RO/EN: Intrebari inainte de operatia de endometrioza – de adresat medicului anestezist si medicului chirurg

Din pacate (sau si din fericire pentru ca apoi vei avea parte de un nou start), esti in fata unei operatii de endometrioza. Pentru pacientele care (inca) nu stiu, endometrioza are mai multe stadii (poti citi mai multe despre ele aici), iar gradul 3 sau 4 implica deseori o interventie chirurgicala complexa, cu shaving sau rezectie de rect/vezica, in functie de situatie.

Pentru ca nu ai nevoie de inca un stres in plus, iata mai jos o lista de intrebari pe care sa o ai in vedere atunci cand vorbesti cu medicul anestezist (orice spital care se respecta ar trebui sa includa aceasta intalnire) si cu medicul care te va opera (de preferat chirug ginecolog, cu experienta in astfel de operatii).

Intalnirea cu medicul anestezist

Eu am fost operata acum 3 ani, in 2016, in Timisoara, iar pe atunci lucrurile stateau un pic altfel decat procedura de acum. Asadar, eu m-am internat cu o zi inainte de interventie si tot atunci am vorbit si cu medicii anestezisti. Primisem de la medicul meu o lista cu analize de facut. In cazul in care nu ieseau bine, trebuia intai sa il anunt pe dumnealui. Mie doar Hemoglobina mi-a iesit un pic mica. Cu restul analizelor m-am prezentat la aceasta intalnire cu medicii anestezisti. Asadar, si la voi ea ar trebui sa fie prima pe lista, alaturi de orice alta intrebare ati avea pe marginea acesteia.

Intrebari pentru medicul anestezist:

  1. Cum se va realiza anestezia?
  2. Cum ma voi simti dupa operatie din punctul de vedere al anesteziei? (eu m-am dezmeticit mai greu, la vreun an dupa operatia mea fetele se trezeau, ba chiar mergeau prin salon mult mai repede, cred ca difera un pic procedura. In plus, e bine sa stiti dinainte eventualele simptome de dupa: dureri, dureri abdominale, durere de gat, ameteala, tuse etc.).
  3. Cum este anestezia afectata de alte proceduri/pastile/tratamente medicale pe care le-am facut in ultimul timp? – mai degraba o instiintare a medicilor cu privire la orice ati luat asa, mai “special”, sa zicem cu o luna inainte de operatie. De exemplu, eu luasem Medrol si antibiotic.
  4. Cum este anestezia afectata de alte afectiuni cronice pe care le am? – de mentionat orice alta afectiune mai grava aveti – de exemplu astm, alergii, diabet etc.
  5. Mentionati orice altceva va nelinisteste.
  6. Mentionati orice “particularitate” ati avea (de spus si medicului care va va opera) – de exemplu, inainte de operatie, le-am spus dr. anestezisti ca, in general, am pulsul mai mare si tensiunea mica. Exact asta s-a intamplat in timpul si dupa operatie (pulsul mare) insa au stiut, nimeni nu s-a speriat, au stiut ce sa imi faca etc.

Intrebari pentru medicul care va va opera

Din nou, acum se procedeaza un pic altfel fata de acum 3 ani. Eu am avut o intalnire cu doctorul meu inainte cu o zi de operatia mea si a fost foarte bine pentru ca mi-a lamurit toate neclaritatile, s-a mai uitat o data peste RMN, desi il avea si dumnealui etc.

Stiu ca acum medicii sunt presati de timp, insa ar fi foarte bine daca aceasta intalnire ar avea loc totusi cu cel putin o zi inainte de operatie.

In alta ordine de idei, atat in cazul intalnirii cu medicul anestezist, cat si cu medicul care va va opera, tineti minte ca sunt niste specialisti foarte solicitati, stapaniti-va emotiile, puneti-va toate intrebarile pe hartie si nu irositi timpul, nici al vostru, nici al lor.

  1. La Timisoara, primesti un formular inainte de operatie, pe care trebuie sa il completezi. Daca ai neclaritati in privinta lui, acum e momentul sa intrebi.
  2. Ce riscuri si complicatii pot sa apara? – aici te sfatuiesc sa nu intri prea mult in detalii, pentru a nu te speria. Doctorul oricum o sa iti spuna ce considera ca trebuie si este normal sa stii.
  3. Cat va dura operatia, cu aproximatie?
  4. Cum vor decurge lucrurile dupa operatie (scenariul ideal)?
  5. Care imi sunt sansele de a ramane insarcinata natural/prin FIV dupa operatie? (daca este cazul)
  6. Nu doresc sa raman, momentan, insarcinata, ce pot face dupa interventie pentru a avea o viata normala si, la un moment dat, sa pot incerca sa raman insarcinata?
  7. Nu tolerez sau nu vreau sa iau tratament cu anticonceptionale. Care imi sunt celelalte variante? La ce riscuri ma expun daca refuz un astfel de tratament? Din experienta dv, aveti paciente care au reusit sa controleze endometrioza si astfel?
  8. Sunt cazuri de paciente care iau anticonceptionale dupa operatie si au avut, totusi, recidiva? (de clarificat aici ce inseamna recidiva – din punctul meu de vedere, un simplu chist care pare a fi endometriozic nu este recidiva).
  9. Aveti cazuri de paciente care iau alt tip de tratament dupa operatie si au avut, totusi, recidiva?
  10. Cat de mult conteaza stilul de viata dupa interventia chirurgicala, indiferent de tratamentul ales?

Sper sa va fie de folos.

Pe langa aceste intrebari, tineti minte ca cel mai important este sa va gasiti un medic bun, cu experienta in diagnosticarea, tratarea si operarea endometriozei, care sa se preocupe mereu de studii, ce apare nou si are cel putin cateva zeci de cazuri de endometrioza avansata operate cu succes.

Daca bifati toate acestea, mai spuneti o rugaciune si cu siguranta totul va fi bine!

Marina Rasnoveanu

Daca vreti sa cititi si alte materiale despre endometrioza si un stil de viata sanatos, urmariti-mi blogul si pe Facebook sau Instagram.

RO/EN: Questions before the endometriosis surgery – to ask your anesthesiologist and to your surgeon

Unfortunately (or fortunately because afterwards you will have a new start), you are in front of a surgery for endometriosis. For those patients who (still) don’t know, endometriosis has 4 stages (read about them here), and stage 3 and 4 often implies a more complex surgery, with a shaving or a bowel/bladder resection.

Here is a list of questions to ask your anesthesiologist and your surgeon. Any hospital where endometriosis is seen as an important disease should schedule these two meetings.

The meeting with the anesthesiologist

I was operated three years ago, in 2016, in Timisoara, Romania and back then things were a bit different from the present moment. Therefore, I went to hospital a day before my surgery when I talked with my anesthesiologists and also with my surgeon. I received from my surgeon a list with blood tests. As everything went right, I came back with those results at this meeting, so these should be the starting point of this meeting.

Questions for your anesthesiologist:

1). How will you perform the anaesthesia?
2). How will I feel after surgery, from the anaesthesia point of view? – it is better to know the common “side effects” like pains, headaches, abdominal pains, dizziness, cough etc.)
3). How the anaesthesia will be affected by certain procedures/pills/medical treatments I have taken lately? – this is more of an update for your doctors to let them know if you took something “special”, let’s say a month prior to the surgery. For example, I took Medrol so I let them know about it.
4). How is anaesthesia affected by some other chronic illnesses I have? – for example, asthma.
5). Mention and ask whatever worries you.
6). Mention any “particularity” you may have – for example, I told my doctors about the fact I almost always have a higher pulse and a low blood pressure. This is exactly what happened during and after surgery (a higher pulse) but doctors were informed and knew what to do.

Questions to ask your surgeon

Things are a little bit different now. Three years ago, I had my meeting with my surgeon a day prior to my surgery and this way he clarified all my doubts, double checked my MRI, met my mother, my mother met him etc.

I know these days doctors are always in a hurry and do not have so much time available but I do believe this meeting is very important and, when possible, it should happen 1-2 days before the surgery.

In another train of thoughts, both in the anesthesiologist case, and in the case of your surgeon, remember they are probably very busy, so calm down your emotions, write down all your questions and don’t waste your but also their time.

1). What risks or complications does my surgery imply?
2). How long will my surgery last?
3). How will things going on after surgery (the best scenario)?
4). What are my chances to got pregnant afterwards (natural pregnancy vs. IVF)
5). I don’t want to get pregnant, for the moment. What can I do after surgery to have a normal life and to be able, at a certain moment, to have my own children?
6). I do not tolerate/ I don’t want to take birth control pills. What are my options? What are my risks if I refuse birth control pills/any other treatment? From your experience, as an endometriosis surgeon, do you have patients who can manage their endometriosis some other way?
7). Are there cases with patients who took birth control pills but still had a recurrence? – to clarify here, what a recurrence is. – from my point of view, and I am not a doctor, just a journalist + an endometriosis patient, recurrence does not mean an ovarian cyst that seems to be endometriosis).
8). Do you have patients who took some other type of treatment after surgery (for example diet, supplements etc) but still had recurrance?
9). How much lifestyle after surgery plays a difference, no matter the chosen treatment?
10). If your doctor gave you a questionnaire prior to surgery, ask him if you may have some questions on it.

I hope you will find all these useful.

Besides these questions, remember it is very important to find a very good doctor, experienced in diagnosing, treating and operating endometriosis, who always reads studies, go to conferences etc and has (at least) dozens of advanced endometriosis cases, successfully solved.

If you check all these, “say a little prayer” and everything will be ok.

Marina Rasnoveanu

If you want to read more articles about endometriosis and tips&tricks about a healthy lifestyle, follow my blog on Facebook and Instagram too.

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