Surgery Prep??

[ktfabian]

Hi all,

I'm getting ready for surgery next week and looking for any tips on making it as easy as I can with my Sjs.  It's a minor job, just repositioning my morphine pump and anchoring it down - it's been floating around loose and getting into places it doesn't belong.  I'm not that concerned about the surgery, but my system is already on a tear because my son is leaving for his first round of training for Iraq.  He leaves Friday, my surgery is next Tuesday. He'll be gone til Christmas, have a 10 day leave, then another few weeks of training and he'll be gone.

Adding to my anxiety and glum mood - my dear husband decided he wants nothing to do with this surgery, he's not going to take any of his time to get me to the hospital or be with me before the surgery - my sister is dropping me off at the hospital on her way to work and my oldest son will come get me when I call for a ride home.  He would come and stay, but works until 7am the day of the surgery, so he needs to go home and sleep for awhile. I'm already feeling very lonely.

But enough of the Pity Party - I have the Sjogren's Surgical Fact Sheet from  Moisture Seekers and my doctor gave me a more manageable list to take to my surgeon and anesthetist, but I was wondering if anyone has any personal tips to make surgery a bit easier on the dryness? and hopefully from causing a flare.

Big drumroll here, but as of tomorrow, I am OFF the MEDROL completely, and I'm doing pretty well without it.  I don't want anything to happen that will make me have to staart up again.

So if anyone has any tips or tricks that have helped them get through a  surgery, I'd really appreciate if you'd share.

Thanks, Tracy

[lesleyjoy]

Hi Tracy, you sound to be coping well under the circumstances... well done for kicking the Med  Regarding the dryness, when I had a D&C earlier this year (also minor) I was allowed to put in some extra eye drops and to use some Biotene Oral Balance Gel for dry mouth, which helped heaps. Just a couple of tips. Good Luck for the surgery next week 

Lesley (NZ)

[Pooh]

Hi Tracy,
Lesley gave you two great tips with the eye drops and mouth gel.  I did the same with my last surgery and it helped a lot.

So sorry your hubby is acting like jerk, but men tend to do this.  Sorry, guys but you don't handle illness very gracefully.

I wish something would come up and your son and all the others wouldn't have to go.  I will keep you both in my thoughts and prayers.  Our new Dad to be, is facing another deployment in a couple months too.  He won't be here for the big event.

Take care and hope everything goes well with the re-positioning.

Hugs and God Bless,
Pooh

[Scottietottie]

Hi Tracy 

You know how they leave you sitting around for a while before theatre? I'd ask the nurses if it would be alright to have some water to sloosh around and spit - promising not to swallow!

I'd also try to make sure that drops, water, mouthspray are somewhere within easy reach when you come round.

I'm sorry you're feeling lonely. I know that feeling. I've always been left to do the hosptal bit on my own.

Take care - Scottie 

[irish]

Tracy, Be sure and tell everyone who comes in contact with you (medical personel) that you just came off cortisone a few days ago. You will most likely need some cortisone to get you through the stress of this surgery.

Doctors always want to know when a person has been on cortisone as generally if it has been in the past year cortisone may have to be administered. Just depends on lots of things. Talk with your doc and the anesthesia people.

Hang in there girl!!! You can do it. Your boys know that you are a tough individual and it is good that your sister and son are there to attend to you. Some people have no one at all to help them. I'm sure that things will go well for you and I will keep you in my prayers. Irish

[eyeamdry]

If they won't let you "swish and spit" water, ask for something they should have --it's like a sponge sucker.  They wet the small sponge and you hold it in your mouth.  You can't swallow any water, but it will keep your mouth moist while you wait.  Ditto the eye drops too.  Lucy

[Starlore]

I have surgery next week as well, to remove a questionable lymph node, so thank you for the post! I was just wondering the same myself

I'll pray for your speedy recovery Tracy! Keep your head up & I know its easier said than done, but try not to think about the lonliness too much--don't want to wear yourself down any further--your boys may not be there in person but I'm certain that they'll be thinking of you, as we will 

*edited to add:* Tracy--or anyone else--I am not a member of the SjS Foundation yet as I haven't had any money to spare for anything lately but I found this SjS surgery prep list via google. Can you just confirm that it's not missing anything, or let me know if any changes are needed, as it is what I'll have to submit for my procedure I guess:

NURSING CARE PLAN FOR A PATIENT WITH SJOGREN'S SYNDROME (SS) UNDERGOING
SURGERY

Nursing
diagnosis           Interventions

Risk for injury     * Ensures that all perioperative team members are
related to            aware that the patient has SS and its affect on a
surgical              patient undergoing surgery.
procedure           * Implements protective measures to prevent ocular
and SS                tissue and mucous membrane injury.
                      * Ensures that preoperative and intraoperative
                        medications with anticholinergic effects, such
                        as atropine, diphenhydramine, glycopyrrolate,
                        and promethazine, are avoided.
                      * Ensures that patients on long-term steroid
                        medications receive stress doses before,
                        during, and after surgery as needed.
                    * Ensures that the anesthesia care provider has the
                      necessary equipment and supplies to prevent
                      ocular tissue and mucous membrane injury (eg,
                      humidifier for rebreathing system, endotracheal
                      tube lubrication, dental guard, ocular lubrica-
                      tion).
                    * Evaluates for signs and symptoms of physical
                      injury to ocular tissues and mucous membranes.

Risk for injury     * Confirms patient identity and verifies surgical
related to            procedure.
other associated    * Implements protective measures to prevent skin
diseases              and tissue injury due to electrical, thermal, and
                      physical sources.
                    * Turns temperature up in room to offset potential
                      problems with Raynaud's phenomenon.
                    * To minimize the potential for positioning inju-
                      ries associated with arthritis and fibromyalgia,
                      the nurse
                      * has the patient independently position himself
                        or herself,
                      * pads pressure points, and
                      * ensures that the patient is positioned neutral-
                        ly and anatomically correct.
                    * Performs skin preparation ensuring that prep
                      solution does not pool.
                    * Evaluates for signs and symptoms of physical
                      injury to skin and tissue.

Nursing             Interim               Outcome
diagnosis           outcome criteria      statement

Risk for injury     The patient's         The patient is
related to          ocular tissues and    free from signs
surgical            mucous mem-           and symptoms
procedure           branes are main-      of physical
and SS              tained or improved    injury.
                    from baseline lev-
                    els throughout the
                    perioperative
                    period.

Risk for injury     The patient's         The patient is
related to          function, sensa-      free from signs
other associated    tion, and motion      and symptoms
diseases            are maintained or     of injury related
                    improved from         to extraneous
                    baseline levels       objects and
                    throughout the        positioning.
                    perioperative
                    period.


Sorry to take up so much space! 

[Epson]

Wow!

I thought we weren't suppose to make disparaging comments about people and now I just read that all men are unsympathetic to people with illnesses.  That's like saying that all women are menopausal neurotics.

Totally inappropriate in my opinion.

[ktfabian]

First-

Thanks for all the wonderful ideas.  I'll be printing out your list, Starlore, and adding it to my folder of information to take with me surgery day.  I'll be praying for you, as well, not only during surgery, but while they biopsy that nasty lymph node.  Both of my boys have had one questionable lymph node removed before they hit 20.  My older son's was some type of staph, they never really gave him the details (or he didn't share them with us, he was over 18).  My youngest had his done when he was about 7, turned out he had Cat Scratch Fever or infection. 

Epson-

As for all men not dealing with illness well - most that I've had dealings with don't.  but while at the hospital yesterday for my preadmission testing, there was this elderly woman - well into her 80's who was also preparing for surgery and her husband stayed right at her side, carrying her purse and helping her along, assuring her that he knew where to take her the morning of surgery and that she didn't need to worry.  I thought they were a wonderful couple and was a bit envious.  But, by the time I'm well into my 80's, my hubby will be well into his 90's, so there's not a lot of chance that will be us.

My husband seems to be suddenly aware that he didn't handle things very well and is backtracking now, saying he can take me to the hospital and he'll stay if he can.  We'll see.  I have to honestly say, I don't blame him for being tired of my illness and all of my surgeries - this is #12 in 16 years.  It gets old.

Irish- do you think I should check with my doctor and just continue on the medrol for another week or so?  I was down to 2mg. and taking it for another 2 weeks won't be a big deal.

Thanks again, all.  Right now, my surgery is on the back burner til we get my son off to his next round of training for Iraq on Friday morning.  We once again look like a military supply warehouse - he'll be taking 4 large dufflebags, a huge rucksack, 2 sleeping bags, a back pack and I believe there may be a partridge in a pear tree in there as well. 

They've changed his departure day, time and location about 5 times since he came home Sunday, and he's had friends with him constantly so I seem to be doing most of the prep work for him (that's about to change as I've asked him to take his friends home and give me an hour or more of face time).  By the time we get him off to Mississippi on Friday, I'll be so tired, they won't need anesthesia to put me to sleep!

Thanks again, everyone, you've been a great help,
Tracy

[irish]

Tracy, It probably would be a good idea to call and ask if the doc wants you to stay on the Medrol until you are a certain number of weeks or days post op because of the stress issue. This is what I would do. Also I would make sure to mention it to the anesthesia people so they can make accomodations if needed. Irish

[ktfabian]

Thanks Irish,

I was going to call my doctor this morning.  It's still a bit early, but  will call as soon as her office is open.

Very Good Idea, and one I wouldn't have thought of,
Tracy