Sunday, 11 March 2012

Pituitary Surgery: Pre-operative Assessment

After meeting my pituitary surgeon Mr Pout, I was trundled off to have my pre-operative assessment. The NHS wesbite describes pre-operative assessments as:

"...carried out prior to treatment, [to ensure] that the patient is fully informed about the procedure and the post operative recovery, is in optimum health and has made arrangements for admission, discharge and post operative care at home. "

I met a very nice nurse and her very nice (and extremely lengthy) questionnaire, which we got to fill in together. What a treat! I got to answer questions about my health, fitness, medications, allergies, medical history and more. It was like being on Mastermind, except the nurse was a lot more judgemental than John Humphrys when I couldn't remember an answer.* Possibly it was more like University Challenge, in the rounds where you're not supposed to confer.

Wait... who actually is my GP?

After hearing about the more technical (and terrifying) side of transsphenoidal pituitary surgery from Mr Pout, the pre-operative assessment was a chance to find out more about the practical side of things, like visiting hours for my ward in the hospital, what would happen in the lead-up to my surgery, and exactly how nice my parents had to be to me for how many weeks afterwards.

With the benefit of hindsight, I would have taken my cue from John Humphrys and done some slightly more thorough interrogation of both the nurse and surgeon. The problem is, you don't know what you're not being told until some time after they've not told you it.

I would have appreciated being told, for example, that after my surgery, I had to have blood tests done every hour for six hours, then every two hours for twelve hours, then every four hours, etc etc. Admittedly, I have complained about this in a previous post. But the thing was, although I understand that the blood tests were necessary to keep track of my pituitary hormones, it wasn't until after they'd already done a couple of rounds of blood tests that I was even told exactly how long it was going to go on for. And my arm was really sore because they kept putting surgical tape on it (it appears there's no plasters on the NHS) and then ripping it off every five minutes to stick another needle in. If only I had shaved my inner elbows.

Plus, it would have been helpful to know precisely what scan they were intending to send me in for on the day of the surgery. This got super confused on the day, and I'll talk more about it in a future post, but I was never told that they wanted me to have a CT scan of my pituitary before surgery, so I was completely confused when a couple of hospital porteers turned up to wheel me away to the scanning department.

Also at the pre-operative assessment, you get weighed and measured and have your blood pressure taken. If it's a little low like mine usually is, and if they suddenly realise that (thanks to their insane waiting times) you haven't eaten anything since before you turned up to the hospital six hours ago, they may give you free cake and biscuits. These are of a surprisingly high quality for hospital-supplied nibbles.

Oh, and they swab you to check whether or not you have MRSA bacteria present on your skin. If you do, you might be put last in the day's queue for surgery.

*Incidentally, did you know that the format of Mastermind was allegedly inspired by creator Bill Wright's experience of being interrogated by Nazis?


  1. Your words are a little reminder to me of what I have experienced. It is one year ago today that I was diagosed with a benign pituitary tumour and two weeks later I had my transphedoidal surgery. ahh- the reminder of those ALL of those constant blood tests !! I wish I had written more about my thoughts at the time. I was in hospital for some time and sketched and drew my way through my experience !

    Some of your words I can relate to and others I did not experience (I had my own little medical adventures). But I really enjoy (not sure if that is the right word) reading the blog. Thanks for sharing and good wishes

    1. Oh my goodness, I can't believe you had such a short turn around between diagnosis and surgery! That must have been quite a shock, I'm not surprised you didn't have much of a chance to write things down.

      I've just been looking at your flickr account though, your pictures are amazing! I remember trying to draw a bit in hospital and I just didn't have the energy or the concentration skills for it, so I'm seriously impressed that you were able to do such amazing artwork, you've got real skill.

      Thanks so much for the comment, best wishes to you too!