New Surgery Protocol on the way. I wonder if it will be integrated into WLS.

[James Marusek 5,244]

Hospitals are starting to abandon the time-honored drill for surgery patients— including fasting, heavy IV fluids, powerful post-op narcotics and bed rest—amid growing evidence that the lack of nutrients, Fluid overload and drug side effects can do more harm than good.

http://www.wsj.com/articles/patients-bounce-back-faster-from-surgery-with-hospitals-new-protocol-1427739292

This new protocol is being used in colorectal surgery, procedures for hip fractures and joint replacements and surgeries for bladder, pancreas, liver and breast cancer.

[395Ron 396]

I hate sights that make you sign in to read the full story. This is what I finally found on a another sight:

Hospitals are beginning to turn to “enhanced recovery” protocols for surgical patients. Traditional surgical protocols, including fasting, heavy IV fluids, powerful narcotics after surgery, and bed rest can have several side effects that lead to a longer recovery time. Enhanced recovery protocols still require patients to fast, but they get a carbohydrate-loaded drink 3 hours before surgery and are given non-narcotic pain killers and epidurals before surgery, which are kept in place after the procedure. Patients only receive IV Fluid when needed. Soon after the procedure, patients are able to walk and ingest solid food. This new protocol has been used for several different types of procedures, including colorectal surgery, joint replacements, and hip fractures. Studies have found that the new protocol reduced the length of patients’ hospital stays and helped with postoperative pain control.

The only part I could understand not happening is this part: Soon after the procedure, patients are able to walk and ingest solid food. Walking yes but solid food no. I wonder how recovery would be different with "epidurals before surgery, which are kept in place after the procedure." Would that mean feeling no pain for a couple of days after surgery? Interesting for sure.

[Pinkgirl1234 761]

Just want ta healthy recovery...means you gotta get back on your feet ASAP!

:-)

[Tssiemer1 549]

I had an epidural nerve block thing for my rotator cuff surgery. The doctor said I should be well managed with Tylenol and ibuprofen after surgery. Everything was great until about 14 hours later when it all wore off and I was screaming in pain! Any time j moved my arm or head or shoulder it felt like I was ripping my arm out of its socket. It was awful. I had to call the doctor for prescription pain pills the next day.

[Dar200 285]

I think performing that type of surgery and not making pain medication available is just negligent and criminal.

[Dar200 285]

Controlling the pain is part of a faster recovery. If a patient is in acute pain, that patient is unable to get up and walk, do deep breathing, it just makes no sense to me. My 86 year old dad had hip surgery and had a weird reaction to the first medication they put him on. I asked her not to give him that, but to give him another pain medication I knew he tolerated well. She let the old med wear off, had him sit in a chair and walk a bit and I'm sure my face must've been some weird color when my sister walked in at that moment. Between the two daughters standing up to one irritating nurse, we had him on the other med and resting comfortably within 45 minutes. I do not understand where these new protocols come from. I throw my hands up.

[Dar200 285]

I left out. My dad was walking and sitting in the chair and Moaning Loudly while she still refused meds. To an 86 year old man. Who just had hip surgery. Who had not received an epidural. I'll stop now.

[samcl1 52]

Just remember. The nurse can only give a med ordered by the doc., I've been a nurse for 35 years. The trend is see is not a good one. Surgical pain is greatly undertreated. This comes from the doctors , trust me. Not the nurses, I have practically begged for pain meds for my patients

Most docs will give you "one dose" unless you stay on them. It's crazy. I still have a fantasy that I will be the post op nurse for one particular doctor.

[samcl1 52]

Oh, I do agree with your point Dar...it is cruel. People get better faster if the are medicated for pain so they can cough and deep breathe and walk. There are some older people that simply do not tolerate narcotics but you usually try another if one didnt. Then there are some older people that get really confused just by being in the hospital. So what?? Protect them during their confusion and medicate their pain. Their confusion will go away and while disturbing for family to see, is self limiting and harmless ( as long as they are protected from falling....or breaking their nurse's nose by wacking herewith the phone. But that's another story). I would rather have a patient with no memory of their post op experience than a poor tortured soul that gets no meds so he won't get confused.

[rking 484]

I have had an ACL reconstruction and a partial knee replacement. For both, I have had a nerve block, I think a femoral and sciatic block for both surgeries. They last about a day and are wonderful!!!!!! You are totally numb until it starts wearing off. With my first c section, I kept my epidural for 24 hours. I was partially numbed and it really did control the pain. I was walking in the mall that weekend. That was 21 years ago.