Monday, June 3, 2013

Pre-op Appt, Provider's working together re: Shunt and Heart surgery.

I am really amazed though equally happy how my core providers (Cardiology, Neurosurgery, PCP, Neuro-Endocrine) have seemed to band together with this upcoming triad of surgeries (Hand, TPL shunt, Open Heart-valve replacement)  and come together in talking to each other via phone as well as exchanging clinic notes with each other. I am totally impressed! I wish it always worked this seemlessly and without much effort on my end but no-less I will take it right now!
Today, Dr. Bragg (neurosurgeon') nurse, Lisa called and asked/verified that my Endocrine dr was just sending them her clinic note and was not in fact the one doing the pre-operative physical notes/approval as she (Lisa) had received and was reading a "very detailed and long" report from Dr.Maas (they usually just get Dr.Maas's pre/post-surgical recommendations for the stress-dose cortisol dosing) and Lisa just commented that she would keep an eye out for my PCP's pre-op paperwork but appreciated the report from Dr.Maas. My Genetics Counselor stopped by ERT (infusion) today and commented she had received my Cardiologist's most recent note and had a few questions.
Additionally I have heard from Endocrine (Dr.Maas) since the appt with her last week asking to be kept up-to-date on the specific dates of all the surgeries so she can make sure her notes/recommendations get to each of the appropriate provider's before each of the surgeries. Cardiology and Dr.Bragg (Neurosurgery) spoke 2 weeks ago within a day or two after I saw Dr.Earing (Cardiology) and are both on the same page as far as what needs to happen with the TPL shunt (moved out of the pleural space and back to the abdomen by the VP shunt distal end) and the time-line between Dr.Bragg's shunt surgery and when she will release me for the Cardiac-valve surgery. She will release me a month (4 weeks) after the shunt surgery and  usually she sees pts a week after surgery or a week after being released from the hospital and then a month after the 1 week fup.
I probably wrote in one of the other posts the actual OHS-valve surgery is just over a month after the shunt valve surgery (June 21 and July 24) with the pre-op Appt at FMLH (cardiothoracic surgery dept) is 1 1/2 weeks in to July (10th).
I think the last provider that needs to be involved is my Pain Management dr., to come up with a post-op in-patient and out-patient pain plan as it will have to factor in what I currently take and whatever they opt to use there, usually in-addition. She is aware of the surgery though and knows Dr.Earing, my Cardiologist so shouldn't be to hard and as well I see her atleast once and likely twice (once montly appts due to the way controlled substance medications are prescribed/monitored) before that OHS surgery. She has worked with Dr.Bragg on the shunt surgeries so that isn't to big of a deal.

Friday I had the pre-op Appt with my PCP for this Wed's Hand surgery as well as for Dr.Bragg's shunt surgery in several weeks. I have to do labs sometime this week (likely when at Dean for the botox) but otherwise the appt was fine. Her only recommendations where 1. they not do general anesthesia (per my Cardiologist) which we knew and which she confirmed with my Surgeon. 2. Limit the amount of fluids during surgery (also per Cardiology) and 3. She suggested taking the Lasix, bisoprolol and Spironolactone the morning of surgery (in the past we have skipped those doses and the bisoprolol is usually a night medication). She felt doing these ahead of the surgery would help pre-empt the heart failure symptoms I had with the last in-patient surgery and that I would feel better overall from a breathing stand-point since they do have to give some fluids during the surgery, regardless if it is just a regional nerve block. I will just make sure and take the meds several hours before I leave for surgery regardless what time it is so I am not peeing every 15mins on the way there and in pre-op!

Will update after the surgery, otherwise the only other update really is that the Pastor heading up VBS (also ran Sunday School) just called and all of us teachers are meeting Thurs night for the pre-VBS meeting to go over next weeks lesson's and acitivities. I am nervous about that and especially since someone else is teaching for me Monday but I also think it should be kind of fun. :)
Thanks for stopping by,


1 comment:

  1. Lots of us wanting to pray for you...have it down that hand surgery is tomorrow: dates for shunt and heart surgeries?