Speaking of Women's Health
The Speaking of Women's Health Podcast is excited to bring you credible women's health information from host and Executive Director, Dr. Holly L. Thacker. Dr. Thacker will interview guest clinicians discussing relevant women's health topics and the latest news and tips.
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Speaking of Women's Health
A Nurse's Insider Tips for Surgery Success
Nurse Samantha Graham joins Speaking of Women's Health Podcast Host Dr. Holly Thacker to share her expansive nursing knowledge and provide essential guidance on preparing for surgery and breastfeeding success. Sam offers both professional insights and personal experiences to help patients navigate important healthcare moments with confidence.
- Various nursing career pathways from nursing assistants to advanced practice nurses
- Flexibility of nursing careers for work-life balance
- Critical importance of following pre-operative instructions precisely
- Special considerations for patients on weight loss medications before surgery
- Why honesty about tobacco, alcohol use, and medications is crucial for surgical safety
- Pre-surgical preparation including bathing protocols and avoiding shaving\
- Importance of having support persons during hospital stays
- Differences between local and general anesthesia options
- Practical breastfeeding advice focused on baby's needs rather than social media expectations
- Realistic approach to breastfeeding challenges and support resources
Visit speakingofwomenshealth.com for additional resources on breastfeeding and preparing for surgery.
Fit, Healthy & Happy PodcastWelcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...
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Welcome to the Speaking of Women's Health podcast. I'm your host, dr Holly Thacker. Back in our sunflower house for a new podcast with a very special guest. I am so happy to welcome Nurse Samantha Graham. I met her almost it's been a decade ago. She was my lead nurse in our Center for Specialized Women's Health. I just love her and she was born two weeks after my older son, stetson, who's been on this podcast, and I never fail to let my son Stetson know how much Sam has beat him in terms of marriage and buying a house and having her first child. Anyway, it's so wonderful to have Sam here in the Sunflower House and I want to tell you a little bit about her.
Holly L. Thacker, MD:She earned her Bachelor of Science in Nursing at Muskegum University. She then went on to earn a Master's of science in management and leadership and she did work in our Center for Specialized Women's Health and she's now a preoperative nurse educator at Cleveland Clinic and she personally came in to do my pre-op nursing when I had major surgery a few years ago and just recently, my husband. She wasn't even scheduled to work and she came in. That is dedication. Everybody would want a nurse, just like Samantha Graham. So welcome Samantha. We're so excited to have you as a guest here to talk about a lot of important topics.
Samantha Graham:Thank you, thank you. I'm super excited to be welcome on this. I can't wait to talk about all these great events or great topics and things like that.
Holly L. Thacker, MD:So Sam is a busy, busy woman married to a very handsome man. She's got a wonderful family in Northeast Ohio and she's the mom of two boys, eight years old, because of course she beat Stetson by four years, because Artemis is just four, almost five, and she is a five-year-old too, so she is just full of energy and she gets up at the crack of dawn to run. In fact, in the hospital I ran into her, I think, at like five in the morning because she was going to the gym. So we want to talk about a lot of different things.
Holly L. Thacker, MD:This is airing in August, which is Breastfeeding Awareness Month, and so Sam's been a breastfeeding mom. She's helped a lot of colleagues and friends and family with breastfeeding, and I mainly also want to focus on her current expertise in terms of just a career in nursing, what goes into being a nurse educator, and also just a little bit about just preoperative preparation and preparing for that, because that is such a big deal and some people may get out of this life without having any major surgery, but most people don't. So I first want to start off by asking you how did you decide to get into nursing?
Samantha Graham:Oh geez, I decided to go into nursing when I was taking care of my elderly grandfather, just really taking care of him alongside my mother, dialysis, his diabetes, his cancer diagnosis, my mom's cancer diagnosis. At a really young age I remember people taking care of my mom through her major life surgery and I just knew right away that was something I wanted to do.
Holly L. Thacker, MD:Well, it's a great field, and do you think it's a good field for people who want some flexibility, they want to raise a family and still have a very fascinating, interesting, helpful, demanding career?
Samantha Graham:Absolutely. I agree wholeheartedly that you can get out of nursing whatever you put into it. As I still teach nursing classes in the evenings, I say I tell everybody the world is your oyster, whatever schedule you want, wherever you want to work, wherever location, it's out there and it's available. So you're. You want to be a mom, so you want to spend time with your kids. There's weekender programs, there's night shift, there's day shift, there's part-time, there's per diem. In today's world, the job is available as long as you want it.
Holly L. Thacker, MD:Well, that's fabulous. Talk a little bit about all the different types of nurses there are. I mean, my mother was a nurse, she was an RN. Talk about LPN versus medical assistant and techs versus RN versus BSN, et cetera.
Samantha Graham:Yeah, this is great topic because a lot of the times our high school students come through and they want to know as well. Where should I start? Definitely, the nurse's aide is more doing the patient care aspect of the vital signs, the assisted daily living of help feeding, help, dressing, help with their everyday activities. An MA or a medical assistant helps the physicians or the LIPs in the office. They help with their rooming, their patients, their vital signs, their testing when they've taken their last medications, immunizations. That is more AIDS or nurses' AIDS and MAs is much less. More certificate schooling, more technical schooling. Those degrees you can get very quickly, some even right out of high school. Some high school programs around here offer those, which is a great opportunity to get into health care at a very young age, getting that seniority very quickly in the hospital area and then hopefully going to an area that offers tuition reimbursement for you to go to school. We're very fortunate in the Cleveland area for all of our surrounding areas to do that. Lpn is typically a year to a 15-month program, more of a certificate program as well. The pendulum swings both ways of where do LPNs work. We're seeing them more in the hospitals. We see them in the outpatient setting. We're seeing them even in the ORs. They're typically they were around for labor and delivery and now they're everywhere. They're a great asset to the nursing family because we all were in the team nursing aspect RN there are a couple of different RNs.
Samantha Graham:You can get your associates, you can get your bachelors. That associate's degree is two years, typically 15 months to two years, and that bachelor's degree is that four-year degree. It just again kind of depends. If you are, you know, can you afford that four-year degree? Are you going to go to a two-year degree and then get a job where they pay for you to return to school to get your bachelor's degree? You know, like I said, as long as you're motivated and you want it, you can absolutely achieve it. There's so many programs out there, online and in person or at night or weekend programs, and then those higher level degrees of NP, msn or nurse practitioner, a master's of science of nursing, a doctorate of nurse practicing and even a PhD. So we can go all the way up or you can just start at the bottom as well, and those are great opportunities within healthcare that have so much job availability now.
Holly L. Thacker, MD:Well, I started in high school as a candy striper and then I realized I could get hired as a nursing assistant. And boy, what a great exposure that was as a high school student working alongside the nurses, going from surgical floors to medical floors, even to labor and delivery. So I really kind of got exposed at a really young age and felt very comfortable in the hospital setting, which, of course, the hospital setting can be so intimidating to people who aren't used to it, particularly if they're ill or their loved one is ill. And I do think that all these different entry positions are really great and they're certainly in demand. And isn't nursing faculty and teaching, like you're doing, quite in demand? I thought that the current crop of nurse educators a lot of them are aging into retirement.
Samantha Graham:Absolutely. The need for qualified nursing instructors is huge, especially in our Cleveland area area. I'm not sure around the whole United States, but we have so many great nursing programs in our Northeast Ohio area that are in need of good instructors. A couple of reasons you mentioned the aging retirement age of people retiring and then you need a certain amount of years of experience before you can teach. So making sure you have those couple of years underneath your belt you know really becoming a content expert in your area or your field of nursing that you're in before you can go into that college experience. To be able to teach an RN class, you have to be master's prepared. To be able to teach a clinical though take students into your facility you do have to be bachelor's prepared. So there is some extra schooling that is required to be able to go into the classroom.
Holly L. Thacker, MD:Very interesting and I guess we can tell our listeners. You moved on from the Center for Specialized Women's Health because you personally wanted flexibility based on hours. I so wanted them to be able to let you do remote work. You know for a lot of it, you know just based on your children's schedule, but it certainly seems like it's worked out really well for you to. It's like broadened your whole career experience.
Samantha Graham:Oh, a hundred percent. I'm doing research, I'm publishing within the Cleveland Clinic, I'm going to conferences and speaking at podiums. In regards to the specialty nurses, I'm certified in two different areas of perianesthesia nursing. It's a good feeling and my cup is full and I will like coming to work. I tell everybody that I love my family, but I love coming to work. It's a good feeling. I miss women's health. I will tell everybody that, through and through every semester, every student I come across, my previous life is all in women's health. I would go back tomorrow. I would have gone back yesterday if the schedule would have permitted or life would have permitted, because my heart really is in women's health. But I still can do that with all my patients, even in it's so wonderful and it's so great.
Holly L. Thacker, MD:It is wonderful to have a passion and enjoy work for so many reasons, and I know your patients know because you just radiate it. So let's move on to talk a little bit about getting mentally and physically prepared for surgery, and you can obviously talk about it from a lot of different perspectives. As a daughter who've taken care of you know your mother, who had such major surgery, and you know she did so well and that was such a big deal. You've also undergone it as a mom with you know, with one of your sons, and I know I have too, and that's just terrifying to be on the other side. In fact, they had me apply the gas mask to my baby Stetson actually, and his body goes limp before they could do a lacrimal gland procedure under anesthesia and then just for the adult personally undergoing different types of surgery. So why don't you talk about just those perspectives as well as making sure that you as the caregiver or you as the patient are kind of healthy and ready for surgery?
Samantha Graham:The first thing that I really want to emphasize for patients or anybody going to surgery is have your questions answered before you go to the hospital. I cannot tell you how many times patients come in and they simple question of is my surgeon good? Or they want to be reassured, I'm sure, or just do you know my surgeon? Or asking me questions specifically about their procedure, and I had to, you know, remind them I'm not in the room with you. Would you like for me to get your surgeon or whoever's going to be in the room with you to come and answer those questions? I like to tell people to make sure you any questions, comments or concerns, contact that doctor's office. Set up the appointment virtually in person. My chart message, whatever you need to do so that you come in with a peace of mind and the confidence that you made the right decision and that you are there for the right reasons. I also like to tell everybody to know their pre-op instructions is huge. I know that is a big topic with our IV shortages post the hurricanes.
Samantha Graham:Anesthesia guidelines are a little always changing. New medications hit the market. The weight loss medications hit the market. The weight loss medications hit the market. We're seeing those affecting anesthesia.
Holly L. Thacker, MD:Tell us about that, because weight and weight loss information is midlife women's number one concern. Even though it's not a menopausal symptom, ladies, but it's something that pretty much all women are interested in, and it kind of peaks at midlife when the metabolism slows down due to age.
Samantha Graham:So often patients who are on these weight loss injections or medications, they are very scared to have surgery. Because the first thing we tell them is, depending on what type of surgery they're having done. If it's more minimal, you know you have to hold it for at least a week. But if it's more if you were having that abdominal surgery, a longer procedure it is you have to hold that injection for two weeks.
Samantha Graham:And when you're on it for weight loss medication, for weight loss reasons, often people get nervous. They're nervous that they're going to gain weight back, they're worried that they're going to get that hunger back or they're worried that, whatever they're thinking about it. And so when I, when we tell patients like you need to stop your injection two weeks before or one week before, they're right away. Well, when can I start it? Right back up or whatever? You know, whatever the case may be, and I know they're so nervous and it's that's a conversation you need to have with your doctor after the procedure. You know as you're restarting all your medications after the procedure. You know as you're restarting all your medications after the procedure.
Holly L. Thacker, MD:But those weight loss meds are huge. What's amazing to me is that I mean, I always ask my patients in the outpatient area bring in all your medicines and supplements. And they'll say, well, just look on the chart, or they can't remember, or they're not sure. And even over-the-counter supplements some of them have to be stopped before surgery. They can have potent drug-drug or drug-food et cetera interactions. And really being on top of what you're taking, when you have to stop, when you have to start and I think there might even be some physicians who want their patients off those GLP inhibitors even more than two weeks, because they can really paralyze the stomach, which if there's food in the stomach and it's supposed to be empty and you get intubated because you're going under general anesthesia, if you aspirate that into your lung you can die. So it's really serious to like pay attention to what they tell you to do or not to do.
Samantha Graham:And answer the nurse honestly yes, yes, especially with those supplements that you mentioned. A couple of reasons yes, they interact with anesthesia. Certain also have bleeding effects. Again, if we're creating a hole in your body or a cavity in your body, we want to make sure that we know we can keep your bleeding under control. So that's another thing where we're like, if you are on a blood thinner or if you are on heart medication or if you have actual diabetes, we want to make sure that you are optimized for your procedure this day of surgery. So following those instructions are so important.
Samantha Graham:When we have those GLP medications or those weight loss medications and that anesthesiologist does go and put that tube down your throat, they're literally seeing whole meals that aren't digested at all yet, oh my, and it's very dangerous. And so there's a reason we're not just telling, we're just not trying to make your life, you know, unfortunate or whatever the case may be. But when you say, bring in your medications, well, it's in the chart, whatever the case may be. But when you say bring in your medications, well, it's in the chart. We are seeing a lot of med spas, a lot of holistic practitioners out in the communities that don't speak with our electronic medical record, so we don't know. So when we're asking, sometimes patients do get a little frustrated or anxious about it. Why are you asking me these questions?
Holly L. Thacker, MD:It's just we want to keep you safe, that's all we care about Absolutely that is so important and even dietary instruction, and we have some information on our speakingofwomenshealthcom site and you're actually listening to our Speaking of Women's Health podcast. I'm the host, dr Holly Thacker, the executive director. Host Dr Holly Thacker, the executive director, and we are speaking with nurse Samantha Graham, who is an expert in a lot of areas in terms of nursing career, nursing education, preoperative nursing care and also breastfeeding that we'll touch on. So on our website, speakingofwomenshealthcom, which you can bookmark or look up, we have a whole column of foods that interact with medicines and it's interesting because to me as a patient, I got instructions like certain foods not to eat before surgery because there's like, for instance, in white potatoes there's a substance that can prolong the effects of anesthesia.
Holly L. Thacker, MD:So like a sweet potato was fine, but not a white potato of anesthesia. So like a sweet potato was fine but not a white potato. And there's foods and just herbs and supplements that might thin the blood and blood loss is like a real big concern because some surgeries are obviously a lot bloodier than others, just like blood clots are. If you're immobilized under anesthesia, having major abdominal, pelvic or extremity surgery, that can certainly be a risk and both bleeding to death and having blood clots, as well as infections and anesthesia complications, are kind of the big things on the nurses, the physicians, the whole medical team and hopefully the patient's mind the whole medical team and hopefully the patient's mind. So one of the things they had my husband do was swab his nose before surgery to see if he was a carrier, a staff or strep. Do you want to talk about that and why people have to?
Samantha Graham:pay attention. The research on that is actually still kind of new. It's always evolving in regards to staff and MRSA, which are really serious complications that you can get after surgery in your surgical site, infections which we know cost the patients time and money and cost hospitals time and money. So if we can prevent that with a simple nose swab prior to surgery to see are you a carrier for it, and if you do, that doesn't mean you're dirty or any, because sometimes patients think that, oh my goodness, I have, I had it, or that I, whatever. No, it's just an extra precaution, just like a simple wash that we give our body just to make sure we're clean. We're going to put on that antibiotic up your nose five days before surgery and the day of surgery just again to ward off, like I tell everybody those evil infections that we don't want.
Holly L. Thacker, MD:Yeah, because antibiotic-resistant infections can be deadly or can necessitate, like six weeks or more of home IV antibiotics. Talk to us about the bathing and the shaving. Some people are told not to shave or not to get pedicures or not to have, you know, cool, funky nail polish, as well as the special wipes and things that people might need to do of their body or body parts before surgery.
Samantha Graham:Yeah. So bathing certain physicians order certain baths or preparation to surgery. So we might do a Hibiclens or a chlorhexidine bath or we might give you special towelettes that you wipe each body part with, one wipe on each body part. Again, that's an extra protective barrier that we are doing to help get rid of any potential infection that you may have brewing on your skin. You know your skin is your largest organ and we're going to create like a cut or something with surgery, with that. As far as not all surgeries need a special body prep, but a lot of surgeons do ask, if not to at least do a dial wash. We say that because you know the bath and body works or whatever is out there really quite aren't that great at getting microorganisms off the skin. The biggest complaint patients come in and saying my skin is so dry or it's so itchy because it's so dry. It isn't. It's not, it's not moisturizing. Again, it's stripping that skin, making sure we're getting it nice and clean.
Samantha Graham:As far as you know the nail polish and the pedicures and the shaving, I like to tell everybody when you're going into surgery, less is more right. So a pedicure they're cutting your cuticles, things like that we. Or nail polish on your toes, we're checking circulation, we're making sure that you're still perfusing your blood throughout your entire body, as well as making sure you're having good pulses and things like that. So if we don't know what you look like prior to surgery or what your nail bed looks like prior to surgery, we're going to have a hard time looking at it postoperatively as well. When you're under anesthesia. All we can do is look at you because you can't tell us what's going on. So we really want to keep you safe with our monitoring system. So if you have, you know, a big funky nail on there or some thick nail polish, with our updated medical technology can the monitors go over your finger and you're fine? Absolutely. But again it's looking at that nail bed, looking to see are you perfusing? Well, that we're really looking for.
Samantha Graham:As far as shaving, again that less is more. When you're shaving, you know it doesn't matter how good you are. You're nervous for surgery, things like that. You might nick the skin and then that is another portal for an infection. If we have to shave before surgery, we have our razors back in the OR where we handle it for you. So don't worry about that. It's included in the cost.
Holly L. Thacker, MD:That's good. You get that in the cost. You know, I tell women frequently who do like shaving of their vulva area just because they don't want pubic hair, that like we don't shave the pubic hair before pelvic surgery because it revs up more bacteria and so when they're shaving it at home they're also increasing their risk of ingrown hairs, infection and just more bacteria. So some people think it's cleaner, but a lot of times it's certainly it's not. And in terms of following the instructions about not eating or drinking or what medicines to take or what medicines not to take, that is so important and I know different surgeons, depending on the procedure, have some different recommendations.
Holly L. Thacker, MD:Like I was surprised that they said if you regularly drink coffee and you think you're going to get a caffeine withdrawal headache, you could have a little sip of black coffee on the morning of surgery. But I was just talking to one of my friends who went in for just a screening colonoscopy which is under conscious sedation, not general anesthesia, and they delayed his colonoscopy by several hours because he had had a cup of coffee. So you know, you might've been able to have a sip of coffee one day but not the next. So you really have to follow that. Do you want to talk about tobacco and alcohol and being honest and why those things really make such a big difference?
Samantha Graham:Especially when we're talking about certain procedures such as orthopedic or joint replacements, or when we're talking about bone. Alcohol, tobacco can absolutely hinder your healing process and if we're putting something artificial in your body and you're already compromised from the alcohol or tobacco, it can really hinder your healing or rejection of that joint potentially. Being honest, sometimes can be cumbersome to patients, because some surgeons won't really want to do surgery on a patient that is a really chronic nicotine or alcohol abuse because of their risk of an unsuccessful surgery, exactly. And so some doctors go as far as ordering a nicotine test. Absolutely, I see that, yes, they will offer the nicotine sensation. They just don't. They still are helping you. They're not just sending you on your way and telling you quit smoking and come back. They're trying to get you the resources. They're trying to make you optimize for surgery. It's not that they don't want to, they just want. Like I said, we just all want to keep you safe.
Holly L. Thacker, MD:Years ago I used to do preoperative you know, medical assessments before surgery in our pre-op clinic before I opened our center for specialized women's health and you always wanted that patient medically optimized and I always hated to have to tell the patient and also call the surgeon to say this person just had a heart attack, so their elective cosmetic surgery really needs to be delayed until everything has stabilized with their cardiac situation. And speaking of cosmetic type procedures, which you know a lot of women and some men are interested in is I do know several plastic surgeons who will not operate on anyone who has any nicotine in their system because the skin healing is so bad.
Holly L. Thacker, MD:And so even if you're going in for something that isn't cosmetic, you know. If it's an internal surgery, you want everything to heal right, even if it's not cosmetic, that's for darn sure. Because repeat surgeries and failed surgeries, failed devices it can be really terrible and really nasty.
Samantha Graham:For sure and even to making sure your diabetes is managed. If you have poor or if you have a high A1C, again that high sugar infection breeds on that high blood sugar. So making sure as well, patients that come in for surgery, we do a day of surgery blood sugar test just to make sure you're not too high and you're not too low, and we're not judging or seeing ooh, what did you eat last night? Again, we're making sure that your level is just right for that good surgery time and for that wound healing post-operatively.
Holly L. Thacker, MD:That is so important and I tell patients who get serious diagnoses and their attention of trying to be healthy is really more focused. You know, with new cancer patients, any serious condition that even just changing your diet strictly in a few weeks or a few days can make such a big difference. Taking out those carbs and eating heart, healthy fats and proteins and just only getting complex carbs can dramatically drop your blood sugar. So even if you previously weren't well controlled, even if you had diabetic complications, it can really improve your chances of responding to the medical therapy and the surgical therapy so much better. And a lot of people think, oh, it's too late or I'm addicted. And with the alcohol it can be really serious if you do have alcohol dependence and you don't let your health team know that. Because if you're out of it and you're post-op and you start going through alcohol withdrawal, that can be deadly deadly, as well as the bleeding risk with alcohol.
Samantha Graham:There's that bleeding risk. That is that waking up with those DTs or those deliriousness that we see patients come out of and that we don't know. Some people are very high functioning with their alcohol abuse or sometimes it's. Whatever the case may be, we really try to make sure that we address it. But because, again, that safety is huge for post-op, you know everybody has a plan and you know if you're. If you don't tell your healthcare providing team you know what it is, what's going on then you know it can have some issues in the back end.
Holly L. Thacker, MD:Now things like contact lenses. People who are so used to wearing contact lenses sometimes they wear them overnight. What do you tell them about those things? Hearing aids, contact lenses, assisted devices?
Samantha Graham:Yeah, absolutely, good question Right away Any dentures, hearing aids, contact lenses? Again, that less is more, because in our area you do not allow any assisted devices or hearing aids, or dentures or contact lenses, anything in the operating room. Now, in the pre-op setting, while we're asking you your questions, while we're getting you ready, while you're still sitting with your loved ones. Absolutely, but when we were going into the operating room we were putting you to sleep Again when your eyes are rolling back. We don't want to have them stuck back there. We don't want to have a corneal abrasion afterwards.
Samantha Graham:Hearing aids and dentures and even contacts are very expensive. We want to give them to your loved ones so they keep it safe. We don't want it getting hustled and bustled with the changing of the beds and going back to your bed and it's sitting in a hallway. God forbid anything happens. So, yeah, we just let keep all your belongings with your family.
Samantha Graham:Now, if their patient cannot hear, cannot see without their contacts, or they cannot hear without their hearing aids, we will do the safety huddle at the bedside while they have those devices, with anesthesia, with surgeon, with your OR team, and then right after surgery, we mark in the chart to have your loved one bring them back to you when you're awake. So I don't. People often wonder. My husband has never seen me without my dentures, so I don't want my husband to see me without my dentures. I'll put it on the chart. We'll have the PACU nurse come and bring your dentures right after surgery Once you're awake and stable. Absolutely, you know that. You can look on Google or YouTube. You know some patients not telling their anesthesiologist that they have dentures and the dentures have been down their throat while they intubate a patient. So absolutely they have to come out. Any. We asked do you have any loose chips, wiggly teeth, thing like that, or dentures?
Holly L. Thacker, MD:because as they're putting that tube down, it's a big tube and if it goes down that throat we're in some issues, yes, and so for people that know they have to have elective surgery and obviously emergency surgery is just a totally different ballgame, but most surgeries are scheduled, most surgeries are elective. I think that for patients to see their ophthalmologist, to see their internist or primary care doctor to get a dental checkup and take care of an infection or a tooth that might need to be pulled um, to get their health maintenance if they haven't had their mammogram or colonoscopy or blood work, and to really work on getting that blood sugar and all their metabolic indices, it's just really. It's like you're kind of preparing for a marathon.
Holly L. Thacker, MD:So, we talked about all the things people should bring to the hospital. What are a couple of things that absolutely the patient should bring with them when they show up at the hospital that they should not bring?
Samantha Graham:with them. No, they should. They should their medications. I know we are a hospital, we will minister our medication. But if you, we, if you don't know your dosage, if it's not in there correctly or if you got it changed from a different provider, we don't know your supplements like or whatever, whatever medicines you're on, bring those.
Samantha Graham:Your living will, your medical power attorney, needs to be scanned in prior to surgery. Living will, your medical power of attorney needs to be scanned in prior to surgery. These conversations also should be having prior to you coming to the hospital. We do sign a lot of medical power, our living will, medical power of attorneys right before surgery. I do witness a lot of them. But those are best conversations to be having to have already all signed, sealed, delivered prior to surgery and have. Most important is have your support person with you. Unfortunately, with COVID we nobody was allowed to come into the hospital, which is a very unfortunate time for us in a whole Our patients, us everybody, whole our patients, us everybody. But have that support person with you is really important so that when you can't talk for yourself, somebody is there to talk for you and support you.
Holly L. Thacker, MD:That's very important and I know my husband was so used to his wedding ring, his watch. You have to leave all of those valuables at home, even though it feels like you're naked. You just keep them in at home. But they do want your photo ID because there have been some cases of people showing up for other people's surgeries to get so insurance fraud is real. Yeah, so they do want your insurance card and your photo ID. But other than that, really you want to be traveling light. So what tell us about anesthesia? And some people, of course, have have local anesthesia where they get sedation as, as opposed to general anesthesia. Some of our listeners may not really understand that difference.
Samantha Graham:So local anesthesia is when they are able to do a minimal invasive surgery that has a quick recovery time and or a quick procedure time. An example like that a carpal tunnel procedure, maybe a manipulation of a joint or a shoulder what else? A colonoscopy? Those are those minimal invasive surgeries that we will just do light sedation. Or we could do something like a peripheral nerve block, where we can block that extremity so that that patient cannot feel the area while the surgeon is doing the procedure. Don't worry, you're not completely awake. There are some other medications that we can give through your IV so that you don't even know your own name, so that you're nice and out of it, because some patients are like I don't want to hear, I don't want to see, I don't want to know anything, and that's completely fine. Those are also for patients that maybe have that heart condition or have that other comorbidity where they're not a good candidate for general anesthetic. Now, when we're talking about a general anesthetic, that is that when you were putting you to sleep and that patient is getting intubated by the anesthesia provider.
Samantha Graham:Other things that we can do are epidurals during surgery, spinals during surgery. I know we hear those a lot during labor and delivery. We still do those on our patients prior to surgery. So some of our hip replacement patients get a spinal just to help with pain control after surgery. So when the pain team comes in and talks to you and they're like, well, why do I need that? Or why do I need my whole arm If I'm still, they still might go to sleep Again, a lot of that that pain control for during the procedure and even after the procedure that are some great options to decrease the amount of narcotics and opioids that you need after the procedure.
Holly L. Thacker, MD:Yes, those local blocks, and some of them, can last for quite a long time, but you have to kind of be prepared when they wear off.
Holly L. Thacker, MD:And then I know some patients who get claustrophobic if they can't feel like a limb and they specifically don't want the block and they'd rather deal with more pain. But the whole opiates they can cause constipation if they're not used appropriately or used too long addiction. So trying to use as many comfort and other additive ways of dealing with pain I think is so important and I think a lot of people just they underrate it but it can really make a big difference.
Samantha Graham:Yeah, we absolutely have had patients who come in and say I hate that numbness and tingling feeling. I'd rather have pain. And that's okay. It's not for everybody.
Holly L. Thacker, MD:Yes, and that's why it's so important to talk to your whole healthcare team and get things sorted out well in advance. So I want to switch topics, um, and get some of your insider tips on breastfeeding. It's Breastfeeding Awareness Month. You've been a very successful breastfeeder and it's certainly so helpful for women's health, weight loss, reducing breast cancer, it's good for bonding, it's good for the baby. Certainly, not everyone can do it and everything has to be individualized. But give us some advice and tips and everything has to be individualized.
Samantha Graham:But give us some advice and tips. I often would tell other moms, family members, friends, you know, go into it open-minded. It is not the movies, it is not the books, it is not the way even maybe your great-grandmother told you it was. That's not how it was. For me it's hard, it is. I right away did not feel like it was natural. Both of my kids had tongue ties. Do you remember?
Holly L. Thacker, MD:I mean it was you had to figure out the problem. Yes, and get your own lactation consultant, as I recall.
Samantha Graham:Yes, I had to go outside the health system, I had to find a specialist to help me. But again, being your own advocate and know what you are doing is right and know who to reach out to your lactation consultants, your OB, you're not alone, that is the biggest thing. Call me, all my friends, call me, text me in the middle of the night, I don't care, I'll help you do this because it's a learning curve for you and the baby, you know, especially if you've never done it before. And often I can speak from experience too. No, two kids are the same. No, my one son was a great breastfeeder and my other son could well, he was lazy and could care less. So that in itself is hard.
Samantha Graham:I often tell new moms, like brand new moms, don't care about pumping. I think I had to tell your daughter-in-law that like no, no, no, don't start pumping right away. Too soon, yeah, too soon. You know we are hyper fixated on social media and people showing their refrigerators and freezers and deep freezers full of breast milk. That is amazing, awesome, but you just need enough to feed that baby. So don't worry about feeding your freezer. Feed your baby, feed on demand.
Samantha Graham:Enjoy your maternity leave, for however long it may be for you, enjoy this bonding time. Don't stress over your supply. Your baby will let you know. Is your baby pooping and peeing? Is your baby sleeping? You are succeeding at breastfeeding. So the STEM like the, you know, the social media, the family, I just I remember all the comments myself of, well, what am I going to be able to feed the baby? Or or how much do you pump? Or, you know, it's all the things and it's you know. You will get those maternal instincts. It's the best thing. It's hard, it's hard work, but it's so rewarding. The bonding, like Dr Thacker said, is something unmatched.
Holly L. Thacker, MD:Well, I'm glad that there wasn't all this social media of people showing their pictures of milk back when I was doing it, because I only made just barely enough. We used to call it liquid gold, like how dare anybody spill it? And so much of the equipment like there was someone on our team the other day who came to our center meeting and was pumping under the clothes with like a portable pump pumper right during the meeting and I thought, boy, that's very efficient. So some of these new things that they have. I mean it's not like you need so much equipment if you're just with your baby and not away from your baby. Less this can be more, but there is a lot of assisted devices, any websites or any resources. I mean you can go to speakingwomenshealthcom. We actually had a really great column last year on breastfeeding, so we do have resources on our website, but any other tips or places that you found particularly helpful.
Samantha Graham:I honestly found whatever was helpful for me was going through my lactation consultant, seeing what your health insurance covers, because a lot of those portable devices and things like that are sometimes a money grab because you might not need all of that, but I had my babies in a world where the portable weren't an option. Now they are an option, which is great. So going through your lactation consultant because will you be away from your baby, like you said? Will you be more at home? Do you need more of that Haka or that, that suction cup that just is collecting while you're nursing on the other breast, or do you really? Are you going to be at work eight hours a day connected to a pump and do you are you able to sit down and pump?
Samantha Graham:So there are multiple different, like the Medela websites, the different breastfeeding websites that are available to see what is. It's not a one size fits all, which is great, but you know you just got to know what kind of lifestyle will you have and it's okay not to know until you get there. Sometimes you see on, like the baby registries, the hands-free and then the one that you connect, and then this, and then that I'm like you know it's great to be prepared, but you know you won't know until you get there.
Holly L. Thacker, MD:So I think the takeaway is you can be a lot more prepared for surgery upcoming surgery than you can for having a baby.
Samantha Graham:At least for me, that's how I felt.
Holly L. Thacker, MD:Yeah, I think that's how it is for a lot of women, so, but the prize is you have a baby. So thank you, samantha, so much for joining us on this podcast on Speaking of Women's Health, and thanks to our listeners for tuning in. We're so grateful for your support and please share it. Give us a five-star rating and, in order to catch all the latest and not miss any podcast, hit, subscribe or follow. Thanks again for listening and we'll see you next time in the Sunflower House. Remember, be strong, be healthy and be in charge.
