Are you aware of the risks before, during, and after surgery or receiving an anesthetic? Everyone has risks. Health, lifestyle, or habits may increase these risks and everyone is not a candidate for this type of procedure. T

"Black Jack" to Prevent a Surgery Setback

A guide to achieving wellness before, during, and after a surgical experience!By Stacey Alexis Karseras

AuthorHouse

Copyright © 2012 Stacey Alexis Karseras LPN
All right reserved.
ISBN: 978-1-4685-9523-9

Contents

Introduction.............................................ix1. Advance Directives....................................12. Consent Forms.........................................23. Necessary Versus Elective Surgery.....................34. Medical History.......................................45. Surgical History......................................56. Anesthetics...........................................67. Risks of Anesthetics..................................78. Anesthetic History....................................89. Immune System.........................................910. Infection............................................1011. Physical Fitness.....................................1112. Scar Tissue and Adhesions............................1313. Wound Dehiscence.....................................1414. Incisional Hernia....................................1515. Multiple Surgeries...................................1616. Physicians...........................................1717. Preoperative Instructions............................1818. Postoperative Instructions...........................1919. Patient Responsibility...............................2020. Anatomy of the Female and Male.......................21About the Author.........................................23

Chapter One

Advance Directives

Advance directives include many types of legal documentation regarding health and financial decisions.

A living will (LW) is enforced if an individual is unable to make medical decisions.

A health care surrogate (HCS) appoints another person to make health care decisions on someone else's behalf.

A power of attorney (POA) appoints another person to make legal decisions on someone else's behalf.

A do not resuscitate (DNR) states an individual's wishes regarding life saving measures in case of an emergency.

Chapter Two

Consent Forms

Have you ever wondered why the use of small print is so common, especially on legal documents? This information is usually the most important and is often overlooked. It usually takes a few more minutes to read and may be difficult to understand but might include details a salesman hopes a customer will just skim over. These documents can be used in a court of law, so the time to ask questions is before signing. It is everyone's right to understand any document prior to signing it, so take the time to read each document thoroughly before signing.

No question is a stupid question!

Before any procedure, you may have several interviews with medical personnel to see how good of a candidate you are for the procedure in question. Each patient should read over the information thoroughly before scheduling a procedure and ask plenty of questions about anything unclear.

Chapter Three

Necessary Versus Elective Surgery

If you have an accident or medical emergency, surgery may be the only option that will allow you to maintain your quality of life. You may not have time to make the decision on your own or to seek a second opinion. A medical professional's goal is to preserve a patient's quality of life unless otherwise instructed by an advanced directive. If you are considering a surgery that is not a medical emergency but may increase your quality of life, then you should consider the risks before scheduling the procedure, meet with the surgeon, and ask questions regarding pre-op, surgery, post-op, and your individual prognosis. A surgeon may have reservations or refuse to perform surgery on someone because of a person's lifestyle or habits, for example, if the patient uses nicotine, alcohol, or recreational drugs.

Chapter Four

Medical History

A patient's medical history tells a story or paints a picture for a healthcare professional. Many patients are uneducated in regard to their own health, but this information is very important and may determine the prognosis before a procedure is ever performed. Undisclosed information may place a patient at an increased risk for complications. Anytime you have an acute (onetime) or chronic (occurring more than once) illness, it becomes part of your medical history. Sometimes, a procedure is cancelled on the day it is scheduled because a patient forgot to mention pertinent information during the preoperative process, such as substance abuse. I've learned that the majority of cardiac patients are unaware that high blood pressure (the silent killer) and elevated cholesterol levels are both heart problems.

An anesthesiologist reviews a patient's medical history prior to the date of service to enable proper facility placement, prevention, and preparation appropriate for each case.

A physician can prescribe medication for a particular condition, but if the patient does not take the medicine or change his or her current lifestyle, the condition is usually still present and most of the time unmanaged. Medication is not a cure to a problem and may even create more problems or secondary conditions resulting from risks for allergies, adverse reactions, and side effects. The more information a patient is able to divulge, the better the chance medical personnel have to provide appropriate care.

Chapter Five

Surgical History

After a patient has an invasive procedure, it becomes part of the patient's medical history. If someone is experiencing a health problem and decides to seek a physician's recommendation for treatment, the least invasive action is usually initiated before surgery is performed. This may include changes in lifestyle, habits, rehabilitation, or pain management. Anyone with uncontrolled health problems increases his risks with surgery. Many surgeons will not perform surgery if the patient does not comply with preoperative instructions prior to scheduling a procedure or if that person's lifestyle or habits, such as nicotine, alcohol, and drug abuse, cause risks for additional complications that are too high. A surgeon always seeks a positive outcome or prognosis, and most do not like to see their patients experience complications or to perform multiple surgeries made necessary by complications. It is important to always check if the physician is board certified for the procedure in question. In many circumstances a person's history may cause a surgeon to hesitate before scheduling the procedure, and the surgeon will make the final decision to treat or perform it.

Chapter Six

Anesthetics

An anesthetic is an agent used for numbing. The route an anesthetic is administered can vary. Several factors are used to determine the best route for each patient, such as age, medical history, the type or length of surgery, and bleeding risk. An anesthesiologist treats each patient individually. A positive outcome with the fewest complications is the primary goal of every procedure. The anesthesiologist will decide the best route and will provide instructions to decrease complications before and after administering the anesthetic. Three types of administration are local, regional, and general. Local and regional anesthetics leave the patient conscious during sedation. General anesthetics may be used with procedures that have an increased risk for bleeding, but a person's medical history may be the deciding factor because of the additional risk for complications. Medicine is sometimes given in doses computed by a patient's weight. Body fat percentage may alter a person's metabolism and the amount of anesthetic given.

The best prevention for preparation is to alert medical personnel if you or any of your blood relatives have ever had a reaction of any type from an anesthetic.

CH7[ Risks of Anesthetics

Anyone who receives an anesthetic is at risk for complications. Reactions may include allergic or other adverse side effects. A patient who has received an anesthetic before is not immune to these risks, and even the healthiest people are at risk for complications. A few allergic reactions are hives, itching, and anaphylaxis (swelling of the tongue and throat). Common side effects are nausea, vomiting, headache, crying, anxiety, and anger. Other complications are early awakening, delayed awakening, unstable vital signs, decreased oxygen saturation levels, malignant hyperthermia (high temperature), and cardiac arrest. A patient with multiple health problems has an increased risk if the medical problems are not managed with lifestyle or medication or if the patient has secondary conditions from medication. A patient with this type of history may require surgery to be scheduled at a hospital in case of complications, because additional support systems are already in place. A person's lifestyle and habits will also increase the risk for complications, especially nicotine, alcohol, and drug abuse. Prevention is the key to reducing such risks, and disclosing this information prior to surgery is very important in order to maintain quality of life before, during, and after surgery. ]CH7

CH8[ Anesthetic History

Prior to a procedure, a patient will be interviewed by a series of medical personnel to answer questions regarding that person's health history, lifestyle, and habits. Every time an anesthetic is received, the same risks apply and can reoccur, so any information disclosed during the preoperative process will educate personnel how to provide proper prevention and preparation necessary to decrease the risks. If medical professionals are aware of health problems prior to scheduling surgery, then facility placement, prevention and preparation can be initiated. Problems for them to be aware of include any personal or family history of any symptoms during and after receiving an anesthetic. ]CH8

CH9[ Immune System

The immune system is our defense against illness and diseases that include cancer. Several factors can compromise this system. Lifestyle, health, and habits can predispose a person for resistance to the common cold or flu. Both are viral infections. The length of time a person may have symptoms varies and depends on individual immunity, prevention, and treatment of symptoms. Consistent nourishment choices rich in nutrients and antioxidants, such as citrus fruit, berries, dark chocolate, vegetables, or shellfish, may improve immunity. Resistance training is another building block for better long-term health and will reduce inflammation and pain. "Black Jack" 21 and the (Advanced Version) are programs included in my books, "Black Jack" to lose fat and "Black Jack" to get your health back. Two full body resistance training programs, I recommend three times a week in the comfort of your own space. Both circuits can take as little as thirty minutes. ]CH9

CH10[ Infection

An infection can be local or systemic. A local infection can usually be seen. A fever may be present in either kind. Other symptoms may include pain, redness, drainage, odor, nausea, vomiting, chills, and lethargy. Infection can invade cells, tissues, bone, and blood, so it is very important to address symptoms immediately. Infection can start with the bacteria on the surface of the skin but can invade deeper tissue, organs, bone, and blood very fast. If the infection reaches the blood stream, septic shock and death can occur.

A person's lifestyle, habits, and history of antibiotic usage sometimes make it more difficult to kill certain bacteria. Fighting an infection that lasts for years may affect a person's quality of life and state of mind. 0

CH11[ Physical Fitness

Lack of mobility equals lack of motility. Sometimes as we get older, our level of activity changes. Even though fitness is an important factor to maintaining mobility, everyone is susceptible to injuries from repetitive movements, overuse, or weak muscles and bones. Several activities can place added pressure on the joints, muscles, and bones, such as jogging, running, and tennis. Consistent resistance training is the best type of exercise to increase lean muscle mass, produce vitamins and minerals naturally, improve calcium levels and bone strength, prevent or decrease fat, allow a person to be remain active and agile, and maintain muscle tone. A strong core (between the neck and waist) will support the body. Those who participate in any activity for recreation or sport can benefit from any resistance training program, such as "Black Jack" 21 and anyone over the age of four can resistance train with proper supervision, so the whole family can exercise together. (Always seek medical advice prior to beginning any fitness or nutrition program.) Allow the body to react to the changes that this type of exercise provides—especially the cardiovascular system, because it is the key to heart health and staying alive. High blood pressure (the silent killer), being the most common heart problem, is often overlooked. But resistance training helps to lower blood pressure, pain, cravings, and increase oxygen levels for more cardiovascular health benefits, and it helps to stabilize hormones, metabolism, and mood. These types of exercises will also lower blood sugar levels and provide a natural, good feeling that will keep you coming back for more. 1

CH12[ Scar Tissue and Adhesions

Our skin is the protective barrier between the elements and our internal organs. A break in this barrier can cause infection and other problems. Cuts, abrasions, and first-degree burns are superficial wounds and usually heal without difficulty or minor scarring. Breaks in the skin resulting from trauma, incisions, or surgery are deeper than the first layer of skin and involve underlying tissue that is more difficult to heal because of the lack of blood flow necessary for new tissue growth. The tissue is replaced with a protein called collagen. Scar tissue can adhere to internal organs and cause other complications, even additional surgeries. Scars appear differently on each patient, the result of many factors, including infection, other complications, ethnicity, and the tendency to develop keloid. Wound care will require treatments to promote healing. A person's lifestyle or habits can affect this process. Anytime the immune system is compromised, the risk for complications increases. Over time, further treatments and surgeries may be necessary, thus impairing a person's quality of life or state of mind. 2

CH13[ Wound Dehiscence

Wound dehiscence (splitting open) at the incision site is a risk that is present with most surgical procedures. The incision may open, exposing tissue and causing bleeding or hemorrhage. It can become very dangerous. Several factors increase the risk, such as a person's lifestyle and habits, placement of the sutures, and patient responsibility. Following the doctor's orders, wound care treatments and proper health will increase the chance for a more positive prognosis. If the sutures are placed in an area of high mobility, for example, the abdomen, elbow, or knee, then the chance for a wound to dehisce is greater, and immobility may be required to prevent this from occurring. This is usually caused by a patient trying to do too much too soon. Another cause is an obese patient putting additional pressure on the incision site. Proper nutrition, health, and lifestyle are required for the best outcome. Patients have a huge responsibility in terms of their prognosis. Surgical error is rarely the cause of most complications, but it does occur. 3

CH14[ Incisional Hernia

An incisional hernia occurs when an organ protrudes thru the incision line, for example, the intestines after an abdominal surgery. This is another risk, which may be caused by a patient's lifestyle or amount of mobility after the procedure. It is another complication that requires immediate attention because internal organs may be exposed and can cause necrosis. If any section of the intestine is without adequate blood supply, it can cause other complications, even death. 4

CH15[ Multiple Surgeries

Each time a person has surgery, risks are present. The risks can increase or decrease depending on the procedure and type or route of the anesthetic. One surgical procedure may require additional procedures because of complications. If ample time is available, educate yourself prior to any procedure regarding the possibility for risks, additional procedures arising from complications, lifestyle, patient responsibility, and whether you are a good candidate for the procedure. Surgery requires an anesthetic each time a procedure is performed, and anesthetics also have risks. Prior to a procedure, do your homework to check if you are a candidate for the procedure in question and what your prognosis may be as influenced by your lifestyle. 5

CH16[ Physicians

Medical personnel assist others to achieve or maintain a better quality of life. Communication between the medical staff and patient is critical for optimum care. If a patient withholds information that may allow better care—for example, about lifestyle and habits—then increased risks and complications may occur. Physicians may be able to diagnose and provide orders for treatment, but the patient must follow these orders to achieve the best possible prognosis. Patient responsibility is a very important piece to the healthcare puzzle, and if this is compromised, complications may occur, thereby reducing the quality of life. A physician can refuse to treat anyone if the patient's lifestyle is going to increase the risk for complications. Some patients represent a high risk for a surgeon. If the outcome will not satisfy the surgeon, and the risk outweighs the benefit, then the surgeon may not perform the procedure.

Preparation and preventative measures may be necessary to provide the best care possible.

The more information the surgeon knows about you the better. All medical information is confidential, unless you allow in writing the release of information to specified persons.

(Continues...) 6

Excerpted from "Black Jack" to Prevent a Surgery Setbackby Stacey Alexis Karseras Copyright © 2012 by Stacey Alexis Karseras LPN. Excerpted by permission of AuthorHouse. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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