*pre-op notes and other info needed*

[Guest guest]

Usually, the pre-operation tests are a blood test (the tube used should be a lavender topped tube), a urine analysis, and a chest x-ray. An EKG is done after the age of 40 in USA. A c-toma is usually an outpatient surgery. Most of the time, you can just go into the ear canal and capture the c-toma. Personally, I have only been cut behind the ear for my mastoidectomies and revisions of the mastoidectomies. The patient just has to avoid direct contact with water and rest. For the first days after surgery, maybe an ear plug for bath time. No swimming!!! If you cannot find ear plugs, coat one end of a cotton ball with petroleum jelly and stick it in your son's ear for bath time. It is a cheap but effective way to keep water out of the ear. To get the patient more alert after surgery, push fluids. The anesthesia stays with you until you can pass it through urine. If you know that you get nauseated after surgery or vomit afterwards, ask for nausea medicine to be administered during surgery. Works like a charm. If there is any blood after surgery (*very unlikely*), it should be extremely minimal. Keep the number of the doctor available in case of any emergency, but a c-toma operation is very simple and should not be anything to worry about. Now, if the patient is sick prior to the operation (cold, upper respiratory infection, bronchitis, fever) the operation should be put off until the person is 100% better for at least a week. General anesthesia means that you will have a tube in your throat during surgery (endotrachial intubation) and almost certainly will cause pneumonia if you are sick when surgery is done. Parents of child patients should make sure to have non-asprin fever reducers on hand in case of fever. Any patients, make sure that you have every question answered BEFORE surgery. Don't go in there with any doubts.

Edmondson

(678)622-6085

Re: C-toma surgery preps

My son's surgery is in a little over three weeks. We went to the

hospital today because they wanted the following tests before surgery:

1. Blood test

2. X-ray of heart/chest

3. heart test with electrodes

4. Urine test

We also met with the doctor again for basically a check up.

Do they do all these tests in America? They idea is to make sure my

son will be okay during the surgery.

I wanted to ask the doctor about having my son out of the hospital

early, but in the struggle to get my son to sit got flustered and

didn't ask. The place where we see the doctor is separated by a

curtain from the waiting patients, and there's a semi-office on one

side, and then two other doctors in the same room seeing patients.

The doctor does *not* wear rubber gloves nor did he noticeably clean

his hands between patients. Pretty much standard in Japan.

I've thought about returning to America at times and finding a

doctor, but I think that would take way too long. Plus we're 100%

insured in Japan (socialized medicine) and have no insurance in

America. I'm sure before surgery the doctor will wear sterilized

gloves and so on. I just can't imagine otherwise.

But other than that they are really, really slack when it comes to

spreading germs. All medical equipment is reusable. They drop it all

in a basket or bucket, wash it and sterilize it, then use it again.

The "cleaned" equipment is *never* wrapped but always sitting in the

open with all the crowded patients looking on and waiting for the

doctor.

At least the doctor we've got now is very careful about never reusing

already used equipment. Anything he touches he quickly threw in the

bucket. That's better than some other doctors I've seen ...

Afterwards I talked with the nurse about my son leaving the hospital

early. She did a double take, like she couldn't believe I was asking

about this. I told her from what I understood most people in America

are in and out of the hospital in one day for C-toma.

I asked her why the long hospital stay. She said that they like to

monitor the patient after the anesthesia to see if there are any side

effects. She then said, if the child goes back to their "normal"

environment they'll play around and perhaps hurt their healing wound.

She also said that in cases where people take their children home

soon, they get inundated with phone calls asking what to do and so

on. She said it's a bit daunting cleaning the wound everyday and

replacing bandages. Stuff like this.

Parents are notoriously lose when it comes to monitoring young

children's behavior in Japan, so there might be some merit to what

she is saying.

Anyway, she said it would be between me and the doctor. We will see

him one more time before the surgery.

By the way, I really appreciate the other stories I've read on this

list. It really helps reading about others' experiences.

Best,

Matt Dioguardi

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