The Empowered Patient: Don’t Be Afraid to Ask Questions

The other day I was with a family member in the day surgery waiting room.  This was the second surgery in six weeks for a client with newly diagnosed breast cancer.  Before the first surgery to remove all calcifications noted on the mammogram, the surgeon had kept telling us he thought it would be benign.  He said it multiple times.  The day before the follow up visit two weeks later, my client’s son got a call at 8PM  letting him know the pathology was positive.  It was a shock to everyone.

At the follow up visit, the surgeon informed my client that he needed to go back in and make sure he got more tissue or in the trade, wider margins from the cancerous area.  It meant another day surgery for my client.

The first surgery had gone smoothly with no complications.  My client was not given general anesthesia, so she was awake an hour after the completion of  surgery.  When we walked in, she was eating her custard and talking to the nurses.

The second surgery was different (no surgeries are the same).  My client was having a difficult time awakening after the surgery. The surgeon had been out earlier to speak with us an hour after we left preop.  All was well he said.

I knew something was not right when we were still in the waiting room  90 minutes after the doctor left.  I went to the desk and was told this was normal.  I knew it wasn’t normal because the anesthesiologist had told me  everything would be the same for the anesthesia.  I didn’t want to show my client’s son my concern but I knew the recovery was not proceeding normally.

I went up to the desk again and was told she was still not awake after two hours.  This I knew was a red flag.  I was giving it 15 minutes more and then I was going to ask to speak with one of the nurses. 12 minutes later, we were taken back.  My client said, she knew it took her a long time to stay awake.

I knew something was off, although it all looked fine now that my client was awake.  I asked the nurse why the long time in recovery and got the standard answer that it was normal.  The next nurse I asked the same question and she said well, it seems she got a lot of anesthesia.  I knew that but why?  The surgeon and anesthesiologist had been clear it was going to be the same amount.  Was there a problem?

I looked at the nurses notes by the bed and need for oxygen was noted as extended.  The anesthesia notes were not there.  No more clues.  My client took a long time to get going and it was over four hours before we left recovery.

The next day the hospital called and explained she had been given more anesthesia than initially  indicated.  The anesthesiologist’s nurse explained they wanted to make sure my client didn’t experience pain during the surgery. In essence they over medicated.

Luckily, my client in the next few days recovered with only slight nausea.  The message here is if it doesn’t feel right, ask questions and expect answers.  Don’t be put aside with uniform answers even while waiting in the day surgery family room.  There is always someone higher up the medical food chain that can answer.  A receptionist is not a medical person. Ask for a supervisor!  Get someone who can answer you.  Unfortunately, it can be difficult to get the assistance needed, but don’t back down.

I wouldn’t have thought anything of the time, if the surgeon hadn’t been out so much earlier.  I needed real time information.  Some centers have nurse liaisons in the waiting rooms.  It helps immensely when these questions arise.  Again, information is the key and it doesn’t take much to calm the anxiety.