Presurgery questions

[Randy & Robyn]

I just thought of a couple of questions concerning my upcoming av surgery next month and thought you guys could help.

I will be going to Mayo which is a learning hospital like most of the best facilities. However I prefer not to wind up being a "learning experience" for an intern. Is it common practice for an intern to perform the surgery, albeit under the supervision of the surgeon and is this a concern that I need to voice with my surgeon?

Question #2: So far, I am handling the anxiety fairly well. However, I know for a fact that once I am at the hospital I will be a basket case. Can I request tranquilizers and to what degree will they be able to safely sedate me prior to surgery? I would prefer to be aware of as little as possible until it is all behind me.

Thanks,
Randy

 

[LLJ]

You can insist on anything you like during surgery, as long as it doesn't comprimise your safety. Even though my hospital was a teaching hospital as well, the surgical team was considered a seperate entity and did not use residents for surgery. Cardiac surgery is VERY profitable for a hospital. Not to be crass, but they do not want to lose cardiac dollars. Be firm with your request and read the surgical release form carefully. The surgeon may say he/she will just have the resident close,which might be ok with you. Remember there is a surgeon,anesthesiologist and perfusionist(heart lung bypass). All three should be of equal skill and used to working together on the same team. You are going to a first rate hospital. They should be used to people being particular about surgery.
They sedate you so well,that I have no memory of anything 5 minutes after they gave me a shot to "relax" me. My friends that were with me pre surgery assure me I engaged in very entertaining dialogue with them.
Best of luck!
Laura

 

[Cris N]

You can definitely ask for an anti-anxiety medication for the pre-surgery waiting. (Maybe for Robyn too!) I might add, though, that many people experience a great sense of peace during those last couple days before surgery. I guess I looked at it this way... it's out of my hands at this point, God led me to this time & place, the medical team, etc. What will be, will be.

If you can, try to treat yourself to a couple days of "vacation" - or at least some distractions before you have to check in.

Will keep you in my thoughts & prayers.

Cris

 

[ALCapshaw2]

Call your Surgeon's office and ASK about the role of residents / assistants. Some surgeons do everything themselves and some have second year residents do the opening and closing while the surgeon comes in and does the real heart work. If this is a 'repeat performance', you definitely want the best mind and hands doing the opening!

'AL Capshaw'

 

[TomS]

It will see like a blink of the eye

It will see like a blink of the eye

You should ask for a sedative if you want one, but don't worry, it all moves fast. I had my AVR last month. Within 30-40 seconds from the time that I walked into the operating room (they didn't offer or give me a sedative) and lied down, I was given an IV and faded completely out. It feels like one blink of your eyes and you'lll be in the ICU realizing that it's all over. It's much tougher on those around you experiencing everything in real time.
Hang in there and realize that there is an "it's finally over" smile coming soon.
Tom

 

[Natanni]

Mayo

Mayo

Randy-Which Mayo? My husband is having his AVR at the Mayo in Rochester in less than 2 wks.

As far as pre-anxiety meds, we have not had our pre-op yet with the surgeon, however, in our facility we medicate our surgical patients once in the 'holding area' with the same meds my husband was given prior to his TEE's (but not as much) We are going to request some sort of sedatives as soon as allowed, and possibly the night before (think I may need to be knocked out even worse than he though as I am not holding up as well as him lol)

We are also going to request no interns/no teaching. I was also told to make sure the surgeons are 'Board Certified' as not all are.

 

[gadgetman]

Randy,

Prayers and good thoughts are continuing for the both of you. As to your first question, I noticed from the after surgery report that a "resident" did the "harvesting" (don't you just love those medical terms ) of the veins for my by-pass. I was assured that Dr. McGiffin would work on fixing my heart. I was in his and God's hands at that point. I'm still here (KNOCK ON WOOD) .

To the second, I was one of the fortunate ones to not even remember them removing me from ICU to the operating room. My next consious thought was back in ICU feeling like I had been run over by a truck . It too passed quickly.

I put all my trust in the Lord that He would get me through this walk. Thanks to His blessing I felt no fear or worry before or after my surgery.

Good Luck and,

May God Bless,

Danny

 

[Randy & Robyn]

I will definitely ask for sedation upon arrival and hope it gets me into the "I don't care what you do to me" mindset. I will also be sure to confirm with my surgeon that he will be doing the important work. I'm going in for a repair as the first option and want assurances that it will be in his skilled hands.

Natanni, I am also going to the Rochester facility. My surgeon is Dr. Kenton Zehr. Surgery is scheduled for the 13th of October so I doubt very much you guys will still be hanging around there when I check in.

Thanks, everyone.

 

[OldManEmu]

Randy I had my surgery at a large public hospital (teaching hospital). I met the surgeon over 4 months before surgery. All the pre-op questions and conversations in hospital were conducted by the assistant surgeon. The main surgeon did phone the night before surgery. When I asked if I would see him on the date of surgery he said I wouldn't see him as he wouldn't arrive until after surgery had began. I wasn't concerned as I knew at the most important stage he would be leading proceedings and he is a very skilled and experienced heart surgeon and is in a very select group world wide. I was originally going to have a Ross procedure.

 

[Lynlw]

I alsdo would ask IF the resident closes, where will the attending surgeon be. I know of a little girl who's family took her across country to have the best surgeon and when the resident closed her, they did something wrong and the attending was not there and by the time he checked her it was too late, (much longer story than that, but you get the idea) the little girl ended up brain dead from a simple mistake because noone was watching what the resident was doing, Thank God that doesn't happen much, but once is too much for me. Lyn

 

[Phyllis]

Dick;s final operative report by Dr. Cohn read:
"I verify that I was there for the key portions of the operation, including cannulation, aortic valve replacement, decannulation, and was available until the patient left the room."
Not sure if "being there" is the same as doing it all, but the result was good, so we're not complaining.

 

[samiam]

Question 1: In the pre-op area, I had an IV with my absolute favorite: Versed. Next thing I knew, I was in the recovery area feeling quite groggy.

Question 2: My surgeon at Cleveland Clinic Weston Ft Lauderdale told us during the pre-op that he does everything; from the first cut to the final suture. Worked for us!

Good Luck. And as someone else said, your family members will be more nervous than you.

 

[hensylee]

we had this discussion once before and I believe someone said that you could talk to your doctor and he can assure you he will be there and do it all personally, if you demand it.

As to tranq, I got mine via injection soon after I entered the hospital and was relaxed till they wrapped me in the delicious warmed sheets. If you go in the day/night before, be sure they give you something for sleep - there's always residual next morning, as well.

 

[tobagotwo]

It is perfectly proper to ask. You will likely get the response that "Dr. So-and-So performs all his surgeries himself." If not, don't take no for an answer.

The residents may assist with the opening and closing processes, though. That frees up the Class Act surgeons to do more surgeries per day.

You will probably find that you're more of a basket case before you get to the hospital than after. Most valve recipients experience the G.C. (Great Calm) once they actually hit the hospital. The vacation idea is a great one, and we usually find that pending surgery members have great vacations, and truly enjoy the time they get.

Best wishes,

 

[Mary]

The "Great Calm" Tobagotwo refers to struck me about two minutes outside the operating theater. That's when they showed me the huge hypodermic I was about to receive via my IV. As soon as I saw it, I relaxed!

 

[Randy & Robyn]

I truly hope I experience the "Great Calm" so many of you speak of. At this point, it's a bit hard to believe it will happen without considerable pharmaceutical assistance.

As for a vacation, we are going up to my in-laws for a few days. Most people might not consider that a vacation but they are like a second family to me. Guess that makes you guys my third.

I would rather wait and plan a more extensive vacation for after the surgery so that I have it to look forward to while I recover. I have so many things to do before surgery that I will definitely stay busy anyway.

Randy

 

[Mama2Rylan]

Hey Randy,

So I noticed that you are going to be going to Mayo in Rochester soon for your OHS...Well I had mine done there in August. I think alot of Mayo and I would recommend them to anyone.

A little bit about my experience..the day of the surgery seemed to go by really fast...almost like I didn't have the time to get nervous...I remember waking up and taking a shower, getting ready...then off to Mayo. I did have to sit in this room for awhile, you are allowed to have your family in there and there is a tv. About a half an hour before the surgery someone finally came in and gave me something to help calm me...it wasn't like I was freaking out or anything, I think it's just something they do for everyone... then someone came to get me and I had to say good bye to my family...I was then taken to another room where there are other people waiting to have their surgery...they just kinda wheel you in there until they are ready to take you to the OR...this was the worst part for me because my family wasnt allowed in there and I felt alone...but there are nurses walking around checking on everyone to make sure they are handling everything ok...then they took me to the OR...once I got in there they put me on the operating table and that is all I remember...I was out right away and they did all the "prep" work after I was already out...

As far as interns being in there...I do know that they have interns in there watching the procedure...and sometimes they will allow them to close the incision...but as far as doing the surgery themselves, they don't...if you feel very strongly that you dont want anyone else doing that...TELL YOUR SURGEON...

The next thing I remember was waking up in the ICU...I don't remember the tubes or anything...but everyone has a different experience with that...I did notice that Mayo is very good about keeping you "comfortable" with your medications...so if you are in pain just let them know...

Like I said before I have only good things to say about Mayo...My surgeon was Dr. Puga...He is AWSOME! but I am sure that all the other ones are just as great as he is....Good luck with everything and if you have any questions just let me know

 

[JohnnyV_46]

You'll have the easiest part of the whole thing Randy....It's the loved one's waiting all day for you that is the hard part. They'll give you really good drugs and don't be bashful to ask for them.