Pre- Anesthesia Questionnaire: Fill & Download for Free

My implants are reconstructive, rather than enhancements.I strongly believe reconstruction is an amazing thing, and helps many women who have either had breast cancer, or those who are like me and had a prophylactic mastectomy to reduce their BRCA-enhanced risk of developing breast cancer. Whatever risks and hassles the reconstruction process entails, it’s certainly far less than the endless stress of screenings with the constant “are they going to find something this time?” fears.That being said, I would never recommend enhancement for the sake of having bigger boobs - and not just because I had big ones naturally and know how awful they are.Surgery dayYou ask what the surgery is like. Well, honestly I have no idea because I was asleep.Usually you arrive at the hospital at 6 in the morning. They do your paperwork and get you changed. You get endless nurses coming by and checking your ID against your bracelet. You get tired of repeating your name and date of birth within the first hour, as well as all your medications, allergies and other medical information. And no, you have not eaten since dinner time last night.Then the doctors start arriving. The anesthesiologist will come and ask the same questions all over again. They will also re-ask half the questions you already answered on the anesthesia questionnaire and in your pre-admin appointment. They will check again to make sure you haven’t eaten anything in the last 8 hours.Your primary surgeon will come and have you take off the top of your gown, while they make like Picasso with a sharpie on your breasts. There will be some adjusting, a bunch of muttering, and often a tape measure involved. Then they’ll cover you back up and say they’ll see you soon.Your secondary surgeon will pop in either before or after the primary surgeon, and introduce themselves. They’ll ask some more questions, but this visit is usually brief.If you’re having a mastectomy and reconstruction, then you’ll have 2 primary surgeons - one for the mastectomy and one for the reconstruction. They will work together, but are in charge of the different procedures. If it’s a revision or they are just putting in implants then the second surgeon is more of an assistant. Often times these are fellows who are studying under your plastic surgeon to specialize.You now get wheeled into the OR and scootch over onto the operating bed. The anesthesiologist will get your IV going (if it wasn’t done ahead of time), and the nurses will all introduce themselves. One will put an oxygen mask over your nose and mouth and encourage you to breathe deeply. The anesthesiologist will bid you good night.RecoveryThe next moment, you hear a voice saying, “It’s all over. It went well. You’re in recovery.” It’s like no time lapsed in between. I’ve had many surgeries and the pain in recovery is sometimes nothing and other times it’s nasty. They usually work diligently to bring the pain level down as fast as possible.There was only one time that this did not happen - and it happened to be the most painful waking. The nurse insisted on giving me a single pain tablet and waiting for a full hour before she would give me anything else. Then she gave me one more - and waited another hour. It was insane. But that only happened in one out of 12 surgeries, so it’s not the norm.If you’re just doing implants it’s a day surgery. So you will spend 2–3 hours in recovery, then get to go home. For the mastectomy, they keep you for a couple of days.Depending on your situation, you may get drains. These are a nuisance, but are far better than leaving the breasts to swell up until they go boom! (Had that happen twice).You can’t lift or put your arms over your head for a time, and you’ll have gentle stretching you need to do. You’ll be given painkillers. Take them. Don’t let your pain get out of hand, or your body won’t heal. Eat extra protein. You need that to heal - and don’t overdo things. Let yourself recover.How it feels.For the first month or two it feels like someone put a bra under your skin that’s about 3 sizes too small. It feels tight. Your breasts will look very high up and large at first. The size is from swelling, and the height is because they need room to settle. Once they settle down they should end up at the right height. It can be disconcerting at first to feel like you have boobs under your chin.At some point your doctor will advise “vigorous massage”. This is to help prevent capsular contracture, and also to soften up the implants. Interestingly I didn’t get this instruction with the gummy bear implants, but with the gels I did.After a few months you won’t really notice them anymore. And within 6 months they feel like part of your body.If you had a mastectomy, you will probably have numbness and loss of feeling. I got almost all my feeling back, but my Mom says hers are still numb. Even my nipples still go up and down which they’re certainly not supposed to do after a mastectomy! So everyone is different.AfterWith most reconstructions, and I’m sure more than a few enhancements, there will be revisions required to get everything looking as you want it. This means more surgical procedures. It’s currently 4 years after my mastectomy and initial reconstruction and I’m back to a tissue expander and a drain on one side. I am an unusual case, granted, but this type of thing almost never gets done in just one surgery. So that’s the biggest thing to be prepared for.Is it worth it? For reconstruction, yes. For enhancements, I don’t believe so.—Attribution was requested: This information is courtesy of First-hand Experience by Me, Myself and I.

I’m not a medical professional. Just a knowledgeable patient. I’m In the United States of America. You didn’t say where you live.I am sorry you’re in so much pain and I hope you feel better soon.Why not an emergency:I was talking to my doctor about what happens if I have a certain medical problem. he said, oh that problem is not an emergency. I asked him what is. My doctor told me “an emergency “ is “life or death.” You are not having an emergent problem from your hernia. You are not actively dying at this very moment. For example, you have blood circulation, an open airway, you are breathing, and you have stable vitals. your vitals are not unstable vitals that indicate likely organ failure.An emergency surgery means you need surgery immediately to save your life. Delaying surgery would kill you.Yes I’m very aware that severe pain reeks havoc on every organ system in the body especially when the pain is chronic, but pain doesn’t count as an emergency.Elective surgery: Sometimes people misunderstand what elective mean. In the medical context of surgery, elective does not mean optional or voluntary.The definition of a “elective surgery” is a surgery that is scheduled in advance. “Emergency surgery” is done immediately.Yes there are elective surgeries where it feels like you don’t have a choice. For example, I needed surgery to remove my tonsils so that I stopped having severe allergic reaction to strep throat, Causing my throat to swell nearly shut. ‘Have the surgery’ or “suffocate again’ is not what I consider voluntary or optional. However the allergic reaction had stopped. my airway was not swollen and compromised at that moment so I wasn’t going to die from it, it was elective. Also my surgery was scheduled in advance so it is considered “elective surgery”.As far as your insurance goes, I don’t know what to tell you. You will get more detailed answers calling your insurance company and requesting to speak with their medical management department.If it is legal to record the call do so! You will need it. If not take detailed notes on criteria that must be met, reason for denial. Notes including the nurse’d name, her supervisor’s name,their phone numbers. Make sure the contact information they have for your surgeon is correct, Record their appeal process and their grievance process. they will contact surgeon for documentation.before you talk to your insurance company or to your hospitals preauthorization department, you MUST find out what their policy is on hernia repair. look it up at this webpage. I read Medicare’s policies because most private insurance companies follow suit. you’re wasting your time if you don’t look that up first. the policy is critical. That is what they are using to approve or deny your surgery.Ask the medical management nurse for a written copy of their hernia surgery policy. Usually for most surgeries there is criteria like a doctor must declare surgery medically necessary and describe how all non invasive treatments have failed to work.Do not have surgery until you and the hospital have received the approval letter. Verify the letter has the correct surgery, the right ICD and CPC codes, and the surgeon’s name.And not until you are sure your surgeon and anesthesiologist and any other billable professionals are in network.Start herehttps://www.bcbsil.com/pdf/standards/hernia_repair_cpcp.pdfDo a new advanced search. If this doesn’t work go to medicare.gov and click on providers then click on advanced search.Medicare Coverage Database - OverviewFYI The Insurance company medical management department handles surgery pre-authorization and nurses decide to deny or approve the surgery.Next call the hospital and request to speak to their pre-authorization department. Hospitals have an entire department dedicated to surgery pre auth and jumping through the hoops that the insurance company puts up.you didn’t ask about this but make sure every single provider is in network. Not just your surgeon. Like anesthesiologist. Ask your surgeon or his staff how to call or email the anesthesiology staffing agency directly. Ask the agency what their policy on ““balance billing” is.refuse care from out of network providers. Which can cost you thousands of dollars. Some people even write it on the financial consent form so that it’s part of their medical record. only receive care from other providers that are in network. Such as radiologists or anyone else that you expect to receive a bill from. It is your responsibility! not theirs, to stay in network and avoid balance billing.The other information you didn’t ask for is find out what your best billing status is. There are two options. The doctor makes this decision. Not you. “Under observation” or “admitted”. Status.Hospitals put people under observation to keep their admit numbers down. They want to look good and receive funding/resources. If you’re going to be in the hospital for 23 hours or less, “under observation” may be cheaper.This is very important because there may be a radical difference in what your insurance company pays for admitted status versus under observation status.Insurance companies often pay FAR LESS for observation status.For example, Patient had a knee replacement surgery and went to rehab for two weeks with an under observation status. She owed $20,000 and went bankrupt from her medical bill. All she had to do, while in the hospital BEFORE discharge, is pester the doctor enough. ask repeatedly what an under observation status means until you get an answer. they will eventually tell you that that it may affect your insurance payment. the doctor may change it to admitted status just to get you to leave him alone or to prevent you from escalating to his superior.In conclusion, I really think you need to talk to your surgeon again and get all your questions answered!You’re asking very basic questions like why is hernia surgery elective. Your surgeon can explain that. In my experience, people that ask questions like yours have never had surgery or spent a lot of time as a patient. If you’re concerned the surgeon may get irritated with your list of questions, talk to the nurse or physician’s assistant about answering your questions. Anything they can’t answer the surgeon can.If you haven’t met the surgeon yet, make sure you Google questions to ask your surgeon about hernia surgery. And create your list of questions.I suggest you fill out a Pre anesthesia screening questionnaire. google it. I wish I had. The nurse that called me to screen me spoke rapid fire like an auctioneer. Also her accent was so thick I couldn’t understand her sometimes.You should also fill out a preop anesthesia evaluation. Being nervous the day of surgery it can be hard to remember the answers. It’s hereThe Preoperative EvaluationUpvote me if this is helpful to you.

The anesthesiologist really needs to meet you. Surgical trauma and the anesthetic drugs have the potential to affect all aspects of your physiology. But both surgical and anesthetic techniques have more than one alternative approach to most problems, alternatives that may have differing effects on your physiology. The goal is to match the appropriate technique to your specific physiology or physiological deficit.When young and fit, your organ systems generally have a lot of built in redundancy, generally on the order of three times greater capacity than needed for survival. Chronic disease and aging both diminish your maximal functional capacity, but that excess reserve is such that you won’t have any symptoms at all until you have lost 60 - 70% of your maximal functional capacity, depending on the system. At the same time, the demands of surgery and healing might double or triple the demands on a given system in the perioperative period.Do the math. Say you start off with needing 30% of your maximal functional capacity to survive, but chronic disease or aging has reduced you from 100% when young and fit to 50% now. Meanwhile, the stress of surgery and recovery doubles the amount of functional capacity you need to survive the operation, so you need 60% of your maximal capacity. So there’s a 10% shortfall, which means you might not survive the procedure.The systems in which this model applies very closely are the respiratory, cardiovascular, hematological and fluid/electrolyte/renal systems. Anesthesiologists are trained to be able to accurately estimate the excess demands and negative effects on each of your systems caused by particular operations and anesthetic drugs and techniques. Furthermore, they are also trained to accurately evaluate your remaining functional reserve capacity for each organ system (ie) how much of your maximal capacity you have already lost due to disease or age. They then do the calculation, and in conjunction with the surgeon, plan whatever modifications are possible in surgical and anesthetic technique, and both pre- and post-operative care, to ensure that you will survive the procedure in the least stressful manner possible.The questions, examination, and investigations done by the anesthesiologist have this as the first goal. In the majority of healthy people, or with minor procedures, the calculation is pretty easy to arrive at, but with major procedures or with frail or elderly patients, it can become much more involved, with further tests needed, and the post-operative planning much more detailed.The second goal is to assess airway anatomy, which is a specialty of anesthesiologists. This assessment is to ensure that the airway can be maintained without obstructing or aspirating during the anesthetic. If a spinal or epidural is being considered, then spinal and neurological anatomy is assessed.The third goal is to establish a relationship of trust and openness as a way to modify anxiety and increase autonomy.For small procedures involving local anesthesia or short anesthetics, a formal pre-operative visit can be skipped, and replaced with a short interview immediately before the operation, but even that entails a health questionnaire and some basic tests being performed at the surgeon’s appointment, with the results forwarded on to the anesthesiologist for screening a week or two in advance of the surgery date.