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I WAS spayed a few weeks ago. They called it a total abdominal hysterectomy, but it's more or less a spay.
Now, I've done hundreds of spays in my nearly 20 years of veterinary practice, so I couldn't help a little reflection and comparison.
I met the surgeon once before the day, after I had spent two hours in the waiting room. He seemed calm, considered and I trusted that he was good with a scalpel because he had been highly recommended by human surgical colleagues. I had a preoperative assessment; I was weighed, measured, had an ECG, chest x-ray and bloods taken. Ten days later, I arrived at the hospital at 7:30 am, and eventually went to theatre at 4:30 pm.
I was asked on three separate occasions before going to theatre to openly declare which body parts I had consented to have removed, and on five occasions whether I had any loose teeth or false limbs. I saw the surgeon briefly; he smiled and simply asked if I was ready.
I met the anaesthetist, who had a lovely bedside manner but no stethoscope; in fact she did not examine me at all. She asked if I would rather have an epidural or patient-controlled analgesia (morphine).
In the pre-med room, she talked to her assistant about whose turn it was to place a catheter, and said she should have let her do this one. I felt invisible. Then a woman in scrubs walked in and asked me to declare what body parts I had consented to have removed (again); she explained she was a surgeon, or perhaps The surgeon. She mumbled so I wasn't sure. I panicked but remained mute. I didn't see the surgeon I had thought was doing the surgery, who I had researched and who I trusted … perhaps he had gone home; it was, after all, almost 5 pm.
I felt suddenly alone. I was being brave but had lost control. I craved a moment of reassurance.
The staff around me were still talking about catheters.
Then a syringe appeared with what I can only assume from its effect contained fentanyl, rapidly chased with propofol …
Recovery from the anaesthetic was smooth, but the pain was instant and immense for 12 hours. Someone put my hand on a buzzer and told me to press it if I needed morphine. I rapidly became addicted to the golden ‘ping’ and mechanical whirr that meant the analgesia was being delivered after countless failed requests. I'm sure my thumbprint is embedded on that buzzer, but boy oh boy did it work. Inexplicably, I craved the sound of waves in those first groggy hours, and hearing the ebb and flow really did help … unless it was the morphine.
I swiftly recognised that the surgeon had done a great job: a neat wound, no swelling, no bruising, no bleeding, and the pain quickly became manageable. When I met him the following morning, he knew too much graphic detail about my viscera to have not been there. I felt reassured.
In the days that followed, I was so grateful for every bit of care and compassion. When they left my breakfast out of reach, I went without. I needed two people to help me get up. Forty-eight hours before my surgery, I was representing my country at an international sporting event; now walking 10 steps was a challenge. Four weeks later, I'm still mostly in bed but steadily improving, when I was sure I'd be almost back to normal by now. Hats off to our patients who walk out of their cages the same day and seem back to normal at a three-day check.
So, finances (and other obvious differences) aside, what has being spayed myself taught me about spaying in veterinary practice?
To do a top notch job in both, your clients and their pets need:
Analgesia, analgesia, analgesia
Nursing in the hospital and TLC at home
Continuity of care
Information; on the procedure, on the medication, on the aftercare
Trust. Once earned, treasure it.
On reflection, I feel that I have provided all of the above, but I know that my experience on the other side of the fence has bought their importance into sharp focus, particularly of hand and paw holding. Now, when I say to my client, ‘I'll be taking care of her today’, I know it will be the very best care I can give to them both – just as soon as I can spay again.
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