GA tomorrow - the fear is building!

[BillyDaveysDaughter]

I'm undergoing gallbladder removal tomorrow under GA. I haven't had a general since 1985, and I am very, very frightened of feeling or being sick afterwards (as in, emetophobic - the fear of vomiting is with me every day and has been for 40 years).

I'm pretty calm about being put to sleep, I don't think I'll want the pre-med - I'd don't like to feel groggy if it can be avoided. I have no fears of dying or not waking up, or of waking up during the op. It's just the sickness thing.

I've had a pre-surgical assessment, they were very kind and understanding and assured me that modern anaesthesia includes an intravenous anti-emetic anyway. I begged them to load me up with anti-sickness and they made a note and smiled indulgently.

I also asked if I could avoid the painkillers which commonly cause nausea, like morphine - I said I'm quite stoic and would like to stick with intravenous paracetamol at first, and see how it goes. The nurse said there are many alternatives to morphine, but paracetamol directly into a vein is just as good.

The majority of people I've asked said they felt fine after a GA and were actually starving hungry when they woke up. A friend who had a kidney removed via keyhole sent his wife for biscuits when he woke up, and he's the biggest wimp ever.

It's just day surgery, I'll only be under for an hour or so and I'll be home by mid afternoon. But I'm still catastrophising and having visions of all sorts of grim outcomes upon waking.

Please tell me your stories of it all being a piece of cake - and yes I have posted before, but now the op is TOMORROW and I'm bricking it.

Peppermint won't do anything for the gas pain I'm afraid. It's inside your peritoneal cavity, not in your bowel, so all you can do is wait for your body to reabsorb it, which it will do within 2-3 days.

You do, Welshweasel? That's amazing...I love knowing the science behind everything, I actually watched a full you tube video of a cholecystectomy just to see how it's done. It looks a bit brutal, is it joined to the liver all along one edge or to something else? It seems to need a lot of...separating! How many keyholes is it, 4? I know he'll be poking a camera down the bile ducts to check for stray stones too.

Yes I've been warned about the air pain, I suffer from oesophageal spasms so I imagine it's similar to that. Thanks for the heads up about the note and painkillers - I'm happy to avoid codeine and constipation haha!

Thanks also Lizzy for the tip about peppermint cordial, I've actually got some of that in the cupboard. How long does the air pain last, is it tolerable (in comparison to gallbladder pain)!? What does it feel like?

I had a GA quite recently and didn't have any nausea at all - the sensation of going under is quite pleasant, and when I woke up I was groggy and disorientated, but not for long. What I didn't anticipate though is quite how exhausted I'd be for the next week, though - the tiredness knocked me sideways. I tried to go back to work on Day 3 and it was a big big mistake.

I could have written your post last Wednesday. Another emetophobe here. I don't cope with others vomiting either. I was armed with an iPod and it was right by my side as I had requested when i woke up. I felt absolutely fine, no pain, no nausea, and really enjoyed my tea and biscuits that were offered when I was awake. (Then a sandwich, and more tea and biscuits!) didn't need anything stronger than paracetamol and ibuprofen ( they gave me hefty doses of both before I went to theatre.) was home the same day and honestly felt ok. Good luck

Thanks Fairy. I'm pretty sure the IV anti emetic comes as standard, at least that's the impression the lovely nurse gave me - she said it was a very modern cocktail!

You'd think they'd leave us with an exit valve for the surplus air Welsh A little pull out straw.

I had my gallbladder out 10 days ago! All totally fine and I went back to work after a week.

I have four holes which look ok now (bandages fell off yesterday). Took painkillers for a few days and generally took it easy. Worst bit was shoulder pain from the gas but they gave me oramorph which helped immensely!

Standard lap chole done through 4 cuts. 5-10mm each. The gallbladder is connected to the underside of the liver. During the operation we dissect out the artery and the cystic duct that are connected to the gallbladder and put clips on these and divide them. Then detach the gallbladder from the underside of the liver, pop it in a bag and pull it out on of the cuts. We do try and vent as much of the gas out before we close the wounds up but some always seems to get stuck!!

Oh and interested to hear Walsh talk about peppermint. They gave me peppermint tea in hospital for the gas and I thought that seemed unlikely - maybe it’s a placebo.

Welsh I mean, sorry!

Ooh I've got a couple of weeks off Hassled, I'm going nowhere! Glad you were okay too.

Hey Sunshine, reassuring story thank you - are you recovered now? We are quite unusual amongst emetophobes I think, in that we fear both ourselves AND others vomiting, most of those I know are one or the other. I specifically asked the nurse if I would wake up in recovery around others being woken up, she assured me that by the time I have any real awareness I'll be back in my own room and wont see anyone else! Result.

I used to be a prolific postoperative vomiter, and was worried about this when I had major abdominal surgery a month ago. It has been a difficult recovery in all sorts of ways not relevant to the procedure you are having, but at no stage was there any nausea or vomiting (and for what it's worth I have never had the gassy shoulder pain either, despite having had 4 laparoscopic procedures over the years).

Wishing you the best of luck tomorrow.

IV antiemetic is as standard yes. I work in anaesthetics...and theatre and recovery . Hardly anyone complains of feeling sick nowadays. I had lots of ops as a kid and was always horribly sick. Had one a few years ago and felt brilliant after! So it’s definitely come a long way. If you do feel sickly when you wake up just let the recovery staff know and they’ll be able to give you something else alongside the standard med.

Hope all goes well!

Wow I could have written your post 4 years ago.
I'm still emmetophobia but have no gallbladder.
I explained to anyone I saw and was taken first to avoid me panicking. I was given lots of antisickness in theatre and afterwards and was fine. No nausea at all.
Best sleep I've ever had.
Hope you have an ok experience

Also we give our patients sick notes here. Just tell the consultant surgeon in the morning when you see them that you need time off work. They’ll make sure you have a note to go home with.

One thing you might need to be aware of is to not eat fatty foods for a while afterwards. I had my gallbladder out (over 5 years ago) and was put onto a recovery ward for knee ops and gastro stuff. All the staff on shift were "knee people" so when I was asked what I'd like to eat before I could be deemed fit to go home I said buttery toast (having wanted it for about 2 years). They gave me said buttery toast and I proceeded to be sick everywhere and then had to spend much longer telling them I was going home whether they liked it or not.

I later discovered that it is apparently well known that eating "high-fat" food after a gallbladder removal is almost guaranteed to result in vomiting.

When I was a student nurse, we always gave peppermint oil for shoulder tip pain after laprascopic surgery - never considered that as the gas wasn't in the bowel it wouldn't do anything except as a placebo

As far as I remember the pain was described as sharp, but not unbearable

Well done Splendide, thanks - I'm half expecting to be working lazily from home in week 2! Doesn't oramorph make you queasy, I'm a bit nervous of it...

FABULOUS description Welsh, I love it...hearing the technical side relaxes me. I don't have a scientific brain, as much as I would have loved to have studied as a vet (not a doctor because vomit) - but I'm an avid medical show watcher. A doctor friend says that watching House was pretty much part of her training!

Had major surgery last year and i was pertified. This is how I recall it happening. The scariest part was being wheeled down to theatre as it's a vulnerable position to be lying in a bed that's moving. The going into the pre theatre where they do the checks was fine. They were chatty attentive and put the canula in. Told me they were flushing it.. and lo and behold... a second later.. i am quite literally purring in the bed under a heated duvet. It was divine.

Asked the nurse hovering over me okay when do I have the GA.

You've already had the surgery! I was gobsmacked I tell you. Zero sickness or nausea.

GAs have improved in leaps and bounds from even 5 years ago, let alone 20 or 30!

OP you will be okay and in good hands x

It didn’t make me feel queasy - I loved it! But I think it can some people so maybe best avoided.

I stayed in overnight and it was actually weirdly pleasant. I spent all night in a sort of happy doze state listening to podcasts.

All these medical people wading in, I'm so grateful and so in awe of you! I could question you for days, I don't have any variety of health anxiety (well, only around vomit), I'm just fascinated by it all.

I should go to sleep so I'll stop name checking everyone now (except you User EWWWW definitely no buttery toast then!) but thank you all so much for taking the time to put my mind at ease. And you really have, thank you.

Come back and let us know how it goes! Now go to sleep...

I'm good thanks, billy, slight stinging around the incisions but mainly caused by the ridiculous amount of glue they've used to seal my wounds. I also found having a pillow to support my legs made rolling over in bed easier as it pulls around the area where the gall bladder was for the first couple of nights.
Hopefully you'll be fine. I was in a bay with 8 others to recover, and had minimal anxiety, which is a definite win for me. I'll be thinking of you

Emetophobe here. Had my first GA last year (tonsillectomy!). Was petrified of the GA and potential sickness afterwards.
I asked for a anti emetic when I spoke to the anaesthetist beforehand and he just smiled! I also asked for no morphine as I heard that caused sickness and hallucinating , but that was ignored too! Anyway going under was fine, I woke up v groggy and felt dizzy for several hours (not helped by the morphine) but was not sick! I felt a tad queasy (prob anxiety) and they gave me an IV anti emetic. It was fine, I just didn't like the dizzy/ groggy feeling. I don't think you'll be sick , good luck!

We should start an emetophobes winter survival thread...

Rubbish sleep last night which I expected, now have a headache. Just arrived and I feel travel sick.

Morning lovely.

You’ll be seen by an ODP (operating department practitioner) they work closely with the anaesthetic docs. They are your go to person, tell them about the emetophobia!

Deep breaths. You’ll be great.