Waking up in the recovery room after an operation can be disorientating, it helps to know what may be happening.

·        There is a high ratio of staff to patient’s in recovery, this is because as you are waking up close monitoring is needed, and even closer monitoring while you are still unconscious.

·        You will have a blood pressure cuff on your arm intermittently inflating, this may happen every 5mins, do not be alarmed if you feel this as you wake.

·        You will have a probe on your finger which monitors oxygen levels.

·        There will be an intravenous drip attached to you, most likely in your hand but it could be further up your arm, remember you have been without food and drink, and anaesthetic is dehydrating, fluids are very important. This will likely stay attached until you have proven you can eat and drink without vomiting.

·        There will be an oxygen giving device, this will be either a mask, or nasal prongs (which literally sit inside your nostrils). They can feel uncomfortable, maybe even itchy, but they are important. Under anaesthetic your breathing rate slows, until you are conscious the oxygen must stay on, once you are awake it may take a little while for your ability to take in enough oxygen to return to normal, so be patient it must stay on until the nurse says it can come off.

·        For more major operations, or if you have had medications such as morphine, the oxygen will need to stay on longer; it may be days or even longer before the oxygen is removed completely. You may need to be weaned off the oxygen, slowly stepping down from different types of masks to nasal prongs, and eventually it can be removed.

·       Depending on the operation, you may have other attachments, such as drains coming from your wound that drain off blood, or a catheter, some operations you will have a tube coming out of your nose for feeding or draining fluids from the stomach. These attachments shouldn’t come as a shock as you should be informed what will be attached prior to surgery. Be sure to check with your doctor what exactly will be attached to you after the operation.

·       You may have an inflating ‘blanket’ on. This is to keep you warm, it’s not always required but theater is cold, sometimes people need extra help to warm up after.

·       Sometimes, surgery needs to be more invasive than planned; a simple scope can lead to more extensive surgery, such as excisional surgery, in these cases you may wake up with more attached than expected.

·       There is a good chance you will be in pain, depending on the operation. Pain medication is generally offered as you wake up, take it if you need it, your body needs to recover, operations are big ordeals, do not try and be tough, take the pain medication. If you are in pain and haven’t been offered anything, don’t be frightened to ask for medication.

·       You may have a PCA (Patient Controlled Analgesia), it’s fairly common these days for more painful operations (not day cases) to have a PCA, and this is a button which allows you to administer your own pain relief. The dose is controlled, it will only provide a limited number of doses per hour so there is no risk of overdose. When you press the button a small amount of analgesia will be released through your IV cannula, allowing you to control how much and how often you get pain relief.

·       You may feel sick, anaesthetic can cause nausea and vomiting, again you will likely be offered something for this as you wake up, if you feel sick and nothing has been offered, ask.

What then?

·        It depends on your operation, some cases are just day cases and you will be sent back to the day ward. In these cases you will be given food and drink upon arrival to the day ward. If you can tolerate food and drink, the pain and nausea are under control, and your vital signs (blood pressure, pulse, temperature) are ok, you will be sent home.

·        Sometimes in day cases the doctor will see you before you go home, otherwise follow up should be organised before you leave the hospital, either with your GP or specialist as appropriate.

·        More major operations will require a stay overnight or longer. Be sure you are aware of the expected length of stay prior to surgery.

·        If you are staying overnight or longer, you will be sent back to a ward, usually the appropriate surgical ward depending on the operation. You may not be able to eat and drink straight away after this, and may not be able to get out of bed.

·        Once your in the ward, the nurse will check your vital signs again and post-operative care will continue until you are recovered enough to go home. Be sure you can reach your buzzer once in the ward, the nurse should ensure this, but if you don’t know where it is make sure you are told or it is moved to a more visible spot for you.

Post from: The Recovery Room

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Preparing for surgery

·        Do I need to go without food and drink before hand? Because of the anaesthetic, regardless of what is being operated on a patient is always required to have no food or drink prior. There is a risk of aspiration (see definition below) during an operation, having nothing in your stomach prevents this risk. Take this seriously, make a mental note of when you have your last food and drink, the admitting nurse will ask you this, it must be an honest answer.

Aspiration – “The accidental sucking in of food particles or fluids into the lungs.”

http://www.medterms.com/script/main/art.asp?articlekey=2369

·        What about medications? Usually it’s a good idea to take medications as normal, unless it’s a medication such as aspirin or warfarin, or any medication that increases the risk of bleeding. Check with your doctor what medications can or cannot be taken on the day of surgery. Medications that increase the risk of bleeding will need to be stopped up to a week prior. Diabetic medications should still be taken but only half the normal dose; again check with your doctor what should be done in your individual case.

·        What about herbs and supplements? You must tell your doctor if you are taking any of these, some herbs and supplements can interfere with other medications, and can increase the risk of bleeding. Do not assume because it’s natural it’s safe.

·        I’ve been asked to take a bowel prep medication, what does this mean? A bowel prep is done prior to bowel surgery, or sometimes when areas close by are being operated on for better visibility, such as during laparoscopes. They are meant to empty out your bowel, it’s not a pleasant experience, be sure to be close to a toilet once you take it, and keep your fluids up. Sometimes a special diet needs to be adhered to prior to taking the prep, instructions for this will be provided if this is the case.

On the Day

·        Generally you’re expected to be there around 2hrs before; you should bring any appropriate scans such as x-rays with you if they relate to the surgery.

·        The admitting nurse will take your blood pressure, weight, pulse, temperature. The nurse may want a urine sample to test as well, not much is required for a test so there is no need to ensure a full bladder, however don’t empty your bladder just before admission, there will be a chance to do so once you’ve seen the admitting nurse.

·        Tell the nurse if you have any allergies or have had a previous reaction to anaesthetic. It is also a good idea to tell the nurse if you are currently or have recently been sick.

·        Is there a risk you are pregnant? If there is any risk at all, tell them. A pregnancy test prior is simple and quick.

·        You will be expected to wear a hospital gown. There have been some improvements and many hospitals have gowns that can be tied across the back, ask the nurse for help tying it if you are unsure how to do so. It’s nice to keep your dignity and the nurse can help you do that by tying it correctly.

·        Can I wear underwear? Yes, sometimes, it depends on the operation and the hospital policy. The admitting nurse should specify this, but check if you are unsure. If your operation is on your shoulder wearing underwear should be ok if the hospital allows it, however a hysterectomy or a curette will obviously require you to remove your underwear.

·        What then? It’s time to wait, make sure your personal belongings are secure somewhere, if possible give them to whoever dropped you off at the hospital rather than leave them with hospital staff. There should be facilities to keep belongings in during your procedure, but they may not be locked, and unfortunately even hospitals have thieves.

·        The anaesthetist will see you before the operation, sometimes it will be in the waiting area, other times you won’t see them until you’re just about to go in to theater. Once in theater, many questions you have already answered will be asked again, be patient and answer the questions, repeated questions are better than errors. Your IV cannula (for medications and fluids to be administered directly into your veins) will be inserted just prior to entering the operating theater.

·        In the theater you may be nervous, or afraid, it’s perfectly normal to feel this way. You may feel uncomfortable with the thought of being exposed to strangers, be assured that the staff see what their doing as a job, they see many people throughout the day, for them they are seeing a body part that needs operating on. Fears of what will be found are normal, it may help to tell the staff what you are feeling as they get you ready, theater staff can provide reassurance and this may help.

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