As your surgery date approaches, chances are anxiety isn’t the only emotion you’re feeling. Frustration could also lead the list. Why? Because the doctors, nurses, and admins keep asking you the same questions over and over. Wasn’t electronic record keeping designed to eliminate just this sort of redundancy? The truth is, even if your medical history has been well documented, there are nuances that each specialty has to consider. Plus, there’s always a chance that something has been left out. Careful preparation can eliminate many surgical complications. So, take a deep breath. Because one of the last interactions you’ll have with a doctor before surgery will be during your pre-admission anesthesia visit. Here’s what to expect.
Prior to the COVID-19 pandemic, most pre-admission anesthesia visits were conducted in the clinic. Now, many preliminary interviews can be done over the phone. Parents of children under 13 will also often be contacted by telephone by a nurse. It’s very important that you keep this meeting––if you don’t your surgical date could be postponed. Cardiac patients are particularly vulnerable to complications from anesthesia, so your anesthesiologist will be evaluating your history of heart disease or infarctions if this applies to you. If you wear a pacemaker, you’ll be asked to provide information about the manufacturer so they can be contacted. That’s why it’s a good idea to gather all of your medical records and other documentation in one place and have them with you during the pre-admission anesthesia visit.
The anesthesiologist or a member of the anesthesia team will discuss with you your overall health and any recent changes to your well-being. Besides cardiac issues and high blood pressure, you’ll be asked about diabetes, sleep apnea, acid reflux, and other conditions that may affect anesthesia delivery. If you have asthma, you’ll be instructed to bring your inhaler. You’ll also be asked about allergies to medication.
You’ll also be asked about any drugs you are taking and their amounts. Overuse of certain drugs or alcohol can make it harder to be sedated or can affect intravenous anesthesia. You will be asked to restrict your use of blood thinners depending on the type of blood thinner you are taking while oral diabetes medication should be halted the day of the operation.
During your visit, you’ll be asked about your history with anesthesia. This will also be a good time to ask any questions you may have. If you have concerns about anesthesia, allow the doctor the opportunity to address them. During this meeting, anesthesia options will also be discussed. Besides general anesthesia which renders patients unconscious, depending upon your medical history and the procedure in question, other types of anesthesia may be available. With monitored anesthesia care or “twilight” anesthesia, you’ll be relaxed but conscious and breathing on your own. With regional anesthesia, the part of the body where surgery is occurring (such as a knee or hip replacement), has its pain sensors blocked when a local anesthetic is injected into the area’s nerve supply.
Several days before surgery, you should be on a once-a-day bathing or showering schedule. Keeping your skin clean prior to surgery is important because it reduces the risk of infection. The day of your surgery you should stop eating or drinking anything including water after midnight. This includes gum or lozenges. Ask the anesthesiologist if you can have black coffee or sips of water. You should also avoid smoking or drinking alcohol at least one day prior to surgery.
Ten years ago a study indicated that the biggest challenge anesthesiologists had was patients that skipped the pre-admission anesthesia visit. In that time, little has changed––it remains an ongoing problem. Remember, keeping your anesthesiologist informed by keeping your appointment is vital for your well being. You risk having important surgery delayed by skipping it.
John Bankston is a published author of over 150 nonfiction books for children and young adults including biographies of Jonas Salk, Gerhard Domak, and Frederick Banting.