Preparing for surgery

[eija]

So, I finally got the invitation to my gallbladder surgery. It sure was a long way to get there! Anyways, the surgery is in a month, at the beginning of June. Now I'm wondering how should I prepare myself for the surgery and what should I know/consider, since this is my first surgery since the Sjs dx?

It'll be a day surgery - that is, I'm going there in the morning and they'll throw me out at the latest 4.30 pm. I hate that but that's how they do things these days It's just awful going home in that condition, still drowsy from the aenesthetic and probably in a lot of pain - if not from anything else then at least the horrible sting in the shoulder.

I tried to browse through old posts about stopping medications for surgeries, but couldn't find any real conclusion about that. I know I must continue Tyroxin and Cymbalta and Venlafaxine probably aren't issues either. So the question is really Oxiklorin (Hydroxichloroquine).

In the past surgeries I've always been given Fragmin as an injection, because I had a DVT in my late 20's. Now nobody has mentioned anything about it - but I'm sure they'll take it up in the morning before the surgery. However, it'll be too late to quit Hydroxichloroquine at that point...

What about dryness? My main problem are my eyes, but lately I've occasionally woken up at night coughing because my throat has been so dry. Is there anything I can do or ask them to do, to prevent possible dryness problems?

Thanks, everyone, in advance. I just wish the day was sooner, hate waiting for it because it does make me nervous. Even if I know it's really not a big deal and just a routine thing.

[Carolina]

Dear eija,

If they are doing the laprascopic surgery for your gallbladder, I'm not sure you'll be so miserable afterwards.

AND, honestly, it's always safer to be at home.

https://www.youtube.com/watch?v=rPuYHj1IDKc

http://www.steadyhealth.com/articles/Convalescence_and_recovery_after_gallbladder_surgery_a4.html

I hope it all goes well.

Hugs,  Elaine

[litliwlowa]

Eija

I've not had this kind of surgery, but my general 20/20 hindsight experience is have on hand simple to prepare foods, have laundry and such caught up day before surgery, basically anything that can make your postop at home easier for the initial few days.

I tried to browse through old posts about stopping medications for surgeries, but couldn't find any real conclusion about that. I know I must continue Tyroxin and Cymbalta and Venlafaxine probably aren't issues either. So the question is really Oxiklorin (Hydroxichloroquine).

I recall you are not in the US. So I am not familiar with pre-op procedures where you are.

Typically, or such as been my experience, there is a pre-op appt where all of that is gone over with you before the surgery day. Perhaps there is someone you can call?

When I've had surgeries (way too many between trauma and losing organs), depends on what type of anesthesia is being used, if your doctor's orders are nothing by mouth after midnight before surgery day, they should be advising you what medications are okay to take with small sips of water. Plus as they are removing your gall bladder, they may have different instructions in that regard.

Usually it is the anesthesiologist I meet with as part of pre-op that goes over meds. Generally speaking when I have had surgeries, unless it's life necessary (like my thyroid meds, Keppra and BP meds) I skip the rest and get back on track with those after surgery. Hydroxychloroquine is one I have skipped in that circumstance as I have to take it with a full meal. Oh, I do take my evoxac though.

Some medications and supplements I've been asked to stop as far ahead as 5 days before surgery, such as vitamin C and a couple of others I don't recall. Depending on the procedure.

What about dryness? My main problem are my eyes, but lately I've occasionally woken up at night coughing because my throat has been so dry. Is there anything I can do or ask them to do, to prevent possible dryness problems?

I would ask them to accommodate from the time they knock you out for surgery, through the surgery and in recovery that your eyes be regularly moistened with replacement tears due to Sjogrens. Ask about that before surgery day if you've been given a number to call with any questions. Perhaps they can place a cool damp washcloth over your eyes as an alternative (I figure your eyes will be closed anyway).

As for the cough and dry throat, I doubt they will permit xylimelts in your mouth during surgery. But have some on hand especially in recovery room. If they work for you, that is.

It really is though up to the surgeon and anesthesiologist as to which meds are okay for you to take, and which need to be held off on - they will also take into account your specific medical situation.

Hugs

Amanda

[Dolly Dimples]

Hi Eija, you'll be fine, just make sure they know about your Sjogrens and other worries  I have had just had 2 procedures with anesthetic, and was absolutely fine afterwards.  Best of luck, Dolly x
             

[Scottietottie]

When you go for the surgery - stress the dryness factor. When I went for surgery it was made clear to me I couldn't drink but I persuaded them to let me take water into the waiting area and a container to spit into - so I could sluice and spit which made it more bearable.

Good luck!

Take care - Scottie 

[Ohiocat]

Before my last surgery, I had gotten permission from the surgeon (in advance) to use a Moisturizing Mouth Spray.  It sprays into the mouth and moistens it, but there is nothing to swallow when using it (So therefore there is still nothing in your stomach which is the important thing).   In addition, I had permission to use my eye drops up to the point where they were taking me back to the surgery.   I stress to the anesthesiologist that my eyes have a dry issue, and he made sure to take very good care of them.

I also have had gallbladder surgery.  Unexpectedly, I had to stay over the next day, even though the plan was to release me the same day.  It seems there was some possible stones in the one tube and they thought that I might have to get a 2nd procedure done (by a different type of doctor).  Turns out the stones were small enough that they passed on and the 2nd procedure was not needed.  They ended up releasing from the hospital late the 2nd day.   

But the one thing that i regretted not having in the hospital was some Saline Nasal Gel or Mist.  I don't normally need to use it, but they keep the air in the hospital so dry, that my nose was really starting to bother me on that 2nd day.  So now I have learned that you need to be prepare to stay longer anytime you head into the hospital, just in case the unexpected happens.

[Ripvanann]

Awww Eija,  I feel so bad that you have to go through this. It will be such a relief when it's DONE. Both my sisterand my aunt had it done outpatient and they were fine. My sister has multiple AI's including SjS. Recovery wasn't exactly fun, but they managed just fine.

The others have given you great advice, however I want to encourage you to do as the others have said, call and talk to them. When I was getting an Upper GI the other day, I overheard a nurse telling a patient that they are changing the rules for outpatient procedures.  You will be allowed to drink water up until 2 hrs. before surgery.  Don't know if that is just this hospital or in general. However, I knew this was okay for two reasons:

1.) I've had emergency surgery a few times and that was the rule that they went by. At one point they were trying to hold off as long as they could because I had had cream in my coffee, had it been without, they could have done it right away.

2.) When I had my teeth removed they told me clear liquids up until 2 hours before (that was general anesthesia). . Every time I've had outpatient surgery since the first Emergency surgery (which has been several times) I will drink water and even black coffee up until 2 hrs. before (even without permission). =)

So do call and ask. Asking a sjoggie to not drink anything for that long is torture. I'll be praying for you.

Grace and pecae,
~Andrea

[LucyD]

Hi Eija,
Make sure you talk to your anesthesiologist about your Sjogren's and dryness. They take extra precautions to keep you moist during the surgery and anesthesia.
I had my gall bladder about  20 years ago. Piece of cake. Laparoscopic. Was up and functioning pretty well the next day. Was one day surgery, too. I know this sounds weird, but I felt better shortly after waking up in recovery. The darned thing that was all sludged up and clogged was out! Body must have started responding immediately.
Agree with advice that you recover so much better at home. Especially after spending four nights week before last as an inpatient for a badly infected dog bite on IV antibiotics. You do NOT get rest or sleep in the hospital and being at home is so much better for healing and avoiding hospital acquired infections.
Agree also with having all your stuff done at home before surgery so you an just heal and rest. Have meals ready, even if microwave meals. When I have had surgeries, I usually made a big pot of chicken and rice casserole with simmered celery and carrots- nice and comforting and easy on the digestive tract. Did not have family nearby to help me.
Please let us know when it is scheduled and good luck to you.
Hugs -
LucyD

[LucyD]

Eija,
Forgot to add that I think they HAVE relaxed rules for water before surgery a little. When I was in hospital week before last on IV antibiotics for infected dog bite, every night I had to be NPO (nothing by mouth) because based on what the bite looked like to the hand surgeon each morning, he was going to take me into surgery. I did escape the surgery, but the nurses and techs let me have little sips of water in the morning while we were waiting for the doctor.
Good luck.
LucyD

[Velcro]

Agree with talking to the anesthesiologist.  They can do things to make it easier.

Also, speak with your surgeon about afterwards.  Surgery (trauma, stress) can make you flare.  I would make sure you had a standing order for a super dosing of prednisone or a Medrol pack already in the works.

[meow]

When I had my foot surgery in January,  the surgeon told me to not take my methotrexate for 2 weeks.
I agree, have laundry and grocery shopping, all chores done for the week.

Then, don't fret about anything getting done. You are the Queen for a few days, commanding your minions.

[susanep]

As the others have said you will do fine. My sister had it done in and out like you. She did well, but slept in her reclining chair the first night due to the gas working out which caused some shoulder pain.

susanep

[slccom]

When you go for the surgery - stress the dryness factor. When I went for surgery it was made clear to me I couldn't drink but I persuaded them to let me take water into the waiting area and a container to spit into - so I could sluice and spit which made it more bearable.

Good luck!

Take care - Scottie 

That is what always worked for me, too.
Sharon

[slccom]

I have to add, I would much rather have surgery than move!

I have seen it mentioned that if you go into surgery convincing yourself that everything is going to go smoothly, it helps. I believe it was even a peer-reviewed study, but it makes sense to me that if you go in calmly and optimistically, your body will be less stressed, which can only help.

Now, everybody, diagram that above sentence!

Sharon

[Katybarstool]

Hi Eija

I have  had several planned major surgeries without having to stop the hydroxychloroquine.

Wishing you all the best.

Kathyx