[ncpatches]

#1059040

I went for my pre-op appt yesterday, my shoulder surgery is 5/18 and scheduled 2 months before being diagnosed with Grave’s. To say I am NOT confidant in the anethesiologist (sp) is an understatement. Not only does she have no knowledge when it comes to Grave’s, she may or may not even be the one at my surgery. If not, the one who is, will have nothing to go by but her notes and she’s clueless! She ordered bloodwork, w/TSH and I told her, ‘that’s a waste of time, I’ve been on the meds less than 2 weeks and you know there is at least a 6 week lag time for changes to TSH, sometimes it takes months or years and she gave me a blank look like she had no idea what I was talking about. The RN that was doing all the paperwork before I saw this person, knew nothing about Grave’s, I had to do a fast rundown on what it was and risks, etc. I shouldn’t have to teach the medical staff that will taking care of my surgery. Am I angry, hell yeah! Am I even more concerned about the surgery, you better believe it! So after fuming and crying for several hours, I called the only rational person I know, my son. “Breathe Mom”…..make a list of all your concerns and what you need to do to get answers, phone calls, emails, etc. You have 2 weeks to get the answers that you need and if you don’t, find another ortho that operates in a place that knows what the hell they are doing.” Most of my life, I have been very level headed and rational, not anymore. Sometimes I think this disease has had more of a mental and emotional effect than physical, but I suppose it all ties in together. I am so frustrated that people in the medical field have so little information. This woman had the audacity to say to me ‘you were diagnosed last month, aren’t they going to take it out in a month or 2?’ How out of touch is that? Seems like she needs to update her knowledge in my opinion. That is such an outdated statement! Sorry ya’ll, yes, I’m still pissed off over the whole thing from yesterday, I’m sorry for the rant. Any suggestions would be greatly appreciated.

[snelsen]

#1171743

I totally understand where you are coming from! To clarify, it is very common for another anesthesiologist to be yours for the surgery. They develop the assignments the day before, generally, based on who is assigned where, and who is working. This was a very frustrating visit for you. I am so sorry.
It is not very encouraging, but very few docs are familiar with Graves.
Your son sounds great. And, I am sure you would be giving the same advice to
him in similar circumstances.

Of course you have your surgery scheduled, and want to move ahead with it. Unfortunately, it is too simplistic to find another ortho shoulder doc, and divine that the worker bees and anesthesiologist will “know what they are doing” when it comes to Graves.

My suggestion.
1. Can you ask your endo to order the labs? Just get them, have the endo fax them to the anesthesiologist department for your chart, and if they are really out of whack, ask your endo if he is concerned. I KNOW you want to move ahead with this surgery, and it sounds like it really needs to be done.
2. Or call the surgeon’s office, make the same request? But Might be easier to go through a GP or your doc.
3. Take them with you on the day of surgery.

Don’t be sorry for the rant. It is well deserved. Good for you for speaking up. Even though it was not helpful. What is your plan now?
Shirley

[adenure]

#1171742

I am sorry you’re dealing with all of this. Doesn’t it suck?!:mad: I just called my endo., to try and ask for an urgent referral to the surgeon. I don’t want to wait a long time to treat my Graves, and you know with my nursing- even weaning today- will take months then the 6 weeks that I’m supposed to wait once I’m dry, I just don’t feel like I can do that. But, who’s to say that the surgeon will be on board to operating on someone who could be hyper? I don’t know. Here I have 3 options, yet all 3 have an issue. Sorry, I don’t mean to hijack your thread, and our situations are different, but I hear you on the tears, stress, and feeling hopeless at times and dealing with people who don’t seem to get the whole picture. My endo. didn’t mention anything about the nursing issue- something I stumbled on myself looking through medical journals– my head aches from all of this- time to just wait for the doctor’s call. Well, let’s try to stay hopeful and positive.

Alexis

[ncpatches]

#1171744

Well, I called the Ortho’s office and spoke with someone, who connected me to his assistant, I left a message on her voice mail, instructing her to call me at work and what hours I would be there and the basic idea of what was going on that concerns me……….no call. I will be on the phone first thing in the morning. Today, I started to recognize a little ‘me’ in there! I’m still dealing with the nausea and little sleep, but I feel like the old ‘me’ is trying to come out. Maybe the high dosage of ATD is starting to do something. I can’t explain it, but I’ll bet others have been thru that too. I’m more determined than depressed for a change.
Shirley, I don’t have an endo, my Dr is Internal Medicine, along with help from the endo staff at UNC. I have no qualms about the surgery itself and I have faith in my Dr’s choice of Orthos, since this man has operated on my Dr twice and that is who he wants me to see. It’s the anesisiologist (sp) that needs more knowledge/experience with Grave’s. I WILL keep it up until someone takes notice! There’s enough of ‘me’ here to get real ugly when ignored!
Alexis, I feel so bad for you and the little one, I’m grateful mine are grown at times like this. Grave’s or any other bad disease is enough on it’s own without other factors weighing in. Let us know what you find out.
Thanks all! I’ll keep you posted on my Dragon Slaying!
OH and BTW, although I had cut my hours back at work to 10-4 instead of the norm, my 10-6, I felt well enough to stay till 5:30! Yippee!! Last week was so bad, I was ready to try for my short term disability, but I just cut my hours instead. My supervisor ( the angel, not my boss the jerk) said my hours would be up to me to handle depending on how I feel. If it was bad, go home, if I felt like staying longer, I could. Today, just felt like I’m a little more ‘me’ and not as exhausted. Don’t know what the next couple weeks will be like, but today was a world of difference. Hugz!

[ncpatches]

#1171745

Feeling like ME only lasted a couple days. I never did hear from the Ortho’s office and have called them again, still nothing. Just called a third time to see if there is an anti-nausea drug that doesn’t knock me out. I doubt I’ll hear from them, considering they haven’t returned the other messages I left. I called my PCP about the meds and they said to call them, since they wrote it. I’m about to scream, I am so frustrated!

[snelsen]

#1171746

Here’s a suggestion. In the pre-op area, ask to be medicated pre-op and intra-op with ondanseton (Zofran) and/or ask the anesthesiologist if she/he what meds you are getting. The anesthesiologists are pretty much the boss of your experience from arrival to discharge in that area. I also suggest that you tell her you are feeling anxious and scared (cause you are normal! everyone feels that way.) The drug for that, which she may give, is midazolam (brand name Zofran.)
Most anesthesiologists will do that anyway. Tell her/him you don’t want to remember anything. This is a marvelous hypnotic/relaxing/forgetting/amnesic drug. It is always given when people have colonoscopies. That is why people dont remember anything about them!!! A darn good thing.
And, I suggest you tell anyone who will listen to you that you’d like to have an anti-nausea med for home if you need it. zofran now comes a soluble, under the tongue form, which is very nice if you are really puking. AND you may not be nauseated at all. REally. Anesthesia is a lot better now. But also is related to the length of the surgery. And remember that pain pills, opoids, tell the bowel to go
on strike and take a nap. So I suggest taking stool softeners propylactically to prevent constipation.
Just my two cents, but this might help you a lot.
Shirley

[snelsen]

#1171747

Zofran won’t knock you out at all.

[gatorgirly]

#1171748

Zofran is my best friend now that I know it exists. I was given Zofran for norovirus a few months ago and it worked like magic without any side effects. Everyone in my family gets very nauseous and vomits from anesthesia, so I will definitely ask for this before my OD surgery. Thanks Shirley!

[ncpatches]

#1171749

WOW I didn’t think about nausea during surgery, I’m just trying to control it now. That’s what they give for colonoscopy? I LOVED that! Nurse fluffed my pillow and thats the last thing I remember, woke up feeling like I slept for 12 hrs and ready to go home. Seriously. I saw no reason why I had to have a ride home, I felt fantastic and more rested than I had in yrs, sleep has been an issue for a long time, made worse by graves. As for the surgery, they say they are doing “nerve blocks’ not general anesthesia, they say they will inject in my neck, under my collar bone, around the shoulder and make it numb…….I dunno…….I’ve had a multitude of injections to try to stop pain from the nerve damage in my hip and leg and it never works, this sorta scares me. They need to give me the gas that the dentist uses, I’ll allow anything with that! It makes me sooooo easy to get along with.
Well, I’m up, my shoulder is screaming, my apartment needs cleaning and I need coffee, will check back later. Thanks all! HUGZ

[NLBatten]

#1171750

Not sure I track back to what the nausea is from, but with regards to Zofran it does work great. I got it after I had kidney stone lithotripsy and proceeded to vomit all night with bilateral ureter stents in. Not fun. Dr did finally give me Zofran (sublingual is best as someone said) and it stopped the nausea right away. I make sure now that I get it anytime I have anaesthesia. Just be sure you tell the anesthesiologist. (Just an FYI, Zofran is the nausea med not the twilight med they use in colonoscopy. That is 2 different drugs. I think it is just a typo in Shirley’s post.) I am not sure that they will just give Zofran for any reason but you can certainly ask your GP. It is prescribed for use after anaesthesia or for nauseau associated with chemotherapy.

Re your shoulder surgery, it seems crazy to me that they wouldn’t use general anaesthesia. Trust me – 4 shoulder surgeries. I cannot imagine how they could do what you need without knocking you out. The nerve block I have had AFTER I was already under was great as it lasts about 24 hours which makes the worst of the post-surgery pain less – and trust me you are very aware when it wears off. I just don’t see how you can just be “awake” for a shoulder surgery. Not trying to scare you but I just wonder if they didn’t explain it very well. Surely they have to give you something – even if the “twilight” type med for colonoscopy. You might ask them to clarify.

[ncpatches]

#1171751

I don’t know, maybe I misunderstood, but they said they wouldn’t be using a general, but the pain block for the surgery. I don’t know if they’re giving me something else to sleep, if that’s the case, why the nerve block except for after surgery pain control? Not knowing what’s going on, makes me even more apprehensive. I guess I’ll find out when they do the surgery, since I can’t get the Ortho’s office to return my calls.

[ncpatches]

#1171752

Oh, forgot, have no idea what causes the nausea, started a few months ago during the hyper period, got extremely sick whenever my stomach was empty, Dr said to snack a lot, my metabolism was moving so fast, it was trying to eat something that wasn’t present. Milk helped but now, not so much and it doesn’t matter if I have food in there or not. And there was a pattern of nausea increasing over a 3 day time period, then vomiting and then start over for 3 days, now that isn’t the same either. Used to be, once I vomited, the nausea was gone for 10-12 hrs and started up slowly. Now, no rhyme or reason or pattern. Don’t know if this has been a problem for anyone else or what causes it.

[snelsen]

#1171753

1. Yes,I’d like to clarify the two drugs I mentioned. I did make a typo.

The anti-nausea drug is Zofran, or Ondansedron. In hospital lingo, it is to prevent PONV (post op nausea and vomiting) In my experience, most anesthesiologists giver it intra-op (during the operation) and many give a dose in the pre-op area. In the preop area, it is given primarily IV, but by mouth is sometimes done. In the OR area, it is given IV.
For intractable nausea at home, this drug comes in a soluble under the tongue form, which is really helpful when you can’t swallow a pill, anyway. this drug used be VERY VERY expensive, pretty much used for chemo nausea, but now it is “off patent” from Glaxo Smith, so cost is much more reasonable.

Midazolam is Versed. That is the one I jokingly call a “forgetting medicine.” It is a short term amnesic, used during colonoscopies. In the preop area, when patients are scared and apprehensive (or when I, who has been a patient many times in this situation) Versed is a great drug to have IV to relax, feel calm before you to to the OR. This is given IV preop. Hope this clarifies.

Most of what I am saying is my own experience as a patient, but also because I am an RN, and have advocated to the docs (usually anesthesia to begin with, ) to get an order for these two drugs if I don’t have orders.
Zofran does not make you groggy or sleepy, in my experience.
Shirley

[Author]

Posts