Pls help with questions I need to ask consultant re parents operations

[ListOfQuestions]

A someone please help me compile a list of questions to take to the hospital.

I will be travelling to go help my parent who is having an operation. No one knows much about what it is going on, so I need to go in there and ask these questions.

They are having a day operation, under GA, on their bladder to remove cancerous polyps. There are 5, including one at 1cm. On a previous observation (camera) they said the surrounding areas/ organs look healthy.

Running alongside this, they are awaiting a knee operation. It’s got as far as an ecg, bloods etc. pre op, so that also sounds imminent. However neither hospitals know anything about the other operation. There’s a bit of avoidance and head in the sand going on.

I feel I need to go in with my parent and ask what’s going on, what do we need to do after the op (they got an infection just from the camera), what’s next and how does the knee operation fit into all this?

That’s a bit hit and miss though. Can someone help me out with what I need to know, and what Q’s I need to ask please.

How long will the operation take?
how long will they be in the hospital recover
what support will they need when they come home?
what medication will they be given, what side effects does it have?
what are risks of the surgery, what can we do to mitigate them?
what should we look out for in the few days and weeks after the operation?
how soon will they see the consultant again after the operation?
how will you know the operation has been successful?
will they be referred to physiotherapy to support recovery with their knee? How long does this last and who does the referral?
if there are any concerns after the operation who should you contact?
who is doing the operation?
who will contact you when the operation is over?

Thank you

I’d contact the knee operation hospital and GP direct, alerting them of this procedure. I know people who’ve been sent home on op day because of a cat scratch or recent dental treatment. Infection risk is taken very seriously for knee surgery.

I would think that they may remove the gallbladder itself, so if it is, then I had my gallbladder removed and that was pretty straightforward, no heavy lifting for a while, dissolving stitches, dressings removed after 2 weeks. The knee operation is completely different depending on what is actually required, but maybe ask if any walking aids will be supplied and any alterations to home, ie stair rail, raised toilet seat, grab rail in bathroom.

But the OP’s parent is having bladder polyps removed, not gallbladder.

OP it is most likely to be cystoscopic again, but with added polyp removal. My DFIL was in for the day only.

Yes, cancerous polyps removed.

They are awaiting knee surgery. The hospital for this know nothing about the polyp removal. A call could come in any day saying that the knee operation is ready to go. No one has addressed the issue of both.

I need to go in and ask about what needs to be done/ support after the polyps removal. If any further treatment. Then ask, what about the knee? Can they still have this? If so, when. What shall we tell them if they call up with a date?

Yes, apparently it’s for a day.

Should I tell them to pack PJ’s just in case they need to stay.

As you can see, I’m clueless

I would ask what to expect in terms of follow-up on the transurethral polypectomy (the polyp removal). It might be that this is based on assessments of the polyps? I would think there would be follow-up intravesical BCG instillations, although if the cancer is very early stage, this might not be needed?

You do whatever it says on the letter. Sticking some PJs etc. in a bag and leaving them in the car (I’m guessing you’re taking him?) is not a bad idea anyway just in case.

The surgeon will talk to him before and/or after the surgery, when you can ask him about how soon it will be safe for knee surgery. If the knee people ring, just tell them that he is having/has had bladder surgery and they will decide what to do.

Unless it’s the same hospital (and even if it is, to be fair) the teams are unlikely to know about the other surgery. You’ll most likely have to press the issue to avoid messing about with the knee surgery.

Don’t be afraid to be gently assertive. Write everything you want to know/say down, and take a pen with you.

anaesthetist PoV... both teams clearly need to know about the other procedures. The bladder should usually be sorted first. Prophylactic antibiotics will be used for an operative cystoscopy/tumour resection so infection is less likely to be an issue. He will need to have recovered from the bladder procedure before having the knee surgery. It would be worth asking if any further treatment is needed after the bladder procedure (although they may not know until they've been in and done it). Actual operative risks will depend very much on the rest of his medical history.

Did they have a pre-op assessment? (They must have). They likely would have been given a lot of this information then or it might have come in a leaflet in the post (I have had a lot of cancer surgery).

If it’s just a day surgery, it should be fairly straightforward. I’d ask when they will be discharged (it will probably be when they can wee on their own and they’re up and walking around). And what care they’ll need after. Again, it should be straightforward, usually just they need someone with them for at least 24 hours. There will be after care instructions on discharge and likely a follow up appointment. I’d make sure to confirm when that follow up is and what to expect (will they have biopsy results? Biopsy can take 8-10 weeks so they may not, but I would want to know what to expect).

As for knee surgery, it’s elective so you simply need to communicate with them what’s going on. Don’t sit around expecting them to talk to each other as they won’t have a joint MDT, as completely separate. You communicate with the consultants secretary what is going on and what they expected timeline is. If cancer, many cancer treatments make it tricky to have surgery due to wound healing and infection risk, so treatment may need to be completed first. Oncology will be able to tell you this once they know the biopsy results and treatment plan, if needed.

Have them available so you can drop them in if needed.

However ask about post-operative care for the bladder polyps. My friends mum has been going through this and had appalling care before, during and after (hopefully you're not at Derriford and will have a better experience!).

She ended up with the GP doing an actual home visit because she was immobile with pain and infection. A scathing letter was sent to the surgeon and dept by the GP. It's been a very very tough clinical process with bladder washes etc as she can't have a general anaesthetic due to her lungs, but she is now cancer free. The less said about the attitudes of the entire department and every person they met, the better

Oh and the knee surgery hospital should do their own pre-op assessment where all of this should be discussed and then they’ll make a determination about the safety of the procedure based on what’s going on at that point.