Under the knife worries
June 17, 2013 6:53 PM   Subscribe

I'm having major surgery and despite working in healthcare, am nervous off my rocker because I've personally never had surgery or anesthesia before. I'm also worried about life while healing and staying active while healing. Please help.

So. After being diagnosed with turf toe, I sought a second opinion because that particular doctor didn't do anything and recommended I pretty much wait things out and my gut told me otherwise. I got the second opinion, it turns out its a sesamoid stress fracture, and I have to wear a boot for the next several months on my right foot.

However, when I had my initial second opinion visit with my new, highly recommended and regarded foot and ankle orthopedic doctor, he ordered a new set of X-rays - and a MRI, which I did not have taken before at my previous doctor (podiatrist).

Well, on the MRI of the same foot with the fracture, it was found that I have a serious osteomyelitis infection of my fifth metatarsal, where I have had a (unrelated to the sesamoid fracture) tailors bunionette which has ulcerated and has been oozing for six months which was what drive me to see my old podiatrist in the first place (old podiatrist told me not to worry, which is yet another reason why I kicked him to the curb).

As a result, I'm having emergency surgery and am nervous. I've never gone under anesthesia before or had surgery before. How do I stop worrying that I'm going to feel and remember everything!? What's it like to have major surgery?

I'm going to be in a boot NOW for 6-9 months and am going to have a picc line for several months post surgery. I'm worried about further infection, especially where I have pets and live in a smallish house. I've already stoked up on Lysol and Purell. I'm also worried about staying in shape while healing. I typically run 10+ Miles a day plus swimming and biking as an avid marathoner and triathlete. I go stir crazy if I take more than two days off. I've already reached out to friends and family.

Words of wisdom? Tips and tricks? Things to do to keep my spirits up? This sucks. :(
posted by floweredfish to Health & Fitness (41 answers total) 4 users marked this as a favorite
I have had two abdominal surgeries. When you wake up, they will ask you your pain level. Don't try to be a hero - you will take less pain medicine if you stay on top of the pain rather than letting it build up to unbearable levels before taking meds.
posted by elmay at 6:58 PM on June 17, 2013 [4 favorites]

Let me tell you, the two times I've had anesthesia, it was awesome! First they give you some stuff to make you relax (Valium!). You sleep through it, then voila! Wake up and it's over. The morphine drip was pretty great too.

Sleep for a day or so and then you're ready to rest some more and heal.

I'm looking forward to my colonoscopy because you get Versed.

Don't fret, you'll actually like it!
posted by Ruthless Bunny at 7:00 PM on June 17, 2013

Best answer: I'm also a runner (though not 10 miles/day) and I had a minor surgery on my toe last year. The bad news for me was that the doctor said I would be running a week or two later and I wasn't running for about a month. But anesthesia is kind of rad. I've had it before for oral surgery and such. The worst part about it is getting stuck with the needle but you forget about that really fast. The first time I had it, the doctor said, "she's getting silly" and I remember saying, "NO" and falling asleep immediately. You might have seen people in movies getting anesthesia and the doctor says to county backwards from 100. I think I get to maybe 98 before I am totally out. Afterwards it's like waking up from a nap where you had nice dreams. And you're kind of floaty. I enjoyed it as much as I could.

Do you know what painkillers work for you? The surgeon I had kept prescribing me things that made me sick. That was the worst part - the buzz of anesthesia and painkillers wore off, my toe started to HURT, so I took the painkillers and then threw up. So not only did my foot hurt but I was sad because I was throwing up. Get your doctor's cell phone number just in case. That shouldn't be an unusual request. My doctor called me the next day to check on me and I said I felt great. About an hour later, I was really unhappy.

Is there a TV show or two that you've always wanted to watch but have never had the time? Arrested Development, The West Wing, Homeland, anything? This might be a good time to plan to watch the hell out of something like that. Being a healthy type, maybe think of some recipes and stuff you can eat that won't make you feel gross. Smoothies, apple sauce, sweet potatoes, kale chips, etc.
posted by kat518 at 7:12 PM on June 17, 2013 [1 favorite]

When I have had surgery it felt like one minute they were giving me the anesthesia and literally the next second I was waking up from it. Easy peasy.
posted by St. Alia of the Bunnies at 7:12 PM on June 17, 2013 [3 favorites]

I've had to go under general anesthesia a few times and I've also had 2 c-sections, and every time I have been nervous. I remind myself that what is scary and unfamiliar to me (such as having my gall bladder removed) is perfectly ordinary and routine for the dr and hospital staff. Having anesthesia isn't bad at all --there is no way you will remember anything or feel anything while the surgery is happening! Your time inactive and wearing a boot will be challenging, but it will pass. Try to see it as an opportunity to grow and discover new things about yourself. It might sound strange, but the medical issues I've dealt with have helped me see that I have more grit and endurance than I'd realized, and I'm grateful for that insight.
posted by katie at 7:17 PM on June 17, 2013 [1 favorite]

Yes absolutely it's a fun and legal high. They ask you if you have a preference for painkillers that they will administer just before they wake you up -- ask for dilaudid, it rocks.

I've had general anaesthesia several times and my favorite person in the world is the recovery room nurse. I always wake up happy and fuzzy.

I've also had a colonoscopy and it's fun but not *nearly* as good as general anaesthesia.

One word to the wise, though. If you are expected to stay overnight in the hospital, bring your mp3 player and something that will soothe and relax you. For me, it was talks by my meditation teacher and the music of Sigur Ros. Hospitals are noisy and disruptive and are terrible places to try to rest.
posted by janey47 at 7:18 PM on June 17, 2013 [1 favorite]

Best answer: What's it like to have major surgery?

You go into a preparation area or the operating room at the predetermined time and make small talk for a few minutes with the anesthesiologist and perhaps a nurse. Sometimes you see the surgeon then, sometimes you don't. You lay down on a padded surface and make yourself as comfortable as possible depending on the required positioning for surgery. The anesthesiologist will come over and (often) hang an IV with a saline drip. He or she may make a few jokes about martinis as the anesthetic agents are added to the line. You will have a moment or two of relaxed, somewhat dissociative laughing and you'll be just about to say something funny back when the tape stops.

The next thing you know, you'll be awake in the recovery room or your hospital bed. For major surgeries this is often temporary and done to check on youbefore returning you to anesthesia and moving you to where you will recover. For minor surgery, this is the end of the anesthetized period.

You will often find that the requisite IV bag or PICC line has already been inserted. Depending on the type of surgery, you may be prompted after a few hours of quiet rest to sit up or stand up. You will not be asked to do anything physically or mentally strenuous.

I've done this a bunch of times. You'll be in good hands. If you luck out, like I did, you may wake up in the recovery room speaking a hilariously jumbled sentence (from the middle, rather than the beginning) and set concerned family members to laughing loudly.
posted by Inspector.Gadget at 7:20 PM on June 17, 2013 [5 favorites]

kat518: Is there a TV show or two that you've always wanted to watch but have never had the time? Arrested Development, The West Wing, Homeland, anything?

Seconding this. One of the most effective de-stressors, surprisingly, for me when I had a minor medical issue was checking out DVDs of shows I wanted to catch up on / re-watch. It gives your mind a break from thinking about your condition, worrying, and engaging with anxiety.
posted by joseph conrad is fully awesome at 7:31 PM on June 17, 2013 [1 favorite]

You'll get to talk to the anesthesiologist beforehand and you are entirely within your rights to express your fears (I've had surgery twice and one doctor was very clear about this; the other less so though I was in late natural labor and had bigger fish to fry.) They have a lot of tranquilizing options.

Things I wish I had known: waking up can happen in a piecemeal way over a few days and it doesn't mean they've broken you. For about 24 hours I had a seriously impaired vocabulary, and found my stack of crossword puzzles quite useless. This was a medically-minor outpatient procedure, and the pain meds alone didn't have this effect. It was scary not knowing if my words would come back, but of course they did. My memory was spotty for 2-3 hours and I needed to call the doctor back later to ask what that important Latin-rooted word was, because it hadn't been part of my initial diagnosis. (She laughed about how well-defined my memory hole was, and was happy to have the same conversation we must have had earlier in the day. This made me realize how common this sort of thing must be.)
posted by tchemgrrl at 7:35 PM on June 17, 2013

Let me be the first to advise you to write "NOT THIS FOOT" in permanent marker on the other foot.
posted by komara at 7:39 PM on June 17, 2013 [7 favorites]

I had a hypnosis session before surgery and worked on some visualizations. A friend of mine gave me a xanax and I took that before heading to the hospital. (I cleared it with my doc beforehand). I have a very hazy memory of being on the table making conversation and then I woke up in the recovery room.

I've also had a couple of endoscopies. Whatever they put in that drip is really something. I'm on the table, I start to get nervous, the drug hits and I'm like "oh, THAT's nice" and then I'm out.
posted by bunderful at 7:40 PM on June 17, 2013

I mean, I appreciate that people are trying to ease your mind with the "it's a fun and legal high!" or easy-peasy stuff, and maybe for some people it is, but I don't think you should walk in there thinking it's going to be awesome and great or anything, I've had surgery and it sucks. It sucks a lot. Not "I wish I was dead" kind of sucks, so don't be scared, but it's definitely not what I'd hope to be doing with my day if you know what I mean.

You wake up and it hurts. They'll give you pain meds. Sometimes they give you enough pain meds and sometimes they don't. Tell them. You might also be really groggy and vomity. I usually am. A lot of times you'll feel a lot better once you urp once. The major concern is probably infection but there's not much you can do about that at the hospital and it sounds like you're ready at home, so that's good.

So, yeah, surgery isn't fun. It hurts and feels yucky. But you get through it and it isn't the worst thing ever (note: I've never had my chest cracked or my skull opened or anything so maybe that would be) so don't be scared. Just be prepared. I think that's the realistic approach.
posted by Justinian at 7:50 PM on June 17, 2013 [1 favorite]

I've had major surgery in a big emergency "we have to operate within the hour" situation, minor dental surgery, and a broken foot (with less trauma than you're experiencing, ouch).

I don't remember much about any of the leadup to either surgery; the big one was a little less calm than Inspector.Gadget describes, because it was seriously an "operate now or else shit is gonna get worse" situation, but I do remember that same thing of one minute being in the operating room and saying something to one of the crowd of doctors (I think I was asking about hey, why wasn't there a gas mask and I count down from 100 like you see on TV), and the next minute I was waking up in a recovery room and asking a nurse what the doctors were going to do to me next. There was enough time in between for my parents to arrive by train and spend an hour in the waiting room talking with my boyfriend.

I didn't have major knock-you-out anesthesia for the dental surgery, only "twilight" anesthesia - where they give you more local painkillers but they also give you a shit-ton of sedatives. Same thing - one minute I remember seeing the doctor come in with what looked like a welding mask and asking me if I was ready, and turning on a walkman (I asked if I could listen to that during the surgery), and the next minute being on the couch at home and watching Sleeper and having absolutely no idea how I got there.

I can relate to the fears about going stir-crazy from lack of activity, though; I did get kinda frustrated after my big surgery about not being able to move the same way right away. But I urge you to really, really not push yourself (I had a boyfriend around to nag me about not over-exerting myself; some exercise, like walking around, was okay, but no heavy lifting or anything). Listen to your body and your doctor, in that order; if you do something and your body feels pain, then ease up. Your doctor will help you assess whether you're recovering okay and let you know when you can gradually get more active.

When it comes to coping with boredom and daily tasks, this is when to call in favors from all your friends. (They will slack off over time, but this is not because they don't love you - this is human nature. Feel no shame about calling them up a couple months into your recovery and being all, "okay, hi - so, yeah, foot still broken. Can you help me get laundry into the washer again?") There are a few sites that have "coping with recovery" tools and tips - this was one of my favorites (even though I never actually needed any of the things they offered). This site is a personal blog with other tips, and is also deliciously snarky. I also cheered myself up by singing U2's song Get On Your Boots whenever I suited up for the day (I could take my boot cast off at night), and wrote one of the lyrics inside to cheer myself up ("You don't know how beautiful you are"). ...Okay, yeah, corny, but seeing that every day was a tiny bit of something nice every day.

The during-the-surgery bit you will not even remember. The after-the-surgery bit, remember to be gentle with yourself. Good luck.
posted by EmpressCallipygos at 7:50 PM on June 17, 2013

I've had surgery twice and it went without a hitch. There were no hitches to be had.

The first time I was really freaked out, but when I met with the anesthesiologist before hand (which is SOP) he asked if I wanted to be put out before I went in to the OR or after. I had no idea this was an option but it was a real relief. He explained that some people feel better if they known exactly what is going to happen and what all the machines and tools were for. The second one didn't mention it but I told him that's what I wanted. Both times I remember seeing the anesthesiologist right before they wheeled me in and the next thing I knew I was in the recovery room. Anesthesiology is a highly specialized field, and anesthesiologists are highly trained.

I'm also worried about staying in shape while healing.

This was worse for me than any part of the surgery. I lost the use of my right arm for a few months so at least you won't have that to deal with the inconvenience that entails, but just give yourself a week or two to recover from the immediate post-op stress and in the meantime look into different ways you can get some exercise.

I got amazing post-op advice here so I'd suggest doing a search.

Let me be the first to advise you to write "NOT THIS FOOT" in permanent marker on the other foot.

When I had my RC surgery the doc did mark the correct shoulder with a pen.
posted by Room 641-A at 8:15 PM on June 17, 2013

I gave this advice a little while ago.

You won't feel or remember anything. One second they'll be counting you backwards, then next you're pulling the nasal cannula and muttering "But I don't want to wear my sunglasses." It's disorienting and not exactly like waking up from regular sleep, but it's not terrible.
posted by looli at 8:19 PM on June 17, 2013 [1 favorite]

Oh, and if your recovery involves ice, rent a cooling machine. Someone here mentioned it in my surgery question and I have no doubt that it contributed to my faster-than-expected recover.

My insurance didn't cover it so I paid out of pocket for just four days and it's some of the best money I've ever spent.
posted by Room 641-A at 8:21 PM on June 17, 2013

Best answer: I've had a PICC line. It's not the worst thing ever, although it can be a little inconvenient; basically I had to carry a pump around in a fanny pack attached to my arm, and be a little careful not to rip the tube out. I also live in a small home; while I have no pets, I'm a terrible housekeeper and I'm immunosuppressed. I had no infection issues; the main thing was keeping the site dry during showers. The only downside is that it ruined the vein for getting blood tests afterward.

I've also had general anaesthesia half a dozen times or more; it's totally awesome. You are laying there, they tell you to count to ten and you count one, two, and then wake up afterward. Boredom is the biggest problem.

(And the time they did a procedure to my arm, I happened to be at a festival the day before with a henna tattoo lady, so I got her to do "NOT THIS ARM" on my other arm. Chuckles all around.)
posted by Homeboy Trouble at 8:21 PM on June 17, 2013 [1 favorite]

I had a spinal for knee surgery, so I was awake during the whole thing, and I had normal anesthesia for thyroid surgery, so I was asleep for the whole thing, and honestly? Asleep is better. Being awake but paralyzed is a very disturbing feeling. Also I kept being paranoid that suddenly I'd start to feel something. I never did, but if they moved my leg and I felt any kind of transfer of movement I'd get nervous and shaky.

When I awakened from the thyroid surgery I remember them moving me to a new gurney and feeling very sore and cranky, and then about an hour later I got good pain meds. My throat was sore from being tubed. Because my surgery was on my neck, they really didn't want me to vomit so they gave me some kind of anti-emetic. It was supposed to be day surgery, but because they started very late in the day I ended up spending the night, and that was the most unpleasant part due to boredom, uncomfortable temperatures, and noise. Once I got home, I discovered that your neck connects to everything, and moving was unpleasant for a few days, but other than soreness I felt fine. My neck healed up very well, and I followed the post-op surgical instructions so I didn't have any complications.

After both surgeries I definitely experienced boredom for a couple of days. The pain meds made concentrating a little difficult, so reading wasn't really interesting. TV was ok, but nothing very complicated.

After my knee surgery I had three months of physical therapy, which was great. Your PT person can give you all kinds of advice for what exercising you can do. Make sure your ortho writes you a PT prescription.

You're going to do great. It'll suck briefly, and then it will just be something you get used to working around.
posted by clone boulevard at 8:25 PM on June 17, 2013

Best answer: 1) Like people say, you usually start counting backwards and then you open your eyes. They usually give you something that helps you "forget" anything that goes on, but I have freaky powers and I remember pretty clearly. BUT I have never felt anything or seen anything scary (not counting the one time I foolishly chose local anesthetic only).

2) Anecdotally/based on experience: ven general anesthesia alone, never mind the surgery, can really make you feel extremely tired for several days afterward.

3) Find a project you can do (scanning photos or whatever) but don't expect to be able to tackle it right away.

4) When your foot comes out of the boot, it's probably going to be alarmingly stiff. Like, intellectually you probably know that, but feeling/seeing it is another. It'll get back to normal in time!

5) Ask your doctor/surgeons about EXPLICIT instructions for aftercare and what complications look like. (I have yet to get enough information/adequate instructions/adequate supplies on discharge, and that's so not when you feel like dealing with it anyway.)

6) Good luck and take care!
posted by wintersweet at 8:31 PM on June 17, 2013

Advice my father gave my husband before he had surgery for his wisdom teeth: the doctor will say take 1-2 pills every 4-6 hours, take 2 pills every 4 hours. Stay in front of the pain, especially at first.
posted by kat518 at 8:55 PM on June 17, 2013 [3 favorites]

I just had surgery three weeks ago, which was my first time having general anesthesia. It was fine; they put me on the table in the operating room and then I was in the recovery room. I might recommend having a bucket in the car for the drive home. I made it home ok but threw up a couple times that day. The worst part for me was probably the nausea from the painkillers. I lost 5lbs in two weeks despite only laying in bed because I couldn't get/keep food down.

I'm also an athlete and I'm going crazy. Well the first ten days were kind of a blur and I just watched Netflix all day, but then I got stir crazy bored. Fortunately I can walk again, very slowly, and I use the time to listen to podcasts. I don't know anything about your restrictions and that's a long recovery time, so I hear your concern. Core and stretching is all I have that doesn't require a foot.

Good luck! I just keep telling myself that it'll be worth it to take the time to recover properly.
posted by carolr at 9:02 PM on June 17, 2013

Best answer: Two rounds of what I guess you'd call moderate keyhole surgery here.

I have been told I can be a bit of a control freak in situations when I'm stressed out, so the prospect of being at the tender mercies of a bunch of strangers (and worse, a flopped out mess in recovery) scared the bejesus out of me. I'm also allergic to latex, so I was freaking out a bit about all the fun new places they could be jamming rubber hoses and whatnot and causing extra pain.

Contrary to my fears, it all went pretty smoothly. Surgery one they had me on a nice comfortable gurney with some heated blankets, and they hooked me up to the IV. As mentioned, there was stage one of the anesthesia, with the martini jokes, at which point I stopped worrying about much, really. I was lucid enough for them to get me into the surgical suite, where they hit me with the oxygen mask and had me count backwards. I think I got to like four. Woke up in recovery a bit sore and sorry, very groggy, but otherwise very well.

Round two I only vaguely remember the martini jokes. They just switched me off, basically. It was also a lot more relaxed because it was the second time I'd been knocked out and I knew what I was in for.

So I guess my best advice as far as that goes is to just relax and know that you're in the hands of some serious professionals. They don't want you remembering anything either, and they have years of experience with this sort of thing. The more relaxed you are going in, the better time you're going to have of it.

The biggest thing I found was that once it was done it was done, baby! You'll hurt afterwards but it'll very quickly become the sort of hurt that means healing. I bet you're in some pain now as it is, and having that pain settle into the ache of recovery is surprisingly relieving. Get some TV you haven't seen, some magazines or lightweight books, and just treat the immediate recovery period like a little holiday your foot is giving you to make up for all the shit it's given you over the last however many months.

As far as activity levels go afterwards, I'd have a chat with your doctor about low-impact activities you can do afterwards. Yoga with an emphasis on floor work may be good. You could also get involved in the organisational end of your sports, too. You could help do some preliminary fundraising for your marathons, or volunteer to help with organisation for triathlon, that sort of thing. Even more sideline roles at the events themselves, timekeeping, registration, that sort of thing. There are other ways to get involved that don't require you to be too active, but that will give back to something you've been enjoying. It'll also keep your head active while you're off your feet.
posted by Jilder at 9:06 PM on June 17, 2013 [1 favorite]

I've had two c-sections (and therefore two epidurals, so I was awake for the whole thing), and one general anesthesia just last week. I am a bit of a control freak, and was TERRIFIED of the general. Like you, I was afraid that I would be one of those people who woke up in the middle of it or something, even though I know its a pretty irrational fear.

I talked to the anesthetist before my general, and explained this to him. I told him I liked the epidurals because I could see what everyone was doing, and how afraid I was of the general. He asked me if I had any family members who had experienced any weird reactions to anesthesia; so it might be worth asking your family members about that. The anesthetist can always adjust the cocktail accordingly, or know what to be on the lookout for. He reassured me that the chances of this happening were (tiny number I have now forgotten) and that he would be monitoring my brainwaves the whole time, so he would see if I was not properly under. This made me feel a bit better. And by this point I was in acceptance mode - let's-just-get-this-shit-over-with mood.

No-one told me that I was given any anti-anxiety medication through the drip, but I remember feeling much calmer shortly before the surgery, so I suspect I was given some. They wheeled me into the OR, and the anesthetist chatted with me about my job. I conked out mid sentence. I appreciate that he did this instead of making me count backwards, because then I couldn't focus on or stress about it.

I woke up in recovery, and felt horribly groggy, and slightly panicky because I was so groggy. I had my gall bladder removed, so for me it was laprascopic and they inflated my abdomen with CO2, so I felt a pressure on my chest (this made me panic because I am asthmatic). But they calmed me down, and I was fine within less than a minute. Still groggy but no panic. I was up and walking around within 5 minutes, doing very slow laps of the recovery area, and feeling better (less groggy) the more I walked. I don't know if your foot surgery means they won't do this, but it seems to be a general rule that they want you to walk around asap after surgeries. You are usually really gassy and walking helps take care of that.

Can't help you on the recovery, except to second watching a TV series to try and distract yourself. Maybe you will be able to work on some upper-body exercises?
posted by Joh at 9:45 PM on June 17, 2013

I've been under a general 3 times, last time a month and a half ago. I agree that going under is very easy, you think nothing's happening and then you're gone. Last time I actually had the chance to feel a bit drunk first but then wham. First two times I woke up from it crying - not because I was in pain, it just seemed to be a very odd reaction.

Last time I wasn't allowed to drink before the op so was desperately thirsty when I came out, but they wouldn't give me much water because it often results in nausea and vomiting. Not so good. The whole thing was more than a bit unpleasant, to be honest, but I was so out of it and dropping in and out of consciousness that it was the confusion which was actually more upsetting. Be prepared for disorientation and potentially falling asleep mid-sentence. Anyway, it improved quickly and I went home the next morning.

You sound like you're in pretty good shape so I don't think you have much to worry about from the anaesthesia point of view.

The lack of activity afterwards is definitely difficult; I probably pushed it too much during my recovery but my surgery was not on my foot so I could. Also I live alone and the cat was pretty useless at putting in washing, preparing my meals, etc. I coped ok. I stockpiled books, including ones that did not take much brain space to read while still being amusing, TV series on DVD that I had missed, jigsaw puzzles, stocked up on easy-to-prepare food, etc. Honestly, entertainment was not a problem. I also slept a huuuuuuge amount. Take the activity slowly, you'll be surprised by how much even a walk around the block takes out of you. Slow and steady. Your body will be working hard to recover from the anaesthetic and heal itself, it will have enough to deal with.
posted by Athanassiel at 9:52 PM on June 17, 2013

I had sinus surgery last year and was skittish about being knocked out. Folks have given you good advice, I'll just add a few other things, and emphasize others

- yes, don't be a hero painwise. Pain management is stable medical technology, let it work for you and be assertive if it isn't
- yes, talk to the anesthesiologist, they are very nice and relatable. I told mine I was nervous and she ticked off all the anesthetic risk factors I DIDN'T have which made me feel better
- you count backwards, from 100, get to 98 and then sort of wake up in another room. It might take folks a bit to notice you're awake. You can tell them to notify a friend/family member who was there with you to be with you.
- my surgery was late-ish in the day and so in addition to just being a bit nauseated and out of it, I was also STARVING. I had them bring me some water and a popsicle and I got food on the way home. Have something available since you will probably have to fast the day before.

I was in a boot (unrelatedly) a lot of last summer and you can get pretty spry with them once the pain is gone. I wish you luck with your surgery and recovery.
posted by jessamyn at 9:57 PM on June 17, 2013

Without knowing exactly what your surgeon has planned, I wonder - are you certain that you will undergo general anesthesia?

You mention anesthesia as one of your worries, but a procedure on your foot has the potential to be done without general anesthesia.

Anesthesia for surgery covers a range of different things, from general anesthesia which involves intubation and being put on a ventilator (completely unconscious), to procedural sedation (which you typically do not remember and do not FEEL as though you are conscious for, but in fact does not involve complete loss of consciousness and does not require a ventilator because you will be breathing spontaneously), to regional anesthesia with nerve blocks that need not necessarily involve any sedation medication. All are very safe, but of course they are different in terms of what's involved, the intimidation factor, and recovery.

In any case, if a procedure is expected to be "very stimulating" (anesthesia jargon for painful), you'll be under general and be best off that way. But ask your anesthesiologist to find out more about what will be done for your case.
posted by treehorn+bunny at 10:53 PM on June 17, 2013 [1 favorite]

Like everyone says, don't be a hero, ask for the pain meds. Chasing the pain is no good at all. Ice is your friend, ice, ice, ice. The less inflammation you have, the faster healing you'll have. Mention your mid-surg fears to the anesthesiologist.

Based on the wildly divergent opinions of the doctors you have seen, I might also consider getting a third opinion. Going from 'wait it out' to 'surgery NOW' is a pretty big leap- any chance you can get in with someone else before the big day?
posted by PorcineWithMe at 10:56 PM on June 17, 2013

I had general anesthesia for knee surgery in December, following on from a couple of other general anesthetics in the past. In every case they were fine, with, as others have described, memory ceasing mid-conversation and resuming in recovery.

The one thing I'd note is, no matter how good you feel, take it easy after surgery. I was allowed to walk immediately after surgery and, underestimating the effects of the anesthetic, felt fine to go shopping and, as the effects wore off half way round a supermarket, suddenly felt very poorly indeed!

Tl;dr Don't worry - its all very straightforward, but take things easy afterwards...
posted by prentiz at 12:17 AM on June 18, 2013

Best answer: There's a lot of good stuff in the above comments regarding the perioperative period. It's normal to be anxious about any surgery. Here are my recommendations, many of which have already been written in this thread:

- talk to your surgeon about your concerns. Talk to the anesthesiologist about your concerns. Talk to your friends and family, and nursing staff as well. Don't be afraid to ask questions, and write them down: it's easy to come up with a lot of questions, and easier still to forget to ask them.

- trust in your surgeon to remove enough bone to ensure that all infected bone is removed, with a little bit of room to spare. While they're not going to just remove bone willy-nilly, they'll be sure to remove enough to ensure that things look clean.

- expect some ambiguity when it comes to the medicines you'll be prescribed. Antibiotic selection will be tailored to what grows out from any cultures taken: blood before and sometimes after surgery (if there's evidence of bacteria in your blood), bone cultures taken during surgery, etc. Any bacteria that is found will be tested to identify not only what bacteria is present, but also which antibiotics are effective against it. Rest assured that whatever you're given in terms of antibiotics will be based on this data. If nothing grows out, as is sometimes the case, the antibiotics will be selected as drugs that cover for most things under the sun that cause osteomyelitis.

- don't be afraid to ask for pain meds. And take your pain meds. It's more difficult to control pain if you only take pain meds when the pain is super severe. Controlling the pain without totally getting zonked out will let you be more active in your recovery. If you've never taken narcotics before, you might find yourself surprisingly nauseated and pukey. There are medicines to help with this, and sometimes the pain meds can be switched to something that won't cause such symptoms.

- eat well from the get go, before and after surgery. Nutrition is a cornerstone for healing. Eat lots of fiber for easy pooping. Opioids commonly cause difficult pooping and constipation.

- exercise as best you can, for all muscle groups. Muscles weaken from day one. If you're bedbound for whatever reason (too pooped out, groggy from anesthesia, non-weight-bearing for the short time post-op), you can still move your arms, and perform isometric exercises. Similarly, keep your brain engaged. Read. Watch TV. Talk to people.

- ask for and use an incentive spirometer after surgery. It keeps your lungs in shape. Ask for proper instruction on its usage, and take it home with you.

- open the blinds in your hospital room. Ask to be allowed to step outside, in a wheelchair if need be. Get sun. Breathe air. Undoubtedly, staff will be busy, but you might find someone who has the time to help with this, or allow friends/family to wheel you out briefly. Do the same at home.

- try to keep your spirits up. Where the mind goes, the body follows: you WILL recover fully. You WILL be able to run around and do all the crazy stuff you enjoy doing. Don't limit yourself without knowing for certain that you'll hit a brick wall: your ability to do anything WILL be just as unlimited as they have been. And when you seem stuck in a rut or if you feel like you're not making progress, remember that you're a badass and that you're gonna SMASH THROUGH that brick wall.

You say you work in healthcare, and I'm sure that you know a lot of this stuff already. I'm also pretty sure that people who work in healthcare can be the dumbest patients (not that I'm implying you're dumb at all! We just think we know the answers or should know the answers). You're a patient now. Don't be afraid to be a patient and depend on others to help you with your recovery.

Some of the stuff I wrote can seem pretty hokey. What can I say, I'm a pretty hokey guy. But I firmly believe that small, seemingly touchy-feely stuff, makes a big impact in everyone's return to health, especially when it comes to my last point: don't limit yourself from doing anything ahead of time. This includes playing with your pets.

As a personal anecdote, I underwent surgery where I had my tonsils removed, sinus work, bone spur reduction, etc. Had general anesthesia. I vaguely remember being in the pre-op room and being wheeled to the OR. I definitely remember being told to count down from 10, saying "10," and then waking up in post-op. I also remember drawing a cartoon of myself with an arrow pointing to my tonsils and writing "PAAAAAAAAAAAAAAAAIN." I don't know if I was in pain, but I think I just wanted to draw a cartoon for the really cute resident who was involved in my care.

Anesthesiologists take the elements of anesthesia VERY seriously, especially when it comes to concerns about remembering the surgery, or the pain associated intra-operatively. Rest assured that anesthesia isn't just about knocking you out. The key elements include knocking you out/not remembering stuff, controlling pain even when you're knocked out, and keeping you still.

posted by herrdoktor at 2:35 AM on June 18, 2013 [4 favorites]

One more thing: bring some regular shirts and shorts, or have friends/family bring some in, as well as toiletries. Hospital toothbrushes/toothpaste/soap sucks. Hospital gowns are a downer. You'll look and feel better with kickass raiments.

Just no long pants, cuz they've gotta get to your foot for wound care.
posted by herrdoktor at 2:43 AM on June 18, 2013

Response by poster: Thanks so much everyone! There are such wonderful answers here! I'm nervous, but am going to keep coming back to this thread for encouragement.
posted by floweredfish at 5:01 AM on June 18, 2013

I've had general anesthesia five times; the worst reaction I've had is a little nausea and itching, and when I told the recovery nurse they gave me medication that helped.

If you're seeing a PT, maybe they can give you some seated exercises - that's what they did when I broke my hip. FWIW, my arms have never been so toned as they were when I was on crutches for a long time.
posted by The Underpants Monster at 6:24 AM on June 18, 2013

Best answer: I had major surgery last year and am also a runner.

Just to reiterate...

General anesthesia can make you horribly sick, and it lasts longer than you think. I was nauseous for DAYS afterwards, and my thinking was blurry. Don't worry if you can't remember things like where you keep extra toilet paper or your grandmother's first name--it goes away.

I go stir crazy if I take more than two days off.

My experience is that the doctor's recommendations for rest are optimistic and you may need a lot more recovery time (or less, but air on the side of caution). Remind yourself that going back to training too early will injure you in ways that will set you back even more seriously, or possibly permanently. And when you do go back, give yourself a break if you can't pick back up where you were. You'll get there soon enough.

Silly movies are a good idea. Nothing too intellectually taxing, your body doesn't have the extra resources to power all that brain and still heal.
posted by epanalepsis at 6:34 AM on June 18, 2013

I've had general anesthesia five times; the worst reaction I've had is a little nausea and itching, and when I told the recovery nurse they gave me medication that helped.

I too had this as an odd side effect. My feet itched! Benedryl knocked it right out.

My first surgery was my hysterectomy. I had laproscopy and for major surgery, it went very smoothly and I had NO pain. None. I felt a bit stiff in the tummy region, but it was like too many crunches.

My second surgery was laser ablation last year and for something that burns your nether-regions, again, no pain.

I was given pain meds and I still have them. I'll warn you, if you get Vicadin for pain, you may want to have a laxative of some sort around, because you can get constipated. My doc told me to eat lots of fruit and veggies post surgery, but even so, it happened to me. Lots of painful gas. Phillips caplets and that was no biggie.

I found that I mostly slept and watched stupid TV. My kitty came to keep me company, and that was nice (she's normally not all that affectionate.)

I went back to work two weeks after my hysterectomy. My first day back I fell asleep at my desk and drooled. But all things considered, I bounced back pretty quickly.
posted by Ruthless Bunny at 7:16 AM on June 18, 2013

If you have a family history of waking up early from anesthesia, it's worth telling your anesthesiologist and others.
posted by bookdragoness at 7:22 AM on June 18, 2013

The throat tube can really hurt, sometimes slight pain (or feeling like there is something deep in your throat) can persist for multiple weeks after, I am told this is normal.
posted by meepmeow at 7:57 AM on June 18, 2013

I had half a kidney removed via open surgery 3 months ago. I went home after 4 days, and was off pain meds and back at work (from home) after 10 days.

I'm an overweight 2 metres tall, but they still managed to get the dose right for the anaesthetic, and successfully put me right out (had lots of nightmares about the anaesthetic not working since the op though - clearly a primal human fear).

Hospital recovery was boring but not too awful - I personally felt happier off the morphine than on it (slept better too, paradoxically), but YMMV. To be honest, after reading lots of horror stories of post-op pain and lengthy recovery from the exact same operation than I had, recovery really was a breeze. Nothing to be afraid of.
posted by bifter at 8:04 AM on June 18, 2013

IANAD. Maybe ask a friend to give your dog a bath, and have a housecleaner come in, just to make it feel better when you get home.


My perspective on germs is that there's lots of them, but we're mostly already exposed to our own and our pets' germs, so I like to have a clean house, but I don't hose it down with antibacterials. While you're healing, be careful about the usual suspects - undercooked and/or raw meats, raw eggs, etc., and wash leafy green vegetables, especially for the 1st week or 2. You might want to take a multivitamin just to help the healing process.

I strongly agree with Herrdoktor about getting fresh air, sunshine, and some exercise. I don't know how long you'll be in the hospital, but in my experience, the combination of not getting much exercise + anesthesia/ painkillers + hospital food = constipation. Ask for extra fruit, veg & salad, drink lots of water, and make sure you get plenty of fiber options when you get home. Please update the thread at some point, so we can hear how well it all went.
posted by theora55 at 8:08 AM on June 18, 2013

I had a general once. When I woke up -- which seemed like seconds after I fell asleep -- I was so fricking cold I was shaking. The nurse brought me heated blankets. Heated blankets! Best thing ever!

So that's another thing not to be a hero about; let them know if you're cold and get those lovely lovely blankets.
posted by The corpse in the library at 12:09 PM on June 18, 2013 [1 favorite]

Also I forgot to say before: before you leave for hospital, change the sheets on your bed (or get someone to do it for you while you're in hospital). Something about coming home to a freshly-made bed with fresh clean sheets is just so nice.

I found my world kind of shrinking a bit after the last round, so that the small things like clean sheets were more important. I think this is an important part of recovery, because it helps you concentrate on what you need to do to maximise the healing, whether it's paying attention to wounds and how they're healing or monitoring your own need for sleep or food. As you get better, your attention and your ability to move and your world will start expanding again.
posted by Athanassiel at 4:29 PM on June 18, 2013

Best answer: Hi there! I had major reconstructive surgery on my leg after having a bone tumor removed last fall. People have hit a lot of the pre-surgery worries pretty well. Here's my two cents:

- Post op time in the recovery room can be kind of scary. My own surgery ended up being twice as long as they anticipated (about 10 hours total), which resulted in a high heart rate coming out of the anesthesia. As I was waking up, I could hear the nurses saying such, which just gave me anxiety and a higher heart rate. Don't be afraid to ask questions if something doesn't seem right. All the nurses were super nice and I'm sure are more than happy to help.

- Don't push yourself. They will send you to a physical therapist for recovery. Do what they tell you and not more. They are professionals and will take your pre-surgery activity level into account when assessing the situation, so don't push it.

- Have activities/distractions planned, but don't be hard on yourself if you're too out of it to do much. I had piles of books saved up to read, but for the first month or so post-op I was too tired and drugged up to care much.

- Crutches are hard. If you will be on them for a while, rent a raised toilet seat and shower seat from a medical supply company. So worth it.

- It can be very disheartening. I had friends coming to visit me regularly, and I still suffered some depression afterwards. It is incredibly isolating being stuck at home, away from the world. As soon as you can, start going out. That was when I started to feel human again, when I could go out and get a cup of coffee and read in public. I wasn't doing anything different from what I did at home, but being around other people was curative.

- Take people's help. I hated how dependent I was on everyone around me, but I know I couldn't have done it on my own. Remember that they are helping because they care about you.
posted by bluloo at 4:49 PM on June 18, 2013 [1 favorite]

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