Pre-Surgery Appointments
A loooong day of medical appointments today, so we’re a bit tired and this may get a bit rambling. Pardon the lack of editing!
Surgery Info
Most important info first. We had some schedule changes and new information regarding the surgery:
Surgery is now scheduled for 10:00 AM on Thursday 2/4/21 instead of 1:30 PM.
That means and 8:00 AM arrival, so we’ll be getting up pretty early since we’re staying 30 minutes away from the hospital and need extra time in the morning for pre-surgery prep at the house.
I had been looking forward to a later surgery time so that I could sleep in, still have my coffee, etc. But whatever. At least with a morning surgery, my wife can get back to the kids by dinner time and miss some rush hour traffic.
We found out that after the surgery, I won’t be taken to the ICU unless there are any complications, which are rare. So I’ll go pretty much straight to a regular hospital room after I wake up.
I also found out that, in spite of COVID, I’ll be sharing a room with another patient. They said that they don’t consider it a COVID risk since everyone who goes through surgery has to pass a COVID test. I guess having a roommate isn’t a terrible thing, especially since I won’t have any visitors. But let’s hope he/she doesn’t snore!
No visitors allowed due to COVID.
We were previously told that my wife would most likely be able to visit me each day that I’m in the hospital.
That’s not the case. She can stay with me for all of the pre-operation preparation on the day of the surgery. She can stay in the waiting room during my surgery. And she will probably be able to see me for just a few minutes after the surgery.
After that, I’m on my own for 3-5 days until I’m released.
That’s bad for me. But I consider it good for Lisa as she won’t have to drive 30-45 minutes each way in traffic every day to visit me. Plus, she can stay at the rental house with our kids the entire time, which should ease any stress on them. Plus, it will sort of force her to rest, which, God knows, she could use right now with everything going on in our life right now.
No benzos! Hooray!
As you might remember, I don’t recover well from sedation / anesthesia, most likely due to the use of a class of drugs called benzodiazepines that include things like Versed.
If I’m given Versed for a morning procedure, I don’t typically wake up until late at night. Even then, I’m incredibly dizzy where even the smallest movement sends my head reeling and my stomach retching. Then it will still take me another 24 hours or more to overcome the lethargy and nausea.
Those symptoms have been true with all 5 surgeries/procedures I’ve had with sedation. But with the 2 procedures where I was able to talk the doctors out of using sedation (liver biopsy and celiac plexus block), I did great.
The reaction to benzos is most likely is a genetic thing as it showed up on Genomind testing that I had done that looks at response to medications based on your genes.
To my relief, I was able to talk about the sedation problem with several people today and it sounds like they’ll be sure not to use benzos with me. Dr. Starnes explained that there’s a different type of sedation they can use that’s more like an off/on switch. As soon as they stop administering it, I should recover pretty quickly.
One of my other main concerns has been pain management after the surgery.
I’ve heard about some negative experiences with this from a couple of previous patients. I was sure to bring that up with everyone I talked to today. They all assured me that they would do their absolute best to make sure I was taken care of. They also explained why some patients have a harder time and they felt that it shouldn’t be a problem for me.
I will have an epidural just before the surgery that will stay for a certain length of time after the surgery (1-2 days? I’m not sure.). Then they will transition me to other pain medications.
The More Detailed Stuff
The rest of this is mostly details for patients like me who take comfort in knowing as much detail as possible about what to expect.
Monday at the vascular department at Harborview Medical Center is “clinic day” where most of the doctors and such are all available to meet with patients. So today felt like a revolving door in the exam room with a flurry of health questions followed by long waits of scrolling through Facebook.
We were at the hospital from around 9:30 to 3:00 PM today, which included these very friendly (truly!) people:
First nurse for the usual blood pressure, temperature, etc.
Nurse Practitioner for more basic health review questions.
Second Nurse to go over pre-surgery bathing routing the night before and the morning of. (Regular shower followed by using Hibiclens antibactierial/antimicrobial all over, then rinse. Clean clothes and clean bed sheets to sleep in. Same type of shower routine the next morning.)
Dr. Starnes in exam room for basics, greet, and encouragement.
Dr. Starnes in the conference room where he pulled up my MALS CT scan results on a massive video wall. I had seen the 2D versions myself on some software that I downloaded. But he had the composite, colorized 3D version — WHICH WAS SO EPIC that I just wanted to keep scrolling through it. How cool to explore all my guts! Can you imagine what people 100 years ago would think about this kind of technology?
It’s hard to tell what you’re looking at in the image below, unless you know what to look for. I’d seen my imaging enough that it made complete sense. You can see the narrowing of the artery coming off the aorta, and then the stenosis (enlargement) of the artery right after that point. That clearly shows the compression that the ligament (not shown) is causing.
This image also doesn’t show any of the nerves, which is the real issue. Dr. Starnes called MALS “carpal tunnel syndrome of the gut”. There’s so much compression on the celiac ganglion nerves that he can feel how they become hard and packed together when he removes them.
After the consult with Dr. Starnes in the conference room, we went back to the exam room for more meetings with other staff:
Internist to go over pre-surgery/pre-anesthesia health history (heart health, liver, lungs, kidney, medications, etc.) and quick exam
Dr. Shen, the attending doctor and post-surgery care doctor to go over pretty much the same questions and exam.
Patient Care Coordinator to go over various details about where to show up and when for COVID testing and the surgery.
Anesthesiologist staff person to answer more screening questions and answer my concerns about sedation.
Other stuff you might want to know if you’re a Harborview patient…
There’s good wifi throughout the buildings that we were in, but not in the parking garage.
To get to the vascular department, we had to enter the building across the street, go through COVID screening, go up the elevators to the 4th floor, then cross the sky bridge. We didn’t get lost, but I would plan some extra time just in case.
COVID screening is currently a drive-through process by appointment time. I expect it to go pretty quickly / easily.
Surgeries are generally done on Thursdays. Your surgery time can change, as mine did, leading up to the surgery. The final surgery schedule doesn’t come out until Wednesday night, so things could change even up until that point. If so, you’ll get a call.
Next Steps
Tuesday 2/2/21 is a COVID test. That’s it.
Wednesday 2/3/21 is nothing, which I’m really looking forward to!
Thursday 2/4/21 is surgery day!