Showing posts with label nails. Show all posts
Showing posts with label nails. Show all posts

Monday, October 11, 2004

Pre-op: packing list

Since many of us come to a hyst as our first surgery, we're not even prepared for the experience of being a hospital patient and may have little idea of what we'll need to take with us when we're admitted. Your "closet" will have only room for a single outfit (to go home in) and your belongings must fit on the surface of a small table plus, perhaps, a small drawer, so anything more than that is going to be a clumsy bother. Most of your time will be spent sleeping, drowsing, or walking, so you simply won't need much with you.

Some things you might bring to the hospital with you

  1. Pre-op instructions/permits/papers, any pre-registration forms you filled out, copy of your health insurance card
  2. Glasses, hearing aides, dental appliances you can't do without. Be sure to bring cases or containers for all, and any necessary cleaning materials. If you don't have to have it, though, don't bring it. You most likely will not be allowed to keep them with you until you reach your room after surgery, so if it's irreplaceable, leave it in the keeping of your partner while you're in the OR.
  3. Toiletries: you'll get a toothbrush and soap and lotion as part of the obligatory personal care kit. You will probably get to shower before you go home, but you aren't going to feel like indulging in a lot of frivolity. Pampering yourself sounds more attractive now than it will be when just water flowing over your body will be a delicious treat and simply standing up the height of your physical ambitions. Just bring the bare necessities (we're only talking a couple days, here): conditioning shampoo, deodorant, moisturizer, hairbrush. Two things that you may find especially helpful, though, are lip balm and a moisture (scented water) spray.
  4. Hair: if you have very long hair, consider arranging for it to be braided or French-braided before surgery and again the day after surgery: you’ll enjoy not having to wrestle with it. You’re going to need to pamper your hair very seriously for several months post-op if you have general anesthesia (it is very hard on hair), so if you must have a perm, get it a week or so beforehand so you can go awhile after without having to repeat it. Most hairdressers won’t use any chemical processing on the hair of someone who has had surgery for several months. Take a very gentle hairbrush with you, so you can keep the “bedhead” rats gently detangled.
  5. Your own sleepwear: not really needed. You’ll want to wear the hospital gowns for at least a little while rather than risk staining your own, and it’s much simpler to put on a second gown backwards than to wrestle your IV into the arms of a bathrobe. Forget struggling with jammie bottoms: bending over is not going to be high on your list, and they are kind of strangling when sliding around in a hospital bed. If you must, make it loose, simple, and no more than knee length. You'll also most likely be wearing heavy elastic stockings or pneumatic leggings and have a catheter for the first day, so jammie bottoms are only going to be in the way.
  6. Slippers: slip on, with non-slippery soles (as in: rubber). No matter how cute, anything else is a liability and aggravation. Washable is good, so you can de-hospitalize them when you get home.
  7. Books, magazines, tapes or CDs or mp3s and player (extra batteries): you’ll probably want some entertainment, but make it really undemanding. Anesthesia dulls the mind, as do the medications you’ll be taking post-op. This is the time to read frothy stuff and listen to gently soothing music. Anything more will be Too Much Work.
  8. Mini-office in a large envelope: notebook for jotting down doctors’ instructions, names to write thank-you notes, keep track of post-op appointments; pens, address book with the phone numbers of anyone you might want to chat with (don’t rely on memory—it’ll be addled by anesthesia); small calendar; consider a mini-recorder to tape your doctor’s visit because you will not remember what he said.
  9. A small huggable stuffed animal or small pillow with washable cover. Hugging something to your tummy supports it while you do the coughing and deep breathing necessary to keep your anesthesia-surpressed lungs from getting pneumonia. Also, you will want a small cushion between you and the seatbelt when you go home. Don’t have one? A large bathtowel or small throw works equally well if tightly folded.
  10. Clothing: send what you wore to the hospital home with whomever you came with as soon as you undress into your gown in pre-op. There isn’t room in your room for much stuff or a suitcase. Bring something loose and comfortable to wear home. Large panties (a size or two larger than normal, that come up to the waist) are helpful. Make sure you can get into your bra without gymnastics. Slip-on non-slippery-sole shoes. Sweats or a long, loose dress (my personal fave) are best—you won’t be zipping up those levis over that tummy for a few weeks. Remember: this only enough to get you from the hospital to your home without being arrested for indecent exposure; you’re not going on a Royal Progression. Don’t bring: panty hose, garments with back closures, anything snug about the middle. Also, remember that you will need to get back out of this clothing at home, when you are tired from the trip: tight pull-over-the-head things are so difficult to remove that you may end up spending days in them before you can extract yourself. It's perfectly fine to go home in a gown and bathrobe or loose coverup, too.
  11. Self-adhesive mini-pads: most of us have a little drainage and these beat the daylights out of the industrial-strength elastic belt and mega-pads the hospital stocks for the maternity ward. Enjoy the thought, when you buy them, that they represent the last time you’ll do business on that aisle of the store!
  12. Comfort stuff: eyeshade and earplugs so that you can sleep when you want to, not when your roommate wants. Big bandaids or cut-off sock tops for your elbows (they will be your primary mode of transport in your bed, and those sheets quickly begin to feel lie sandpaper). Backscratcher (if you are prone to itchies)—it also makes a nice extension hand.

Some things you shouldn’t take to the hospital

  1. Jewelry of any kind. You may want a watch afterwards, but get someone to bring it in for you after the surgery. Don’t bring any personal adornments—they just get in the way and you won’t want to bother. Check at your pre-op appointment with anesthesia as to whether they will allow you to keep a wedding ring on: some will, taped; others won’t. It’s best to leave your ring in the keeping of your spouse than risk it being lost by someone whose job it really isn’t to keep track of stuff like that. Most anesthesiologists will also require that you remove nail polish and any nail adornments on both toes and fingers—check with yours at your pre-op appointment if this is important to you. Although it’s not something you can leave at home, don’t come in with fresh tattoos or piercings: your doctor may postpone your surgery out of concerns for infection. If your plans include these, discuss them with your doc pre-op (there may also be a time guideline for how long he would like you to wait after surgery, as well). Speak with anesthesia at your pre-op about the possible need for removal of nose, tongue or nipple ornaments; if you are having an abdominal incision, speak with your surgeon about any navel, labial or other operative-area jewelry pieces.
  2. Checkbook, credit cards, driver’s license—anything you won’t be using. In fact, leave the whole wallet home: there is no security for your belongings. Bring a small amount of cash for vending machines, pay phone or snacks from the hospital coffee wagon. If you plan to make a large number of long distance calls, you may wish to bring a pre-paid phone card to cover them if you don't have a cell phone.
  3. Demanding handwork projects, that challenging book you’ve been meaning to find time to read, anything that takes concentration and involves multiple pieces. They are too hard to keep track of and you won’t have the concentration. Save those for when you are home.
  4. Hair dryer, styling stuff: too much effort to hold your arms up that long. Figure out a no-effort hairstyle or braid your hair. Really, no one expects you to look great: go for clean and tidy and the world will consider you radiant.
  5. Makeup: ditto.
  6. Your own prescription or over-the-counter medications or vitamins/supplements. You should have discussed these in detail with both your physician and your anesthesiologist at pre-op appointments. Do not bring anything in with you unless you and your doctor have previously agreed that you do so. The doctor will also need to write “patient may take own [med]” as an order in your chart in order to protect the hospital staff from liability for any mistake you may make with your own meds.
  7. Contact lenses. Use your glasses instead. You will be dropping off to sleep at odd intervals and it’s too hard to get to a schedule of taking them in and out. The care for them is too involved and bothersome as well, and the hospital is full of Bad Germs. It’s only a few days and there’s nothing much you need to see anyway.
  8. Abdominal binder, surgical stockings—unless your doctor has specified you should do so. If he wants you to have these, he’ll arrange for them in hospital. Ask him at pre-op: different doctors have different procedures, and reasons for them.

Things to do

  1. Listen, take notes (or use a mini-recorder), say thank you. Ask for a copy for your records.
  2. State your needs clearly. If they are not met in a reasonable amount of time, ask for the charge nurse. The management tree from there is head nurse, then nursing director.
  3. You have the right to question and refuse anything. Ask what that medication is for. If a medication doesn’t look the same as the last dose did or you don’t think you’ve been taking it, ask to see the order for it. If you really think it’s wrong or you really don’t want it, simply state “I refuse this medication. You may note this in my chart and I will discuss it with my doctor on his next visit.” Do not be intimidated at “causing extra work” by asking a nurse to double-check your medication: that is their job and legal obligation.
  4. Similarly, if you are in pain and you have had all the ordered medication (or have other medication needs), politely insist that your doctor be notified that it is not providing adequate relief and request another medication order. The fact that it is the middle of the night and the nurse would have to wake the doctor is not an excuse for delaying this. You are paying the doctor and the hospital very well, and not suffering excessively is part of what you are paying them for. If your nurse is resistant, work up the management tree. If necessary, call your doctor's answering service yourself (have that number in your phone notebook) and ask that the on-call doctor covering for your surgeon get back to you asap.
  5. Never let your IV run dry. Remind the nurses when it's getting low and really get noisy if it gets to the bottom of the bag. You're the one who gets another stick if it clots off.
  6. Move around in bed, with special attention to stretching and flexing your legs, often. In this application, "often" means hourly.
  7. Walk. Then walk some more.
  8. Deep breathe and cough; use the blow toy as you are shown—these are making you well, so don't skimp. Hourly is good.
  9. Drink until your pee is nearly colorless.
  10. If your temperature goes up, drink, breathe and walk more. The walking and drinking are also the remedy for gas and constipation.
  11. Stand up straight when you walk. Contrary to the way you may feel, your guts are not going to fall out onto the floor.
  12. Don’t let yourself be overwhelmed with visitors. Before surgery, suggest that your friends call you to see if you want company rather than just popping in. Visitors are exhausting, especially in the first day or two, so tell them that it will most likely be a few days before you’ll have the energy to enjoy their visit. Also, if there are obnoxious family members or “friends” you don’t want to see, or you want a graceful way to keep the entire 86 members of your family from camping out in your room for four days, ask the nurses to post your room as “no visitors” with your spouse (or single other designated Acceptable Visitor) okayed by you as the exception. If folks are determined to send flowers, suggest that they wait to do so until you go home, where you can enjoy them properly. Hospital rooms are just too small to hold very many things, and that’s not when you will be most appreciative. If they want to do something while you’re in the hospital to show their concern, suggest they have a double-latte milkshake delivered to your room instead ;)

Friday, September 24, 2004

Questions for your pre-op appointment

This is a list of basic questions to ask your doctor at pre-op appointments. It may not cover absolutely everything that might be pertinent to your surgery, but it should help you cover the important points. A good way to use this list would be to copy the page, paste it into a word-editing document, add extra lines between the questions, and print it out. Then you can take it to your appointment and write the answers down (or take a mini-recorder and tape them) so you can review them at home, when you have time to think things over. Be sure to jot down any other questions you may think of while reading this, so you remember to ask them, too.

  1. What is the full name of my surgery? (Write this down!) What exactly will you remove: uterus? ovary/ies? cervix?
  2. Will you be combining this with any other procedures? Appendix removal? Bladder repair? Rectocele? Tummy tuck?
  3. How will you remove the organs and where will the incision be? Abdominal (horizontal "bikini"? vertical?)? vaginal? using a laparoscope?
  4. Which things you remove will be going to the lab for pathology tests and when will I get the results? If my surgery is for suspected cancer, how soon will I begin treatments and what will they be?
  5. Should I donate blood before my surgery? If so, when? If not, what if I need a transfusion? If I don’t need a transfusion, is there something else I should do afterwards to build my blood back up?
  6. Right now I am taking (list all of your vitamins, herbs, special dietary practices as well as prescription medications, birth control pills, hrt; if in doubt, list it!). Should I stop them before surgery? If so, when? And when can I go back to taking them after my surgery?
  7. Will I have any special surgical preparation: enema? laxative? douche? Will I be shaved? If so, where and by whom? May I do it myself instead?
  8. What if I have my period when I’m supposed to have my surgery?
  9. I am planning to have my [whatever] pierced or get a tattoo. If I have it done before, how long must it have to heal before the surgery is scheduled? How soon may I have it done afterwards?
  10. May I leave my finger- or toenail-polish and/or artificial nails on when I go to the OR? May I leave my wedding ring on?
  11. What kind of anesthesia will I have? What if I prefer a different kind? Will I meet with my anesthetist before surgery?
  12. How long will my surgery take? Will you report to my family afterwards, while I am still in the Recovery Room? How long will I be in Recovery before I am taken to my room?
  13. How will my pain be managed and what will you be giving me? Will I receive it in the Recovery Room? Do I have to ask before I can have it, or will it be given to me? How often may I repeat it? What if that doesn’t work—will I have another option? How will I get that second option?
  14. What if I become nauseated after surgery? May I have something for this? May I have it before I vomit? in the Recovery Room?
  15. How long will I be on bed rest? When will I get up? How often should I get up?
  16. Will I have a catheter into my bladder? Will I be awake when it is put in? When will it be taken out?
  17. When can I take a shower? When will I be able to bathe? Use my hot tub?
  18. Will I have vaginal bleeding after my surgery? How much and how long?
  19. Will I have on special stockings or pneumatic leggings to prevent clots in my legs after surgery? How long will I have to wear them? Will I be receiving any medication for this purpose? Which one, and how long?
  20. Will I be hooked up with/using any other equipment or special things after surgery? Tummy binder? Breathing exercise devices?
  21. How long will I have an IV after surgery?
  22. What will I be taking for post-op gas and constipation? How long will I need this? If I'm not prescribed something and develop these problems, what do you recommend I take?
  23. If I am having my ovaries removed, when will I start taking hormones and which ones will I take? What is this choice based on? How can I expect them to make me feel? What if I don’t like the way I feel on the first prescription or think I am having a bad reaction?
  24. If I am not having my ovaries removed, how can I tell if they are or are not working post-op? Will I have hot flashes anyway? If my ovaries don’t work right away, what will I experience? How long will I have to experience menopausal symptoms before I can take something to relieve them?
  25. What things have to happen before I will be discharged from the hospital? How long should I expect to be in for?
  26. When will I see you after I leave the hospital? What if something happens or I have questions about how I'm doing before then?
  27. What pain medication and other medications will I go home with? If I run out of pain medication, how do I get more?
  28. What kind of problems should I be watching for at home?
  29. Do I need to have someone stay with me at home after I am released from the hospital? for how long? Should I arrange for another caregiver or board out my kids and/or pets?
  30. What activity restrictions will I have at home? Stairs? Bathing? Driving? Housework including laundry and vacuuming? Lifting how much when? What about my kids or pets—when can I pick them up?
  31. What if I do something and it makes my incision/belly really hurt? Can I hurt myself by doing too much too soon? How will I know?
  32. Will I need to wear a tummy binder or light girdle at home for belly support? If so, for how long?
  33. I am planning to do something special (go to my son’s wedding 2 weeks after surgery—move to a new state a month postop—return to grad school classes of 3 hours a day at about 3 weeks after surgery—take a tropical vacation 2 months after surgery—start paragliding lessons—whatever) in the first 6 months after surgery: is this going to be okay? Should I reschedule it or my surgery to accommodate this plan?
  34. When can I return to my job? (Note: be sure that your doctor knows the exact nature of your work! A work-at-home web designer does not have the same physical demands as a warehouse worker toting hundred-pound sacks of cement mix working a twelve-hour shift.) If I return to work and find it too strenuous, will you authorize an extended leave or a limited return to work?
  35. When may I have sexual intercourse (penetration)? May I engage in other forms of sexual activity (including orgasm) before that time? If so, when?
  36. When may I resume exercising? I normally do for exercise (walk, run, swim, step aerobics, ride horseback, lift weights, bike)—is there any part of that activity I should avoid at first? When and how can I work on regaining tone in my belly? Will you refer me to physical therapy after surgery so that I can work with them on preventing internal scarring and regaining physical conditioning safely (check to be sure your insurance will cover this, but many will if your doctor orders it)? When can I do Kegels again, and should I?
  37. If I have more questions after this appointment, how can I get them answered: email? fax?