upcoming surgery

OH Binney, I wish I lived next door to you too. It's amazing what thoughts I remembered just by your one question, L&H&P's sassy

sassy, when you figure out that iPhone, please post some detailed instructions to explain it all to me. Even having grandchildren has not helped me master the darn device. We'll work on finding a lymphedema connection for the information!

Glennie, I hope you're more comfortable with all this now--going into surgery at ease with all the variables really helps not only the pre-op anxiety but the entire healing process. Be sure to get your therapist on board and ready to help afterward as needed. 

Be WELL! Yes!
Binney

Hope I'm not to late to wish you well glennie. Enjoy the Versed, I always melt into stretch with it, it's so relaxing to my constantly stressed back muscles. MHHHHHhhhhhhhhmmmmm...

I'm going to have a full now as well. Let the fun begin. Um, I mean continue 

glennie, I'm drowning in errands and life's details this weekend, after a week of working away and needing to head out again for the week starting Monday.  I'm afraid if I wait until tomorrow, I'll forget to wish you the best of luck for your Monday surgery.  So:  Here's some psychic energy in favor of a hassle-free, goes-according-to-plan, no-drama, and minimally-uncomfortable surgery.  I'll be thinking of you on Monday!

Carol

Glennie, I was rereading the posts over the last two pages. It's a perfect place to add a description of "Surgical Stress Response". The body undergoing any sx procedure perceives it is being attacked. The body has many protective sensors that transmit info to the brain. When the sensors indicate trouble -i.e. real or perceived. the brain interprets the signals and activates all kinds of things within the body. This is a very simplified description of the "Negative Feedback Mechanism"(loop mechanisms). How this occurs in the body is so absolutely amazing.

One of the mechanisms causes the body to decrease urine filtration through the kidney. This reduced function of the kidney is VERY advantageous if being attacked by a saber tooth tiger, but now can interfere with recovery after sx. This reduction of filtration allows the body to maintain volume. What the anesthesiologist does is use a smorgasboard of drugs & fluids to trick the body/ brain into not closing down systems that need to keep working.

Generally, lots of fluids are used from pre-op>>OP>>post-op to trick the body/brain. A usual expected affect is fluid retention. So, in the case under discussion of your particular position in sx with a 30-40 degree head down position, add to that that the anesthesiologist is working to fool the kidney/ brain etc. it may make it clearer why people appear to be puff balls after sx. Even when the surgical table is flat.

What then happens after the sx is over, the bodies loop mechanisms are assessing the balance of the body. Once the brain decides the threat has passed, it sends chemical & nervous messages that cause the body to come back to balance(homeostasis). This can start from hours to days.

In the case of fluid retention, once the brain decides it's not threatened anymore. Chemical/nervous signals are sent to the adrenals & kidney. This causes the kidney to start dumping extra fluid. Peeing like a race horse is the typical description. May occur in hours. May not occur for days. May have to be "encouraged" by a diuretic(water pill/shot).

What can you do to help Note your weight on your home scales just before you leave home, and at the hospital in the preop area. They are usually different. But if you have had nothing by mouth---and your home scale weight is 150 and the preop area scale is 160. That's important. You didn't gain 10 lbs, it's a difference in the scales. Post-op then if you go home, you can accurately track your weight. Your home scale may be inaccurate, but you know what it was immediately pre-op. So, a wrong becomes a right for tracking purposes. Clear LOL?

 IF you are admitted, then the pre-op area scale becomes the tracking device. Make sense?

Does get confusing if you are discharged the next day. But when the body is under attack mode, consider it will take several days for it to readjust to a balanced state. So, if you are discharged early use your home scale as your tracking device.

If post -op you are peeing allot, that's a signal that all systems are ago for coming back to normal YAY!. If there seems to be a feeling of being a puffball and there is little urine output, then the body is still not convinced that all is right.

One thing that will cause the body NOT to come back into balance is PAIN. Post-op pain should be well managed i.e controlled post-op. Scale below 3. High pain scale descriptions remember when I said >5-6 chemicals are released that can interfere with wound healing. Pain convinces the brain that trouble is still abrewin'. The brain WILL NOT let it's guard down in the presense of PAIN.

Believe it or not PAIN is a protective mechanism. Not seen that way when we are going through it. But in the days of saber tooth tigers and such, yeah, it was.........Think I'll stop here. Reread a few times before sx. Just as a game---I'm terrible. Ask folks as you go through the process  "Tell me about Surgical Stress Response and what can I expect".  Report back after with your stories

Why do I know about it? Serendipity. Not learned in surgery--(4 years), Not learned in all the teaching I'd done on trauma for the next 6 years. How? I was prego and toxic. Searched Toxemia. Toxemia of pregnancy mimics Surgical Stress Response. I'd been in the business for 10 years and never saw the topic written or discussed. That was 1984. The parasympathetic and sympathetic nervous system that controls all this was my favorite bedtime reading---I'm weird. Never once saw it mentioned from a surgical standpoint.  Trauma, life, drugs, oddles of other things. Not surgery. You're Anethesia folks are well versed, perhaps recovery folks. Your stories will tell me abouthow well others know.

I know I was still teaching staff nurses that had gone through a 4 year BSN program, and it was never  mentioned  as of 5 years ago.

Remember to do your weights pre &post and pay attention to how much you're peeing

Oh Carol you make me feel so good Thanks bunches Hugs sassy

Glennie, I hope all goes well with your surgery. I'll say a prayer for you. 

XOXO,

Stephanie 

Good to hear from you Glennie.  I hope you have sweet, restful dreams tonight.  Take care.

glennie, hooray!  Get lots of rest, hydrate...you know the drill.  Let the healing begin!