Cancelling pre-op again, not sure what to say

[whichspidermummy]

I had a thread last week, about attending a pre-op when I'm not sure if I want the operation. I cancelled it (by saying I was ill), but they sent me another one over the weekend and want to go tomorrow.

I've also been phoned by booked admissions, who've left voice messages saying that I need to call them to arrange, which I've avoided so far.

I've sent another email to the consultant's secretary, saying that I'm unhappy to have the operation based on the fact that I don't know what it's for, what the aim of the surgery is and due to the fact that it appears to be based on wrong information.

I've heard nothing from the consultant when I emailed before and have heard nothing since and I can't get through to them on the phone.

I'm going to phone the pre-op in a minute, but I'm not sure what to say. I said I was ill last week, to stall for time, hoping the secretary would get back to me (which she always has in the past), but it seems as though they're hoping that I just attend, get booked in and have the op without any further talks (I've not spoken to the consultant at all since the first op 14 months ago).

Would I be unreasonable to say that I'm not sure why the op is necessary and that I need to speak to the consultant/registrar before it goes ahead? I'm mindful that it may be necessary, but they've not listened to my experiences (and this op appears to be based on something the registrar noted incorrectly).

How did it get this stage without you saying you didn't want surgery? Do they know you don't want the surgery?

@whichspidermummy why even bother wasting doctors time and consultants time and hospital time if you do not want an operation!! surely you know why you went to the doc in the first place???????

@Harvestfestivalknickers how did it get this far? Good question. I was only told a month ago.

I had a fusion in November 22. The surgeon was also going to do an osteotomy on my tibia, as it had a malunion from a very bad break over 30ys ago. I have arthritis on my ankle and talonavicular.

I had a steroid injection into the talonavicular, to see if it would help, therefore a fusion would be beneficial, it didn't, yet he wrote to my gp saying it did 🤔.

I found out after the operation the osteotomy wasn't done

I've seen registrars since and have clearly said that the pain is still there (along with new pains). My arch is now much higher than the other and my toes 'claw' the ground. I cannot stop them doing so. I haven't walked unaided since the fusion.

At my last appointment (last month), the registrar wondered if it was the metalwork causing the problem. He suggested using an orthotic then waiting 6 months. However the consultant came in, flexed my foot, said the metal needed to come out this month, then left, before I could question further.

In the letter to my GP the reg said I had no symptoms until recently (which is clearly untrue and if this is the basis for sugery, then it won't work).

I've explained my reluctance in emails to the surgeon, but they've been ignored.

So basically I've been railroaded into it, in less than a month.

I struggle to see how you’ve got this far in medical care, and you don’t know/ have never asked what’s wrong, why the operation etc? How is that possible?

For goodness sake, stop wasting doctors/ nhs time in an over stretched service by lying your ill and what not. If you don’t want an operation, or any further investigation then tell them that!

I wonder if the Secretary has been on leave over Christmas or something. I would phone again.
Pre op assessment is primarily to check that you are well enough to have the surgery and to make sure pre op investigations etc are done. In most hospitals this service comes under the auspices of the Anaesthetic Dept and they're not going to be in a position to decide whether or not your operation is necessary.
You need another outpatient appointment with the surgeon to discuss things properly. It sounds as though you are not in a position to consent to surgery and that needs to be sorted out before you get any further down the pathway, both for your own benefit and for that of other patients on the waiting list. I know it can be difficult negotiating hospital systems, especially when you are anxious about what's happening. Have you spoken to PALS? They may be able to support you and help you speak to the correct person - they're not just for complaints and in my experience can be very helpful. I hope you get things sorted out soon.

@MrsPinkL I'm not sure whether you've not read my update or are being deliberately obtuse!!! How dare you suggest I've lied! How very dare you!

I have certainly not lied and am seriously offended!

I had a spiral fracture of my tibia. It never healed and is classed as a malunion.

Over the years it has caused arthritis (due to the bones being out of alignment),

My ankle is the thing that causes me the most pain.

I had a fusion last year and the surgeon was supposed to fix the malunion but only did the fusion then lied on his reports to my GP.

I have been in pain ever since. I cannot walk unaided.

I'm really not sure how you can so wilfully ask ridiculous questions such as why it has got this far or why I don't want it fixed? Of course I do, but taking out metalwork is not going to cure the malunion or ankle, which is why I saw him to start with. He has decided, without even speaking to me, to take out the metalwork and no one has told me why!. I've not seen him (except for 30 secs when he told his reg to book me in within weeks).

@AgeingDoc thank you, a sensible suggestion, unlike a previous poster who just accused me of lying.

I have attended monthly for the last year since my operation, seen a different registrar each time, told them my pain is getting worse, then the last one told the surgeon my pain had gone away and come back, which is why they want to do the operation, based on a lie, without any plan or explanation why the last operation wasn't what they planned.

I can understand how you feel.
can you contact the consultant again and request a phone consultation.
msybe the metalwork has to come out anyway despite it not helping the issue. Either way I agree you need more information.

Have you posted before, as this sounds familiar ? Have you spoken to pals about the unwillingness to listen and explain? Would the preop not be an opportunity to ask for a second opinion or review?

Yea absolutely you should cancel the pre op if you don't currently intend to proceed. More importantly, you should also say you won't be having the op until you've had another appointment.

Firstly you need to get the right treatment for you, secondly you need to properly free up the space for other people, not just the pre op but the actual operation slot which is invaluable.

By your own admission, you said you were ill - to stall for time.

If you were actually ill, you would have just said that in your OP. It does read like you lied to them to buy yourself time. Not sure why you've kicked off that that poster quite so aggressively, any misinterpretation is down to your poor articulation (or the poster is right...)

Did you read the OP 😂. Her first line is "I had a thread last week".

Not fair on others to keep wasting appointments. Sort it out.

Just tell them the truth and they will sort it for you instead of putting all their effort in to you to surgery they will probably book a phone appointment with your consultant.

I would ring PALS and explain the situation- from what you have said, communication on what is being planned (an operation) has been very poor and the operation may not be appropriate for your situation. At the least, the reason for the operation should be clear in order for you to give informed consent to proceed.

You did lie. You have conserns about the operation and didn't want to go ahead with it but instead of telling them that you told them you were ill.

Ok, what I would do is contact PALS today - there should be a phone number and/or an email address on the Trust website.
Tell them basically what you have said here - you have a longstanding painful orthopaedic condition and treatment so far has not been terribly successful. You don't feel that you are being listened to and there hasn't been a lot of continuity in your care. You are scheduled for further surgery which you are not comfortable with giving consent to as you don't feel things have been properly explained and you've been unable to make contact with the Consultant. You'd like plans for surgery to be put on hold until you can speak to him properly (or maybe get another opinion??) but you don't know how to sort it out. Please can they help.
Consent is yours to give, not for the surgical team to take and you cannot give it if you are not fully informed. Yes, the NHS is stretched to breaking point currently and it can be very hard to find time to talk to patients as much as everyone would like, but informed consent is a pretty basic tenet of good medical practice and you have the right to refuse treatment that you don't understand or agree with. Whether this operation is right for you or not is almost irrelevant if you don't understand the rationale. You are not unreasonable to want clarity. They won't be short of people to operate on I am certain. If you step back until you are properly informed someone else can have surgery in your slot so it is in everyone's best interests to get things sorted out asap.

I had to cancel a pre-op too as I thought I had Covid. Apparently the pre-op is where you get to ask all the questions so I’d suggest go to it, have a list of questions. At the end of it if you’re not happy to go ahead say you don’t consent, please cancel and don’t rearrange.

@MaggieFS the one I am thinking of was a month or more ago

Speak to the team doing the pre-op, this will be a different team to the surgeon etc so please don't go with a list of questions regarding the procedure itself. Explain that you wish to postpone the pre-op until you have spoken to your consultant. Contact PALS today stating what you have said here and all the contacts that you have made with no return communications.

Stop wasting appointment slots OP and just pick up the phone and simply say 'I would like to cancel this appointment please, I no longer wish to attend/be seen'. Your medical history is irrelevant (to anyone on here) really. The bookings team at pre-op aren't going to be able to advise or discuss it either, they simply want to know if you want to attend or not so they can give it to someone else.

Nobody has railroaded you into anything, you've been offered an appointment, you are and always were welcome to decline it but have instead said you're ill, not attended, ignored their reasonable contact and have said yourself you claimed you were unwell to avoid the first booked appointment so goodness knows why you're so affronted by that being pointed out.

If you think mistakes have been made or don't understand what's happening in terma of your treatment then please speak to PALS at the hospital, and/or go back to your GP/call the secretary again. Your consultants surgical list has no relation to his clinic list so even if you want to see him and want to wait for a face to face to discuss alternatives, you still need to cancel this apppointment and let them know you don't want to go ahead at this time - then you separately make a request for a follow up appt, with the department or have your GP refer you again. If you don't attend this, as it is your 2nd appointment I would expect them to discharge you back to your GP entirely otherwise.

Surely the point of the pre-op is to have this conversation and ask questions. Stop cancelling it and go to it and find out what you need to make a decision.

No it's not the right place for this conversation. The pre op assessment will be carried out by a member of nursing staff, usually following a proforma to ensure that the patient is fit and prepared for surgery that is already agreed on ie appropriate blood tests are done, co-existing medical conditions are stable and any particular problems that might affect the care are identified, such as previous problems with anaesthesia. There will be some info provided about anaesthesia, pain relief, peri-operative processes etc but it is not the time to be deciding whether or not you want the operation, and the pre -op assessment team are most definitely not the people to be advising the OP on the specifics of her orthopaedic condition and the pros and cons of this particular procedure. That is the job of the surgeon, and he won't be there.
The OP needs to cancel this appointment and get an outpatient appointment with her consultant.

Can you not go to the pre op and ask these questions OP? Just because you go to the pre op doesn't mean you still have to go through with it if you don't want to.
I recently had a pre op with the NHS and the surgeon was there and he asked me if I had any questions. So you would be able to, hopefully, have all this answered when you go.

Sorry you are going through this and I hope you have a speedy recovery ❤️‍🩹

But you did lie, you said you were ill to stall time.

If you were actually ill, you'd just say you were ill, instead of saying it to stall time.

No ides why you're so offended. No one on here can help or answer you, we can't see your ankle and we don't know what you're going through.

Just call and cancel the pre op and be done with it. Book another outpatients appointment. You sound like you don't trust what this consultant is saying. He is a professional, if he said you're better off having surgery and you choose to kick up a fuss, lie and stall, then that's up to you.

You're wasting everyone's time including your own.