Surgery Pre Admission Appointment.

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Paul L
Veteran Member


Date Joined Dec 2005
Total Posts : 647
   Posted 9/30/2008 8:29 PM (GMT -6)   
Yesterday I had my surgery pre admission appointment. I am scheduled for the first stage of J-pouch surgery on Oct 20th. I arrived at the hospital 10 minutes early for my 9:00 am appointment. Shortly after 9:00 I was taken to a small room and was told that several different people will come to see me in this room and it will take a few hours.

The first person that came in was doing a sleep apnea study on patients heading for surgery. This is at a teaching Hospital and quite often I am approached with new studies and students accompanying doctors. This study is not necessary for surgery but it may provide useful information beforehand. I was given a questioner about my sleep habits and I was asked if I would like to participate in the study. They would send someone to my home to connect a monitor and probes to me overnight and then again in the morning to remove it. It would collect data as I sleep for one night. I agreed to it and they will have someone call me to make the arrangements.

The next person to come in was the ostomy nurse. The first thing she asked me was to explain the surgery to her in my own words. After doing so she said I have a good understanding of what is going to be done. She gave me a pamphlet about the surgery and dealing with an ostomy. She had an ostomy bag and flange with her and explained how to install, empty and change it. She gave it to me to take home. She marked the location of the stoma on my stomach with a permanent marker. She told me to re-mark it if it starts to fade. She will check the spot just before I go for surgery.

She told me that for a colostomy, the stoma would be on the left side and for an ileostomy, like I am having, it will be on the right side. It can’t be too far on the right because it must be located within muscle. She then located a spot on my stomach that was flat and could easily hold the flange. She could not locate it too low because I have a belly that rolls under towards my belt. Because of this I wear my belt fairly low, under my belly. The stoma should not be located at the belt line. I do not have enough flat and smooth area below my belt line to locate it there. Most people with a flat stomach would have it located below the belt line. She then pealed off the back of the flange and stuck it on my stomach. She then had me bend forward and back while I was sitting to make sure there was no interference with it. She marked the spot with a permanent marker.

The flange didn’t hold very well because of all the hair I have on my belly. They will shave it off for surgery and I may have to shave it periodically when I change the bag. Because it will be located above my belt she recommends I don’t tuck it under my pants. I should leave it out and cover it with my shirt and not tuck it in. This is fine for a temporary ileostomy but I wouldn’t want to do that for a permanent one. Once I’m released from the hospital a nurse will periodically visit me at home to make sure I can handle the ostomy properly.

The next person to enter the room was a pharmacist with a student. She asked me questions about all the medications, vitamins, minerals and other supplements I have recently been taking. Currently I am on no UC meds. I am taking Celebrex for my arthritis but it isn’t helping. I was told to stop it after 3 weeks if it doesn’t work. That will be at the end of this week. The Pharmacist told me that if I continue to use Celebrex that I should temporarily stop it one week before surgery. She then asked if I have used Prednisone in the last 3 months. I did use it but completely tapered off it 3 weeks ago. Because of that they may give me a prednisone injection just before surgery.

The next person to enter the room was a nurse with several questionnaires about my health. Shortly after completing them the nurse came back and we were just starting to talk when a doctor that is part of the surgical teem came in with a student. He wasn’t my surgeon but he works with her. He went over one of the questionnaires about my medical history, medications and answered questions about the surgery. He had me sign a release form. I asked him about filling out a form for my work. It would allow me to be paid for my time off work. He told me to take it to the surgeon’s secretary. He gave me a prescription for Cipro and Flagyl. I am to take both the day before surgery. After he left I had to wait about 30 minuets for the nurse to come back.

The nurse also discussed my medical history. One of the forms I filled out asked the type of room I want, ward, semi private or private. I wasn’t sure if my insurance would cover anything better than a ward so I left it blank. She told me I could call in later to change it. Today I found out my insurance will pay 100% for a semi private room. The form also asked if I want a telephone for a flat rat of $15. I asked if I could use my cell phone but was told no. I then signed up for a telephone. I asked about a TV and was told that someone would come around to my room offering TV’s.

The nurse gave me information on what to bring on the day of surgery. She gave me information on bowel preparation the day before surgery. I am to take 2 bottles of Fleet phosphasoda, one at 9:00am and the other at 5:00pm. Earlier I was told my surgery would be at 8:00am. I thought that meant I had to be at the hospital at that time. The nurse told me I had to be there 2 hours earlier. That is going to be tough. I will have to wake up at 4:00am in order to get there by 6:00am. The nurse then gave me a pamphlet about using a morphine pump for pain relief. She then took my blood pressure and pulse followed by blood samples for testing. I was finally finished at 12:00 noon. That was 3 hours in that room and I managed it without going to the washroom at all. I went immediately before and after.

I then went to the surgeon’s secretary to give her the form from work to have the surgeon fill out. She said it wouldn’t be until next week and she will fax it to my employer. She told me they normally request 6 months absence from work to cover both surgeries and if I feel better sooner I can go back between surgeries. I don’t mind and I won’t be in any hurry going back to work. Over the last 18 years I have accumulated over 6 months of 100% sick leave and another year of 75%. I then went for lunch and returned to work at about 1:45pm.

Thanks for listening
Paul
Diagnosed in 2000 at age 43 with UC extending half way across transverse colon.
Bad reaction to Asacol, Pentasa and Dipentum - can’t take any more 5ASAs.
Prednisone - worked well for 1 month, then side effects became unbearable.
6-MP - blood tests showed not metabolizing properly.
Corticosteroid enema, Flagyl, Ciprofloxin, VSL#3, Adacolumn Apheresis – no effect
Methotrexate with Remicade - 7 infusions with no improvement
Folic Acid and B12 injections.
Abatacept trial - no effect
Visit our photo albums at: http://www.laflammefamily.ca 


Sunshineonmyface~
Regular Member


Date Joined Sep 2008
Total Posts : 202
   Posted 9/30/2008 8:38 PM (GMT -6)   
wow Paul, thank you for sharing

quincy
Elite Member


Date Joined May 2003
Total Posts : 30406
   Posted 9/30/2008 10:30 PM (GMT -6)   
Paul....thank you for the update.
Did you take notes while you were there?? I'm always amazed at the specifics of your appointments. You don't seem to leave anything out. turn

Too bad about the fleet you have to drink the day before....I'll assume you're OK with drinking it? I'd beg for the gallon or half gallon prep...lol! especially if it was the last time having to take it.

How cool you were requested to take part in another study...

Keep us posted as to how the sleep apnea part goes....never a dull moment..lol!


quincy


*Heather* Status..Asacol 6 (3 twice daily); enemas every 4th night
~diagnosed January 1989 UC (proctosigmoiditis)
~Bentylol (dicyclomine) 20mg as needed
~vitamins/minerals/supplements 
~Probiotic 4(Natural Factors Protec) bedtime + Primadophilus Reuteri Pearls occasionally
~multi-digestive enzymes as needed
~Ranitidine,Pariet (reflux);  Effexor XR 75mg(depression);  Pulmicort/Airomir (asthma)
~URSO for PSC (or PBC) 500mg X 2 daily (LFTs back to NORMAL!!)
My doc's logic.. "TREAT (FROM)BOTH ENDS"  worth it !!!
 


Paul L
Veteran Member


Date Joined Dec 2005
Total Posts : 647
   Posted 10/1/2008 4:32 AM (GMT -6)   
Thanks Sunshineonmyface~ and quincy,

No I didn’t take notes but I had several pamphlets to refer to. Medical trials are not the only studies I’m involved in. A few years ago the natural gas company installed separate gas meters on my furnace and hot water heater for a study. They transmit my gas usage for each appliance over my phone line every night. The original study ended recently and they called me and asked if I wanted to participate in another study for a new low flow showerhead. They are interested in whether it will reduce my gas consumption. They only asked people that participated in the previous study. They installed the showerheads a few weeks ago. They are paying me a small credit on my gas bill for participating in these studies.
Paul
Diagnosed in 2000 at age 43 with UC extending half way across transverse colon.
Bad reaction to Asacol, Pentasa and Dipentum - can’t take any more 5ASAs.
Prednisone - worked well for 1 month, then side effects became unbearable.
6-MP - blood tests showed not metabolizing properly.
Corticosteroid enema, Flagyl, Ciprofloxin, VSL#3, Adacolumn Apheresis – no effect
Methotrexate with Remicade - 7 infusions with no improvement
Folic Acid and B12 injections.
Abatacept trial - no effect
Visit our photo albums at: http://www.laflammefamily.ca 


Y2K Bug
Regular Member


Date Joined Jul 2008
Total Posts : 114
   Posted 10/1/2008 4:47 AM (GMT -6)   

Paul thanks for the heads up. I have my preadmission appointment in about 6 weeks, the day before my op. It will also be at a teaching hospital, so i imagine the happenings will be similar.

I might take notes!

I have been told the prep is free fluid, no prep yuckies!


Peter
 
49yo single dad 
dx 1985
mesalazine 1.5g, prednisolone 15mg
tried infliximab (remicade), humira, salofalk (5-asa enema), entocort, Azathioprine, steroid emenas, abadacept


Red_34
Forum Moderator


Date Joined Apr 2004
Total Posts : 23551
   Posted 10/1/2008 6:04 AM (GMT -6)   
Thank you Paul for letting us know about your pre appointment. Please keep us updated because I know that many of here would like to know since we may be contemplating surgery ourselves. I can't wait to hear of your surgery and how you feel afterward.
 @--->--SHERRY--<---@
Moderator for Allergies/Asthma and Co-moderator for UC
~Left sided Uc-'92-Colazal(9 daily),6mp(50-100mgs),Prilosec,Biotin,Forvia,Pro-Bio**Unable to tolerate Asacol, Rowasa or Canasa**~Year-round allergies-Singulair, Zyrtec~Secondary Reynauds Syndrome-'04-Norvasc~Spinal Stenosis(?)~Sacroiliitis-epidural injections~bulging and herniated discs C5/C6 & C6/C7~3rd epidural injection 9/4, Neurontin and Skelaxin
To help Healingwell - click here: DONATE
 
 
 
 

 
 


Paul L
Veteran Member


Date Joined Dec 2005
Total Posts : 647
   Posted 10/1/2008 7:41 AM (GMT -6)   
Thanks Peter and Sherry,

Peter, I’m surprised your preadmission appointment is the day before surgery. I was told they wanted it 3 weeks before in case anything unusual comes up and I need more tests. Also it gives me time to fill the prescription they gave me and stop any medications as needed. One reason I posted this information is so I could compare it to others experiances.
Paul
Diagnosed in 2000 at age 43 with UC extending half way across transverse colon.
Bad reaction to Asacol, Pentasa and Dipentum - can’t take any more 5ASAs.
Prednisone - worked well for 1 month, then side effects became unbearable.
6-MP - blood tests showed not metabolizing properly.
Corticosteroid enema, Flagyl, Ciprofloxin, VSL#3, Adacolumn Apheresis – no effect
Methotrexate with Remicade - 7 infusions with no improvement
Folic Acid and B12 injections.
Abatacept trial - no effect
Visit our photo albums at: http://www.laflammefamily.ca 


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 10/1/2008 7:48 AM (GMT -6)   
It's not unusual to have preadmission for surgery done the day before, in fact I think it's more common. All my preadmission tests were done the day before my jpouch surgery, in a teaching hospital, and I stayed that day and night in the hospital although I understand much of that is out-patient now. I have never heard of preadmission tests done 3 weeks prior to surgery. Especially since they will want a more current chest xray and blood work closer to surgery?

Of course I had my surgery 7 years ago so things may have changed since then.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


Bennie
Veteran Member


Date Joined Nov 2006
Total Posts : 552
   Posted 10/1/2008 8:35 AM (GMT -6)   

Paul, it's great you had your pre-admission appointment. Bratcat's appointment was a week before her surgery. It was much quicker (although the wait wasn't). She had no tests done other than some bloodwork. Alot of questions though. The nurse explained everything (although the surgeon had discussed this in detail earlier). We didn't meet with an ostomy nurse until after surgery. And the surgeon waits until the day of surgery to mark his patients. The morning of the surgery he explained how he chooses the ostomy site. It was very similar to what you said. He has the patient sit and bend. He uses that and the fact that it has to be in the muscle to place it. Bratcat's is fairly high (she also does not have a very flat stomach). Because it is high, the surgeon told her to expect her output to be a bit more liquidy. Since she has nothing to compare it to, it hasn't been an issue. And depending on what she eats, it can change. Bratcat also had recently finished prednisone. They did give her prednisone before her surgery and a small taper back down after surgery. She did have to be at the hospital 2 hours before her 7:30 am surgery. It was not fun or easy getting up and being there that early.

Bratcat goes for her official pouchoscopy on October 20.


--Mom of bratcat (17 years old) and nonamejames (19 years old)--
Daughter bratcat was diagnosed with pancolitis October 2006
Flared Fall 2006, Fall 2007, Spring 2008
Asacol, Rowasa, hydrocortisone enemas, prednisone, 6-mp, Remicade
7/3/08-Step 1 j-pouch surgery and no more meds
Step 2 scheduled for November 10
 
Son nonamejames was diagnosed with Crohns in Spring 2008
Asacol, Pentasa, 6-mp


bookworm21
Veteran Member


Date Joined Mar 2008
Total Posts : 1766
   Posted 10/1/2008 9:04 AM (GMT -6)   
Thanks for sharing, Paul.

If I would have had surgery, my preadmission appt. would have been the day before surgery.
Female, Age 19
9 Asacol, Rowasa1000 mg Canasa, Proctofoam, Rifaximin 2/day
Digestive Advantage (Crohn's & Colitis), 1 Florastor, 50 mg 6MP,1 Primadophilus reuteri, Remicade (4 infusions), 2.4 g Lialda, 1 Forvia, 6 Colazal/day, 2 Anucort
 


Old Hat
Veteran Member


Date Joined Feb 2007
Total Posts : 5167
   Posted 10/1/2008 9:24 AM (GMT -6)   
Thanks for sharing, Paul. Be sure to drink plenty of water during & after the phosphosoda, for the sake of your kidneys & bladder. / Old Hat (nearly 30 yrs with left-sided UC ... [etc.])

Eva Lou
Veteran Member


Date Joined Sep 2006
Total Posts : 3442
   Posted 10/1/2008 10:31 AM (GMT -6)   
just for more perspective, I had my pre-ops done about 4 weeks prior to my surgery date. At the Lahey Clinic, in Burlington, MA, they require the pre-ops done no more than 6 weeks prior to surgery. And all the stuff you went thru (aside from the sleep apnea study ) Paul, sounded a lot like my pre-op stuff- aren't the ostomy nurses the best?!?!? They really put me at ease. Of course I wound up cancelling my surgery, but.... I did like the pre-ops! Good luck!
diagnosed with UC '02
meds-
Asacol- 8 tabs/day
Remicade-10mgs/kg- since 4/07
Imuran- 150mgs/day
Culturelle
Fiber supplement
 
 
 


Paul L
Veteran Member


Date Joined Dec 2005
Total Posts : 647
   Posted 10/1/2008 10:37 AM (GMT -6)   
Thanks everyone. It’s amazing how different our preadmission appointments can be. I’m sure if I had it the day before I would have had to receive a lot of the information earlier.

Sue, I didn’t receive a chest x-ray. I remember the secretary mentioning an x-ray when I made the appointment but either they forgot or I will receive it the morning of the surgery, unless the one I had a few years ago is good enough.
Paul
Diagnosed in 2000 at age 43 with UC extending half way across transverse colon.
Bad reaction to Asacol, Pentasa and Dipentum - can’t take any more 5ASAs.
Prednisone - worked well for 1 month, then side effects became unbearable.
6-MP - blood tests showed not metabolizing properly.
Corticosteroid enema, Flagyl, Ciprofloxin, VSL#3, Adacolumn Apheresis – no effect
Methotrexate with Remicade - 7 infusions with no improvement
Folic Acid and B12 injections.
Abatacept trial - no effect
Visit our photo albums at: http://www.laflammefamily.ca 


suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 10/1/2008 11:30 AM (GMT -6)   
Paul,

No, you will need a current chest xray. They know this at the hospital.

Sue
dx proctitis in 1987
dx UC in 1991, was stable until 1998

1998 started prednisone, asacol, pentasa, nortriptylene, ativan, 6MP, rowasa enemas and suppositories, hydrocortisone enemas, tried the SCD diet, being a vegetarian, omega 3s, flax, pranic healing, yoga, acupuncture, probiotics

2000 lost all my B-12 stores and became anemic

2001 opted for j-pouch surgery- now living life med-free


Beth75
Veteran Member


Date Joined Jul 2007
Total Posts : 2148
   Posted 10/1/2008 11:53 AM (GMT -6)   
Paul, thanks so much for sharing and for the details. Please keep us updated on your progress, I wish you a speedy recovery!

Also, I prefer the fleet phosfo soda, it was the only one that did not make me hurl. But definitely drink plenty like Q says to help your kidneys.

Take care.
Beth, 33 ~ hoping to taper pred successfully, wish me luck!
Major Flare Sept/Oct 07
UC dx'd 03/00 (Proctosigmoiditis); Pancolitis since 09/07
Azathioprine 200mg 1xday nightly; Calcium and Vit D 500mg 3xday, Multi Vit, Folic Acid 400mg 2xday, Prilosec, Probiotics.
Minimal Change Disease (Kidney Disorder) dx'd 09/07. Close to remission since 9/08.
Prednisone 5mg/2.5mg alt days 1xday, Simvastatin 20mg 1xday, Diovan 160mg 2xday. Tekturna 300mg 1xday, Fosomax 70mg 1xweek. MCD may be from hypersensitivty to 5ASA drugs.  Do you have edema? If so, check your blood protien level!
 

New Topic Post Reply Printable Version
Forum Information
Currently it is Tuesday, April 24, 2018 11:54 AM (GMT -6)
There are a total of 2,955,088 posts in 324,179 threads.
View Active Threads


Who's Online
This forum has 162212 registered members. Please welcome our newest member, Baileydude.
365 Guest(s), 14 Registered Member(s) are currently online.  Details
Craftylady, Serenity Now, peterusa, Starlight*, Fronton, WalkingbyFaith, Boosted, Old Mike, quincy, ltc1225, IntestinalWasps, Fawn P, Tall Allen, iPoop