Will they cancel operation if heart rate/bp is high?

[elliejjtiny]

Ds2 is 16 and is on the waiting list to have a minor operation on his foot. He is also currently being assessed for autism.

His heart rate is normally around 65-75 but when he is stressed it goes up to 130 and his blood pressure gets high as well. 170/83 last time I think.

He is likely to be stressed in hospital as one of his triggers is people or medical equipment touching him.

Will they postpone his operation if he presents with high heart rate and no on the day?

I was pinning my hopes on the clinical psychologist having some ideas on how to help when we saw her last week but she had nothing.

It would be a good idea to flag up to the preassessment team before the date. It's pretty uncommon to measure a teen's BP pre-op, but the numbers you've quoted are pretty sporting for (even a stressed) 16 yr old. It may be that, if he'll allow it, it would be sensible to check it at home to demonstrate it is just a stress response to the environment rather than something more medical that needs investigating/managing before putting him through an operation. It may also be a good opportunity to discuss his anxieties re. hospitals & what not so they can perhaps think about an anxiolytic when he gets in. (Also, would a walk round the ward/day unit so he's familiar with the environment help?... some places organise trips like that to help with reducing the anxiety a whole bunch of new things can cause on the day... may be worth asking?). HTH.

Thank you. I have taken his pulse at home lots of times both when he was stressed and not so I know his normal heart rate and his heart rate when stressed. He had his pre operation assessment a few months ago and I explained he is being assessed for autism and they saw him in shut down mode. They tried to take his pulse and bp then but he refused. I will ask about a tour of the day surgery unit, that's a good idea.

I have tried and tried to talk with him about strategies but he won't, he much prefers to stick his head in the sand.

Just asked ds about a tour of the day surgery unit and he said no, as apparently he doesn't need it.

Unfortunately ds seems to think his meltdowns and shut down are some kind of unique anomaly that will never happen again so there is no point in trying to prevent them.

shame... sounds like there's not much more you can really do then unfortunately. Things can get tricky with older neurodivergent teens re. consent/capacity/what happens if there's a meltdown and refusal on the day - it isn't always in best interests to proceed in those cases. I would still make sure the anaesthetist covering the list knows about the BP going up quite high pre-op - it's unusual for kids to have the more serious causes of high BP and it's much easier to spot the odd serious one if you've already had heads-up. Hope it all goes smoothly.