I’m now back home and have ‘quite’ a bit of time on my hands so here’s a more detailed version of my experience at the ROH Birmingham UK. Please bear in mind that this is what happened to me and hospitals use different approaches and techniques.
During the pre-operation admin, the Anaesthetist and a nurse explained the differences in anaesthetic types, pros, cons and relative risks. Basically, a Spinal Block will take all pain away during the operation and for a good few hours afterwards. This could be combined with either a full General Anaesthetic so I would be completely unaware of the whole process or; light sedation where I would be conscious. The ‘being conscious’ bit sounds a bit grim but read on….
Although conscious, you cannot actually see the operation, you can hear the sounds of the operating room including tools being used, I was allowed an Ipod to listen to music which softened the sounds I could hear. There is no pain and light sedation relaxes you; I did almost doze off.
Initially I wanted to be completely unaware of anything but I also had a bit of fear about not waking up afterwards etc. The anaesthetist and nurse explained both approaches so well I would have been equally happy with either method from an outcome point of view, I chose the spinal block with sedation mainly because I wanted to know the result quicker!
So here’s what happened. When it was my turn I was wheeled down to the anaesthetic room and prepared for surgery. A recurring theme in my treatment was the ease at which all staff from Mr Treacy to the porters put you; especially important to me at this stage when I was most nervous!
First thing to happen was a little local anaesthetic before a cannula was inserted in my right hand – no pain or discomfort. Every step was explained thoroughly; next I was put in a slumped forward sitting position to expose my lower back, freeze spray applied and another local injection at roughly the area of the spine where a belt would lie. Then the spinal block was given, this was 2 injections of Diamorphine close to the nerves that require blocking. I felt no pain or discomfort just sensations of light pressure. I was then laid on my back while the block took effect. I also had electrodes attached for ECG.
Probably about 15 to 20 minutes have gone by since I came through the anaesthetic room door, the spinal block is beginning to work and I can feel sensation leaving my legs progressively. The Technicians carry out various checks and turn me onto my left side to prepare the right hip for surgery. It’s about now that the block is fully effective, my brain knows that I’m lying on my left side and my eyes can see that I’m on my left side. The leg is shaved and I don’t feel it although I can hear the razor. Next, I’m wheeled into theatre and transferred to the table; I’m plugged into the monitors, O2 and given the sedative – better spark up some Muddy Waters!
Throughout the last few minutes I’ve been feeling more secure and less nervous, a green paper screen prevents me from seeing what’s going on and the staff are constantly checking on me and the odd joke or question keeps me at ease. I am feeling really cosy now, completely nerve free and interested in what’s going on. Obviously when they operate they have to move your legs, you don’t feel them move, but you do feel the effect on your upper body. I realised they must have cut me open when I started hearing a drill and other machines, you also hear a bit of light hammering – don’t let it put you off, I felt absolutely no pain. First hip done and they wheeled me out to have the other side prepped.
Back in for the Left side which went as above - approximately an hour start to finish. Before going to the recovery room I was put on my back to check leg length. As I was awake I could ask how it all went and, especially important for me, did I get BHRs or THRs! The most bizarre feeling is the surgeon holding both big toes in his hands and moving the ankles, asking you how you are and telling you it all went well, while your brain is telling you that it can feel you lying on your left side!
Once in the recovery room my blood pressure dropped, the symptoms I felt were a dizziness and clammy skin; the team were all over it, so it was only 5 or 10 minutes of mild unpleasantness. It’s a common reaction to the Diamorphine used in the spinal block.
I imagine that this wouldn’t be for everyone but I’m pleased I did it this way, if anyone would like more detail of specific aspects please ask. I’ve deliberately not been too graphic about the tooling sounds during the op, I used to do structural repairs on aircraft so the sounds of air tools don’t scare me. The most important thing is that whatever I was hearing, I felt absolutely no pain.
Steve
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