Con-sul-ta-tion

con·sul·ta·tion/ˌkänsəlˈtāSHən/

noun:

1.) The action or process of formally consulting or discussing

2.) A meeting with an expert or professional, such as a medical doctor, in order to seek advice

Did you know that a tonsillectomy entails removing one’s tonsils?

Shocking, yes?

This is what I learned yesterday from my pre-operative consultation.

The question I had asked after the nurse practitioner tried to speedily push me out the door in order to get to happy hour at a reasonable time was: So what is going to happen in the surgery?

“You’ll get your tonsils taken out,” she replied.

Um…knew that. Let me rephrase: How the fucking hell is it going to be done? Pliers? Hedge clippers? The Expelliarmus charm from Harry Potter?

“Oh…I don’t know. I’ve never witnessed a tonsillectomy before, but he’s a really good surgeon.”

Well then, I am filled with relief. He will be using the good-surgeon method as opposed to the shit-surgeon one. Phew! Big weight off my even bigger tonsils. Wait, I’m sorry, aren’t you leading my consultation about my tonsillectomy? Shouldn’t you have a basic understanding how such a surgery is performed? Can you at least tell me how long it will take?

“Oh…well, they’ll call you into a room. There’s paperwork to fill out. You’ll have anesthesia. I’m guessing…hmm…90 minutes?”

So is this guess being pulled directly out of your ass or thin air? The distinction is important to me for some reason because otherwise my brain will blow apart into little pieces. Maybe you would like to see that so you can tell future patients what that looks like.

“If that’s all…”

Hold up, hold up…um how long will it take to recover?

“A week.”

Okay, well I read on some blogs written by people who had this saying the first couple of days aren’t so bad, it’s really fifth–

“Tenth,” she interrupts. “Tenth day’s usually hard. You’ll be fine.”

You just said I would recover in a week. Although I feel completely insane, I’m pretty sure there are still only seven days in a week.

“Oh, you are right! Anyway, I don’t want to keep you. You’ll do great.”

Wait..wait…wait. I’m getting anesthesia so is there any time I should stop eating?

“Oh yeah. Yeah, that’s right. Don’t eat after midnight.”

Because I’ll turn into a Gremlin? This might have been something to have told me during our consultation not in this five-second frenzy of quick questioning as you stick one leg out the door.

Here was the consultation:

“You’ll need pain medication, but don’t worry, it’s liquid.”

“You can have milkshakes after the surgery. Vanilla not chocolate.”

“He’s a good surgeon.”

She did listen to my heart.

“Wow. It’s pitter-pattering like a little humming bird.”

No shit.

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62 comments

  1. Omg….if this wasn’t your health, I’d be laughing my ass off. I would have asked to see his Guatemalan diploma.

  2. I would usually not say something like this, BUT there are times when you might want to NOT spend too much time obsessing over the details of how a surgical procedure is done. There are times where it might be best to choose a well-known surgeon, with a good reputation, who spent a million years in med school, who has done the surgery you need a TON of times, and then just go with it. I think you’re right to worry about and realistically plan for the post-surgery part, but maybe best not to torture yourself too much with the procedure itself if you are truly committed to having it done.

    1. I agree wholeheartedly. The main issue I had with this non-consultation was she told me nothing about what to expect in recovery like what’s normal and what isn’t. I don’t want to be freaking out over every little thing only to learn “oh yeah, that’s completely normal.” I’m calling the surgeon next week to just get some idea about that facet.

      1. Hi,
        I totally agree and I’m sorry that you got such a crappy consult from the nurse. It’s BS, but everyone below has supported you there, and you sound like you are ready to go get that part dealt with. I would be and upset about that too. It’s really important to know about prep and recovery. Good luck! Will be waiting to hear what happens!

  3. I’m not a nurse practitioner (but I play one on tv) and I think I could have answered your questions better than she did. I am a nurse, though. Seriously, I think your surgeon needs to know that this person is not doing a very good job of answering patient’s pre-op questions or preparing them for the “event”. What if she forgot to tell someone not to eat or drink after midnight, so they ate breakfast then they vomited during the procedure, aspirated stomach contents into their lungs, and died? The doc is charging you (or your insurance company) full price for a consultation, and using a half-assed nurse practitioner to save money. I love nursing, as a profession, and usually stand up for colleagues, but as my recent surgery proved, there are bad practitioners in every profession. From the nurse anesthestist student who botched my intubation to the genius who told me I “wasn’t trying” when I told her I couldn’t breathe – there were plenty of examples of bad practice to see.

    Before my surgery, my surgeon sat down with me himself, drew pictures of what he was going to do on the back of his business card, and told me to call day or night with any questions. I loved him, but hope I never see him again. Or those nurses.

    I am not sure you should watch a video of the procedure – I’m not sure what your tolerance for blood and gore is, and frankly, some of it you may not want to know. If you want, I’ll look through some of my textbooks and find some information for you. Let me know.

    1. Thank you. May I first say “I love you” because I do after this comment.

      I’m less interested in the surgery and more interested in how to best get through the recovery. I’m calling the doctor on Monday and saying I need this info or I’m postponing till I get it.

      1. Excellent. And I do hope you say something about the nurse practitioner. Ask for a copy of the discharge instructions so you can be prepared. I don’t know why they don’t give that information out before the surgery so you can have any supplies you need on hand. When is the surgery scheduled? I remember my mom had her tonsils out when I was about 6 or 7. All I remember is my stepdad burning dinner every night for a week. Get a supply of take out menus for the family!!!

    2. In all seriousness, I agree. The surgeon would want to know if his/her patients were not getting adequate pre-op information. Or at least I would hope he/she would, since the surgeon is the one ultimately responsible for the patient’s outcome. Telling a pre-op patient about eating and drinking dont’s, what to expect before and after the procedure, etc. are very important details. No one having surgery should have to walk out the door without having all of their questions answered beforehand. As someone in the medical field, I often feel the need to issue a mass apology to all who have to endure these unprofessional encounters.

      There. Now that I’ve done my preaching and have gotten the serious out of the way, let me say that “The Expelliarmus charm from Harry Potter?” as a tonsil removing technique is brilliant. But then again, your writing always is. :)

      1. Thanks. It feels nice knowing that I wasn’t completely out of my mind feeling bewildered by the experience. I’ve never had a pre-op before so I didn’t know what to expect, but I knew this one didn’t feel quite right.

  4. I can see why you might be feeling a little uneasy. Those doctors are always in such a rush it seems. I hope all goes well. My only advice is to take the pain meds if you need them. The milkshake part sounds good though.

    1. I was the last appointment on Friday. If she could have fit her coat over her white jacket, she would have. I think she would have also agreed to the consultation out in the parking lot or the local pub.

      1. My doctor is typically brief with me, too. Luckily, I don’t have to see him often. Otherwise, I’d want a new one! Best of luck with your surgery.

  5. See, when I’ve lived in countries with socialized medicine, I sort of expect this treatment. I think they expect you to have google and use it because ,damnit, they’re on a tight budget. But not in America. I mean…they do realize you’re paying for them to put you through pain right? They could at least be polite and professional…
    …otherwise, what’s the incentive?

      1. Ha,ha,ha. I don’t know if I’d call it the best. The customer service aspect of it is just much better. They at least pretend to be nicer and care more (usually) because they know you can go somewhere else.

  6. Holy bejeebus. I am not sure you’re supposed to walk out of the consultation feeling less informed. I guess she at least knew where your heart was? That’s a good sign, right? Fuck. No. No words for that.

    1. Holy bejeebus is right. She did tell me I insert the medicine into my mouth so that was helpful. Otherwise I would have been dripping that stuff directly into my eyeball.

  7. I work in the operating room of a children’s hospital and can tell you that the kiddos are offered popsicles after the procedure. Some surgeon’s give a local anesthetic after the patient has fallen asleep, to ease the pain once the surgery is complete and the patient is in recovery. The care you receive during the procedure better be a heck of a lot better than the so-called care you got during the consultation. Best of luck to you! xoxo

  8. When I had knee surgery a couple years ago, my surgeon described what would happen during surgery in detail (partly because I got to choose between three different operations) and gave me a 20-ish-page handout about the recovery process, broken down week-by-week. I also got the prescriptions for my post-op drugs in advance, so I wouldn’t have to worry about filling them right after the operation.

    On the other hand, I’m jealous — if milkshakes had been an option when I had my tonsils out, I would have avoided my cherry vanilla ice cream trauma.

    1. Yes. That sounds like the thing that was suppose to happen. My last doctor visit, I had a stack of paper detailing how to clean out ear wax. This time? Nada. I mean it’s just open sores in my throat affecting how I eat, sleep, breathe, etc. It’s nothing like ear wax.

  9. That is a shameful consultation. When we went for my son’s re-op consult we were given a whole list of things that could go wrong and then they shoved the consent form in front of yes. Okay, so he could get an infection, have severe bleeding in which case he would need another surgery, the tonsils might grow back, as with all anaesthesia there are millions of risks, not excluding death. Perhaps having a kid who contracts tonsillitis every two weeks isn’t so bad … the fever, the vomiting, the refusal to take mediations, forcing medicine down him, projectile regurgitation of said medicine, forcing more of the vile potion down him, going back to the doctor to get more of the sticky orange liquid because he spilled it all, cleaning up vomit, backed up laundry full of bedsheets and pyjamas. You know what – give me that consent form … I’ll sign it … I’ll sign anything … now would you like that signature in blood??
    One year later …the kid is fine, no tonsillitis, no fever, no vomit, no missed school, no scars, no trauma. Can’t say the same for myself though.
    Shitty pre-op consultations aside and possible horrible recovery period, it’s a decision you won’t regret.

    1. That’s what makes this so frustrating…I hate my tonsils with the intensity of 1,000 suns. If they don’t come out on Friday, I might take them out myself with pliers (I think that’s how it’s done. I didn’t learn much at my consultation). So this has to be done. I just wish the consult went like it was suppose to.

  10. Holy mother of pearl. Did that broad get her Nurse Practitioner license from a Cracker Jack box? Unbelievable. Once again, this is why I became a patient advocate, because too many people have expereinces like this. She obviously is not capable of making sure a patient is prepared for a surgical procedure. Not telling you about when to stop eating, etc, is pretty negligent. But on the plus side, you’re getting the GOOD surgeon! Thank God when they drew straws for your procedure, you didn’t get the guy who just got his degree and still refers to the instruction manual during operations.

    1. I think she might have gotten her degree from a pennysaver. But hey, you know, it was Friday afternoon, time to relax and get the weekend rockin’–can you really expect her to be bothered with explaining a surgery that could possibly lead to my death?

  11. Oh dear. Where i am, it seems like our pre-op nurses are on their last stop before the glue factory….maybe this is more common than i thought!?

  12. I recommend not doing the surgery until you can personally witness it being done to this witless asshole of a practitioner.

    Like others have said, the doctor needs to know how she. The NP’s behavior is completely unacceptable and she should be looking for a different line of work. She isn’t not telling you about the possibility of rain in the afternoon — she’s not telling you vital information on a “routine” operation. This is important stuff. What does she do with folks who aren’t as comfortable forcing her to try to answer questions?

    Like others, I’ve had at last count 10 surgeries. The surgeon has described each and every one of them and answered all my questions. That goes with the territory.

    When you speak with your doctor, ask him:
    (1) why didn’t you explain to me what is involved?
    (2) what is the pre-op procedure;
    (3) what sort of clothes you should wear (I always go with sweat pants as even under the influence I can figure out how to put them on);
    (4) normal signs and symptoms;
    (5) potential side effects from the anesthesia and pain meds;
    (6) when to be concerned.

    Then ask him why he hired/doesn’t fire a nurse-practitioner who can’t explain a surgery like this. And if you don’t like his answer, find a different doctor.

    Do not be nice. And when you’re funny, make sure there are daggers involved.

    Also, let us know the date of the surgery. We can send good karma your way (it worked wonders for Baby Sophia!)

    1. *standing ovation*
      I know you’re in DC, but if there’s any chance you can come to my hometown tomorrow and accompany me to the doctors, please let me know.

      1. Got “Face time” on your cell phone? I’m sure the doctor wouldn’t mind you bringing somebody along to help you bitch. (That said, do bring someone if at all possible. Somebody not easily intimidated.)

        Also, print out this post and all of the comments. And write down your questions ahead of time. Do not leave until you have satisfactory answers, and write them down. The doctor has likely kept you waiting. Others can too.

        Better yet, ask those questions as if it is your son’s surgery — because we are all mama bears for our kids, not so much for ourselves.

        Good luck! And remember, THEY WORK FOR YOU. But only if their answers are satisfactory.

      2. Oh, I forgot one more question to ask:

        What have I forgotten to ask? (That makes them pay attention to what you’ve already asked, and what they answered.)

        Sorry to have hijacked the discussion!

  13. Although I believe in this case, that the important thing is that the surgeon is of sound mind, qualified and skilled, I also believe the practitioner should be reported. Perhaps it was not her fault and was as uncomfortable about it as you were. I think often they are thrust into these things unprepared because the people who should be doing it are “too busy” or “don’t have time”. It may not have been their fault but who ever is responsible should be called out.

    1. I’m calling tomorrow. He is known as the tonsil surgeon in this area so I’m not worried on that front. I just don’t want to be calling the office daily after the surgery because I don’t understand what is happening to me.

      1. You have to go into the surgery feeling confident and comfortable. I hope the phone call works out better than your consult did.

  14. All I remember is asking for said tonsils (I woke to find them in a jar) and all the ice cream I wanted. Of course, the doctor was a cousin and it was 1965, still, I remember the procedure.

    I hope this has helped alleviate your fears.

    PS My mom wouldn’t let me keep the tonsils, damn her.

  15. My advice? Buy a book on witchcraft, and perform the spell yourself. You’ll save a lot in both co-pays and hassles. Plus, maybe you could find a good spell to use on the NP…

    Nah, K8’s advice was dead on though. Good luck.

  16. Since I,m a doctor (no I’m not) I would advise not trying to drive for at least 5 minutes after waking up from the sleepy drugs. Also, avoid any porn auditions. Reschedule until next month, just to be safe.
    When I got the damn things out, I think I lived on meal replacement shakes and popsicles for two weeks. The popsicles can reach far enough back that you can rub them on your gaping wounds. I had mine out by laser (not grapefruit spoon). They neglected to tell me that during the healing process there might be some discolouration. I nearly fainted five days later when I looked into my throat, and it was white. White? Yeah, like when your scabs get really wet while swimming… You’ll be swallowing scabs. It’s kind of badass.
    Have a great day!

    1. Thank you for this. I had a porn audition scheduled the next day. How embarrassing would that have been?

      I will not be looking in my mouth or eating anything for the foreseeable future. But on the plus side, I’ll be super slim. . . and possibly dead.

  17. Hey, she should work for my insurance company. Hell, she’d be employee of the month every month just like Spongebob is at the Krusty Krab.

  18. This is one of many reasons why I envy your anonymity. The freedom to light up people’s shit on a blog.

    Can we have a farewell party for your tonsils? I mean, I don’t know them that well since I’ve only really met them online. But they seem like extremely nice tonsils.

  19. Don’t you love it when doctors are so helpful? There is a free clinic for city employees I used to go to, but the NPs there freaked me out. They’d bring their computers in everytime and punch buttons and look at me and punch more buttons. One guy said, “Wow, you’re complicated” after looking at my chart. Yeah, I have allergies so I’ve gotten sick a lot. But hey, that’s kind of your freaking job, dumbass. Also, sometimes doctors will say, “What’s wrong with you?” Uh, again, your job, moron. Yeah, I stopped going there. Better to pay.

    Good luck on the tonsil surgery. Eat ice cream. Try not to think of E.L. James. Eat a popsickle. Wait, she ruined those too. Eat them anyway.

  20. I agree completely with Elyse.
    If you have any issues or concerns or questions at all, keep asking them, in tones that show less and less patience.
    I’ve had to deal with way too many medical folks lately, and I’ve found that explaining to them in a clear loud voice that they need to answer the questions and any others, and then not letting them blow me off is surprisingly effective.
    Stick to your guns, and if you get pezhead nurse again, ask her questions like she’s a two year old.
    And then smack her in the back of the head.

  21. No chocolate milkshakes, only vanilla? WTF?? I would back out right there if I were you:)

    In all seriousness, that did not sound like a consultation at all. How could she not know how the procedure is done???

  22. Why do supposed medical professionals often don’t look like they know what they’re doing? Wouldn’t you think that in medical/nursing school, they’d have at least one course on faking it?
    Before my surgery, a nurse called me to ask what procedure I was having done.
    *facepalm*

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