Elizabeth N.
Herder of cats
The purpose of this thread is to address the expectations of people who have never had abdominal surgery with general anesthesia. It's not specific to any WLS procedure, just to the experience of surgery. My reason for this thread is that I keep reading really ridiculous posts from people who are like 24-48 hours postop who think they should be back to normal and see evidence of weight loss on the scale and in the mirror.
Um, NOT realistic. I would like to think that the hospital and surgeon people would educate folks on this stuff, but I know they don't. So, let's educate please.
Would people please chime in here and tell about what happens the morning of surgery when you check in and get prepped? My experience was a little different from the usual because of my severe medical situation at the time, so I don't want folks to go by my details on this. Bascially: You'll show up at the hospital, sign lots of papers, change into surgical attire, get blood drawn, IV port started, fast interviews with several medical people, and get herded into the waiting line for your OR room/team. Chances are you will have to say goodbye to the people who accompanied you to the hospital and then still hang out on your gurney and wait for a while.
At this time, if you want happy juice so you remember nothing, you will have mentioned this to anesthesia people at your preop evaluation, but you can still ask for it now if you start to freak. Do NOT lie there on your conveyance and just endure fear/panic/misery. SPEAK UP.
You will either be wheeled or asked to walk to the operating room. Some people find walking into the OR to be pretty wild. Control freaks like me think it's great LOL. I don't want to give up any control I don't have to until the last second! If you get happy drugs they'll wheel you in cuz you'll be too stoned to maneuver.
You MIGHT remember some of this: In the OR you will be asked once again your identifying info (compared to your bracelet and their written stuff), what kind of procedure you're having and that you consent to this whole spiel. You'll get on the table, which will be cold and uncomfortable. At this time, THINK about what will help you to lie there paralyzed for hours with a minimum of misery. Do you have a bad knee/back/hip/shoulder/elbow/neck? SAY SO. Insist on getting your bad joint supported with pillows or towels or whatever, cuz you're gonna be there a long time and you will not automatically change your position like you do when you're asleep.
If you have limited range of motion somewhere, like your neck, demonstrate your range of motion to Anesthesia Dude and say in plain English what the limits are. They will listen and try to accomodate. They LOVE IT when people tell them stuff that will help them make you less miserable later.
Somebody will stay at your head and talk to you and say goodnight. You might remember getting a mask on your face and being told to breathe deeply and relax. You might feel suddenly drugged/dozy for a moment. The next thing you will know--and it will seem like no time has passed and that loss of time will be a little weird--someone will be shaking you awake and telling you it's over. (You will very likely not remember any of this either, especially if you had happy juice.)
You can use Google to find a total demonstration of everything that happens in your surgery with as much live or cartoon detail as you want. I will skip those details except to say in general: The general anesthesia involves drugs that render you unconscious, paralyzed, devoid of sensation and amnesic. Look up general anesthesia for more information if you want it. The anesthesia team will do EVERYTHING for you except run your heart and your brain, basically. Anything the paralytic drugs stop, they do, like breathe for you. This is why you must be intubated and have a catheter during surgery.
You will NEVER receive as much focused, professional, carefully, absolute attention in your life as you do when you are under anesthesia. It's just about the safest place on the planet to be. You are at greater risk of being hit by a car than you are of dying under anesthesia. Probably the risk is higher of your house collapsing on you than of dying from anesthesia, but I haven't actually SEEN those stats lol.
Once your surgery and anesthesia are over, you will be wheeled from the OR to the PACU, post anesthesia recovery unit. There you will be lovingly attended by your very own PACU person and a hell of a lot of equipment. Various people will be bugging you about how you feel, telling you to breathe, asking you your pain level, having you move your feet, etc. You will have pressure cuffs around your lower legs and these will inflate/deflate. You might be damned cold. This is cuz the OR is about icebox temperature, and because of the effects of anesthesia. COMPLAIN....about ANYTHING that bugs you. Trust me, your complaints give the folks valuable info and they can and will help you. This is NOT the time to be brave and suck it up. This is whining time.
If you are happy as a clam and higher than a kite, SAY SO. This is also valuable information.
By all means tell everyone your life's story, that you love them, that you will make them filet mignon, have their baby, whatever. They LOVE hearing you talk. It's good for your breathing and it entertains them.
Oh BTW everyone in the world will be bugging you to BREATHE and COUGH and it will suck because your belly got blasted. THAT you must suck up. Your one major task in life right then is to breathe deeply and often. If it hurts too much to breathe, whine loudly, but BREATHE while doing it. REMEMBER THIS,. do you hear me? DEEP BREATHING IS IMPERATIVE. You gotta get the anesthesia out of your person, you gotta get the crap out of your lungs, you need the oxygen.....BREATHE BREATHE BREATHE. Trust me, you do NOT want post anesthesia pneumonia. Look it up on Google, get scared and BREATHE.
After a while in PACU, you will get removed to your room. IMNSHO remembering this (which I do, from multiple surgeries) is a bummer, because it involves moving and getting bumped even by the most careful of orderlies. Motion on post anesthesia belly is nauseating. Getting bumped with slashed belly hurts. Close your eyes, take a shot of your pain meds if you have a pain button and try to go unconscious for this. Use brain power to black out for this ride if possible.
You'll arrive in your room. Depending on how your surgery went and how stoned you are, you will either sit up and step from gurney to bed or you will be transferred by personnell. Both methods suck but for different reasons. I cannot recommend a preference.
Your bed will be fucking cold. New people will arrive. There will be lights and noise and annoyance. You might welcome or resent the activity, and you may or may not remember any of it. Follow instructions, whatever they might be, with all the zest you can muster, for obeying your instructions will lead to going home sooner AND to feeling better faster, even though you might not be able to imagine it at that point.
For me, my instructions were to lie there and shut up, basically. Okay, not really, but I was in ICU and had major medical shit going on and nobody knew what I could do for myself because I came in to the hospital on oxygen and barely walking. So I got treated as sicker than I really was and it was a miserable experience. Most of you will be dragged out of bed and told to walk, pee, etc. DO IT. Yes it will hurt and yes you will be cranky. DO IT ANYWAY. It's good for you.
Depending on your procedure, surgeon, medical condition and protocol, you might wake up with: a catheter between your legs, NG tube in your nose, oxygen in your nose, drains in your belly, peg tube aka feeding tube in your belly. You WILL have some kind of IV port going, could be a basic vein in arm, a port in upper arm, chest or a central line in your neck.
(Central lines are da bomb. You can get an eggplant sent through those suckers and you'd never know. Do not resist a central line. They get put in when you're out and held in place, usually in your neck, by one or two stitches. The scars are miniscule but resemble vampire bites, so they are cool looking. Central lines free up your arms and you don't get bruised to hell because they go in deeper veins.)
Regarding the tubes: Chill. They are your friends. The catheter means you don't have to haul your miserably sore ass out of bed immediately for two tablespoons of pee--and trust me, with all the fluids they are pumping into you, you will have LOTS OF PEE.
Catheter removal for women feels like removing a very soaked/lubed tampon. Sorry guys, dunno what it's like for you.
Belly drains: Also your friend. They get fluids out of your surgically traumatized gut that would otherwise hang out and hurt and maybe cause infection. Ignore them unless you have to go home with them. Then treat them as your friends and follow your care instructions. Really, they are no biggie if you expect them and just do what you have to do.
Jtube/feeding tube: The way to not get back in the ER with dehydration from hell. LOVELY invention. USE IT to make sure you get tons of fluids, your protein drink, etc. Be glad it is there and use it to get stuff in that will help you heal faster. When drains and J tube come out it will be WEIRD but only minimally uncomfortable unless they stick to your skin. Then they will pull and hurt a bit. It's okay. They are your friends. Attitude is imperative to enduring them and using them well.
I've had general anesthesia for same day surgery, as a revision to my "tummy tuck." If i were to compare the differences in my experience between that and the inpatient stuff, there are two major differences: One, I "had" to walk into the OR, and I HAD TO walk out (EDIT: walk out of the surgery center, not out of the OR) under my own power. The drugs in the anesthesia/pain management cocktail were a little different, so that I was functional faster but way happy happy joy joy LOL. I went home from that pretty big operation happy as a clam, could have started a new business and who knows what all that day.....But the NEXT day I felt like shit on a stick.
The surgeon warned me that my same day experience would be quite different from my inpatient experience, even though it was less than 12 hours' difference in time. The whole protocol was different.
So, I think what's really important for you to understand is that THIS IS REALLY SURGERY FOR REAL. It is NOT "less invasive" or "simple." You are taking on ALL the risks of abdominal surgery in general and WLS in particular. Do NOT minimize or ignore the warnings about how big this is. This is not ingrown toenail surgery.
Um, NOT realistic. I would like to think that the hospital and surgeon people would educate folks on this stuff, but I know they don't. So, let's educate please.
Would people please chime in here and tell about what happens the morning of surgery when you check in and get prepped? My experience was a little different from the usual because of my severe medical situation at the time, so I don't want folks to go by my details on this. Bascially: You'll show up at the hospital, sign lots of papers, change into surgical attire, get blood drawn, IV port started, fast interviews with several medical people, and get herded into the waiting line for your OR room/team. Chances are you will have to say goodbye to the people who accompanied you to the hospital and then still hang out on your gurney and wait for a while.
At this time, if you want happy juice so you remember nothing, you will have mentioned this to anesthesia people at your preop evaluation, but you can still ask for it now if you start to freak. Do NOT lie there on your conveyance and just endure fear/panic/misery. SPEAK UP.
You will either be wheeled or asked to walk to the operating room. Some people find walking into the OR to be pretty wild. Control freaks like me think it's great LOL. I don't want to give up any control I don't have to until the last second! If you get happy drugs they'll wheel you in cuz you'll be too stoned to maneuver.
You MIGHT remember some of this: In the OR you will be asked once again your identifying info (compared to your bracelet and their written stuff), what kind of procedure you're having and that you consent to this whole spiel. You'll get on the table, which will be cold and uncomfortable. At this time, THINK about what will help you to lie there paralyzed for hours with a minimum of misery. Do you have a bad knee/back/hip/shoulder/elbow/neck? SAY SO. Insist on getting your bad joint supported with pillows or towels or whatever, cuz you're gonna be there a long time and you will not automatically change your position like you do when you're asleep.
If you have limited range of motion somewhere, like your neck, demonstrate your range of motion to Anesthesia Dude and say in plain English what the limits are. They will listen and try to accomodate. They LOVE IT when people tell them stuff that will help them make you less miserable later.
Somebody will stay at your head and talk to you and say goodnight. You might remember getting a mask on your face and being told to breathe deeply and relax. You might feel suddenly drugged/dozy for a moment. The next thing you will know--and it will seem like no time has passed and that loss of time will be a little weird--someone will be shaking you awake and telling you it's over. (You will very likely not remember any of this either, especially if you had happy juice.)
You can use Google to find a total demonstration of everything that happens in your surgery with as much live or cartoon detail as you want. I will skip those details except to say in general: The general anesthesia involves drugs that render you unconscious, paralyzed, devoid of sensation and amnesic. Look up general anesthesia for more information if you want it. The anesthesia team will do EVERYTHING for you except run your heart and your brain, basically. Anything the paralytic drugs stop, they do, like breathe for you. This is why you must be intubated and have a catheter during surgery.
You will NEVER receive as much focused, professional, carefully, absolute attention in your life as you do when you are under anesthesia. It's just about the safest place on the planet to be. You are at greater risk of being hit by a car than you are of dying under anesthesia. Probably the risk is higher of your house collapsing on you than of dying from anesthesia, but I haven't actually SEEN those stats lol.
Once your surgery and anesthesia are over, you will be wheeled from the OR to the PACU, post anesthesia recovery unit. There you will be lovingly attended by your very own PACU person and a hell of a lot of equipment. Various people will be bugging you about how you feel, telling you to breathe, asking you your pain level, having you move your feet, etc. You will have pressure cuffs around your lower legs and these will inflate/deflate. You might be damned cold. This is cuz the OR is about icebox temperature, and because of the effects of anesthesia. COMPLAIN....about ANYTHING that bugs you. Trust me, your complaints give the folks valuable info and they can and will help you. This is NOT the time to be brave and suck it up. This is whining time.
If you are happy as a clam and higher than a kite, SAY SO. This is also valuable information.
By all means tell everyone your life's story, that you love them, that you will make them filet mignon, have their baby, whatever. They LOVE hearing you talk. It's good for your breathing and it entertains them.
Oh BTW everyone in the world will be bugging you to BREATHE and COUGH and it will suck because your belly got blasted. THAT you must suck up. Your one major task in life right then is to breathe deeply and often. If it hurts too much to breathe, whine loudly, but BREATHE while doing it. REMEMBER THIS,. do you hear me? DEEP BREATHING IS IMPERATIVE. You gotta get the anesthesia out of your person, you gotta get the crap out of your lungs, you need the oxygen.....BREATHE BREATHE BREATHE. Trust me, you do NOT want post anesthesia pneumonia. Look it up on Google, get scared and BREATHE.
After a while in PACU, you will get removed to your room. IMNSHO remembering this (which I do, from multiple surgeries) is a bummer, because it involves moving and getting bumped even by the most careful of orderlies. Motion on post anesthesia belly is nauseating. Getting bumped with slashed belly hurts. Close your eyes, take a shot of your pain meds if you have a pain button and try to go unconscious for this. Use brain power to black out for this ride if possible.
You'll arrive in your room. Depending on how your surgery went and how stoned you are, you will either sit up and step from gurney to bed or you will be transferred by personnell. Both methods suck but for different reasons. I cannot recommend a preference.
Your bed will be fucking cold. New people will arrive. There will be lights and noise and annoyance. You might welcome or resent the activity, and you may or may not remember any of it. Follow instructions, whatever they might be, with all the zest you can muster, for obeying your instructions will lead to going home sooner AND to feeling better faster, even though you might not be able to imagine it at that point.
For me, my instructions were to lie there and shut up, basically. Okay, not really, but I was in ICU and had major medical shit going on and nobody knew what I could do for myself because I came in to the hospital on oxygen and barely walking. So I got treated as sicker than I really was and it was a miserable experience. Most of you will be dragged out of bed and told to walk, pee, etc. DO IT. Yes it will hurt and yes you will be cranky. DO IT ANYWAY. It's good for you.
Depending on your procedure, surgeon, medical condition and protocol, you might wake up with: a catheter between your legs, NG tube in your nose, oxygen in your nose, drains in your belly, peg tube aka feeding tube in your belly. You WILL have some kind of IV port going, could be a basic vein in arm, a port in upper arm, chest or a central line in your neck.
(Central lines are da bomb. You can get an eggplant sent through those suckers and you'd never know. Do not resist a central line. They get put in when you're out and held in place, usually in your neck, by one or two stitches. The scars are miniscule but resemble vampire bites, so they are cool looking. Central lines free up your arms and you don't get bruised to hell because they go in deeper veins.)
Regarding the tubes: Chill. They are your friends. The catheter means you don't have to haul your miserably sore ass out of bed immediately for two tablespoons of pee--and trust me, with all the fluids they are pumping into you, you will have LOTS OF PEE.
Catheter removal for women feels like removing a very soaked/lubed tampon. Sorry guys, dunno what it's like for you.
Belly drains: Also your friend. They get fluids out of your surgically traumatized gut that would otherwise hang out and hurt and maybe cause infection. Ignore them unless you have to go home with them. Then treat them as your friends and follow your care instructions. Really, they are no biggie if you expect them and just do what you have to do.
Jtube/feeding tube: The way to not get back in the ER with dehydration from hell. LOVELY invention. USE IT to make sure you get tons of fluids, your protein drink, etc. Be glad it is there and use it to get stuff in that will help you heal faster. When drains and J tube come out it will be WEIRD but only minimally uncomfortable unless they stick to your skin. Then they will pull and hurt a bit. It's okay. They are your friends. Attitude is imperative to enduring them and using them well.
I've had general anesthesia for same day surgery, as a revision to my "tummy tuck." If i were to compare the differences in my experience between that and the inpatient stuff, there are two major differences: One, I "had" to walk into the OR, and I HAD TO walk out (EDIT: walk out of the surgery center, not out of the OR) under my own power. The drugs in the anesthesia/pain management cocktail were a little different, so that I was functional faster but way happy happy joy joy LOL. I went home from that pretty big operation happy as a clam, could have started a new business and who knows what all that day.....But the NEXT day I felt like shit on a stick.
The surgeon warned me that my same day experience would be quite different from my inpatient experience, even though it was less than 12 hours' difference in time. The whole protocol was different.
So, I think what's really important for you to understand is that THIS IS REALLY SURGERY FOR REAL. It is NOT "less invasive" or "simple." You are taking on ALL the risks of abdominal surgery in general and WLS in particular. Do NOT minimize or ignore the warnings about how big this is. This is not ingrown toenail surgery.
