Blog 4 - Pre-op assessment

16/07/2010


I had my pre-op assessment this week.

The summary – if you don’t want to read the full rant is:

1.       1. Took measurements and an ECG

2.       2. Asked a series of medical questions to assess my suitability to the op

3.       3. Urine sample

4.       4. Spoke to the anaesthetist to discuss the anaesthetic risks and post op pain relief

5.       5. Blood tests.

First they measured my height, weight and body mass index. I had an ECG done and blood pressure taken. I was surprised at my pulse rate. It’s always been high, even when I was at my fittest and doing athletics, but it averaged 93! My blood pressure was low, but then it always has been.

I was then sent to another nurse who asked me a series of questions. This was really annoying, as she had so many forms, she was asking the same questions several times. Not her fault, but she wanted me to go into every inconsequential detail. For example:

“Have you ever been a smoker?”

“Yes, when I was 16 and stupid”

“How long did you smoke for?”

“Maybe two years. I only smoked on occasion”

“How many did you smoke a day?”

“I don’t know, it was over a decade ago, some weeks I got through a small pack, other weeks I didn’t smoke at all”

“So how many”?

Now I’m thinking - for fuck sake, does it really matter? It was over 10 years ago! It’s not as if I chain smoked constantly for 2 years! I expect there are people who have more damage from passive smoking, than I had for the occasional ciggie!

And it carried on in that vein. She seemed convinced I used to be an alcoholic because I don’t drink anything anymore. Even when I said, no – it’s because if I drink anything other than water it irritates the bladder and causes pain. Then she seemed to think that if I wasn’t drinking, I must be taking illegal drugs. I said no, my prescription ones are bad enough thank you. Then she seemed surprised I was on so many pain killers, like I was some kind of junkie  – at that point she seemed to realise she was seriously pissing me off. I had come there to prepare to have my bladder removed after all, what the hell did she expect!? Normally I’m very patient, as I’ve gone through this sort of thing many times. I don’t object to the questions she asked, but I really didn’t appreciate her attitude.

So anyway, it was an hour of answering medical questions, and then I had to provide a urine sample.

As for asking questions about my op, well, she didn’t know diddly squat. She gave me a booklet on Cystectomies for cancer patients. Well, thank God I’ve already done my research, because hardly any of it applied to my situation. That made me really angry. If someone had gone in not knowing what the op entailed and read the booklet given, they would have read that they would have their bladder, womb and part of the vagina removed and this is not the case for women solely with Interstitial Cystitis. The only illuminating thing about the booklet was that some of my nerves used for sexual function may be damaged during the operation. Okay, that wouldn't be good, but in the scheme of things, that is way down on my list of priorities. It’s not as if I have a sex life to speak of anyway. With IC it's too bloody painful!

The last person I saw was the anaesthetist who was the only one that seemed clued in and acted in a professional manner. She said an operation like this would take around 8 hours. For pain relief when I wake up, I have a choice of an epidural, which is where they put a small flexible tube called a catheter (not a urinary catheter obviously) into your lower back, though which they drip local anaesthetic constantly and this numbs your pelvic region and abdomen.

The other option is spinal anaesthesia. This is slightly different to epidural anaesthesia as the drugs are injected into a different space. During a spinal, pain killers and other substances are injected directly into the spinal fluid of the spinal cord.

I want to opt for the epidural as it sounds like the most effective method to me, and I’d rather not have extra painkillers if I can avoid it, as I’m not sure what effect it would have on me after I’ve been on my prescription drugs for so long. (I’m really looking forward to not having to take any more drugs afterwards!)

The one issue I wanted to press was that I didn’t want the surgeons to remove my womb. You hear these stories of surgeons taking the wrong limb or organ and it’s made me paranoid. She made a note of it, but I would have to reiterate this when I sign the patient agreement before the op.

Finally I had some blood taken.

And that’s that! It’s made it all fractionally more real to me. I don’t think it will seem real until I’m there, I’ve spent so much time waiting for this. Only 6 weeks to go!

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