To ask anyone in the NHS how day surgery lists are determined?

[ScuderiaSedici]

As above

Yes part of the issue is I’ve had very little information about the surgery. It’s just the generic name. He’s not explained anything about what he’ll actually be doing. The pre-op call was just me saying no to everything, and no real discussion of anything. I feel like they just aren’t really interested in telling me anything

My letter says I can have a milky coffee before 6:30 (but I won’t, because the caffeine will send me mental and it’ll have stomach repercussions), and I can drink until I arrive at the hospital - so 7:45. So it’s not sip till send I don’t think?

at some point they should have explained what they are doing? That sounds very strange. In the morning the surgeon will go through a full consent form and explain what will be happening. I guess if it’s surgery you’ve been waiting for for two years you’ve had time to do some research or reach out and explain you’ve been listed for surgery which you don’t know anything about?

Interesting, I have latex allergy and wasn’t first on the list when I had my gallbladder out, but they were aware and did check with me, plus my latex allergy is not severe, just a skin reaction rather than breathing issues etc. But I’m not sure if they just took me to a different theatre where all latex allergic people go or decided as my allergy isn’t severe that it was less of an issue etc.

This is the thing - nobody’s explained it. I’ve tried googling and I can’t find much about what it’ll look like inside etc. funnily enough, I feel alright about the recovery - because I’ve been able to research as much as I can about it. But the actual day of, I’ve had very little information

They will tell you when you get there. It was a response to someone else saying they’d been allowed to drink. It’s now quite common to allow sips of water, but they won’t know how quickly you’ll be seen until you get there.

He just told me the name of the procedure- but when you google it, a lot of the information relates to other procedures that are done at the same time.

Why does latex allergy mean they need to be first? Surely the theatre should be cleaned thoroughly between each op not just at the end of each day?

If it’s a severe latex allergy but there’s another patient who needs to go first you can either treat the other patient as latex allergic too or pause the list between cases to allow any latex to be cleared from the air. Latex-free sterile gloves feel very different to do procedures in so a lot of surgeons don’t like using them unless it’s really needed (as surgery depends very much on feel), but if there’s no alternative they just have to. Most kit apart from gloves is now latex free.

This isn’t true - we have patients going in last on list at 3/3.30/4. Last Thursday I had to find a bed for a patient going in for planned surgery and didn’t get one till 3pm.
surgery at my trust goes
children first, day cases next, inpatients last (to give us more chance to find beds) unless there is clinical reason to change this (diabetics, urgency of surgery, medications that have been stopped)

Oh and if no MRSA swabs/MRSA positive last on list.

Also, do I need to do the pregnancy test? Unless I’m carrying the next baby Jesus I will not be pregnant and I’ve never done one before, so I don’t know how to!

I’ve not been asked to do MRSA swabs?

Latex ‘spores’ take time to clear from the air even with high air turnover in theatre. Some people with severe allergies could react to those particles in the air.

The pre-op people are usually nursing staff just going through a list to rule out issues that might cause a problem in surgery etc; they usually won’t know the details of any surgical procedure themselves, but ideally you should have had at least one consultation with ENT before being listed for sinus surgery where they could have gone through the details.

But I’m very aware that often these days it’s something that can get brought up at the end of a consultation eg we could book you in for surgery on your sinuses which might help if you’d like us to do that? And if you say yes you might assume that at some point someone will explain a bit more about the details of it to you and I do think prepandemic if you were waiting 2 years for it that would have happened, but I agree that doesn’t always happen these days ahead of time. I was listed for gallbladder surgery after being admitted for a gallstone complication, so never actually got to speak to a surgeon at all until the day of the procedure. Fortunately with my medical background I basically knew what to expect!

You will get a basic explanation of the procedure tomorrow from the surgeon who will come and see you beforehand to consent you for the operation and make sure you’re happy to go ahead. But I appreciate many people would prefer to have that info ahead of time!

Have you had your pre op?

They will ask you about pregnancy. You can sign a declaration saying it isn’t possible if it isn’t, or pee in a pot and they’ll test it.

You maybe had them taken at your pre-op appointment?

Yes this is exactly what happened. Sat down, said my CT showed thickening, asked if I wanted surgery then started chatting to me about my weight loss (my records he had stated my weight from when I was referred, 2 years ago). That was it, he didn’t explain if they’d be doing anything else etc.

My pre-op was over the phone

It was by phone

I was just saying what my local hospital does. They do a groin swab when you first check in and ask you to do a pregnancy test (but maybe NHS dont do this?). I always find the pregnancy test tricky as I obviously haven't weed for ages! They ask for all girls/women age 12-50 to do it but maybe this is just the two I use. All you do is wee in a cup

I’d ring the secretary - usually the phone is for ASA status but they usually need to do bloods and swabs.
have you got a date for surgery.

I didn't realise latex could be airbourne. I'm surprised that hasn't pushed them to remove it from use at all.