Having surgery and I feel like an absolute wreck

[ChattyChai]

I was told last week I needed sinus surgery. I was told it would be a year away.

I got the call this week and was told it’s actually in two weeks time. I feel totally overwhelmed. I’ve never been put under before and I’m terrified.

im going to be having endoscopic sinus surgery.

im terrified that i wont wake up, im terrified that something will go wrong and ill end up blind, I dont think ill be getting travel insurance so im going to have to cancel my holiday.

im at work and all in a flap. I just want to cry, I was supposed to have a year to decide if I wanted it or not. I wasn’t prepared for this. I’m just not ready for it at all, I’m scared of recovery and everything. I’m not going to get the time off work; because my work are being dicks to me anyway because I’m in my notice. I’m just terrified

It’s also the recovery, no sleep for weeks, agony, bleeding all the time. I just don’t see how I can get through it.

I love GA aswell; the pre-med, that beautiful relaxing feeling.... OP I don't know whether it helps, but there are wonderful pain killers available post op; also, think of Katie Price. How many times has she been under the knife now? Probably hundreds, she positively enjoys it. Totally addicted - and so far she's survived! As others have said, you can always put the date back; they've probably offered you a cancellation. They'll totally understand. Also, ask for something to calm you down prior to going in - your GP may give you diazepam or something similar - I always have this or I wouldn't go to some of the things I've had to endure over my lifetime! Good luck.

If you contact pals not to complain but to say you have questions and nobody is getting back to you they will contact them on your behalf iv had to do this a few times and the secretary will all of a sudden be capable of picking up a phone to call you back

I don’t know what im being offered etc., it’s things like I am on Mounjaro and have always believed I need to stop, and seen horror stories about the fact you have to stop. I get my pre-op assessment call (Monday) and they say I can continue taking it! Stuff like that has sent me into overdrive because I’ve been told it’ll all but kill me if I continue taking it.

Right so your getting a pre op call Monday so between now and Monday write down everything you want answering, explain to them your worries and things you've read and hopefully they will be able to explain clearly, answer your questions and reassure you. Then hopefully you will feel a lot better about the whole thing

I meant had - not get. I had the call Monday, and this was on the basis of surgery being a year away.

Oh ok then go back to trying to get hold of the secretary like i said previously pals have helped me do this a few times you can call or email them if you just google pals for your area the details will come up

The advice re mounjaro has recently been changed and it is not always/usually necessary to stop it.

Honestly OP I would stop googling and get advice from people who can assess your health and the risks vs benefits for you. If you don’t want the operation then all you have to do is say so. If you’re on mounjaro for weight loss and feel that you can optimise that by postponing a while then that’s fine, but if you’re at maintenance/on it for another reason then that’s ok.

The risks/side effects that you seem fixed on are not things that I see as a frequent complication & I suspect the other anaesthetist who’s posted would agree.

If you aren’t able to get hold of anyone before the proposed date and decide to go in on the day and the consent process raises more questions/concerns for you then you can just say ‘no thanks’. It’s mildly irritating (for patients and staff) if a cancellation happens at that point, but if that’s the only opportunity that you can have to speak with the surgeons again then that’s fine. It really shouldn’t feel as complex as it sounds like it’s become.

Nobody has called me back, I’ve had an information sheet in the post which just says continuing Mounjaro puts me at risk of aspirating but not to stop it!

Did you contact pals?

Yep, no response

Did you leave an answerphone message or email them you need to try more then once when contacting the nhs

I’ve had many surgeries and they’ve always been very uneventful.

They usually ask you if you need a fit note when you are admitted on the day.

Hopefully this might be reassuring...

Quote from the recently published consensus guideline for the management of patients on Mounjaro (a GIP):

In patients taking GIP/GLP1-RAs, continuation of treatment is currently recommended, but should be supported through risk assessment and stratification, shared decision-making and the use of peri-operative techniques to mitigate risk of pulmonary aspiration.

Patient advice from the Royal College of Anaesthetists for patients on Mounjaro:

If you are taking a GLP-1 or dual GIP/GLP-1 receptor agonist, make sure you inform your healthcare team including the anaesthetist about this prior to your surgical procedure.
This medicine slows the emptying of your stomach, increasing the risk that stomach contents (e.g. food and drink) could enter into your airways and lungs during surgery or procedures whilst you are under general anaesthesia or deep sedation. This means that a modification to the pre-procedure instruction and anaesthetic technique may be required.
Take your prescribed medicine(s) as usual and do not stop your treatment without first discussing this with your doctor.

The anaesthetist will be able to discuss the risk for you in the context of the rest of your general health and the operation you're having (the rest of your health, duration of time you've been on it, and the type of surgery can also affect the risk of aspiration... you might be reassured to know that a FESS is low risk surgery for aspiration). There are things that anaesthetists do to offset the risk of being on mounjaro (the risks are similar to those that anyone needing emergency surgery has or any woman needing a GA on labour ward might have) and the anaesthetic most of us would probably do for a 'normal' FESS only needs a minor tweak to make it the sort of anaesthetic we'd do for someone we knew was at higher risk of a full stomach. The really risky times are when patients haven't told us they're on it so we lose the opportunity to do an individualised risk assessment and think about modifying the technique. It is difficult for anyone on here to provide any more concrete advice for you personally, but it really doesn't sound like what they've told you is in any way out of the ordinary.

Most hospitals have routes by which higher risk patients for anaesthetic complications should be flagged up to the anaesthetist doing the list or someone with an interest in high risk pre-assessment. If the pre-assessment nurse is unsure about anything they would normally escalate things so the anaesthetists can get in touch before the day.

I forgot to stop taking mounjaro prior to my surgery and I didn't die.

I’ve left multiple voicemails across PALS and ENT.

But you have to give them a chance if you only rang tonight pals in my area finish at 4 and a lot of secretaries only do part time hours

I’m feeling a bit better this morning. Still really anxious, but not as teary. I just feel so unsupported, people are just not answering my calls

I’ve still not heard back from the surgeon or pals, but I do feel better today.

My advice is weigh up carefully whether you do need the surgery or not. Try to take the fear out of it and think rationally about how you are affected by your symptoms, what the prognosis is without the operation, might you get better or worse without it etc. Then on the basis of that info decide whether to go ahead or not. I was pushed into surgery in hindsight that I never should have had and it went very wrong. All fine now but I wish I had thought more carefully about whether I needed it or not in the first place.

@ChattyChai anaesthesia is really safe. Please google RCOA patient information, that’s “The Royal College of Anaesthetists” lots of good information about what to expect and there is a section called “preparing your mind” which includes some relaxation help for dealing with worry/anxiety

So cancel it 🤷🏼‍♀️
You clearly think you know what you want, just hope that in the future you don’t regret not having it done.

Ok so do you want the surgery before your holiday? If no then ring and say you can’t do that date and they will give you the next available date.
If they said you would be fine to go on holiday then you are fine to go on holiday.
i have a prolapsed disc that has put me in hospital this year and could obviously cause problems whilst away, I also take strong meds. My insurance is £52 for a family of 5. It is usually roughly half that but still manageable.

On Monday, ring the hospital and ask to speak to the Service Manager (or Ops Manager) for ENT. Explain that you've left several messages for the secretary and ask for their help to find someone who can talk things through with you. Hospitals are terribly short-staffed on the admin side, and combined with it being the holiday season, there's probably just nobody picking up the messages.

Exactly. Accusing them of lying because they offered her an earlier slot is absolutely fucking ridiculous. They truly can’t win.