I work in the Operating Theatre. AMA

[1AnotherOne]

I’m an Operating Department Practitioner working in the private sector.

I work the majority the time in a senior speciality role as a scrub practitioner or surgical first assistant.

Sometimes I work alongside the anaesthetist.

ask me anything!

I'm in Australia and for a couple of procedures I've had twilight sedation, I feel entirely knocked out until I wake in recovery. Would I have been intubated and catherterised for these?

pleasure I’m a medical history nut love the subject.

Can you tell if it is cancerous during the operation? Is it obvious if a tumour is cancerous or does it just look like another tumour?

Some years ago I had surgery i woke up and sat up pushing people away and gasping to breathe i just couldn't get a breath. I seriously thought I was dying. I feel like it may have been in the operating theatre but I can't be sure.
I remember some lady saying calm down its ok you are having a throat spasm and pushing me back down.
It was terrible I was terrified
Is this the laryngospasm you have spoken about?
What exactly is it and what causes it ?
Will I be prone to it happening again?

My daughter had ankle fusion surgery and woke up pain free, she was still pain free the following day when she came home. She’d been given some kind of nerve block, it wasn’t an epidural. At least I don’t thinks so as she still had feeling in her other leg and lower body. It wore off after she came home.

I've had a laryngospasm in the night twice (over about 50 years, so not common!). I'm due to have a GA soon; is it more likely that i'll have one then because I've had them before, or is it random? I feel like if I tell them about some of the things I'm worried about, they'll suggest it just be done with a local anaesthetic, which I don't think I want, even if I'm a bit jittery about the GA.

Can I keep my knickers on, given that the surgery is nothing below the waist?

They have suggested a nerve block might be a possiblity (I think in addition to the GA, not instead!). Is that generally a helpful thing to have or is it risky?

I have to stay with someone for the night afterwards (day surgery) as I live alone. They aren't going to be checking on me during the night or anything (I can't ask them for more than they are already doing!!) but I guess the point is that they would perhaps be able to drive me back to hospital if I needed it - but what sort of complications might I experience in that time, and would I be able to notice them in myself?!

sorry for so many questions, this is all very interesting!

Gosh , how awful 💐

Guessing you a probably busy working now and now so available to answer questions, but if you do come back, I have a couple more.
Are you allowed to wear a tampon in theatre, and do you have to tell them (not for gynae procedures or anything, but just normal things like eg bone setting or something unrelated, above the waist!).
And, they say you have to remove nail varnish - I guess because it interferes with the oxygen measuring device on your finger, or is there some other reason? If it's just the oxygen thing, then presumably toenail varnish is fine, but if there's some other reason, then maybe not.

@BrunchMonster I'm not medical, but in case OP doesn't come back, I've had GA while on my period.

Absolutely not allowed to wear a tampon. Too much risk if you either end up out of it / forget with the stress of the op and anaesthetic that you have one in and get toxic shock / sepsis.

I was allowed to wear cotton pants, they were very specific about that, and a sanitary towel. Rather than no pants, which is what I was told to do before I explained.

That was for wisdom teeth being removed, so nothing gynae related!

Thank you! It's the sort of thing I worry about as things are v unpredictable at the moment and there's every chance I could need that on the day of my op. Mine is not gynae related either. I'd prefer to keep my knickers on regardless (and they are cotton) so maybe I'll just do that and they can tell me I have to take them off if necessary.

This is a weird question but what do people smell like inside? If you do heart surgery can you smell anything when you open the chest up? What about inside a knee? And a stomach or head? I've always wondered this

The main smell is the iron smell of blood - unless operating on the gut, when you can guess!

Operating theatres tend to smell of diathermy- the technique used to seal off small blood vessels with heat. It’s a bit like when you singe something with an iron.

@brunchmonster maybe give then a ring if you're worried, or ask at the pre op? My cycle is pretty regular and I knew i was most likely going to have my period when they gave me the date of the op. So I rang the dept and asked what I should do. Then on the day when they gave me the gown etc to get changed into I told them I had my period and had spoken to someone who said to wear cotton pants and a pad, and was just checking that was still OK.

I expect it happens every day, with all the people they see, no one batted an eyelid.

MissLucyEyelsbarrow. Thank you. I’ve always wondered that

As a child I had 2 separate ops to remove tonsils and adenoids. I remember having what seemed to be an out of body experience where I was floating up by the ceiling looking down on myself, I believe I was 7 or 8 at the time. I didn't realise what this was until young adulthood, would something bad/emergency related have happened to me?

@MissLucyEyelesbarrow I wondered that too. I have a colostomy bag which is left on when I have surgery but left open. They don't always remember to close it which makes them super popular when I am on the ward and.... well.... covered.

Please don't feel even a smidgen embarrassed (if you do - I'm not sure if that's what you mean). Operating theatres have vicious air circulation systems that are bloody freezing, but also mean any smells dissipate quickly, plus you are wearing a surgical mask, and everyone involved in gut surgery is totally used to a bit of bowel gas. I promise that no one has ever thought twice about any odour with the stoma - a well-functioning stoma is a thing of beauty to any gut surgeon 😀

A Whipple is huge surgery.
Deflate a lung, resection of your oesophagus, stomach, pancreas, ducts, small bowel. Chest drain, multiple abdominal drains, NG, catheter, epidural and a PCA, fluids and anti biotics. I flipping loved nursing them and seeing the progress over a week.
Also the fact you are here 6 years later is amazing as the 5 year survival is low for pancreatic cancer. Congratulations.

The smell of bone cement is horrendous.

I can smell pseudomonus which not all people can, it hits right at the back of the throat.

C Diff has a specific smell different to other diahorrea.

Gangrene as you can guess is pretty horrendous.

A normal body outside of the GI tract smells irony from blood when in surgery.

@Missingthegore

I had no idea it was THAT extensive. Well, I sort of knew due to the recovery and I knew what came out 😂 but the deflating of a lung etc. wow!!! 5 weeks post surgery my pancreatic acid leaked through one of my main arteries at home - that was incredibly scary and took 6 blood transfusions and an embolisation. I was out of hospital after 8 days post whipple which is my bragging right 😂 but I had an incredible surgeon (often said to be the best but he's very humble 😂) Mike Raraty. 22 goes of chemotherapy and a good hospital is how I got here. We still speak every 6 months - I could be discharged if I wanted to be but it's nice to check in.

We had a conversation re: survival rate and what 5 years means - when you hit that 5 year mark, you're as likely to get pancreatic cancer again as somebody on the street. I always thought I'd be higher risk but nope! The immense relief that brought us unbelievable as I was only 28 when I had my surgery, with two children under 2.

The NHS is incredible - forever indebted 💪❤️

The smell of bone cement is horrendous.

This is interesting. I haven't been in a T&O theatre for a long time, so maybe the stuff they make it from has changed, but I remember it being mildly pongy at worst.

Funny how we all perceive smells differently.

I can smell ketosis from across the room. There is also a particular smell of acute renal failure (I don't mean an offensive smell, if anyone with kidney disease is reading - it's more than it helps with diagnosis).

Really interesting about the various smells. I have an acute sense of smell and am easily revolted by unpleasant ones, so I’m not sure how I’d cope at all in a hospital environment at all.

My experience (aged 4) more than 50 years ago was similar. I can still remember the smell of blood on a rubber bib. Felt as though I bounced from first-person to out-of-body and back again. I was living abroad at the time and the op was very quick - in the UK there was a fortnight in hospital, but where I was, a one-way journey through the hospital and delivered to my father's car at the back door of the hospital immediately after the op.
I suspect the 'floaty' bit was due to changes in the anaesthetic delivery as everything was quick and went according to plan. GP visited me at home every day and I was up and around in no time apparently.

I have got a really good sense of smell. You learn to breathe through your mouth!

Breathe through your mouth indeed! A little bit of essential oil in a face mask can help. I'm in obstetrics, so the worst we normally get is a little bit of poo. The worst we've actually had was an awful case where baby had died in utero and had begun decomposing (the whole story is extremely sad, and one I am not at liberty to divulge). After baby was delivered, we could smell the smell from outside the labour ward. Inside labour ward was bad enough. Inside theatre itself was a test of your gag reflex. A smell I hope never to experience ever again.