After spending 10 days in Orlando, Florida (to see the Mouse and ride some roller coasters with family and friends), I got to come home for my abdominoplasty pre-op appointment.
I would just like to throw out something before I go into the appointment, this will probably not be like your appointment unless you live in the Netherlands. This pre-op was kind of surprising in a lot of ways and only a few things I was expecting to be done was actually done.
The first pre-op gespreak (talk) was with the pharmacy department. Basically all they wanted to know was what drugs or drug combos I’m allergic to, what prescribed medications I’m on and what I take over the counter. If this talk lasted 5 minutes, I’d have been surprised.
- I’m allergic to the opioid Tramadol. Especially when paired with Paracetamol (i.e. Tylenol). The side effect is severe edema. Think retaining about 8kg (about 17lbs) of water and everything is swollen like little sausages left out in the sun, water retention.
- I take the insulin novorapid for my diabetes and birth control.
- Over the counter I take vitamin D, B, C, magnesium and potassium.
Pretty easy and straight forward.
Next step was an anesthesiologist. I say ‘an’ because apparently the hospital employs about 100 of them and the chances that whomever I speak to during the pre-op gespreak won’t be who gets my surgery on the 17th of December. However, she was great in writing everything down and I know the nurse, anesthesiologist and anesthesiologist nurse all read what she wrote.
Basically we went over:
- If I ever had a bad reaction to general anesthesia before. Yes, when I had my gall bladder out when I was 17 years old in 1997. I came out coughing and puking.
- If anyone in the immediate family reacts bad to anesthesia. I talked to my mother at length about this awhile back (it’s ALWAYS good to ask about these things in your family history) and apparently everyone is just fine with it. None of the concerns that they were looking for were present.
- My diabetes.
The first thing that I had going for me was I’d be the very first patient going into the operating room so that I wouldn’t have to fast too long. Unfortunately, some people’s diabetes reacts by raising the blood sugar if they don’t eat. Others will go low because their basal (long lasting insulin) profile is off or that’s just the way their brand of diabetes rolls. Me, I generally go high in the total absence of carbs. So I was pretty happy with a very early OR time slot.
The next thing we went over was my insulin pump. She looked up the hospital’s procedure when a diabetic has a pump and anything over 2 hours means the pump is turned off. So we agreed I’d wear my pump someplace that its out of the way and I’d turn it off completely the last minute and let the anesthesiologist take care of my blood sugar management.
The third thing we talked about was my CGM (continuous blood glucose monitor). Since it was expiring the morning of the operation, she asked that I just remove it and not replace it. Once I was back in my room, I could go and put the new one on.
And the last thing was going over the things that typically raise a diabetic’s blood sugar when it comes to surgery. I wouldn’t have any glucose in my IV drip, they would just add some if I went low. They wouldn’t put any steroids (apparently popular for anti nausea) in my IV mix nor prescribe it for the swelling unless there was no other recourse.
The only other thing she wanted was me to go get an EKG to make sure my heart was fit because of my diabetes. I thought that was going to be something that was long and drawn out. I swear the EKG tech had the little thingies stuck to me and was yanking all of them off within 30 seconds.
The last person that was part of the pre-op day was a nurse that went over the questions I had to fill out before hand (well, my husband filled out because I was in Orlando when they sent it to me).
First for control reasons she asked my birthdate and what I was expecting to have done in my own words. After that, we went through a bunch of questions about my current health, some stuff about the surgery itself and the aftercare.
We went over that the cut would be in the fleur de lis cut (hip to hip then from the middle of that incision to just under my sternum) and that my belly button would be saved and relocated. I had thought about this for quite some time and after reading people’s experiences and seeing pictures of belly buttons gone wrong, I had decided to not save my belly button and just get identified in the future as an alien.
After about 10 minutes we were done and I could go back to the office my client is located at just down the street.
What shocked me the most about how the hospital went about doing this pre-op is they didn’t weigh me at all. They just asked what my current weight was (115kg) and if I knew my current A1c. They also didn’t do any blood labs where you hear about people going in for plastic surgery and getting the full monty done in blood work.
My best theory on why they didn’t do all the things that are usually done in the states is because the Netherlands and Europe at large isn’t sue happy. Perhaps the beds could weigh the patient as well so that the anesthesiologist had the correct weight for the medicine. Or maybe they figured that I had no reason to lie. I really have no idea if it’s right or wrong. I guess we’ll see!