Pre-op visit 2

Seventeen days before surgery I spent the better part of a day at MGH for the pre-op visit.

The first visit was with Dr Tomford and Dr. Collin May, who will be assisting Dr. Tomford in the surgery. Dr. May took a pre-procedure history, which, among other things, confirmed it was the right hip they were going to replace.

Dr. Tomford said I would be on my feet for a while Tuesday, the day of surgery, gets lots of physical therapy Wednesday and Thursday and be released either Thursday afternoon or Friday morning, depending on how I am doing. That’s a big change from 2004. I was expected to be in the hospital four nights in 2004. I was actually in five nights. So two or possibly three is a much shorter length of stay. They said it was because post-op procedures have improved, but I bet it’s money. Medicare pays a fixed amount for a hip replacement. Getting two done in the same time they used to do one doubles their revenue. Am I being cynical?

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Dr. May recited all of the possible risks of the surgery. These include: blood clots, dislocation, leg length difference possibly requiring the wearing of a lift, infection, fracture, nerve and/or vessel damage, need for transfusion, need for further surgery, wear, and loosening.

I was told that MGH is a teaching hospital and therefore residents, fellows, and/or students may take part in the surgery as allowed by Dr. Tomford. MGH may photograph, videotape, or record my operation for teaching purposes but won’t identify me. Parts of me taken out may be thrown away by MGH after possible use in research, education, or other activities. (Don’t you just love the legalese?)

There was one part that was written in. That says that I will receive a video recording of my procedure but it is for my personal use and I may not publish it. So sorry folks, you won’t get to see a video of my hip replacement. The video camera is in the light handle so wherever the light is pointing at, the camera is recording. I will be watching the video on a screen as the operation is taking place. That will be a little weird. I can always close my eyes, right?

Anyway, I signed the consent form.

I brought up the subject of recording sound during the operation. Dr. Tomford is OK with it but I will have to check with the anesthesiologist the day of the surgery.

After seeing Dr. Tomford, we had lunch at the Yawkey café, which wasn’t bad.

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Our next appointment was next door to Dr. Tomford’s office in a part of the Preadmission Testing Area, I guess. I met with a jovial nurse practitioner whose name I didn’t get. She reviewed my medications and the supplements I take and told me that I must not take vitamin E, fish oil, or flaxseed oil one week prior to surgery. Also, I must not take Advil 3 days prior to surgery but can substitute Tylenol.  I am to eat nothing after 10:00 pm the night before my surgery, which is scheduled for 10:30 am Monday, April 2. I can have one cup of clear liquid up to four hours before surgery. I should take my three prescription medications the morning of surgery. I am to report to the Center for Perioperative Care on the third floor of the Wang center the day of my surgery. They didn’t say what time; I am to call one or two days before to find out if I am still in the 10:30 slot and what time they want me in.

The NP also gave me a bottle of Hibiclens and told me to wash with soap and water then with the Hibiclens the day before and the morning of surgery. Wash with soap and water, rinse, put on Hibiclens with a washcloth, let it sit for five minutes, then rinse. Especially the area to be operated on and the groin area. A doctor friend of mine said I should shampoo with the Hibiclens before the surgery, too.

I had a brief discussion with an anesthesiologist but not necessarily the one who will be with me during my surgery. We discussed that I want a spinal and I do not want the drug that causes short term memory loss. I want to remember everything. He is OK with that. Both the nurse and he looked down my throat to see how easy it would be to put a breathing tube in if they had to switch to general anesthesia.

Finally we walked to another part of MGH that is as far from Yawkey as is possible while staying on the main campus. We went to a room, I forgot its name, in the Jackson building. They drew blood samples and collected a urine sample. Apparently this is a special area for collecting specimens for pre-op patients.

And we were done. Another milestone passed. Back to the Berkshires in time for the Berkshire Award ceremony at the Berkshire Museum. Our friend Sandy Newman of CATA was one of three honorees.