Pre And Post Surgery Considerations For Potsy Folks

[Gena]

My gynecologist will be doing minor surgery on me in June. I told her that I have dysautonomia/POTS and she said that my legs will be elevated during the surgery (which will take about 15 minutes) and then lowered --will this cause any problems??. She said she can have extra blankets on me to keep me warm if that will help. She will leave everything else up to the anesthesiologist, whom I will meet with prior to the surgery.

She said normally they do a light sedation in IV with anesthesia block from the waist down, or I can choose to go under full general anesthesia -- which would be best?

Does anyone know if Dr. Grubb or someone else has published anything on surgery prep and post-op suggestions for those with POTS? It would be great to have an official document to bring to the anesthesiologist. If not, then I'll gladly take anyone's tips and suggestions to help alleviate any possible complications?

Thanks,

Gena

[Poohbear]

Gena,

You may want to take a look at this link

http://www.dinet.org/links.htm#anaesthesia

Good luck with your procedure. I don't do well with surgery at all so if I was in your shoes I would opt for the light sedation because those meds tend to clear your body quicker. However, we are all different.

Hopefully you can print something from the above link and see "What to avoid" under the POTS section of this website too and that will help your Dr.

Let us know how things go and what you decide to do!

[JanetM]

Poor You! I am also due to have surgery later this year and I am terrified of the effects having a general will have on me. I am having extensive surgery so doc is insisting on putting me asleep for it. PLEASE let us know how you get on and the very best of luck to you.

[ellen]

Gena, I have one recommendation, which you might talk to your doctor about. When I had surgery, I was told I would have to have a tube of blood drawn the morning of the surgery (which was scheduled for 7 am Monday). . I know MY body does not recover quickly from a blood test, so I asked if I could do it the day ahead, and was told it could be done at most two days in advance and the blood lab is open on Saturday only for one hour at 6 am. , closed on Sunday. I gladly went in on Saturday to do the test. . . I arrived Monday at 5:30 am for my pre op and was told they LOST my blood work and they cheerfully told me I would have to repeat the test. This blood is only required in case of the rare emergency that I would need a transfusion. . . I calmly told them they would have to cancel the surgery because I couldn't take the chance of going into shock from a blood draw after 12 hours of fasting. Surprise! they called downstairs to the lab and found it. . . They were willing to send me down to do it all over again, rather than pick up the phone and make a phone call !!!! . . My surgery went smoothly and I learned a lesson- you have to be your own health advocate. Good luck !

[Gena]

Poohbear, thanks for the links to those articles. I will send them to my doctor.

Janet, thanks for the well wishes.

Ellen, thanks for the valuable tip about the blood tests. I had forgetten that they often do that!

I guess my final question is .....since the surgery will only take about 15 minutes, should I have a catheter inserted to manage fluids for fluids and arterial pressure management? I am not really familiar with this, but I"ve read about it in articles and other posts. Or should this only be done as a precaution in MAJOR surgery for those going under full anesthesia?

Thanks,

Gena

[Poohbear]

Gena,

Sounds like your surgery is intended to be minor so I wouldn't think you would need much "intervention" in terms of consistent monitoring etc unless you decide to have the general. Usually with Light sedation you are MUCH better off. Talk to the anesth. if you are sensitive to meds, make sure they don't use any numbing agents with epinephrine in it. Other than that, if you have a tendency to dehydrate you may want to ask your Dr about getting a bag of IV saline to "boost" you a little.

With the light sedation I would think you will do fine you may just want to make sure they allow you lay flat and rise slowly after surgery and allow your body a little extra time to adjust.

Try to have pain mgmnt plan for after surgery worked out ahead of time since pain can aggravate symptoms.

[goldicedance]

Gena...Good luck on your upcoming surgery. Here are some suggestions I have: Be sure you are well hydrated. Talk to the anesthesiologist about the need for hydration. Have your POTS doctor talk with the anesthesiologist and the gynocologist before the surgery about your special needs. I have had gall bladder surgery and a lumpectomy. Both times extra hydration was given. The anesthesiologists did not think I needed an arterial line as they believed they could manage blood pressure fluctuations without the arterial line. I had an arterial line put in when I had lung surgery in 1994 before POTS was a diagnosis. An arterial line is no piece of cake with regard to its insertion.

My internist always stresses to the surgeons the need to keep my head elevated during the surgeries.

I would try to avoid general anesthesia if I could. When I had the lumpectomy and removal of a pacemaker and replacement with an abdominal pacemaker (a more complicated procedure), the anesthesiologists used an IV anesthetic which put me in a "sleep mode." I did not feel anything, see anything, etc. It helped to avoid the sore throat and possible nausea from a general anesthetic.

If you would like to talk further, please Email me.

Again, I wish you an easy surgery and a super easy recovery.

Lois

[Gena]

Thanks to everyone for your suggestions, great tips and advice. I will print these out and take them to my doctor and anesthesiologist. You guys are the best! The surgery won't be until early June, but I'll let you know how it goes.

Hugs

Gena

P.S. Lois, it's good to see you post. I hope you are doing well these days! And thanks for the reminder on keeping the head elevated. I can get very symptomatic when lying flat. Take care.

[DancingLight]

Gena,

As you know I had the 'ol GB surgery, and the only thing that they could do for me for a 'boost' beforehand was dump in a liter of fluids BEFORE surgery and extra hydration afterwards.

Since you function pretty well and the surgery is 'minor' I hope you will have relatively few problems...

I did fine with bp and hr during surgery, it was afterwards that my ANS went bonkers, as you know! But, I really think I am an unusual situation!

I also had my surgery first in the morning, so I didn't start out dehydrated. I do not think for minor surgery you would need an arterial line or anything like that.

After surgery I had those pumping 'hose' things around my legs to keep the blood circulating and they helped me a lot. When they took them off, I was much more close to passing out.

I didn't have my head elevated...

Keep us posted. I found that it was most important to have the anaestesiologist clued in and the surgeon talked to my POTS doc ahead of time also. They were all VERY careful with me.

Do you have your new puppy/doodle yet??????????? Is her name Ruby? I love that name and have thought about naming a dog that myself!

Best, Emily

[Gena]

Hey Em,

I've been thinking about you a lot lately and wondering how you are doing. I was so happy to see your post!! Thank you for all the info. You are definitely the "pro" at dealing with the aftermath of surgery. I hope you are doing better. I know the last couple months you had been sliding deeper in the POTS hole. I know you were trying some new treatments...did any of them pan out for you?

Yes, we got our goldendoodle and named her Ruby. She is now 4 months old and just a sweetheart. She and our cockapoo get along great. We took her to puppy obedience class and one of the other couples in the class also had a goldendoodle - named Rusty and he's just a few weeks younger than Ruby.

Okay, I'm getting off topic here, but I wanted to say thanks for your post. Keep in touch and let me know how you're doing.

Hugs,

Gena