to worry so much about a D and C under GA?

[MamasGirl]

My mum's scheduled for a D and C tomorrow to investigate post-menopausal bleeding and the doctor suggested that she undergo the procedure under GA.

I looked up the risks of GA and they sound quite serious, especially since she is a smoker.

We aren't currently in the Uk and I find the doctors here quite alarmingly relaxed and a bit unprofessional.

Shall I suggest she give local anaesthesia a try or is general not that risky for a short 20 minute procedure?

I would appreciate it if ladies who have had a D and C can share their experiences with details such as - what kind of GA is it? Do they intubate you? Is a urinary catheter required? How painful is it? Does the GA have many side effects like sickness and grogginess etc? Did you fast and/or avoid smoking the night prior to the procedure?
Please share anything else that you may feel is significant.

Thank!

Hi - I really understand your concern. I had a d&c about 7 or 8 years ago after a missed miscarriage. I had never had a GA and was petrified. I think it was being out if control that scared me, along with the thought that I might feel the procedure and not then wake up. I worked in the hospital where I had it done and the staff were all immediate colleagues - they were gynae and I was in maternity.

The anaesthetist was shocked at my fear and told me (nicely) I was being daft! I did not like the feeling of the premed immediately before going to sleep but was fine afterwards - no nausea. I was not catheterised and went home very soon afterwards. The emotional scars were my main worry - had no physical effects at all.

I don't know what else to say to reassure you. No one could have reasoned with me! But the risk is very very small - thousands of GAs are done every day without trouble. I don't know whether they would do it under spinal or epidural? Might be worth asking. Hope it goes ok.

Ga is a lot less dangerous than it used to be but the studies don't all reflect that yet

In the last few years there have been massive advances in precise dosaging, unless your mother has chronic lung problems or certain heart or neurological conditions you don't need to worry.

My 15mo dd has the have a ga every 3 months, I did loads of research on pubmed and scared myself silly. Then I spoke to the anaesthetist and he basically said the tiny amount of anaesthetic required to put dd under for half hour, even given every three months, was incredibly unlikely to cause her any side affects beyond the nausea and confusion most people experience when coming round.

Ga starts to be dangerous when you have conditions mentioned above or when they need to do a lengthy, invasive operation that involves much heftier doses.

Studies should read statistics, I mis edited myself

You def have to fast before ga and no water 6hours before - so no food after midnight for example and no drinks or chewing gum.

They can prescribe a blood thinner if they think she is a high risk for clots eg bexause of smoking.

I don't think a d&c under local is a good idea -maybe with a spinal block but even they have risks.

That is what worries me. I was the one who had to tell her not to have anything to eat or drink after midnight.

And despite knowing that she is a smoker, they didn't tell her to take any blood thinner. They didn't even tell her not to smoke prior to the procedure. She had a fag after dinner this evening and the D and C is in the morning.

This all seems so carelessly managed to me.

Thank you for sharing your experiences MrsPatrickDempsey! I'm so sorry about your miscarriage, but I am reassured that GA isn't all that bad.

HerrenaHarridan. Sorry to hear that your DD needs all those medical procedures. I wish her the very best of health!

I'm a student nurse and I've seen a d and c. Your mum is best to have it under a GA. With an experienced anaesthetic there is nothing to worry about.

To answer your questions, the type of GA will depend on the anaesthetists preference. Some prefer to use gas induction and throughout the surgery and some will use a drug called propofol to initially send you to sleep and then gas. Then others use only propofol. All patients under GA will be intubated and ventilated as they are given muscle relaxants and are unable to breathe for themselves. This will be removed in the recovery room.

She may or may not be catheterised but it will only be momentarily to drain the bladder before the procedure. It's unlikely to be left in. Here a d&c would be done as day surgery so a patient definitely wouldn't be catheterised.

She will be a little groggy after the procedure but it is dependent on the type of anaesthetic used as they do differ. The anaesthetist should give pain relief and anti sickness medication before she wakes up to prevent post operative nausea. And there should be more prescribed if she does feel sick in the recovery room.

She should fast before the procedure and ideally not smoke for a few days before as smokers are more at risk of post operative chest infections.

And yes having your cervix dilated is painful. I have had an hsg.

IMO, you are over worrying. I am a smoker, I've also had several D+Cs and loads of anesthetics.
Some anesthetists ask that people don't eat or drink anything for eight to 12 hours prior to the GA, others are happy for no solids for six hours but clear fluids up to the time of the surgery.
FWIW, I've never been given any anti coagulant.

I've had one under GA and it was fine. I went to sleep, woke up and was given a nice cup of tea and a sandwich. I felt fine 'down there' and was very glad I was asleep when I had it. Try not to scare yourself too much.

the prescribed blood thinner is actually injected post op by the nurse if the surgeon feels it is necessary. 2 ladies on my ward on friday had it injected into their tummy area.

I had one at around 2pm and I had eaten breakfast (it was unplanned)
I was physically fine afterwards.

And I believe it would have been a horrible experience under local anaesthetic.

The food and drink thing is in relation to vomiting, the times will vary depending in hospital and anaesthetists policy.

Eg, many will allow water or breast milk right up to or within a short period of the operation IF its not a cutting you open kind of operation, this is because if you vomit the fluids it is unlikely to choke you and the anaesthetist (who monitors you constantly, and I mean s/he sits by your head and does not take their eyes off you for a second) can turn you head and allow the fluid to run out.

Thanks for your consideration op, fortunately these are not all surgical operations. She needs 3 monthly MRI scans and MRI scans require the scanee to lie completely still. Until I can explain that to her AND get her to actually bloody do it, anaesthetic will be required. The hospital estimate about 6! But we're practising sleeping lions and hoping it'll be we'll before then.

I totally understand why your worried, like I said there have been massive advancements in this field and I trust our anaesthetist completely but thr doesn't mean I don't feel sick when I watch her slip under and fret te whole time she's down!

Your mum will be fine, you sound like a very good daughter