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What you ought to know before you sign up for surgery

By Vision Reporter

Added 11th April 2011 03:00 AM

KEEPING one’s health as a major focus after surgery is important to ensure smooth recovery.

KEEPING one’s health as a major focus after surgery is important to ensure smooth recovery.

KEEPING one’s health as a major focus after surgery is important to ensure smooth recovery. Vicky Wandawa lets you know the important things you need to consider before you schedule a surgery

Emily’s story
I had my first baby, Keisha, three months ago. The antenatal clinics showed I would ably give birth naturally, but I exceeded the due date and the doctor suggested that I be induced. I still was not able to give birth, and had to be operated on.

However, we had not discussed the surgery procedure. I underwent local anaesthesia, and could actually hear the doctors perform the operation. I found it very disturbing. Had we discussed the procedure earlier, I would have opted for the general anaesthesia where I would be fully unconscious.

The doctor later explained to me that local anaesthesia is the better option. Following the operation, I had a terrible headache that lasted almost three days, and was told it was one of the complications of local anaesthesia.

Nonetheless, I still think that even though my doctor and I hoped that I would give birth naturally, we should have discussed the operation procedure. This way, I would have been better prepared for the discomfort and excruciating headache that followed.

Importance of discussing the procedure with your doctor
Listening to your doctor confirm or justify the need for surgery will most likely offset a bout of fear.

Chances are that as soon as you digest the doctor’s proposal, your mind races through question after question in a flash. Perhaps the question, “Will I come out alive?” will run through your mind over and over.

It is essential that prior to the operation, a meeting is set up between you and your surgeon, to discuss the operation. This is the time to ask about the procedure.

Dr. Ahmed Mulwana, a surgeon at Mulago Referral Hospital, explains that the type of operation one undergoes determines whether or not one will get the chance to discuss the operation with his or her surgeon in detail before it is carried out.

“There are two types of surgery; emergency and elective — carried out depending on a patient’s condition,” Mulwana explains.

Emergency surgery
“Emergency surgery is carried out for conditions that require immediate remedial action such as pulmonary obstructions, pre-eclampsia pregnancy (an acute and life-threatening complication of pregnancy), ectopic pregnancies, acute respiratory failure, poison episodes, brain injuries, burns et cetera,” Mulwana explains.

He adds that principally, emergency surgery is designed to promptly deal with life-threatening situations. There is barely time for extensive diagnosis of the patient.

Elective surgery
Elective surgery is scheduled to a date and time agreed upon by both the patient and the surgeon.
If you are to undergo an elective surgery, it is important to make time and discuss the operation with your doctor. Discussing with the doctor also puts one’s mind at rest as a number of unfounded fears are eased. The patient also prepares better for the surgery.

How to achieve a successful
operation

So given the option of undergoing elective surgery, how should you prepare for the procedure, considering that with elective surgery, you have the time to prepare?

For starters, you should ask the doctor to explain the surgery beforehand. You need to ask your anaesthetist the kind of procedure to be carried out on you and how it will be administered.

Henry Bukenya, a practising surgeon at Mulago Hospital, explains that the first step in preparation for a surgery involves the patient availing his or her past medical history in detail to the surgeon. This also includes availing information about the last time the patient underwent surgery, as well as the type of surgery.

Bukenya explains that it is crucial for the surgeon to be aware of the last surgery if any, so that the right incisions are made.

For example, if a woman is to give birth under surgery and she previously had a caesarean section, the same area where the C-section was made, is the same area it will be made again, with a similar incision to avoid complications.

The patient should also divulge any chronic diseases that run in the family such as diabetes and epilepsy. “There are diseases that dictate that a particular sedative be used. When those sedatives are used, they may not work as required during the surgery,” Bukenya explains.

Furthermore, the patient should avail his or her social history. For instance, in case you take drugs or consume excessive alcohol, there are sedatives that should not be used during surgery because they will not work as expected, as they would on a patient that does not do drugs.

Therefore, alternative sedatives would be used. Bukenya also notes that one’s past medical history should be revealed, for example whether or not the patient has had a blood transfusion before.

“Having undergone blood transfusion earlier could imply that the patient has a low clotting factor. Therefore, during the surgery, blood transfusion facilities should be on standby.”

Also, revealing past medical history helps the surgeons know what kind of drugs one might be allergic to so that they are not administered.

Prior to the surgery, Bukenya says all infections are to be treated, or the patient risks infection spreading the area that has been operated, delaying recovery.

One should spend a considerable amount of time with their doctor explaining to them about the procedure. “Have a lengthy discussion with your doctor regarding your concerns and fears about the surgery so that your questions are answered, and perhaps your fears lessened,” Bukenya adds.

Furthermore, keeping a positive attitude and focusing on positive outcome reduces the fear. Meditation by focusing on relaxation could also ease the fear.
In addition to mental preparation, you should also have physical preparation.

Dr. Ahmed Mulwana, a practicing surgeon with Mulago Referral Hospital says doing exercise prior to the surgery does not only get your mind off the forthcoming procedure, but also improves blood circulation which gives a greater chance of the wound healing faster.

In addition, if you are overweight, cut down on your weight. “Extra fat increases chances of infection and slows down healing,” Mulwana notes.

Dos and don’ts prior to the operation
“Normally, patients are advised not to eat and drink within 12 hours prior to the operation,” Bukenya says.
When patients eat within this time, they risk vomiting or chocking on their tongues in reaction to the sedatives during the surgery. Particularly, if the surgery is in the gastrointestinal system, eating may cause complications during surgery.

Drinks are just as dangerous. Bukenya says a patient could vomit while under anaesthesia, which vomit is likely to be inhaled in the lungs. This can cause difficulty in breathing and lead to complications such as pneumonia, hence delaying full recovery.

Following surgery, one can take plain tea and soft foods like water melon and bananas to prepare the digestive system to resume its usual work.

“Tea boosts the electrolytes, thus aiding blood circulation, which fastens healing,” Bukenya adds. But much as surgery is done to enhance one’s health, it is risky and may not always go as planned.

Risks of surgery
Blood clotting as a result of surgery: This may start in the area that has been operated upon. Medication can be given to treat the situation, but in case it is complicated, clotting can cause a stroke.
Delay in healing following surgery: This, according to Bukenya, differs from one person to another. However, patients with a weak immunity may spend longer before recovering, compared to those with strong immunity.

Infections following surgery: The wound creates an opportunity for infection into the body, so antibiotics are used to reduce the risk.

Bleeding problems during surgery: Much as a considerable amount of bleeding is expected during surgical procedures, in severity it may require significant transfusion.

Death: This is a risk that comes with surgical procedures generally.

What you ought to know before you sign up for surgery

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