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1. What is an anaesthesiologist?
An anaesthesiologist is a qualified medical doctor. After having qualified, he can further qualify himself as a specialist in any field of his choice. Anaesthesiologists are doctors who qualified in anaesthesia, intensive care and pain management. The standard of training in South Africa is very high. 2. What does "informed consent" mean? This means that you are informed about options regarding treatment, general and more serious risks involved in the treatment, as well as pro's and cons and the result of being treated or not. You should also be given the opportunity to ask questions. Written consent is usually required, except in extreme emergencies. 3. What should my anaesthesiologist know? It is important to answer all questions honestly and truthfully. These questions are related to your health and any medical condition that may pose a risk. You will be asked questions about your next of kin's medical history, medication, smoking habits, drug habits, previous anaesthetics etc. 4. Why is a pre-operative examination necessary? The effect of anaesthetic drugs is influenced by numerous factors. Age of patient, weight, pregnancy, race, alcohol consumption, tobacco, medication, drugs, kidney- and liver diseases are but a few examples. In some instances certain anaesthetic drugs should not be administered at all. Some medical conditions increase the risk of anaesthesia, e.g. heart diseases. Although seldomly experienced, Malignant Hyperthermia is one example where anaesthesia can be fatal if not administered correctly. Anaesthesia and surgery can affect all the systems of the body, therefore it is vitally important that the anaesthesiologist should be informed of all medical conditions you may have. This will enable him to use the most effective method 5. Should I inform my anaesthesiologist if I am taking any herbal/ natural medication? Some of these products are very potent and can be dangerous, especially if the anaesthesiologist is unaware that you are taking them. Some herbal medication prolongs the effect of anaesthetics while others may tend to cause bleeding or induce palpitations and high blood pressure. The use of herbal medication should ideally be stopped 2 weeks pre-operatively. If this is not possible, the product should be taken to hospital in its original packing so that the anaesthesiologist can familiarize himself with the contents of the product. 6. Do I have to inform the anaesthesiologist about smoking and alcohol consumption? Tabacco and alcohol sometimes affect the body more than medication. Due to their effect on organs such as the heart, lungs, liver and blood, they have an influence on the way anaesthetics work. This is especially important with regard to "street drugs" e.g. marijuana, cocaine, amphetamine, heroin etc. Patients are sometimes embarrassed to reveal this information, but it is worth while to remember that all information is strictly confidential. It is important for the anaesthesiologist to be well informed. 7. Do I have to stop smoking before my operation? Tabacco has an influence on your heart, lungs, blood and other aspects of the body. You should stop smoking 6 weeks prior to your operation. If not possible, stop the moment you are scheduled for the operation. 8. Why am I not allowed to eat or drink before my operation? Aspiration is the inhaling of foodparticles into the lungs and can be extremely dangerous. The body has an effective mechanism to prevent this, but when you are unconscious, this mechanism is also "unconscious". It is therefore important for the stomach to be empty when you are receiving anaesthetics. In cases of emergencies where the patient has been eating and/or drinking less than 6 hours previously, the anaesthesiologist will take special precautionary measures to minimize the risk of aspiration. This rule of no eating and drinking 6 hours prior to anaesthesia, should also be applied when regional anaesthesia is administered because the possibility that general anaesthesia might become necessary can not be ruled out. It is also not advisable to chew gum or suck sweets, as these enhance the acid secretion in the stomach. 9. Will I need a blood transfusion? There are many factors determining the need of a blood transfusion. The most important is the type of operation you will be undergoing and the condition of your own blood prior to the operation. During some procedures the loss of blood is unavoidable, regardless the skills of the surgeon. Most blood transfusions are given directly after or just before an operation. All fluids given in the operating theatre are administered by the anaesthesiologist. Blood is only given when the risk of not giving blood exceeds the risk of giving it. Anaesthesiologists are specialists in the field of making these decisions. 10. What are the most common side-effects of anaesthesia? Sore throat: This is due to the breathing tube in your throat during anaesthesia. At least 95% of all patients have some or other tube in the throat during anaesthesia. This causes friction during breathing, hence the sore throat. Please note - nothing went wrong with the anaesthesia. Pain: This is due to the surgical procedure. Most anaesthesiologists administer pain medication during the procedure. He will also prescribe medication post-operative. Please ask - it is unnecessary to suffer pain. Nausea and vomiting: There are various reasons for this e.g. the type of operation, your pre-operative condition, the use of pain killers as well as the use of anaesthetics. Some anaesthesiologists will administer "anti-nausea" medication during the procedure, but medication will also be prescribed post-operatively. Drowsiness after the procedure: Some patients are very sensitive to anaesthetics. Everybody reacts differently - some people need more than others. Longer procedures also influence the post-operative recovery. Less serious side-effects may include: Dry mouth or temporary breathing problems. Itchiness, bruising or pain at the spot of injection. Rash due to plasters or medication. Sore neck, sore or dry eyes. Pain in arms or legs due to the positioning during the operation. You may also feel cold and shaky. These side-effects usually do not last long and do not need any treatment. 11. What are the complications of anaesthesia? The less serious complications have already been discussed. More serious complications are not necessarily due to the anaesthesia, but a combination of various factors. These include: serious allergic reactions, heart attacks, massive blood loss, thrombosis, pulmonary embolism, stroke, serious asthma attacks and other cardio-pulmonary problems. These complications are very rare and your anaesthesiologist is well qualified to deal with any such complication. 12. What happens if I am allergic to anaesthetics? Some people may think that they "are allergic to anaesthetics" because of previous unpleasant experiences such as nausea and vomiting. These are side-effects and not allergies. True allergies include swelling of the mouth, throat or eyes, breathing problems, hives and wheals, and sometimes a drop in blood pressure. It is possible for a patient to show allergic reactions to some drugs, although it seldom happens. If it does happen, it is seldom permanent, because anaesthesiologists are specialists who will notice these reactions immediately and act fast to prevent any permanent damage. Allergy to latex is an increasing phenomenon, but seldom serious. If you suspect such an allergy you should inform your surgeon and anaesthesiologist in order to avoid rubber products being used. If any allergies occur, you will be tested after the operation so that those products can be avoided in future. You may have to wear a "medic-alert" bracelet. Allergic reactions to one type of anaesthetic does not mean that you will not be able to receive anaesthetics in future. 13. My child and anaesthetics: How can I help? The anaesthesiologist and surgeon will do their utmost to keep your child happy during his stay at hospital. You as the parent can also help. It is important to prepare the child as soon as it has been decided that an operation is necessary. Children deal with surgery and anaesthetics better if they are well prepared. The keyword is honesty. Explain to him that he will be in a strange evironment, but that there will be friendly people to look after him. Children should know that they are going to get an operation and that they might feel a bit uncomfortable afterwards. Prepare them for the fact that you will not be with them constantly, but that you will be close by. Talk to them light heartedly about the hospital, the long passages, the hospital beds and the possibility of other children in the ward. A calm parent leads to a calm child. How long must my child fast before the operation? As a general rule children should not eat any solid food or milk 6 hours prior to the operation. Clear liquids may be given up to 3 hours before the procedure. 14. What about my account? PAYMENT: MEDICAL ACCOUNTS ARE CHANGING INFORMATION FOR PATIENTS From 2004 there is no recommended or fixed tariff for medical services. To comply with the law of the country, there is no medical aid rate or "contracted in" fee, neither is there a " contracted out" or SA Medical Association rate. This means that doctors would be allowed to charge whatever professional fee they can justify. Every medical scheme, on the other hand, will determine the level of benefits they are prepared to pay. There is a so called " National Reference Price list" compiled by associates of the Department of Health. This is a reference list only and no doctor or medical aid is under obligation to comply with this. We have been advised by the SA Medical Association that accounts rendered according to this list, do not compensate doctors adequately. This means that patients are responsible for paying their own accounts or at least expect an extra payment over and above the amount that the medical aid may agree to pay. Rates and perceptions are changing rapidly and this is and attempt to keep you informed. What has not changed is our commitment to render a quality health care service. Please discuss your concerns with us. 15.When can I resume my normal activities? Normally this depends on the type of surgery you had and you will be guided by your surgeon. Anaesthetics are usually out of the system within a few hours, but it is not advisable to drive a motor car or to sign any legal documents for at least 24 hours after anaesthetics. If you have any questions other than these, consult your surgeon or anaesthesiologist. |