What To Expect In A Pre-Operation Assessment #Pre-Op

With the date for my foot operation looming (Mon 21st August), yesterday saw me head to the Pre-Operation Assessment Unit for a check that all was well prior to next Monday.

I have to admit it’s something that I was nervous about, not only had I been having really weird dreams that I’d be told I wasn’t suitable for the operation, but I was also meeting with the surgeon more-or-less immediately afterwards to talk what and how he’d been performing the operation, so I was a bit anxious, to say the least.

I’d already been emailed a questionnaire about how my #scarfeet were currently affecting me and there were a further set of forms to complete once we arrived, around next of kin details and a very detailed one asking about medical history, medications and after-care support at home as I’ll be having a general anaesthetic.

And then it was time for the   consulation.  My pulse rate was waaaay too high so we had a general chat around some of the answers I’d given, including the fact I’d fainted and knocked myself out earlier this year (which now, thinking about it, might explain some of what  subsequently happened yesterday) and some general background.

My height and weight were then taken and my neck circumference measured, this is so that the general anesthetic is specifically tailored for me, the neck measurement is for the length of the tubing used.   I never like being weighed (does anyone?) and it is literally a number on a form to them, part of the process.

Post-op care was discussed, as I’m having day-surgery, I wouldn’t be allowed home unless someone would be able to take me and I also have to have a “responsible adult” with me for 48 hours afterwards with strict instructions only to leave my bed for a bathroom trip, not to drive, operate machinery or make any important decisions whilst the GA effects leave my body (the first two would definitely be out and hopefully the latter will just be a case of whether I’d like a coffee or not). 

I remember the day after my op last October very well, we had to go to A&E as one of my feet wouldn’t stop bleeding and my GP wouldn’t come out, I picked up some crochet to do whilst we waited to be seen and could not remember what to do or how to hold the hook – a very strange feeling! 

There is also a fasting requirement before surgery, this is to ensure that there’s no choking risk from anything in the stomach,

For morning surgery and a 7am/7.30 admission, it’s important that there is nothing eaten after 2.30am that morning (I’ll have something light before going to bed) and after this, it’s only clear fluids (water, black tea/coffee, well diluted squash) until 6.30am (with the recommendation of a large glass of water at 6.30am) and then nil by mouth until after the operation.

For afternoon surgery with an admission time of 11am or 12.30pm, the cut-off time for a meal is 7.30am and for clear fluids 11.30am.

Then I was given this:

A wash lotion which I have to use for five days before my operation to control the level of bacteria on my skin, there are also very specific instructions as towels useage (changing daily), bedding (changing on days 1 and 4 of using the lotion) and using the lotion as a hair shampoo on alternate days (usual shampoo and conditioner is not to be used). 

Nail polish also will have to be removed from both fingers and toe nails, this is so that the levels of oxygen can be checked (i.e. if my fingers/toes turn blue under my nails, I’m not getting enough oxygen).

Swabs from my nostrils and inside my mouth were also taken, if I’d had an overnight stay in hospital during the last year, I would have also one taken from my back passage, thankfully this wasn’t the case but to the staff, I can imagine it’s just another “hole”, however embarrassing it might have felt!

Because my pulse rate was still high, I was sent off for an ECG, this measures my heart rate and consists of markers being placed on quite a few places on my chest and ankles, with the need to have nothing on my upper body, all over very quickly and again, it’s nothing that staff haven’t seen before.  I was told that I might need to be checked for anaemia if the readings were still high but at that time all seemed okay.

There’s a recommended list of what to bring into hospital, as far as valuables go, be aware that your hospital bed bay will be unattended obviously whilst the operation is in progress and therefore any valuables could be at risk.    

My bag will contain a lightweight robe that I can wear as an outer garment, my cat face slippers which take up virtually no space, a pack of baby wipes, small crochet project, a book, a bottle of water for post-op and my phone.  All jewellery must be removed so that will stay at home and, as I can’t eat or drink anything, I won’t need any money.  I’ll also wear pyjama trousers and a vest top, which means I can go straight to bed once home.

Underwear, bras must be removed prior to the operation but, unless the surgery is relevant to that area, pants can stay on.

So, armed with everything I needed to know, I headed off to my chat with the surgeon – only to be caught up with and told that I would need some blood tests afterwards!

They had three attempts at taking blood in the pre-op unit before sending me to pathology.  

If I am found to be anaemic, then my operation will be delayed as I’ll need iron but I think (and hope) that it’s only because I mentioned that I’d fainted a few months back.  They’re being cautious, which I’m grateful about, I should know this afternoon if everything is okay.

A pre-op assessment is valid for surgery within three months of the assessment so, as my next surgery is looking likely to be in January 2018, I’ll need another one.

But, bearing in mind, how anxious I was yesterday and subsequent tests – which saw us spend most of the day there yesterday – I think I’ll request that I have the chat with the surgeon beforehand! 

Fingers crossed here that it’s all systems go for Monday! 

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