Major Surgery, How do I prepare?

[ohiolady]

I have a question, how do I prepare for major surgery with Sjogrens?  Have any of you had problems with your eyes and mouth dryness?  I am thinking specifically of how my eyes will be under anesthesia.  Also, I take Evoxac 3 times a day to have any quality of life.  I'm not sure how long, I'll have to be without this med.  My eyes are very dry, as well.  Any suggestions, or experiences will be of great help.

Thanks,

Anna

[Cheryl]

Anna,
   I haven't undergone major surgery since my dryness became serious.  When I have had outpatient procedures with anesthesia, I spoke with the doctor about my need for eyedrops, and he let me put vials in the hospital gown pocket.   That gave me peace of mind, and my first action upon waking was to reach for them.   Why don't you speak with the surgeon ahead of time.  Ask him to promise that your drops and Evoxac will be administered on a regular basis until you are able to take care of your own needs again.   Surely he could write those orders on your chart to assure your comfort.   I hope so!
  Best wishes for a successful surgery and an easy recovery!
Cheryl

[Linda196]

If you can get a copy of the Sjogren's Syndrome Handbook, there's a chapter on preparing for surgery and the special considerations that your anaesthesiologist and surgeon should be prepared for.

Having the anaesthesiologist allow fluid for "swish and spit" moisturizing of the mouth is one important step, as well as asking if he routinely orders a pre-op drug like atropine or scopalomine, which are given to dry up oral secretions before anaesthetic...obviously not necessary for sjoggies. He should also be made aware of the increased need for eye drops or gels.

The single most important reminder is if you take any steroid drug, which must be continued (or even increased) through the surgical period.

I wish you well through the operation, and please let us know how you make out, and if your experiences lead you to any new hints for dealing with anaesthetic and surgery.

[kimbo]

ah ooo

I just did a no no- I copied a portion of an article, instead I should have gave the link.

Seeker gave the link in a previous post a while back in the general discusion threads.

I'll go try to find it........  and copy it here........ be right back

kimbo

[kimbo]

I'm back

  http://dry.org/fox20020816/guide.htm 

there it is.

kimbo 

[ktfabian]

Anna-

I had surgery back in Oct. which required general anesthesia.  I took the recommendations available at Kimbo's link and I did just fine.

I was able to take my evoxac prior to the surgery with a sip of water (in fact, I was able to take most of my meds that morning).  I made sure I gave a copy to my surgeon and the anesthesiologist. The surgeon's office actually put together a folder and that folder followed me everywhere  - and the extra copies were in there.  I also took all of the medicines and drops/ointments/nasal sprays that I use with me to the hospital, and they were right there at my bedside with my husband waiting for me when I woke up.

I've had general anesthesia in the past and just dread that waking up period.  This time was a breeze - I had no dryness issues at all. 

I wish you the best Anna and hope you'll recover quickly.  Take really good care of yourself leading p to the surgery as your body will be stressed by the surgery and could put you in a flare afterwards.  Unfortunately, that happened to me, but it isn't a given, and I'll say an extra prayer that you don't develop a flare after your surgery.

Be well, Tracy

[Epson]

Anna,

I had two surgeries this year and the only thing I can tell you is bring your Evoxac, hospitals don't carry it and it will take several days for them to get it.  Each time I have been in the hospital, I have found that they will not let you use your own meds, so I don't tell them about the Evoxac.  All mt meds were approved as safe after pre-op exam.

If you wait for the hospital to get your Evoxac, you will be as dried as a bone.  If you use Ayr's for your nose, bring it.

[irish]

Anna, One of the first things to make sure is done is to have yourself scheduled first on the operating schedule if at all possible. I had carpal tunnel surgery a few years ago and was scheduled for 8AM. An emergency loooong surgery was done by my surgeon and I was not operated on til 4PM. I thought I would die from my dryness and I am a lot more dry now than I was then.

Also, have your doc write the order that you may take your own prescription of Evosac. This is the best way to work this as then everyone knows that you are taking the medication. If they are not aware of it they may chart that you have a lot of saliva and think that is the "normal" you. This is an example of something that could happen if nursing staff isn't aware.

When I had my ear surgury 10 years ago my ENT wrote the order that I could keep all my phych drugs at bedside and take them myself. I had to skip some doses now and then because of the IV pain meds I was on and it was just easier this way.

Also, when going to surgery have them put in eye ointment (that you bring with you) and tape your eyes shut during surgery. This is the best way to protect the eyes. When I have my surgery end of Jan(not a long one) I will have to have them wrap my left wrist with some of that new colored "gauze" that they have now. I am having carpal tunnel and if my hand gets in a wrong position I could be in big trouble. I have to wear a brace during the night to protect it.

Hope all goes well with you. Just be sure and tell anesthesia what you need done. Make a list for them and for the nurses if you are going to be there a few days. Good luck. Irish

[ohiolady]

Thanks so much everyone!!!!!!!!!!!!!!   I will print the instructions and discuss with my doctor.  I will also ask if I can bring my own meds.  I will be in the hospital for 3-5 days and cannot imagine being without for that long.

Anna

[Scottietottie]

Hi 

I realise I'm in a different country but when I had knee surgery and was in hospital for five days I was told to bring all my meds and supplements with me. The nurses then dispensed them which wasn't totally satisfactory as they tried to give me two things, that don't mix, together.

I kept my eyedrops and my mouth spray and nose gel with me.

Take care - Scottie 

[tuckerdog]

I had surgery about a year ago.  My surgeon ordered benedryl post op - I think the nurse told me this is common because it helps with swelling.  Well it did not help my eyes.  Find out if the surgeon is planning to give you benedryl post op and ask if you can go without it. 

Tuckerdog

[ohiolady]

Tuckerdog,

Did you put eye ointment in during surgery?  The doctor told me today that I can bring my own meds to the hospital.  So, I will start on Evoxac as  soon as possible after waking.

I will check on the benadryl.  Don't want any of that.

Thanks,

Anna

[ruby52]

Sorry I don't have any advise beyond all the good info already mentioned but I want to wish you the best of luck and blessings.
                                                                                                          Ruby

[tuckerdog]

Anna,

My surgery was not a long one - only about 3 hours and I don't do well with ointment - my eyes feel like they are gummed up.  I just got the artificial tears in them as soon as I could.

Tucker

[Scottietottie]

Hi Anna 

I don't know if its the same in the US but in the UK eye ointment is pretty routinely used during surgeries whether people have SjS or not. The tube of lacrilube I get has it written on it that it is for that purpose.

Take care - Scottie