How does the day of surgery pass?

You will be awaken at 6:00 a.m. after having been admitted the previous day, made all the necessary tests, consultations and preparation and you have spent the night in hospital. The morning toilet is following, which for moving patients is their care, but for not mobile patients is the care of the nurse. Perhaps you are already hungry and thirsty? So, it will be before the operation and after that. If there are appointed medications that have to be made before surgery, the nurse will make them when it is the time. If you need to take any pills before the operation, she will remind you and control you. According the operational program of the ward at a given time the nurse will give you a surgical gown to wear and will ask you to go to the bathroom. A nurse will accompany you to operating theatre by trolley. There you will meet the anesthetist nurse. She will ask you for your name and will give you socks to put them on your feet and a hat for your hair. She will check if you do not have accidentally nail polish, earrings and ornaments and will ask if you have removable dentures in the mouth. If you have, you will need to remove them. Then she will introduce you into the operating room and will put you on the operating table. You will notice that the room is cold. This is only due to the stress and because you are naked and under pressure. The minimum temperature that is maintained there is 23-24 degrees. An intravenous (IV) line will be placed in a vein in either your hand or arm, / the same procedure as in taking blood from the vein / and will connect the bank with the solution. She will stick a few sticky pads with little “nubs” on the chest, which will connect the cables to the electrocardiograph. She will put a 'clip' on your finger with which we will monitor the level of oxygen in the blood. She'll stick another patch of the lower leg, which is connected to appliances that will work as grounding. Then a physician anesthesiologist will come who will care for your anesthesia throughout the surgery and will monitor your condition in the early postoperative period. He will ask you your name and will tell you what is your condition at the moment and what anesthesia he intends to give. I would like to clarify that he will offer the best anesthesia for your operation. Provided that there is possibility for another one and your express a request to do another, he will comply with your wishes. Nothing in the hospital can happen against your wishes. If your desired anesthesia is incompatible with the operation, then you will have to choose on what you keep more on the operation or the anesthesia.

Provided that anesthesia is general, the anesthesiology team will put a mask on your face, and you feel the breeze / the oxygen / and will wish you "good night" and you will fall asleep. All other necessary painful or unpleasant procedures such as inserting a probe through the nose catheter for urination, insertion of a central venous line and others will be performed once you are under the influence of anesthesia.

Provided that anesthesia is local, after having breathed enough oxygen from the mask, the anesthesiologist will ask you to take up a suitable position. It is unnatural and sometimes difficult to understand by the patient, but we will help you to take it. There will be a prick with a very fine needle for placing the anesthetic at the site of the subsequent puncture with significantly thicker needle. In fact essential anesthesia is placed with the second needle. The procedure is generally more uncomfortable than painful. At this stage of preparation the surgeon intervenes. If you are under general anesthesia it is very likely that you even do not see him, but if you're with a local you might have the opportunity to listen to music, the sounds of the equipment or the conversations of staff.

After completion of the operation follows a similar procedure of returning you to your bed in your room or in such care unit / if your condition and the size of the operation requires /. First hours after surgery are usually with unpleasant feeling, a significant sleepiness, there may be nausea and vomiting, fever or chills, you will feel cold. The nurse on duty will take care of everything. If you feel that something unusual happens, just call the nurse from the display on the remote device that she has left when you were settled in the bed. If you do not find anything alarming in the state -  do not ring. She will appear over time and ask you how you feel. It is very likely 2-3 hours after surgery the nurse to ask you to get out of bed in order to make a few steps to the bed or go to the bathroom. This is part of your recovery program. So, it will be until the evening, when you're completely exhausted. Then to improve your sleep the nurse will give you an analgetic and make a medicine for sleep. Good night until the next morning when you will feel rested and much fresher than the previous day.

Nutrition during hospital stay

According to the particular disease and your state the doctor will decide what diet to follow during your hospital stay. He appoints your diet and you will receive it as hospital meal. It can vary daily. For surgeons even pure water is a diet and it is very often a good start of feeding.

After certain operations and in some diseases you may need to be fed by intravenous infusions of nutrients or in a probe into the stomach.

Regardless of the specific diet, your food will be cooked fresh and with controlled products in compliance with all rules of hygiene and healthy eating.

Important:

In the name of your security the importation and storage of large quantities of food and drink is forbidden in hospital rooms. It is in your own interest to strictly follow the prescribed diet. Your relatives can bring you juices, mineral water, fruits or other dishes if you have a general diet. However, you must remember the risk of food poisoning by eating faulty or improperly stored food imported from outside. Always ask the nurse or doctor about the possibility of taking something you like.


Possible complications after surgery

In every operation there is possibility for complications. But we should never forget that even if operation is not done there is a risk of possible severe complications as a result of the disease. So, we are always looking for better, safer, less risky action or inaction. Here is the surgeon to decide which will bring more benefit to the patient and will provide a higher quality of life and longer life.

The most common early postoperative complications include:

Instant
  • Primary bleeding - starting during the operation or immediately after it, resulting in increased blood pressure. May require blood transfusions or return to the operating room for the revision of the surgical wound
  • Basal atelectasis - small portions of the lung not unfold well
  • Shock - blood loss, acute myocardial infarction, pulmonary embolism or septicemia
  • Decreased urine output - improper replacement fluid during or after the operation

Early
  • Acute confusion - dehydration, or sepsis
  • Nausea and vomiting - from anesthesia and anesthesia-related
  • Fever - see 'High fever after surgery " below
  • Secondary bleeding - often as a result of infection
  • Pneumonia
  • Insufficiency of the wound or anastomosis
  • Deep vein thrombosis
  • Acute renal retention
  •  Urinary tract infection
  • Postoperative wound infection
  • Intestinal obstruction due to adhesions of fibrin
  • Paralytic ileus

Later
  • Intestinal obstruction due to postoperative adhesions
  • Postoperative hernia
  • Recurrence of the underlying disease - such example malignant Keloid
  • Poor cosmetic appearance of the wound - it depends on many factors
 
Fever after surgery

From 0 to 2 days:

The temperature is slightly increased / 38° C / very often:
Tissue damage and necrosis of the operation in the surgical wound
Hematomas

Persistent / over 38° C. /

Atelectasis; collapsed lung can be infected secondarily
Specific infection associated with surgery
Transfusion or reaction of the given drugs

 
From 3 to 5 days:

Bronchopneumonia
Sepsis
Infection of the wound
Infection contributed a vein or phlebitis
Shaping the abscess cavity
Deep vein thrombosis

From 5 to 7 days:

Specific complications associated with surgery - insufficiency of the anastomosis, forming a fistula

After 7 days:

Wound infection
Infection unrelated to the operation organs and systems
Deep vein thrombosis
Pulmonary embolism


Risks if no action is taken when surgery is recommended

For the various diseases and conditions there are different risks. They always exist in medicine. The aim is to be minimized. There is risk both in action and in inaction. So, when you discuss with your surgeon an operation and you have your deep reservations ask him to explain you concerning your specific case.

The best time for surgery

The time is determined by several factors. First in a planned surgery the patient have to be at full health. Do not cough, do not sneeze, no fever, no visible bleeding from somewhere, to feel healthy.

It should not be a period of recovery from a serious illness or recent previous operation. Furthermore, upon consultation the surgeon must have rejected all diseases and conditions contraindicated for specific operations. For example if a patient with a hernia has significant difficulties with urination: definitely we should first solve the problem with urination /because it increases abdominal pressure / and only then we can operate the hernia. If we do things in reverse order the chance for hernia to appear again is very high. Finally, but perhaps most important: the inner conviction of the patient that exactly this surgery and this surgeon will solve the issue. When the common sense prevails over the emotions, torments and constant questions give way to peace and confidence in a good outcome of surgery - it is the right time! And the fear - it just shows that you are a living creature and anything human is typical to you.

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