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Care Credit

The Biggest Secret of the Operating Room? It’s an Extremely Clean Place Full of Nerds

April 20, 2015

People seem to think that the operating room is this magical place shrouded in mystery and that surgeons are the masked wizards behind the curtain. Whether you’re preparing for your own surgery, or are just curious for some insider secrets, you’ve come to the right place. Here is a peek behind the curtain.

I’ve been working in the OR as a First Assist my entire career as a Physician Assistant. I’ve worked with many different surgical disciplines, and now have the privilege of doing gynecological surgery with the wonderful surgeons of Oakland Macomb.

These are questions and concerns I’ve heard from patients over the years.

1- “I’m worried I’m going to say something embarrassing while falling asleep”- People really don’t. Most people get very comfortable and relaxed, quiet and Zen as they come back into the OR and fall asleep. You will be surprised how quickly it will all feel to you. Even if your procedure takes a few hours, for you it will seem like mere minutes before you wake up and it’s all over. And usually people remember only a little bit about being wheeled into the operating room and then nothing again until they wake up, because of the anesthesia medications. In all my years, I’ve never heard anyone reveal any hidden family secrets (‘YOUR GRANDPA IS REALLY YOUR SISTER?!?!’) or safe combinations or anything. Sometimes people get a little silly and maybe start to sing, but we don’t judge, we usually join in.

2-“What will it be like in the OR while I am asleep? Will there be music? What do you talk about?” Some surgeons like some background music while they work. For the most part, the Oakland Macomb surgeons prefer to work in focused quiet. If you have a request or an aversion to any type of music, let us know. We certainly wouldn’t want you waking up with a Neil Diamond song stuck in your head for the rest of the year, unless you are a Diamond Head like some of our docs (ahem, you know who they are). We talk a lot about the task at hand, of course. Your doctor constantly evaluates the progress we’re making and considers the best tactics to accomplish the goals. We also are human and talk about what all humans talk about most of the time- food and movies. (DID YOU SEE THE NEW ‘STAR WARS’ TRAILER?? I KNOW, SO AWESOME, RIGHT?? AND HAVE YOU TRIED THE CRONUT YET??)

3-“Who will be in the operating room with me? How much is this like TV?”  It’s not like ‘Grey’s Anatomy’ or the other fictional surgical-themed tv shows. It’s much quieter, calmer, more systematic, and drama-free. Thankfully. There is no upper deck window with bleachers with a bunch of students watching or anything like that. We keep it just to the essential staff. You will have your doctor, the First Assist (me, usually), your nurse, your nurse anesthetist, the anesthesiologist, and a surgical scrub tech. We are your team, here to help you have a safe, efficient surgery. Also, I’ve never seen anyone have to de-activate a live bomb in the OR and I’ve yet to open a linens closet to find staff members getting too friendly on each other.  The only scandalous thing you might find a staff person doing in a closet is scarfing down a Snickers bar between cases on a busy day. (Because we’ve been talking about food all case and they’re starving).

4- “I’m worried about infection.” So are we! We are obsessed with it, in fact. You don’t even know how crazy we are with sterile technique- the manner in which we clean and maintain everything germ-free. We are all neurotically committed to keeping germs away. You would be amazed at the lengths we go to maintain a sterile, germ-free environment. That is one of the surgical scrub tech’s primary functions and they are extremely terrifying dedicated to maintaining a sterile field. (Seriously. Some of my favorite people are scrub techs, but they get downright mean when it comes to keeping a sterile field. They are heroes who we are all very, very afraid of).

5-“I’m going to be mostly naked and I’m worried that the doctor and OR staff will be looking at me.” We get that it takes a lot of trust to be this vulnerable and we are extremely respectful of your privacy. Also, I promise you, we are professionals who have been doing this for a long time and are, frankly, kind of numb to it. While you yourself are a unique flower, and we provide individualized care,  I can assure you that people’s bodies are way more alike than they are different. As I concluded when a colleague did a minor surgery on my very own body, “my parts are just like everyone else’s. She couldn’t pick mine out of a lineup afterwards.” 🙂

The only body parts we ever comment on or are impressed by are your internal organs. Does that sound weird? It probably is, but again, the variation in anatomy that is going to make our task easier or more difficult is what we’re most concerned about. It’s not unusual to hear, “those are great vessels! Look at the peristalses of that ureter- beautiful! That is one healthy looking liver! etc.” We’re anatomy nerds. Any areas of your body you are anxious about in your everyday life, I assure we haven’t given them a second thought. Unless you are especially proud of your broad ligaments? Then we’re probably fans as well.

6-“I’m worried that surgery will hurt.” Well, yes, there will be some pain. Consider what a paper cut feels like and extrapolate for what we are doing to accomplish your surgical goals. We haven’t found painless surgery yet, BUT we’ve come a whole lot closer. This is why when we’re able, we’ve moved away from large incisions to ‘minimally invasive’ surgery with small incisions and using a camera and narrow instruments, sometimes with the daVinci robot. Of course it depends what you’re having done and why, but most patients are pleasantly surprised how well they feel afterward and how quickly they recover. And we are very aggressive in pain management, and other postoperative symptom control.  Also, if you’ve ben dealing with miserable symptoms like heavy vaginal bleeding or pelvic pain, the temporary pain after surgery will seem like nothing compared to the relief you’ll feel over time.

Those are just a few insider tips. If you have any other general questions about life in the OR, please post here or message me. If you have specific questions about your care or surgical plans, please speak to your Oakland Macomb provider.

Be well!


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