Pre-op Testing and Appointments Completed

Jun 13, 2010

Well, I have had such a busy week this past week getting prepared for surgery. I'm mentally and physically exhausted, but excited about having everything out of the way. Now, I just have to continue my pre-op diet and make a few last preparations before my surgery on the 22nd.

I thought it might be a good idea to post what I went through with pre-op appointments in case anyone out there is wondering about this aspect of things. I actually scheduled all of my own preop clearances. (The surgeon's office scheduled the preop appt I had with them and the hospital.) The surgeon's office has specific doctors they work with for the clearances and I went with those instead of trying to do something closer to home. I didn't want any delays with the results getting to my surgeon. This actually ended up being for the best because the surgeon's office and all of the doctors they use for clearances are tied into the hospital's computer network. They are all able to view most of the same info, reports, data, etc. about patients using the hospital's doctors. This should help prevent any delays if a piece of paper gets lost along the way.

I actually had my first preop clearance last week, which was pulmonary. This appointment was quick and to the point and a total breeze. I guess that's because I don't have any pulmonary isses, but it felt somewhat like a waste of time. I wish I had scheduled this one on the same day as one of the other appointments and that would have been one less day of driving 45 minutes each way to the hospital offices.

This past week, I had the Upper GI, cardiac clearance, phone intake with the hospital admissions department, pre-op appointment at the surgeon's office, and pre-op intake at the hospital. This was all done over 3 days.

Wednesday morning I went in for my Upper GI. This required that I have nothing by mouth after midnight. I was allowed to take my meds that A.M. with a sip of water. As others have said, this test is not pleasant. It's not the one where they put you to sleep and put the camera down your throat. This is the one where you drink a ton of nasty stuff and roll around on a table like a beached whale while the GI doc looks at live action xrays of your stomach handling all the nasty stuff you drink. I got a quick look at my GI system in action at one point during the test. It was pretty cool to see the liquid running through my system on the screen as I drank, but I was too queasy to stare at it much.

I managed to drink everything they threw at me, but I was SOOO sick to my stomach afterward. I had planned to run and eat immediately after, but I didn't feel like it. My stomach was full of chalky stuff! But, I decided that instead of walking around without any sustenance in my body, I would make myself eat something. I went and got a meat omelet from IHOP and immediately felt better. Lesson for me, go ahead and eat after the Upper GI even if you don't feel like it. The stuff seemed to move through my system fairly quickly after I ate. I learned a couple of days later that the results from this test were that I have significant GERD. Go figure. That explains all the recent burping - which I never did up until about 3 or 4 months ago.

I did my phone intake with hospital admissions after the GI appointment. This was basic info gathering, a review of my current medications, and somewhat of a test of my understanding of what I was about to do to myself.

Later that afternoon was my appointment for cardiac clearance. When I got to the back, I was given an EKG. Then, the cardiologist came in and reveiwed the EKG and my history information. He said that the EKG was normal and that I seemed to be in good health for my weight. He then said he wanted me to do the treadmill test. Now, I had thought this was automatically part of the cardiology clearance, but apparently it's not because they had not scheduled me for one. They couldn't fit me in that afternoon, so I had to come back the next day. GREAT!   But, I didn't balk because I am too determined to have this surgery to let an extra appointment get in the way.

For the treadmill test the next day (which was Thursday), I had to have nothing to eat or drink - except small sips of water - 4 hours before the test. I was instructed to wear or bring something comfortable to wear during the test. Since I had to go in to work that morning, I took a gym bag with me. I changed in the private exam area and the tech swabbed off my chest area with alcohol and hooked me up to an EKG machine. I was allowed to keep on my bra, a hospital gown, and my bottoms and tennis shoes. She took my vitals and then had me get on the treadmill. I started off at a moderate paced walk and then the speed picked up. I never had to actually run but I did get sweaty and exhausted toward the end. The point was to assess how much exertion it took to increase my heart rate and how my body responded during the phase with a high heart rate. I was able to do this at a fast walk. I think the whole thing took about 30 minutes from the time I entered the room. The actual treadmill time was about 5 to 8 minutes.

The next morning, Friday, I had my appointment with the surgeon. This went really well because my diligence with my preop diet paid off and I came in 1 pound under weight from my initial consultation.  Lord I was so worried about that because my weight had been up and down (mostly up) since that initial consult appointment and your surgery can be cancelled if you gain weight. I think I"m in the clear now because I don't expect to gain any weight on this low carb preop diet.

I turned in all of my surgical clearance forms to the insurance coordinator and she put together the packet for me to take to my hospital appointment later that am. She had to get the GI clearance from the computer network through the hospital because they hadn't given me anything after my GI appointment like the other two had.

I then spent some time with the nurse reviewing my preop and postop instructions and the progression of the diet. This was really interesting because my surgeon has changed his bariatric diet progression recently and it's much more liberal than it used to be. I plan to post it in another blog, but I'm thrilled to only have 2 days of clear liquids post op!! Yay!!!   By day 7/8 postop, I'll be on pureed/soft foods. I'm really excited about that.

After talking quite a while with nurse (she also took some measurements for reference points), I got to meet with the doctor. I think I surprised him with my list of about 20 questions, but he took a seat and answered every one of them. I'm going to try to post that as a separate blog also for anyone who needs ideas of questions to ask. I thought of a couple more as we talked, so it was very informative. I'm very comfortable with getting the procedure done after our Q&A session.

After that, I went over to the hospital and completed my preop admission. I met with the intake rep and handed over my ID and insurance card (for the umpteenth time)   and got a nice little armband for the remainder of my preop. Then, I went to the testing area to meet with the preop folks. First, I talked to the anesthesia nurse practitioner about my anesthesia history. Nothing significant there. Then, I met with the bariatric nurse specialist to review everything I would go through on the day of surgery, immediately post op, and long term post op issues. This aspect of the preop visit was unexpected and very helpful. I learned about the bariatric wing of the floor I would be on postop, some things to remember for the morning of testing (like to request an antinausea patch before surgery), got to review aspects of the diet progression, and got some tips and tricks for eating postop. The bariatric nurse specialist will be visiting me throughout my stay in the hospital and checking on me post op for quite awhile. It will be nice to have another point of contact when I have questions.

The last leg of my hospital preop appointment was the general surgical nurse. She took some vitals and reviewed my chart and history briefly. She made sure that all clearances were in order and on file and made sure that my chart was complete. She then took a few vials of blood and took that hospital bracelet off my arm. I was so glad of that because I once had to wear that thing around for almost a week before a surgery because "that" hospital had to know that I was the same person who had given the blood during the preop - STUPID. The nurse reviewed the procedures for the morning of surgery with me and that was it.

Anyway, I hope this "book" I just wrote about my preop tesitng helps someone get a better idea of what they might be in store for in the days before surgery. I'm sure it's done differently in many places, but I guess the overall point is the same - to make sure we're healthy and sane enough to go under the knife. If I had any advice, it would be to plan your appointments strategically and be clear about what's expected at each appointment. I'm not sure that I could have cut down on my driving any because there was so much to get done, but I might have been able to cut out at least one or two days of the back and forth with better planning.

Now that I'm done with that, it's on to week 2 of my preop diet and just trying to keep my head on straight until surgery day. I'm still getting a case of the nerves here and there, but I'm going to see it through.

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