And today was my pre-admission prep session
And today was my pre-admission prep session
skeptic49, my AV area may be down to 0.5 cm2 now, according to the surgeon I spoke to today. (He's part of the larger team, but unlikely to be in my OR, because he doesn't actually specialize in AVRs.)
It was partly a diagnostic session -- blood, urine, EKG, chest X-rays(!), swabs for MRSA & VRE, about 5 different stethoscopes on my back and chest -- but mostly a "meet and greet" info session.
[BEGIN SIDEBAR on
X-rays:] The chest X-rays seem dumb-like-post to me. They were vital and life-saving 4-plus decades ago, when tuberculosis was a real threat in the community. And if a patients who's getting inhaled anesthetics has undiagnosed TB, things can go very badly very fast, so they instituted mandatory chest-X-ray screening pre-op. I wrote an article on this policy around 30 years ago, and discovered that virtually every Toronto-area hospital REQUIRED pregnant women to have a chest X-ray before being admitted to give birth, because they might have to be anesthetized! These days, I don't think anybody can X-ray a pregnant woman without first getting written permission from the head of the UN, the Pope, and a few other people!
At about that same time, barbers and hair-dressers and waiters had to have ANNUAL chest X-rays, to protect public health from TB. Of course, since then, TB has almost gone extinct in our society. It's still occasionally found in recent immigrants, but it's usually caught very quickly, and it's essentially unheard of in the people who've been here more than a few months. We've eliminated a lot of those routine scans, because they never find anything (and fail a cost-benefit or risk-benefit test), but the pre-op chest X-ray is still hanging on, for some reason. They needed 3 exposures of my chest, before they were satisfied with the shot. [END SIDEBAR on
X-rays:]
Before going for my X-ray on my way out (when I bumped into THE Dr. Tyrone David in the elevator -- MY elevator!
), I got to watch an old (1997) video about what to expect, several nurses made sure that the hospital computer knows all my contact numbers and medical history, several nurses and doctors asked me identical questions . . . Though in fairness, a few said things like "Well, I see that Mary Jane has noted that you don't have any drug allergies. . ." so they could check the info without completely repeating all the same questions!
I met my anesthesiologist, and asked him to try to avoid two outcomes I'm not looking forward to: (1) increased migraines or auras, and (2) amnesia, even short-term or s-t retrograde. For (1) he decided that he'd concentrate on the IV anesthetics and soft-pedal the inhaled vapor kind, because he thinks that's the way the known side-effects go.
For (2) he said he'd have to skip a whole family of anti-anxiety drugs that are known to have that effect. (Benzodiazepines?) I told him I thought that would be OK. It's not as if I'm going to be awake during the surgery (I hope!), and I doubt that I'll take much anxiety with me when I go under, even if I am anxious on the way in. . .
We'll see. I don't want to experience, or worry about loss of memory (wait, did I already say that?
), and I don't THINK I'll regret this decision. . .
I got my spirometer (to take home and bring back), and got to practice on it. (I thought you BLEW into it -- what did I know?) And I got a suppository, and I got told I probably shouldn't bother using it! As long as I'm regular. . .
I also got to meet two volunteer "survivors", one of whom had the Bentall procedure that will constitute at least part of my op.
Quite a few of my questions got answered, some not so much. The one surgeon who came by speculated some on why Dr. Feindel is more pessimistic about my MV than he seemed to be 6-9 months ago. Basically (and without reviewing any of my test results), he said it was probably due to the deterioration of the MV in the interim period, when I was asymptomatic and happily pumping hard on my bike to climb hills and make it through yellow lights! All that back-pressure on the MV has opened up a gap in one of the cusps, which will either have to repaired or replaced. (OTOH, his description of the repair sounded totally different from Dr. Feindel's, so maybe he's wrong.)
In any case, they will be doing a TEE on my while I'm under, which should give them a good picture of my MV, before they even pry me open. So the decision should be based on good info -- if not based on a long thoughtful discussion with the patient!
So, I'm one step closer to the door between the Waiting Room and the OR. It's starting to seem very real, and I'm also starting to worry that I'm going to run out of time to finish the things I had really better do before I go in!
