anesthetic

[Graham39]

I am considering having a hip replacement op. I have no sphincter at the base of my oesaphagus following my cancer op. six years ago. I wake up choking due to reflux occasionally but can deal with it by sitting up, as I'm conscious, which would not be the case during an operation. Does anyone know if special arrangements are put in place for patients like ourselves ?

[Hidden]

Hi Graham, I had an incisional hernia repair last year, two years on from the Ivor Lewis procedure. Prior to the op the anthesiest explained that he was aware of my previous operation and they had procedures in place should there be any problems. Rather a vague reply I know but hope it reassures you. All the best Keith

[Graham39 in reply to Hidden]

Thanks Keith, I would obviously seek medical advice

[Bernadette100]

Should not be a problem as there would be NO food or drink in your system due to fasting before op.

[Graham39 in reply to Bernadette100]

Hopefully you are right Bernadette

[Bernadette100 in reply to Graham39]

good luck with the hip op..my own hip has been giving me jip somedays, must say I had not thought about that issue..but do worry if I was in an accident and they put me on my back after eating

[AoifeMcC]

I had 2 children post our surgery (they were c-sections, one of which was an emergency (she is 5 today)) - yes, the surgery will be fine and they can allow for people like us.

Best wishes,

Aoife

[Graham39 in reply to AoifeMcC]

Thanks for the reassurance

[Bernadette100 in reply to AoifeMcC]

Happy birthday to your daughter

[Hidden]

I am sure the anaesthetists will know what to do, as further surgery takes place fairly regularly.

But it reminded me that for some who are worried about being laid flat in a situation where you might be receiving first aid, for instance, there is a MedicAlert bracelet that says something like 'I have had an Oesophagectomy - Do not lie me flat' . The OPA helpline 0121 704 9860 may be able to help further.

[Graham39 in reply to Hidden]

Thanks Alan, I'll give them a ring

[Hidden in reply to Hidden]

I have this bracelet but round my neck and also have what I am alergic to on it, it is good to have

[geranium1111]

Hello Graham

I have had two hip replacements though prior to my oesophagus opp. and each time this was done with an epidural and sedative - I had earphones on listening to music and did not feel a thing either time and I am sure you would be fine having it done this way

Good luck

Mick

[Graham39 in reply to geranium1111]

Thanks Mick, I'll look into it

[gutlesswonder]

Hi Graham

All of us in this situation are at real risk of inhalation pneumonia.

I am sure you have read that mistakes in the operating theatre are alarmingly common; they include amputating the wrong leg, etc etc!

You should have no problem provided that during work-up you see and explain to the Consultant Anaesthetist and also to his Registrar and ask what they propose.

Read your notes and ensure that suitable comments have been included.

Then on the day as they wheel you in and before the preliminary needle, check that it is them behind the masks. You can make a joke of this.

Specifically it is likely that they they will employ an extra suction drain in the throat and monitor you very carefully.

I have had this done twice.

Also I insist upon endoscopy being carried out on the right side as opposed to the more common left side since this reduces the likelihood of reflux. This causes some consternation as it entails rearranging the theatre but the seriousness is recognised.

[erasuretim in reply to gutlesswonder]

just wondering why it is better to lie on the right rather than the left?

[Graham39 in reply to gutlesswonder]

Thanks a lot for the useful info. Sorry about delay in reply, but have been on holiday.It's a case of your life in their hands. I was told I would be hospitalised for 10 or 11 days for my oesophagus op. but was there for over six weeks.

[Graham39 in reply to gutlesswonder]

Thanks for the info., I will definitely do my best to ensure the medical team are all aware of my situation

[gutlesswonder]

Hi erasuretim

Referring to the diagram in the post below :-

healthunlocked.com/oesophag....

You will see that in (b) , the normal anatomy, there is a very pronounced bend to the right after the pyloric sphincter exit from the stomach down into the duodenum.

Clearly when lying on the right side liquid (chyme - the mixture of semi digested food with stomach secretions, bile and pancreatic juice) tends to drain down and away from the throat. Of course then pre-op one still also had three sphincters acting as one way valves.

But post-Ivor Lewis that bend has been straightened out to a greater or lesser degree, depending how much of a pull up the surgeon had to do in order to close the gap where the oesophagus has been removed in whole or in part.

Curious about my own reconfiguration I persuaded a houseman (young doctor, qualified but still in training) to do some research. We crept into the x-ray dept after hours, I swallowed some contrast medium then lay in various positions while he recorded images on film. This clearly showed that I had about half of the bend intact and that there was a pronounced difference in the rate at which intestinal content flooded back when prone to the right or to the left.

Of course radical (drastic) surgery, necessitating closing a large gap, could leave a patient with a reconstruction that is vertical and straight as a die in which case the above would not apply. Each of us is different, the carcinoma was unique and the surgeon did his own thing.