Please walk me through outpatient surgery

Or is it called “ambulatory”? I have never had an operation other than tonsils when I was very little, and cataract surgery a couple of years ago.

I go in next Monday for the removal of a cyst on the back of my neck, which will involve general anesthetic, removal of a strip of skin, and excising of the cyst sac.

I’m not overly nervous about this procedure, but have no idea what to expect during the hour run-up to the procedure, or the aftermath coming out of anesthesia. I don’t even know how the anesthetic is administered, but I’m assuming via IV?

Please walk me through the general order of the day, if you will, as I’d like to be mentally prepared for the whole thing. I know that in terms of surgery, this is like wiping your nose, but as a first-timer I’m a bit apprehensive. Thanks, all.

I’d say “walk me, too,” but my upcoming is knee surgery…

I have driven family members for such things more than once, but my experience is completely from the waiting room. So far.

Had arthroscopic surgery years ago, can’t imagine the routine is much different. You will likely have fasted prior to the surgery, and they will verify upon registration. You’re brought into the pre-op area which is nothing more than a curtained off section of the room. Strip down, put on gown.

Doctor will come in and review procedure. For my knee, they had me initial it, acknowledging that they’re doing the correct knee. They set you up with an IV, and I’m pretty sure they give you the sedation at this point (I don’t remember much between this part and waking up in recovery).

In recovery, they wait for you to come out of sedation more, maybe give you something light (crackers, juice), and review after-care. You will probably not be allowed to drive home since you were under sedation. In my case, I was told to bring crutches but strongly discouraged from using them.

Altogether, I don’t think I was there more than three hours. Your time may vary.

In short, piece of cake. You won’t miss any shows.

Thanks. They’ve said it will be about four hours. My neighbor is going to take us and pick us up, as my wife really can’t safely drive until she gets her cataracts taken care of. I know that the doctor will prescribe pain killers, but I’m hoping I can grit my teeth through any discomfort.

The only ambulatory procedure I’ve had is a colonoscopy, but some things might be similar. You’ll have less prep the day before, of course. Let’s see what I can remember or extrapolate from regular surgery.

Paperwork at the counter.

Taken into the back, assigned a locker and shown which dressing room to change in.

There will be a gurney to climb on and an IV, but the order depends on the hospital.

For most in-patient surgery, you get a tranquilizing shot to keep you from stressing out, but there are shorter gurney rides with ambulatory procedures and less to dread, so they might skip it.

You may be introduced to the anesthesiologist, who may have questions for you, or to other team members. You may have the coming sequence of events explained or be asked if you have any questions. You can ask for information at any point. If there’s any after care that you need to do, they should tell you before you’re sedated, but sometimes they wait until you’re ready to leave.

The anesthesia is usually injected into the IV and you’re usually asked to count backwards from some number. You usually don’t get to the third number on the countdown.

There may be other people on gurneys in the recovery room. They may or may not be awake yet. Don’t sit up or try to stand until someone tells you that’s OK. They’ll monitor you until they decide you can be released. Your IV may stay in until that point.

If someone else is driving you home, you may be taken to the car in a wheelchair. Any aftercare instructions should be given to you in written form before you go. You may be given a prescription. If you have any questions, this is the last opportunity to ask before you go. If it’s not your regular doctor doing the procedure, be sure you have a phone number to call if you have questions later.

Oh, and if the prescription is for pain, you may want to get it filled before you need it, especially if you’ll have to arrange driving to get it filled. Waiting for a prescription after you’ve decided you need the pain relief is its own special purgatory.

They give you these cute little socks with grippers on the bottom.

Since they are disposable, feel free to take them home.

They come in handy around the house. A little bonus gift.

I’ve had a few procedures under anesthesia the last few years. It’s really a piece of cake.

You’ll most likely fast before the procedure, nothing after midnight. If you are a diabetic there will be separate instructions as to your medication.

Two days before (this was major surgery) I had to take a shower with special soap. I also had to sign paperwork indicated that yes, I had showered twice with the special soap.

Morning of the procedure, I am escorted back and I have to wipe out my nostrils with an iodine solution and brush my teeth. I strip and put on a gown. The IV is inserted, any electrodes are attached to monitor blood pressure, oxygen levels, and temperature. The nurses come in periodically to tap on the computer.

The docs come by and check in with me. I have a tendency to vomit after waking up, but now that I know this I tell them and they give me something during the procedure to calm down my tummy. Sometime before the procedure they may give you Versed, which is a nice sleepy time calming drug.

Then they reel you into the OR, get you moved over to the operating table, put a mask over your face…

And then you wake up. I am always amazed at how fast it takes to put you out.

They’ll keep you in recovery for an hour or so to make sure you wake up okay and with no problems, then you get dressed and go home. Take it easy for the rest of the day.

If they give you pain pills, TAKE THEM at first. It’s the only time you get the legal good stuff and depending on the procedure you may not need them after a couple of days. Listen to the doctor’s instructions for taking care of yourself after. Failing to heed them may make your recovery time longer.

The accounts above are consistent with my experience when I had finger surgery, so I won’t recount the whole thing.

I do wonder why a general anesthetic is required for a cyst removal, unless it is quite deep. I had a cyst removed from my back, center just below the shoulder blades, with just a local in the doctor’s office.

They will tell you exactly what to do from the moment you enter the clinic to the moment you leave the clinic, in loud, clear, friendly voices. (They are used to dealing with people who are elderly, disoriented, or otherwise not at their best).
[ul][li]Check in at the desk.[/li][li]Fill out your paperwork, saying yes, I know I am having general anesthesia and I might die, you can bill my insurance company, medical students might watch, etc. - all the stuff nobody reads.[/li][li]Go to the waiting area until your name is called by the cheerful nurse who looks like she wasn’t born until Clinton was President.[/li][li]She will take your vitals, and send you to a different area. [/li][li]Wait until an older nurse who does this twenty times a day calls you into another room. There she will tell you to put all your stuff into the locker and put on that humiliating gown that shows off your ass, not to advantage.[/li][li]She will tell you to lie down on the gurney. From then on, you need do nothing more than lie still and answer questions.[/li][li]They wheel you into the staging area. There they ask you your name four or five times, and the nurse will start an IV.[/li][li]You lie there and stare at the ceiling until the anesthesiologist comes in and introduces himself. He will ask your name again. Then he will give you something “to relax you”. Trust me, you are going to be plenty relaxed, in the sense of “what was my name again? Oh well, never mind - the nurse’s uniform is suuuuch a pretty color…”[/li][li]Then they take you into the operating room. Take a good look - within a minute or so, they will say "we are going to administer the anesthetic now. You might feel something cold…[/li][li]Oh look, you are in the recovery room. [/li][li]Then you lie there until the doctor comes in to tell you everything is fine.[/li][li]Then you put your clothes on, and your neighbor drives you home.[/li][li]Don’t be a damn hero - take the pain meds. You will recover faster.[/ul][/li]
Don’t worry about it - they do it a hundred times a week. They have everything down to a science. You are just cargo, and they are really good at handling cargo, even cargo with feelings who are worried.


I just had a cyst removed from my cheek yesterday, although it was under local anesthesia.

The whole procedure took about 10 minutes (I spent more time waiting in the room for the doctor to show up).

I’ve also been under… I think they called it “twilight anesthesia”, where I was awake, but not really in a normal frame of mind. Like, I could feel some discomfort, but I had basically no concept of the passage of time, so all the discomfort was temporary and fleeting, and I didn’t care that there was probably more coming up. It was kind of cool, since I’m not squeamish, so I was able to see what was going on and not hurt.

Be prepared to spend the rest of the day sleeping. Or at least a few hours after you’re home. Anesthesia affects everyone differently but in my experience I always have a lot of sleeping to do when I get home.

A few years ago I had a wisdom tooth pulled under general anesthesia, in the dentist’s chair. I was under for about 40 minute. When he was finished, I came out of it, and got up and went home. Someone had to drive me. That was about it. Post-op was pretty much the same as for any other dental extraction.

Because of the location and the fact that it’s fairly large. The neck bleeds like a mutha, and the cyst sac adheres to the muscle and must be stripped away. There are also a lot of nerve endings in that area. I’m sure they don’t want you suddenly feeling pain under a local and jerking or twitching.

You may want to have a garbage bag or can or something to throw up in on the ride home. 2 of our boys had their tonsils out on the same day and they took turns throwing up on me. I got some free scrubs because I was soaked. Luckily we had some grocery store bags for the short ride to my in-laws which one child used and after they had napped a few hours my MIL sent us home with a few coffee cans for them for just in case. When I have had various in and out surgeries I always bring a little waste basket for just in case.

You will want to take the pain meds (and have them beforehand) because it’s harder to get the pain under control than to control it before you notice it.

The nurses will ask you questions to determine if you are “with it” enough to be discharged. Try to not answer too sarcastically :smiley:

One thing that wasn’t mentioned: After you’ve changed into the flimsy gown and placed on the gurney… you may be left on that gurney for quite some time, awaiting your time in the ER. It can be damn cold in there. Do not hesitate to ask for a blanket. They are available and they’re for you.

One of my memories from my childhood tonsillectomy was waking up and vomiting. But I’m pretty sure that was a reaction to coming down off the ether; it’s a known effect among those who use ether to get high.

Can’t get the pain meds ahead of time. We’ll have to pick them up on the way home, which is stupid.

You might want some popsicles at home if you’re going to be intubated, since you’ll be on your face. I’ve had to have a tube at least once and maybe it’s because I still have tonsils but I woke up with quite a sore throat. Popsicles did the trick.

Don’t be such a damn “hero” - take the damn pain meds. At the very least, take them before bedtime so you’ll get some good sleep. Sleep is necessary to healing.

And they’re often pre-heated. So you get not just a blanket but a warm, toasty blanket.

You arrive at the hospital at o-stupid-thirty. Sit in a waiting room until they call your name. Change into a dressing gown. Lie on the gurney for about 45 minutes while a nurse asks you questions and tries, multiple times, to get your IV in.

When it’s in, she gives you diazepam, and that’s when the best day of your life starts. You giggle all the way to the OR, where the anesthesiologist–who manifestly likes her job–says “oh honey, they gave YOU some drugs ALREADY.” You giggle that they did. She says “Imma give you some MORE” and the next thing you know, you’re waking up in recovery.

There is a recovery nurse who pretty much stays nearby while you wake up–for about an hour. You find that you and she are soul mates. Truly, the best friend you never met. You might love her.

Then they release you (without having gotten the nurse’s number) and your escort drives you home, where you spend the afternoon emailing all your college professors to tell them what a profound impact they had on your life.

It’s all about the diazepam.

That’s likely 4 hours from the time you walk in to the time you walk out. I had shoulder surgery and I don’t think I was in the hospital that long.
As far as throwing up. Everyone is different. When I had general, I did puke (I also had a migraine). I’ve also had twilight 3 times. The first time was so not a big deal that I was planning to get some painting (walls, not art) done the second time but ended up sleeping for about 12 hours afterwards, and deep enough that multiple phone calls and texts didn’t wake me.
OTOH, my sister was crying as she came out of general and was assured multiple times by the recover staff that it as totally normal, a lot of people get very emotional.

I had the IV in me for quite a while. I’m sure it was partially to get my hydrated and partially so I was ready. Then they stuck a needle in me and I said ‘what was that’, she said ‘versed’ and I recall saying ‘so I got about 5 minutes left’ and the next thing I remember is waking up, wondering why my shoulder hurt so much.
Honestly the time that you’re asleep is erased, gone, it doesn’t exist any more. I can’t say for a cyst, but four surgeries like I had, I always tell people that the actual surgery is a walk in the park, don’t worry about it, it’s the recovery (all PT) that’s a PITA.

As for driving home, no, they won’t let you do that. There’s no driving after general. In fact, anything you sign your name to within 24 hours is null & void (don’t try anything though, if you go try to buy a house, they’ll actually ask you if you’ve had anesthesia in the last 24 hours).

Anyway, lots of words, but it’ll be no big deal. I don’t know what kind of cyst, how big or how deep. But my WAG is that you’ll be out for a few minitues and wake up with a numb spot from some local and a few stitches (unless we’re talking about something on an organ).
BTW, FWIW, ‘ambulatory’ means ‘walking’. IOW, It’s not a surgery that they need to keep you for a day or two.

@AB, I wouldn’t be surprised if they had you walking the same day. I can’t say for sure with knee surgery (and you didn’t say what they were doing), but for hip replacements, they have the patients up and moving within an hour or two of the surgery. The longer they lay around in bed the harder it is to get moving, both mentally and physically as the joint swells and stiffens. Even with my shoulder surgery, they had me using it, literally, within minutes of waking up.