Standard Disclaimer: I’m not seeking medical advice
I’m scheduled to have some surgery done next week. Specifically, it’ll be a bowel resection with 10 cm removed and they’ll also be taking out my gallbladder due to stones.
I went through all the preparations and instructions with the folks at the hospital, and I had noticed a discrepancy in some of the info. They handed me a pre-printed sheet of what not to do before the surgery, and one bullet said “No Ibuprofen, aspirin, or other NSAIDs for 7 days before the day of your surgery.”
The seven was scratched out and replaced with a 10. When the PA was going over the instructions, he made mention of “No NSAIDs for 10 days prior to surgery.”
I had mentioned this to a colleague at work last night, and he received similar instructions prior to some oral surgery, except that he thought he was told five days (he wasn’t 100% sure on that).
Now, of course I’m obeying the 10 days rule, but I’m just wondering if there’s some kind of factor of safety worked in there? Are they being overly cautions or were the others being foolhardy?
Slightly off topic: I’ve never been under general anesthesia before and I’m scared witless.
It is my understanding that NSAIDs work as blood thinners – you do not want to bleed excessively during surgery. Being a gastric bypass patient, I am disallowed NSAIDs (except under very strict circumstances) for life due to them being a trigger/cause of ulcers. So I am told. Personally, I never took NSAIDs anyway, so no big.
General anesthesia is no big deal, either. If you are anxious, ask for Versed (pronounced ver-said) pre-op – trust me My only issue with GA (due to some strange things with my system, I have to have GA for any procedure during which I might lose blood) is that it makes me nauseous. Very, very nauseous. I always make sure to tell the anesthesiologist beforehand. I insist that they give me Phenergan before surgery, a nausea patch and before they bring me out of the GA, another shot of phenergan. No one needs to puke immediately post-op!
oh, yeh, standard disclaimer #101: I am not a doctor
Thanks for the response. I do take comfort hearing that GA isn’t a big deal.
As far as NSAIDs go, I take indomethicin for occasional gout flare ups. I told that to the doc and he made sure to tell me to stay off it for the ten days.
As for the gout, I take allopurinol as a maintenance drug. One little pill everyday and I have not had a single flare-up since. Gout sucks giant, green, greasy, herpes-infested donkey nads! I would rather take a ($4/month at wal-mart) daily prevention med than an after-the-fact pain med. You might want to look into it.
NSAIDs don’t work as ‘blood thinners’ in the medical sense of the word. But they are anti-platelet medications. NSAIDs as a class inhibit the cyclooxygenase enzyme (COX) of which there are two main types (COX-1 and COX-2). This enzyme serves several purposes, one is to produce prostaglandins that are part of the inflammation and pain pathways (hence it’s usefulness in pain control, arthritis, gout, etc). Another purpose is to enhance platelet ‘stickiness’ when the body needs to heal a wound.
Most NSAIDs are reversible binders, meaning their effect on platelets wears off after several hours. Aspirin on the other hand is an irreversible binder and will inactivate a platelet for the duration of it’s lifetime helping to avoid such catastrophic platelet aggregations as heart attacks and strokes.
If you read the eensy print in the “fear sheet” that comes with every NSAID, in the rarely-occurring side effects section, you’ll find gastric bleeding. The docs who remodel Lazlo’s bowel will be checking for bleeding from their own work. If there’s blood from upstream, it might lead them to conclude the blood is from the bowel.
Yeah, they put me on it for about a year and it didn’t help. I mentioned this to the surgeon and GI doc and they suggested I speak with my PCP about a newer drug whose name escapes me at the moment. I’ve also been able to control it mostly with diet - lots of water and taking it easy on red meat and alcohol.
I have also heard that tart red cherries work. Adding them to your diet supposedly helps eliminate the evil uric acid as well. I don’t know if it really works or not, but some people I know swear by it.
My only issue with GA (due to some strange things with my system, I have to have GA for any procedure during which I might lose blood) is that it makes me nauseous. Very, very nauseous. I always make sure to tell the anesthesiologist beforehand. I insist that they give me Phenergan before surgery, a nausea patch and before they bring me out of the GA, another shot of phenergan. No one needs to puke immediately post-op!