Anaesthesiologist?

[Snoopy]

Hi.
  I have a meeting with the anaesthesiologist this week, and was wondering if anybody had ideas about what to ask?  (Most of the discussion on this list has involved what to ask the surgeon; oddly, my center hasn't mentioned anything about meeting the surgeon yet.)
     Thanks, Snoopy

[WilliamLFreeman]

Snoopy,

It looks like you were accepted to donate indeed.  (By my memory, your last post on LDO was something like "Committee still has to decide.")  GREAT!   

I am sure you will get several excellent suggestions for LDO -- so I won't try to duplicate them.  Rather, I will suggest a set of questions that few people ask.  (They may seem "socially impertinent" to some people, but as a physician I do not see them that way.  This is *your* life, and you can ask for experienced people to care for you.)
   A]  How many years experience as a practicing anethesiologist does the person have?
   B]  How many similar operations -- "laparoscopic nephrectomy" -- has the person done?
Note that, for "B],"  I do not ask for the number of kidney donations.  The same operation, laparoscopic nephrectomy, is often done to remove a kidney that has cancer, for instance.  Those count for experience.

I recommend asking the same questions to the surgeon (substituting "surgeon" for "anesthesiologist" of course.)  Finally, ask the surgeon what "surgical floor" will you be on after surgery, if you and your family or friend can visit it beforehand, and can family or friend be in your room much of the time for company and to assist you for small stuff (a "go-fer").

ALL THE BEST!     Please keep LDO informed about your journey pre-donation, within-donation [by family or a friend, presumably], and post-donation.   

Bill

[sherri]

Just to add to Bill's list, which I think is somewhere on the information section of this forum, I would also ask about pain management. Obviously, they will ask about allergies but you may want to think back about surgeries you have had before and if you had pain medication that didn't work well or didn't agree with you, not necessarily an allergy, or something that did work well.

I would ask if they are going to use a PCA pump or medication by mouth, epidural etc. I would learn how to rate your pain. Learn how to use the PCA pump (never let a family member use the pump for you!). I know this seems easy but at the the time I was really unsure how to rate my pain on a scale of 1- 10. I wish they had shown me the happy/sad faces they use for kids. In the  back of my mind, I kept thinking this is supposed to be minimally invasive surgery where I go home after 2 days. Why do I feel like I've been hit by a Mack truck? Oh, how could I say 10 when my brother is the "real"patient, I'm just the donor. As if there was a ration of pain meds like a ration of organs. I don't know what I was thinking but I wish I had been instructed about the pain meds and encouraged to answer honestly. I was also worried about putting drugs into my poor little lone kidney and imagined the kidney pumping and pumping and overworking trying to get rid of these toxic meds. I know seems silly but I tend to over think things. So get it straight now before the surgery with anaesthesia and ask which are the best meds to use, how to rate your pain, the effects of the drugs etc. There is a very funny youtube video by a comedian Brian Regan where he goes to the ER. I think this is the link http://www.youtube.com/watch?v=k9m2FLHlEwA if not search. It is so funny and actually true.

The first night I had a great nurse named Liz. She was an oncology nurse but working on my floor that night. Her voice was soothing, she came in to check on me. I just had a calm feeling. But then morning came and I never saw her again. I had another nurse who was so busy charting and writing and didn't really talk to me other then ask me the memorized questions she had been taught. She came in and I guess saw how much pain I was in and asked me to rate my pain on a scale of 0-10 (0 being no pain and 10 the worst pain I can imagine). Well I could always imagine worse pain! Anyway, not sure of what to say and not wanting to be a "bad donor" (I felt like the doctors and nurses thought I was a pain in the neck donor anyway at this point), I said 5. So she said well if you said 6 I could give you more pain medication. So I said, ok lady tell me what the right answer is and I'll say it. 

Some donors here say they weren't in any pain and walking around just fine after surgery. Not me. So be prepared either way and use the pain meds. Definitely will help you heal faster. Have a good advocate with you in the hospital, maybe one who has had surgery so they know what it is like to be cut open. And also remember it is just for the first few days and the pain will definitely get better over time.

Take care,

Sherri

[treehugger]

I had so much more trouble post-op with nausea than I did with pain, and for me at least, I believe that has a lot to do with anaesthesia. So, the next time I have surgery (hopefully never!), I plan to discuss that extensively with the anaesthesiolgist.

Kara

[lawphi]

I love across the pond spellings of words! 

Anesthesiologist are concerned with your ability to be put under.  They will want to look at your throat, your nose, lungs and a history of you being put under. 

I was given my dietary and prescription restrictions at my pre-op.  I think a 24 hour clear liquid diet was key in limiting nausea after surgery. 

[Snoopy]

  Thanks to everybody who responded to my question.  I met with an anaesthesiologist today (not necessarily "mine", but simply the duty doc for pre-op interviews).  He didn't examine me at all, but asked a few general questions about my health and condition. Noting my mild asthma, he asked if I can walk up two flights of steps (!) (I can). 
   In any case, he ordered that, on the day of the surgery, I receive an inhalation therapy, just to be on the safe side.  Fine with me (particularly since I found out that my center doesn't do bowel preps; I figure I'm getting off quite easily.)
  I was surprised that I have to fast for only 6 hours before the surgery, and can drink water (but only water) up until 2 hours before surgery.
   Remembering many posters' experiences with nausea, I asked about a patch, and he said that I do not fit any of the categories of patients who can expect nausea. Interestingly, he said that it's mainly females who experience nausea.
  I was given a standard consent form to sign, and he was very nice and patient about answering my questions.
   It struck me as sort of strange that, while I was told to come in to meet the anaesthesiologist, I was not originally offered a meeting with a surgeon.  When I asked for one, they told me I could do it the same day.  So, today I was brought into the unit head, who is not the surgeon doing my operation, but was certainly able to answer my questions (he told me they no longer use clips for live donors, because of the risk of slipping. Instead, they use staples).  Nobody even told me the name of the surgeons who will do my operation until I asked the chief today.  I wonder if I'll get to see their faces before I get put to sleep?
   Be well, Snoopy

[snatiep]

Hi Snoopy!

When I met with my anesthesiologist he asked me if I got sick from being put to sleep.  I said I'm not sure, but when I was out for my wisdom teeth I did get a little sick afterwards.

When I woke up in the recovery room, all I remember is very bright lights and the worst dry heaves I have ever had!  I was so nauseous! I can remember a nurse walking over to me and laying one of those kidney shaped bowls on my chest and walking away.

If I were you........I'd tell them to give you something before you wake up to prevent that sick feeling.  It wasn't fun.

I also got sick from the Morphine they gave me.  I told them right away I wasn't feeling well when they gave it to me through my IV line and they quickly gave me another shot of something that got rid of that sick feeling right away.

Nate

[Aries7]

Hi Snoopy,

Everyone here has given you great advice. One other thing that came to mind is, make sure you mention to your anaesthesiologist if you have a bridge or similar dental work in your mouth. They should ask you this. They did ask me prior to my donation. However, I had a different surgery where the anaesthesiologist did not ask me, but I knew he should had so I mentioned it. (I do have a bridge from knocking out a front tooth when I was 11). The anaesthesiologist asked me of it comes out, and I replied "It's not supposed to!"
Just thought I would mention this in case you have anything like this and they forget to ask.

Best Wishes!
Linda

P.S. Yes you are getting off quite easily by not having the bowel prep!

[Snoopy]

  The night before the surgery, I asked the nurse about PCA, and she said that you need to discuss it with anaesthesiology before the surgery, but that this type of operation is not considered too painful, and so they don't typically use it.  Maybe I'd get it, maybe not.  In practice, I either forgot to mention it at the right time, or never saw any opportunity.
  When they took me down for the surgery, I was probably one of the happiest pre-surg patients in history (well, excluding women having babies): I was so happy finally to get to do this.
  The first stop was the anaesthesiology floor, where they told me they were first giving me some sedation. I didn't actually want it, but it wasn't exactly offered as my decision. What did worry me was that, even a few minutes after the sedation, I didn't feel any different at all. I didn't miss the sedation itself, but worried that if their sedation didn't have any effect, maybe the "main event" meds wouldn't either.  Now, while I would have loved to be awake to watch my own operation, I never intended to do it without any pain management!
  In the end, I went to sleep like a good boy, woke up on schedule, and never needed PCA, or any painkillers after that first night in the recovery room.
  But I just remembered something else that did happen in the recovery room:  I kept reporting the urge to urinate, though I realized that was impossible since I was catheterized.  They kept telling me I'd already mentioned that, and it was normal.  Each time, though, I didn't remember having already raised the issue.
   Overall, though, that nurse was right--this was not such a painful experience, fortunately.  May everybody else have the same luck!
          Be well, Snoopy