Why do surgeons do this? (Drugs)

[ChickyNuggies]

I'm not sure if this is standard practice or not but welcome discussion!

I had "minor" (doesn't feel minor) keyhole gyneacology surgery last week. When I awoke I was completely out of it, I later learned that they gave me Fentanyl (!) as pain relief prior to waking up. According to Dr Google, Fentanyl is up to 100 X stronger than morphine. So, I was completely out of my face high. Which was fine.

When I was taken back to the main ward (still literally high as a kite) the surgeon came round and explained what had happened during my surgery. I first of all couldn't really comprehend at the time what she was even telling me as I was barely sure of my own name but several hours later when waiting to be discharged, I realised I couldn't remember a bloody thing she had said to me about the surgery.

Thankfully a senior nurse had all the notes and she managed to explain to me, which was just as well as the surgery had turned out to be a lot more complicated than originally thought and I had to have a lot more removed than anticipated as well.

Has this ever happened to you and also WHAT is the logic behind explaining slightly complex surgical detail with someone who is completely off their tits on drugs and can barely even talk?

Although fentanyl is much stronger than morphine the doses used reflect this so doses of fentanyl are measured in micrograms while doses of morphine come in milligrams.
And I guess they come and talk to you then because that’s when they’re available… though not necessarily ideal!

Yes I guess the obvious answer is this is when they are available! The hospital I was at has literally been set up to deal with the backlog of minor surgeries and it was a bit like a conveyor belt - quick turnaround between surgeries from 9am to 5pm so that likely is the only time they had free but yes, not ideal 😬 maybe a better alternative would be to arrange a video call the next day or something. For me I had questions about my surgery that the nurse was not able to answer so I'll never know (it doesn't really matter but I am still curious).

I had surgery to remove fibroids last year and actually considered making a complaint about my surgeon for something similar. She came over to me in recovery, literally minutes after I woke up and explained how the surgery had gone. That didn't actually bother me. What really did was that she also took the opportunity to lecture me about losing weight in order to reduce the risk of fibroids reoccurring. I completely understand that this was good health advice but really not appropriate in that setting.

They talk to you when they can and it looks like you’re recovered enough to have a conversation. A phone call the next day wouldn’t work because they’ll be doing their next day’s work by then. There isn’t often an ideal time to talk to patients having day case surgery - it doesn’t reflect that the surgeon is bad, more that the service is so stretched it’s like a conveyor belt and if we don’t move onto the next thing quickly enough the managers will be breathing down our necks. You should also have a copy of the discharge summary in addition to what the surgeon and nurse told you which may fill in some of the blanks.

A video call the next day would be fantastic - but sadly there isn’t the time or the resource to facilitate this unless it’s complex surgery or something genuinely unexpected.
hope you recover smoothly!

I remember being talked too I'm nodding away and I said.....I've no idea what your saying to me she paused said you should be fine I think we got it all (retained placenta I lost a lot of blood) told the nurses to get her if I had questions and left

I was out of it totally

Singingtherapy to be fair I'm sure she didn't want to see you again in a couple of years for further surgery so it was sensible advice

Well this was me after my first c-section. DD is 16 now and I'm still sad that I was really out of it and utterly confused afterwards.

Seems like it is fairly normal then!

Appreciate there isn't an ideal time, and that the staff are really stretched. It's just unfortunate there isn't an opportunity later on to ask questions if you have them.

For me, I was in to have 1 x 10cm ovarian cyst removed.

I ended up having 1 x 14cm cyst removed and 3 others ranging from 6 to 9cms.

My questions were more around, assuming the 14cm was the one that was 10cm 6 weeks ago at my last scan, how has it grown so much in such a short space of time and why were none of the others seen on the numerous scans I've had - have they just grown in the last 6 weeks too?

To be fair, likely the surgeon wouldn't have been able to answer them fully but it would be nice to have an idea.

That aside, all the staff were honestly wonderful, especially the anaesthetist who had me in hysterics when he could see how anxious I was!