Do I need to ask for any follow-up after surgery?

October 19, 2017 1:35 PM

I had laparascopic gallbladder surgery on Monday at a small private hospital in England, subcontracted by the NHS. When I came to after general anaesthesia, I was told that my pulse had dropped to 28bpm during the surgery and I'd had to have an injection to speed it back up. The anaesthetist actually said to me that "it was scary!" During recovery my pulse dropped again to 31 and was up and down over about 24 hours before stabilising at my normal RHR of about 50bpm (I'm not an athlete but have always had a slow heart rate).

After the surgery I had difficulty urinating. On the first day I could only go a few drops and on the second day just a little dribble at a time. I had to be catheterized three times and on the third day I was finally able to urinate almost normally in terms of flow rate but still had urinary retention of about 450ml. I was sent home and told if I stopped being able to urinate or became uncomfortable I should go to the emergency room. I'm now home, urinating pretty much normally and feeling good.

During my entire recovery I was attended to by nurses and didn't get a chance to talk to any doctors apart from the "scared anaesthetist" but at that point I was still pretty out of it. I do have an appointment to see the surgeon for follow up in 3 weeks and would like some advice on what to ask about. Basically: 1. How concerned should I be about what happened? 2. Should I try to insist on a referral to a specialist such as a cardiologist or urologist? 3. If I need surgery in future (I've been told I may need a hysterectomy at some point) how scared should I be?

posted by hazyjane to Health & Fitness (5 answers total)

Best answer: I work for a surgeon but do not have medical education - I would ask for your anesthesia records and operative report (the anesthesia record may be incomprehensible to you as it is for me, but any future anesthesiologists will be able to decipher it) so you have notes on what medications you were given and dosages/what interventions were taken. As far as the bladder goes, you experienced temporary neurogenic bladder, it happens rarely during surgery, you should tell any future surgeons and anesthesiologists about it, it probably won't happen again and probably isn't something to worry much about (although it sounds terrible!) I wouldn't bother with referrals to specialists but if it will put your mind at ease, go for it. Weird things happen during surgery and I don't think your experience necessarily means you are at a greater risk of complications. The most important part is to tell future surgeons and anesthesiologists what happened so they can avoid it happening again. You may also want to get an EKG and a history/physical done before any future surgery, although they will probably require that anyway.
posted by tatiana wishbone at 1:59 PM on October 19, 2017 [4 favorites]

If you are concerned, the thing to do most immediately is see your GP as you will not be able to self-refer on the NHS.
posted by DarlingBri at 2:53 PM on October 19, 2017 [1 favorite]

So I had this same operation a few years back and after I came to they told me it had taken many hours longer than it should have, because my gallbladder was so infected that it had fused to the organs surrounding it. Other than having to stay in hospital for four days (for an overnight procedure) in the worst agony I have ever experienced in my life, with a gross tube sticking out of me, they didn't seem to be overly concerned. I guess my lesson was that with surgery of any kind, shit can happen. There was a follow up of sorts I think like 3 months later, just to check in.

If you need surgery in the future they will get all your records and review them.
posted by turbid dahlia at 3:29 PM on October 19, 2017

Best answer: As a nurse, I've taken care of patients who had reactions such as yours after surgery. The general recommendation has always been to tell the patient how important it is that he/she inform future doctors if they are facing surgery. If you had this reaction once, you will probably have it again, given the same anesthetic agent. We usually recommended a Medic Alert bracelet with this information if it was a very serious reaction, in case the patient were to have an emergency, such as a car accident, when they could not inform the surgical team.

I recall one patient that lost his pulse - had cardiac arrest - with a common anesthetic. It happened more than once because he thought it would not occur again and didn't report the reaction before another surgery a year later. He was given the same common anesthetic, and it happened again. He was revived both times but got both a Medic Alert necklace and bracelet which he wore simultaneously from then on.

A first step would be to obtain your anesthesia records, so you can learn the name of the anesthesia agents and discuss the issue with your physician. Don't assume anyone will have access to your records if you need future procedures. What if you travel out of the area or country and need emergency surgery? You need to be proactive and advocate for yourself.
posted by citygirl at 3:36 PM on October 19, 2017 [4 favorites]

Great advice above, especially the point that your records do not yet follow you in the #NHS,


Convo with my Anaesthetis/ologist hubby recently

'So, when you get a severely unwell patient on your ITU how do you get their history from GP'
' we have to call the GP, & THEY FAX THEM OVER'
Me: jaw on ground.....FAX??? ( NHS is the largest buyer of fax machines in the world I kid you not!)
'But...but...so you guys have a super secret number to get through right...??? ( people generally spend hours trying to get through to their GP surgery....)

' nope, we use same number the public does...'

GASP!
End scene
posted by Wilder at 3:32 AM on October 20, 2017