Informed consent

On Thursday afternoon I got to see my surgeon again. This was essentially a last chance for me to ask any questions that I might have about my coming operation. But of course, there wasn’t much more to discuss. We planned all the things we were going to try, and the order we would try them over a year ago. We’re just executing the plan we made then. There are no other options left for me to try now, so it’s really just a case of turning up and getting on with it.

But it did give my surgeon an opportunity to get my consent for the operation. I’ve done lots of these; it’s a large A3 form, in carbon-copy triplicate, full of pro-forma small print, with some spaces where the surgeon details what he is planning to do to me, what the outcome will hopefully be, and what might go wrong. We both get to sign and date it.

The thing that gave me pause this time was the “what might go wrong” section, especially as my surgeon expanded on the written details to explain in more detail what he actually meant by some of the rather brief phrases. Of course, I know that the nature of informed consent is that he must tell me about all the possibilities, even when they’re very remote. But even so, it was sobering to see things like “Death”, “Nephrectomy” (removal of a kidney), “Haemorrhaging”, “Sepsis”, “Loss of sexual function”, “Loss of bladder control” actually written down on the form. For once I find myself rather wishing I didn’t know about any of that stuff – I’d prefer someone to just reassure me that it will all be OK.

Ah well. Too late now; you can’t take knowledge away. So we signed the form and talked about our kids. As you do.

Here we go again

I spent Thursday morning back in hospital for all my pre-admission checks. It all started with lots of questions about my previous medical history. This was rather amusing, as the nice nurse who was running the session had all my notes with her, but had obviously decided that it would be easier to ask me what I’d had done to me and when, rather than trying to tackle my folder, which is now some four or five inches thick.

It was a good plan. But I’m now at that stage where I can only remember the key events; the rest is a bit of a blur of procedures, anaesthetics, hospital visits and hospital stays. In the end we settled for me outlining the major items, and she agreed to look up any details that she needed later.

I aced the ECG test again, but was a bit depressed at how much weight I’ve put back on while I’ve been struggling with my current temporary ileostomy, and not able to exercise. It’s going to be a major personal goal to start getting that back off again while I am recovering from this operation, and then continue to improve my general level of fitness afterwards. Sadly, about 50% of colostomy patients end up with hernias, and I figure a good way to make sure I don’t end up part of that statistic is to build up a good level of general physical fitness.

As usual, they wanted a selection of samples from me; swabs from nose and groin to check for MSRA were easy, as was the urine sample. The three vials of blood I expected to be a real issue, but it turned out to be surprisingly easy; it seems that the veins in the crook of my elbow are still in good working order.

And with that, I am declared healthy enough to be operated on. I have to admit myself on Wednesday morning before 7am. I must not eat anything after midnight of the night before, and can only drink water from then until 6am, after which it’s nil by mouth until after the operation. I guess it’s one way to start the diet.