Pre-Op Appointments Monday

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Jazzman1
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Date Joined Sep 2010
Total Posts : 1160
   Posted 10/21/2010 9:54 AM (GMT -6)   
I've got my pre-op appointments on Monday to get ready for my Nov. 2 surgery. My appointment sheet says they're doing an EKG, routine lab, an admitting interview and preoperative clearance.
 
Can anybody fill me in on what to expect? Will they give me any better information than I have now about what to expect before and after surgery? Any questions I should be asking that I may not thought of?
 
Is it just me, or does everybody feel like they're flying blind through this process?
 
Age 55

PSA:
8/09 2.69
7/10 4.00
8/10 4.11

Biopsy 8/10
Three of 14 cores positive: 10%, 60% & 80%
Stage T1C
Gleason 6

proscapt
Veteran Member


Date Joined Aug 2010
Total Posts : 644
   Posted 10/21/2010 10:07 AM (GMT -6)   
My experience was they are mostly doing tests for things that could potential be problems with the anesthesia, etc. and doing paperwork. They gave me a stack of material to read about the surgery and recovery, which was useful, but certainly not as complete as it could be.

BillArb
Regular Member


Date Joined Jun 2010
Total Posts : 35
   Posted 10/21/2010 11:15 AM (GMT -6)   
There's a wealth of information on this site about what to expect before and after surgery. It would be helpful if you specified whether you were having open or robotic surgery. You usually spend more time in the hospital after open surgery, but you also experience gas pains after robotic.

BillArb
Regular Member


Date Joined Jun 2010
Total Posts : 35
   Posted 10/21/2010 11:16 AM (GMT -6)   
There's a wealth of information on this site about what to expect before and after surgery. It would be helpful if you specified whether you were having open or robotic surgery. You usually spend more time in the hospital after open surgery, but you also experience gas pains after robotic.

April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 10/21/2010 11:52 AM (GMT -6)   
With my hospital pre-op testing, it was just a few tests and I was out of there in 20 minutes with a bottle of this special soap that I had to use twice before I arrived at the hospital (shower with it the night before my surgery and shower with it the morning of my surgery).

Really no specific info on my specific procedure and what to expect at the pre-op testing. What I had came from my doctors office in the mail or from my doctor consultation a few weeks before.

Overall, I knew generally what would happen (about how long the surgery was, how long I would have the catheter, how long the hospital stay was, etc), but the specifics were addressed as the situation arose. Any time I had a question it was always answered thoroughly though.

Good luck on the surgery! Your stats indicate you are very likely to have a great outcome! And if you are anything like a lot of us here, the part leading up to the surgery (right now) is the toughest part of the whole PCa ordeal.

Dan
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

cantexplain
Regular Member


Date Joined Jun 2010
Total Posts : 74
   Posted 10/21/2010 12:11 PM (GMT -6)   
 Good luck with your surgery.  Before then:  read English Alf's sticky "Really Useful list..."  Very comprehensive, and well organized.   Just take it easy and relax...


Age at Dx: 56
DaVinci Prostatectomy: 10/28/09

Stage: T2C

Gleason - 3+4 = 7

Prosate: 52 grams

Incontinence - absolutely at first, better with time and kegels

ED - Indeed

Married, father of two (boys 19 and 18)

11 months later: member of the "zero" club, working on one "safety" pad for 24 hours. Took Cialis for 6 months (no apparent affect), Tri-mix works, though!

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6947
   Posted 10/21/2010 1:08 PM (GMT -6)   
Pre-op visits for me included a brief OK for surgery physical from my GP, an OK from my Colo-rectal Doc, then two visits to the hospital.
 
1) an evening tour of the facility (they do this for groups of families with scheduled surgeries), meet the surgical dept. and recovery head nurses, look around the public areas/facilities, visit a patient room, where are the snacks & drinks for whoever was to wait during surgery and stay over, how to use the coffee machines, where to park, etc.
General Welcome Wagon stuff, which was all helpful.
 
2) A half day - Chest x-ray, multiple vials of blood for tests & type matching, piles of forms to fill out / read / sign off on, visit to the accounting office to re-verify insurance pre-auth, pay my co-pay/deductible balance, discussions about living will and what they were required to do if I did not have one. Registering car info for the security folks so that they knew what cars would be there with my family. I'm sure there was more, but I was sort of glazed over with the shock of the impending surgery.
 
There was no discussion in either visit of procedure-specific details.

Herophilus
Veteran Member


Date Joined Sep 2009
Total Posts : 662
   Posted 10/21/2010 1:44 PM (GMT -6)   

I scheduled my pre-op visit about 10 days prior to surgery.  Because I had to drive 70 miles to the hospital I arraigned for the first appointment of the day just in case something required additional time I could still get home at a reasonable hour. As things turned out however; I was in and out of the preoperative visit in about 45 minutes including Chest X-Ray, EKG, lab draw, exam by physician assistant and meeting with a nurse that coordinates ongoing urology studies.  I signed up for all the genetic study groups and the dietary study group. Because of the efficiency of the pre-op staff, I was forced into driving across town to the BassPro shop. I spent about 3 hours looking at “stuff”.   I wish BassPro could set up a system like the hospital… as in, I’d only have to pay a deductable!

Hero


clocknut
Veteran Member


Date Joined Sep 2010
Total Posts : 2667
   Posted 10/21/2010 2:10 PM (GMT -6)   

I had my pre-op testing done at a hospital facility just a few miles from my house over the course of two weeks.  That included a bone scan, a CT scan of the abdomen; rib x-rays, multiple blood draws, and so forth.  Then my family doc (an internal medicine specialist) did an EKG in his office and saw something he didn't like, so he ordered a nuclear stress test of the heart.  I passed that in fine shape, but he still had me see a cardiologist, who also said my heart was strong and no problems.  The only test I had done at the hospital where the surgery was performed was a blood "type and screen."  That test HAD to be done at the hospital where I was having the DaVinci surgery, and it had to be within 24 hours of the sugery.  The hospital where the surgery was performed was about 20 miles from my house.  The morning of the surgery, I checked in at 5:15 a.m. and went right to the OR suite. 

Of course at that point I had been on clear liquids for two days and had performed two enemas the night before (which was interrupted by my son and his wife winning an on-the-spot trip to Las Vegas while they were attending a baseball game, and which meant my son would not be at the hospital to sit with my wife as planned, but that was OK).  That was an exciting evening.

It looks to me as if the pre-op stuff is handled in different ways depending on the individual circumstances.

 

 

 


lnwm
Regular Member


Date Joined Oct 2010
Total Posts : 21
   Posted 10/21/2010 2:38 PM (GMT -6)   
The only thing I can add is to be sure you have recorded all of the meds and dosages you are taking and bring that along with your visit. In my case, I am also on blood thinners for a heart valve which requires additional prep work days prior to surgery.

Be sure to be doing your keigels and excercises to get in as good of shape as you can. If you have hairy arms, shave the backs of them from your hands to your elbows to allow for ease of removal of the IV's when it comes time to take them out. Hairy arms and tape will be painful removing the IV's. You will have one in each arm for surgery. If you are unfortunate, like me, and end up staying in the hospital longer than a couple of days, they will be changing those IV's out every 3 days and I had 12 days worth so no hairy arms was a small blessing.

Follow the prep instructions and do completely the bowel prep - don't short cut it. You will want that stuff out of there later and glad you did for sure.

Best of luck to you on the surgery.
Age 58 Gleason 6 T1C 7/12 samples with 5%-40%. No prior family history of cancer.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6947
   Posted 10/21/2010 3:01 PM (GMT -6)   
Contrary to what others have said, I was told not to shave any areas beyond the morning beard, as any accidental cuts could promote infections.
 
In the past we have heard from members who were actually sent home and surgery rescheduled for "pre-shaving", but others have said it was ok.
 
I suggest you ask before doing anything of the sort.
 
However, keeping a list of medications (include vitamins and supplements) with times per day and dosage makes that part of the form handling easier.
 
I was told in the "what to bring" checklist to bring my meds with me in the labelled Rx bottle. They used those for each day, instead of "selling" me more at an inflated price, then returned the bottles/extra as I checked out.

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 10/21/2010 5:30 PM (GMT -6)   
about that shaving. I was suprised when I woke up after RRP, I took a look when i recovered some of my wits and I still had all of my pubic hair. That made some sense after thinking about it, since there were no incisions in the pubic area. The best thing about waking up, besides the fact that I did wake up, was I felt great. There was apparently a long delay in getting a room for me but I was floating in a field of clover. Later I thought that must be why some of the illegal drugs have a big market. Anyway, I hope you do well and get the field of clover experience. I never had any pain or pain meds after the day of surgery and really the operation and the recoperation was not bad at all. Good luck and have a speedy recovery.
Ron
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent after 3 mo. PT
ED, pre-op severe, post op total , considering IPP
10/10 Dr Boone, Baylor recomended AUS
post op psa's 0.04,<0.1,<0.1

lnwm
Regular Member


Date Joined Oct 2010
Total Posts : 21
   Posted 10/21/2010 5:49 PM (GMT -6)   
142 does bring up a good point about shaving. It was something my nurse mentioned to me while she was changing out my IV's on day 4. If you are lucky, you will only need to go through this once. I had the unfortunate circumstances requiring 4 changes during my 12 days. But I think I am on the extreme side. Most have a "non-eventful" surgery and feel pretty decent the next day.

I would not do the shaving at the risk of any nicks that you may cause. Just be ready for that un-intended "Brazilian" effect later.

Good luck
Age 58 Gleason 6 T1C 7/12 samples with 5%-40%. No prior family history of cancer.

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1160
   Posted 10/21/2010 5:53 PM (GMT -6)   
Wow, pretty divergent experiences here. So I guess there's no telling what to expect, huh?

To answer Bill's question, it's open surgery. Dan, thanks for the encouragement. Birthday's April 5, so maybe some of your luck will rub off on me.

I did read the sticky; lots of good information there. I'll re-read it before I go in for surgery.

Hero, does BassPro do EKGs, and will a fish finder do the job?

As for shaving, I'll play it safe and let them do the shaving unless otherwise instructed. It's bad enough that my career as a belly button jewelry model is going down the tubes.

This already became more complicated than I expected. They sent me to the Red Cross to get a unit of blood stored, but they rejected me after I told them I had a little cold. I called my doc's office, but the PA said not to worry about it. Nothing is simple.

Thanks all for the info. You guys are the coolest.
Age 55

PSA:
8/09 2.69
7/10 4.00
8/10 4.11

Biopsy 8/10
Three of 14 cores positive: 10%, 60% & 80%
Stage T1C
Gleason 6

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1160
   Posted 10/21/2010 6:00 PM (GMT -6)   
Ron, I hope I get the field of clover experience too, but I'll have to bring my own drugs. I'll be awake for the surgery; my doc likes epidurals.

The drugs may come in handy if they go for the Brazilian. I'm hoping the just keep me for the two days as promised.
Age 55

PSA:
8/09 2.69
7/10 4.00
8/10 4.11

Biopsy 8/10
Three of 14 cores positive: 10%, 60% & 80%
Stage T1C
Gleason 6

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6947
   Posted 10/21/2010 6:01 PM (GMT -6)   
Interesting on the blood. I can see them not taking you because of the cold, but in my discussions about how things would work for open surgery, the hospital would have taken the blood and kept it for my use to eliminate the risk of picking up something from tainted blood. A relative who had knee surgery was handled the same way - donated 2 pints, maybe 3, and they were stored at the hospital.
 

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1160
   Posted 10/21/2010 6:06 PM (GMT -6)   
Yeah, for some goofy reason they sent me to the Red Cross. You'd think they could do it at the hospital with all the pre-op stuff.

The ways of medicine are deep and mysterious.

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 10/21/2010 6:14 PM (GMT -6)   
I did not bank blood and did not need any either. I did have open surgery....Woke up clean as a baby. :)

Best of luck Jazzman. We will be waiting for your report.


Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3741
   Posted 10/21/2010 9:08 PM (GMT -6)   
The most important man in the O.R. will be the anesthesiologist..You spent a lot of time choosing your surgeon but you know little or nothing about this guy. In the O.R., he is generally the Boss, controlling the overall operation.

When you meet him, in pre-op just before he turns out your lights, ask him if he will use a "breathing tube" to administer the anesthetic gas..If so, please ask him to be careful of your vocal cords and your ability to swallow, two important "complications" seldom discussed.. He will of course have you sign a paper absolving him of any and all responsibility no matter WHAT happens..

Other that that, the WORST part is the 24 hour "bowel prep" where they expect you to purge yourself from end to end and cut off all fluids 12 hours before..That last day before you go in is not fun..In pre-op, they will quickly start an IV and if you tell them you are thirsty and dehydrated, they will run it in pretty fast and you will feel better..
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
age 61: 5.2
age 64: 7.5, DRE "Abnormal"
age 65: 8.5, " normal", biopsy, 12 core, negative...
age 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
age 67 4.5 DRE "normal"
age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010, pos margin, one pos vesicle nodes neg

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 10/22/2010 5:21 AM (GMT -6)   
Jazz, when my husband was getting ready for his surgery, he received information from both the surgeon's office and the hospital about what to expect/do before and after the surgery. Definitely do not shave any body part...the hospital will take care of that for you. My husband had robotic surgery and his pubic hair was left intact...his belly was the only area shaved.

He was told to have a physical with his regular doctor...blood work, urine, the usual stuff. Didn't need a chest xray or anything like that. The urologist/surgeon had done a CT scan at diagnosis so that was taken care of early on in the process. The admitting interview by the hospital was done over the phone...a nurse spent about 30 minutes on the phone with my husband asking him questions about medical history. His regular MD, during the physical, took all the vital signs and faxed everything to the hospital clearing him for surgery.

On the day of the operation, we had to report at noon for a 4:00 pm start time. We reported to the surgical registration desk and he had to hand over all his valuables to me. Ideally they don't even want you to wear your wedding ring but since my hubby couldn't get it off his finger, they wrapped his ring finger in surgical tape to make sure the ring didn't fall off. Once he was set up in the pre-op area (IV lines in, blood pressure taken, etc.), the surgeon and anesthesiologist came in to visit with us for a while. The anesthesologist spoke to my husband about what type of anesthesia he planned on using and recommended a pre-anesthesia sedative since my husband was getting very antsy. They gave him a shot of something that took the edge off and my husband was wheeled into the OR staging area happy as a clam (I, on the other hand, was a nervous wreck). Since the robotic surgery takes several hours, the surgeon told me to go out and eat dinner. The OR nurse had my cell phone number and would call me about 1/2 way through the operation to give me a status report. John (my husband) was wheeled into the staging area around 4:15 and was done between 8:30 and 9:00 pm. The surgeon came out at 9:15, spoke to me for about 15 minutes, told me what he found (and didn't find), said it was a textbook surgery, then gave me 10 minutes with John in the post op area.

Yes, Jazz, you do feel like you're flying blind. I sometimes think the doctors purposely don't tell you alot of stuff so as not to add to your anxiety. For instance, my husband had no clue that a drainage tube would be inserted in his abdomen to remove the fluid that builds up after this type of surgery. The tube was removed the morning after - no pain or anything, just a weird feeling. The surgeon came into his room at 7:00 am the next morning, said take a deep breath, then gently removed almost 3 feet of plastic tubing!

My husband is a self-confessed baby when it comes to any type of pain. He was pleasantly surprised at the lack of pain he had after the surgery. His recovery was unremarkable and uneventful. Hated the catheter (everybody does) but once that baby was out, he was good to go.

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1160
   Posted 10/22/2010 3:39 PM (GMT -6)   
Thanks for the good wishes, Jeff. I'll see what I can do about coming out of this "clean as a baby." I'm very competitive and I can't let you out-do me. tongue

Fairwind, thanks for the good advice, but I'll be doing this one wide awake. They're giving me an epidural. I'll be cracking jokes with the surgeons while they're snipping. If you've got any good operating room humor, I'm preparing my material now.

Sephie, thanks to you too. I think I'll let them earn the $50k they're gonna bill me and do the shaving themselves. It sounds like your man's surgery was pretty uneventful; I hope I do as well. I've had a drainage tube before, so I know that's no big deal. Having a catheter for 10 days is another matter, but it's one of those things you just have to live through. If I could just fast-forward to 10 days after surgery...

What gets me mostly is the flying blind part and not knowing quite what to expect. I do much better with good information. Reading about your experience is really helpful in that regard. Thanks so much.

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3741
   Posted 10/22/2010 3:59 PM (GMT -6)   
Hello Jonathon..

Wow, the epidural IS the way to go if YOU can handle it psychologically..I had an umbilical hernia repaired that way..Completely painless.. My voice is just now returning to normal after 4 hours of gas anesthesia 6 weeks ago...

Enjoy this weekend because things are never going to be quite the same again, at least not for a while...

.
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
age 61: 5.2
age 64: 7.5, DRE "Abnormal"
age 65: 8.5, " normal", biopsy, 12 core, negative...
age 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
age 67 4.5 DRE "normal"
age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010, pos margin, one pos vesicle nodes neg

Highwayman
Regular Member


Date Joined Sep 2010
Total Posts : 148
   Posted 10/25/2010 7:26 PM (GMT -6)   
Jazzman,
Nov 2nd will be a good day. Best of luck. You will have the best of possible surguries, get rid of all of the cancer, and I will get my cath out. Positive thinking is the way to go right now.
Mike
Age 48 w/diagnosed
10/25/06 PSA 3.0
11/13/06 PSA FREE 0.5
11/13/06 PSA % FREE 13.2
10/25/07 PSA 3.4
12/18/07 Biopsy-neg
1/7/09 PSA 4.6
6/18/09 psa 5.8
2/9/10 psa 8.7
7/19/10 PSA 10.8
8/19/2010 3rd Needle core biopsy- single focus of prostatic adenocarcinoma, GG 3+3=6, Tumor involves one of eight cores -2%, Prostate 78 (big)
LRP scheduled for Oct 22

Jazzman1
Veteran Member


Date Joined Sep 2010
Total Posts : 1160
   Posted 10/25/2010 7:31 PM (GMT -6)   
Hey Mike,

Thanks for the positive message. Sounds like Nov. 2 will be a better day for you than it will be for me, but my day will come. Meanwhile, you have a happy catheter day next Tuesday.

You must be doing well to be posting here so soon. So how does it feel three days after surgery?

Jonathan

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 10/25/2010 9:21 PM (GMT -6)   
Jonathon,

It's quite a production at CC. Like a maze you have to follow. Really pretty impressive. They move you through pretty quickly.

By the time you get to the doctor, he has everything he needs.

Good luck ! I'd come up and see you, but you really won't feel like talking much for a few days.

Walk, drink, walk, drink, drink. poop. Can't go home until you poop.
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01
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