,,,,

- [ ] how will it work with my partner there, will she be able to be there when i wake up, before i go under etc, if not her then will a nurse be there when i wake up or will i be alone until someone notices

- [ ] what happens after im fully awake when will i have to leave? and what are reasons that i might have to stay overnight

[KittyTherapy]

Hi,

Sorry in advance for such a longgg reply but hope its helpful...

I will have to make several replies as there is a character limit on here:

I can relate to the worries as I have anxiety and depression, so I to was anxious about the unknown. I had my lap in March of this year.

I can tell you my experience and hopefully that will answer some of your questions- I had my preop appointment face2face in clinic, this was with a Nurse. They took bloods, did an MRSA swab, took weight, blood pressure then went through the procedure, gave me educational leaflets about the surgery and then asked if i had any questions. They were able to answer many of my questions to a point but some questions required an answer from the Doctor. I raised those questions with my gynaecologist on the day of surgery but if I wanted an answer ahead of this I probably could of sought this by contacting the gynaecologist/ gynaecologist secretary (if you don't have a number already then try calling the clinic/ hospitals main number and asking to be put through to the named doctor, I would also suggest asking for the actual number so you can contact them directly without going through switchboard in the future).

The bloods and swab results had an expiration essentially (think it was something like 6/8 weeks) so ideally your preoperative assessment should indicate that surgery is coming soon. But unfortunately for me the window lapsed and I had to have these re-done as unfortunately I was waiting another 4 months before I had my op. But hopefully you won't have to wait that long!

- access for my op was through my tummy. But as i was having the mirena coil inserted they did need to remove my underwear (i was asked to remove my knickers before going down to theatre. They gave me some netted underwear to put on which they then removed when I was under anaesthetic). When I awoke, I was in a recovery room, fully covered with a sheet, I didn't have any underwear on but a large pad was placed between my thighs due to bleeding (I was on my period but I suspect you will bleed regardless). As far as I'm aware I didn't have a catheter placed but I'm not 100% sure as didn't specifically ask but they didn't tell me that had happened. They do ordinarily ask you to remove your bra but they did allow me to keep mine on when I asked for modesty (it had no metal in it). I would also recommend taking a thin dressing gown in with you, as the hospital gowns are open back so for your dignity you can wear your dressing gown to cover your bottom when you walk down to the theatre. They will then ask you to remove it prior to going in to the operating room.

- I didn't do a clean shave (as doing do makes it very uncomfortable for me) but i did trim so only a small amount of hair was left.

- i already take anxiety meds but I'm sure if you raise this query then this can be considered. On the day of surgery I was also visited by the anaesthetic who was the most loveliest man ever! And he asked me about my nerves/anxiety and reassured me he would administer meds to help with this. It's also worth mentioning that following the op and over the course of the next couple of weeks my anxiety was sky high and my mood was low, frequently tearful. This did settle down, especially once I weaned off the strong pain meds.

- i had already signed the consent forms previously with my gynaecologist from a previous clinic appt. But these forms were reviewed with me again at pre-op with the nurse. They will discuss what action they might need to take if things don't go to plan during surgery and what your happy with. For example for me they said there is a small chance that laparoscopic (keyhole) access may need to change to open surgery. They also discussed to what extent I wanted the them to do - did I just want the surgery to be mostly diagnostic with minimal removal of adhesions/ endo or did I want them to remove and do as much as possible (I chose the latter).

-there were some complications during surgery and I lost a lot of blood, they were having trouble saving an ovary but they did manage to do that (phew). But they might of needed to remove it, so it's good to chat through any concerns you have but obviously they can't predict how surgery will actually go until they're doing it.

- i also have a fear of being sick. The gas, anaesthetic and meds post op can all cause nausea/vomiting. They can give you antiemetics to control this. I also found peppermint tea can help rid the body of gas which helped nausea and ginger biscuits. But i was also prescribed Cyclizine as the nausea did continue for about 2 weeks before it settled.

- as mentioned above, i was actually on my period during the op too. This was not a problem for the medical team at all. They allowed me to wear a sanitary pad inside of the netted underwear but everything was then removed (when I was already under) during the surgery so they can do their job. They put a large pad on me following everything. But I would suggest packing your own pads as the hospital only provide large and bulky ones which aren't terribly comfortable. I also was allowed to take all my normal meds right up until surgery but is definitely worth checking with your care team for your individual circumstances.

- the pain meds can cause constipation and did in my case. My prescription meds can cause this anyway but I usually self manage without laxatives etc. However the new pain meds did make the constipation worse and so I bought Dulcolax (bisacodyl) tablets which helped give me relief. But drink lots of water as that helps too.

- speak with your doctors/nurses about pain medication and it's effects and I'm sure they can help you find something that is the best for you.

- pain meds were already delivered by the anaesthetist during the op. Then they ask you how your pain is when you wake up and can offer more. Be very honest about your pain levels, don't minimise it.

- i was advised to stop eating after 10pm the night before surgery . I could drink fluids until so many hrs before the op (can't remember off the top of my head exactly but was something like 3 hrs). I wasn't given any specific advice around alcohol intake but obviously wouldn't recommend heavy alcohol intake leading up to your surgery date.

CONTINUED

[KittyTherapy in reply to KittyTherapy]

- i dont smoke or vape but would suggest speaking with your GP for help quitting and I'm sure they can advise / refer you to a service to help.

- i'm not sure about numbing cream for needles. I was not offered this but im not sure if its an option if you ask (i didnt ask as can tolerate the needles). My IV was in the back of my hand.

- like i say, im not sure if a catheter was placed during the op but didn't have anything when I woke up. I was encouraged to go the toilet post op, they asked me to collect a wee sample for them to check (gave me a disposable pan which sits over the toilet seat).

- my consultant did meet with me before and after surgery to talk through things and how it went. In terms of a time frame it will likely depend on their capacity/ caseload on the day so it's tricky to give a time. But you will be given time to come round from the anaesthetic. My partner was not allowed to see me until visiting hrs so the consultant just feedback to me directly when they visited.

- I would suggest speaking with your doctor before your surgery to ask for permission regarding your partner being with you. Ordinarily I don't think this is standard so you may need special permission. Just speak with them and be very frank as to why its needed. A nurse will absolutely be with you in recovery whilst you come around / wake up from surgery. They must monitor you, so you won't be alone.

- if all goes well then you should be discharged home the same day. Bc of some complications during my surgery I needed additional monitoring, so had to stay in overnight. They took several bloods from me. I was teetering on needing a blood transfusion and they were concerned about possible internal bleeding. Once I was awake, I was moved from the recovery room back to the ward. They moved me from the recovery bed into a normal bed. I was given more pain relief and something to eat and drink. I would suggest packing an overnight bag just in case.

CONTINUED

[KittyTherapy in reply to KittyTherapy]

If you want packing suggestions:

> Overnight bag just in case.

> Bring something to keep you entertained as there will be waiting around. I bought my cheap tablet in. Wouldn't advise taking mega valuables in just in case they get lost (sadly it happens).

>Some comfy loose pj's (like a nightdress) which I wore during the day and on the journey home as it was the most comfortable.

> comfy knickers are essential! I packed my biggest granny knickers.

> Also a gown/cardigan to save your dignity when walking about/down to theatre in an open back gown.

>I also took slides as meant i didnt have to bend down to put shoes on!

>bring a pillow/blanket as a barrier between your tummy and the seatbelt for the journey home.

>I found peppermint tea helped get rid of bloating/excess gas (I hate the taste but forced myself to drink it bc it genuinely helped so much) or look into things like windeze or deflatine.

>You might want to pack some snacks to munch on in hospital.

>Maybe some earbuds if you think you will struggle to sleep as its quite noisy in hospital at night.

>Take all your normal meds with you and let the nurses know.

>sanitary pads.

Hope all goes well for you in surgery and recovery. Just take the time to heal, experiences vary wildly but for me it took 2 weeks of being in bed before I started to do anything. Total of 6 weeks signed off then went back to work on phased return. Some people are quicker or longer to heal, try not to compare and judge yourself 🩷

END

[velvetonion in reply to KittyTherapy]

Thank you so so soooo much for your reply, it helped me so much to add more to my questions and to add specific points, for example you asking to keep your bra on i didnt even think that my boobs would even be coming into the picture hahaha, having anti sickness meds for at home too, as well as letting me know what sort of thing i can expect at my pre op and the surgery day etc! i appreciate this so much really, you have no idea how much this helps <3 ive got me pre op tomorrow and im so ready, with my numbing cream for the blood test, to the incredibly detailed and specific question list! im gunna kick tomorrow's ass and the overnight bag, i manage a charity shop so i've been slowly adding to my list as time goes onive got my gown and slides and night dress, and im going to do a shopping day to get everything i need like meds, teas (i also HATE the taste of peppermint tea, or any tea really, so im glad to hear that you hate it too but that it actually genuinely helped with recovery! so i will be forcing myself to drink that) and other bits and pieces i might forget thank u again friend <3

[KittyTherapy in reply to velvetonion]

You're so welcome! Thanks for reading my incredibly long replies 😆 I just know from a personal perspective how anxious I was about it all and wanted to try and answer as many of your questions as possible to help you feel more prepared and in control. Hoping tomorrow goes well for you 🙏 x

[velvetonion in reply to KittyTherapy]

thank you it really did help my anxiety so much, i feel miles better about it and feel super prepared i’ll let you know how it goes <3 xx

[velvetonion in reply to KittyTherapy]

it went really well today! the nurse was so lovely and answered allll of my questions i feel so much better with all the reassurance she gave me im getting a little more nervous now as it feels more real after that appointment, like the next time i go will be in just over a month and ill be having surgery!! its definitely a bit scary but i know all of my concerns are looked after and the team are all lovely <3 thanks again xx

[KittyTherapy in reply to velvetonion]

Hi, oh I'm glad to hear it went well and that you feel supported! I think the group on here is great, so I'm sure someone will reply if you have anything else crop up. Remember to be kind on yourself, it's a massive toll on the body and mind and those early moments post surgery can be tough x