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.

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

Awkward Turtle

I may or may not have mentioned (who knows?) my crack team of endocrinologists* who seem to be as numerous as the autumn leaves.** On the one hand, I enjoy meeting new people; on the other, I have an incredibly poor memory for names and consequently can only remember the names of two-and-a-half of the endocrinologists who've actually treated me.***

For the first four months or so of my treatment I consistently saw the same doctor when I went to the hospital; then, for reasons never specified he disappeared. Since then, I've seen different doctors every couple of months. I can only presume that I'm committing some kind of hideous endocrinological faux pas without realising it.

Anyway, the other weekend I was at the local train station, and joined an epically long queue to buy a ticket. As I was standing there, I suddenly became aware that in the queue in front of me was.... my original endocrinologist, Dr ---!

I had to make a choice: say hi or stand by? And obviously I went for the stand by option - because when you're a doctor, I imagine it's very annoying to have former patients come up to you in a public railway station screaming "WHY DID YOU LEAVE ME? WAS MY HEAD TUMOUR NOT INTERESTING ENOUGH FOR YOU?" and wailing and gnashing their teeth. Also, he looked somewhat stressed and was doing that peculiar leg-hopping thing that means somebody's either running late or desperate for the loo.

Unfortunately, when I said that this was an epically long queue, I was exaggerating only inasmuch as the fact that, although it was extremely long, no-one had actually written a poem about it. To my knowledge. After a few minutes of trotting through a winding s-shaped queue, I think Dr --- may have recognised me, but by then the English Acknowledgement Horizon had passed and, having not acknowledged one another before then, it was officially too late to do so. Because I am English (well, English-ish). And those are the rules we live by.

So it was a somewhat awkward queueing experience.
If only I had defused it by means of the awkward turtle.

Inicdentally, I feel like what I had intended to be a short, short post about a very brief and really-not-that-exciting occurrence has turned into an alarmingly long and overinvolved essay. I promise, next time I will attempt to write about something more interesting.

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*N.B. that here that I use the term "crack team" in the sense of "expert professionals", not in the sense of "drug dealers".

**Or maybe it's just one guy with five masks. And a pair of fake boobs.

*** If you're interested, the half is for one guy whose nickname I remember, but not his actual name, which had about eight times as many syllables.