Considering a tubal... - page 2

Okay so I have been considering getting a BTL for a long time, but beng the typical control freak I want it done my way lol. well as far as the anesthesia goes. So I have been told I HAVE to have a... Read More

  1. by   smk1
    Quote from akcarmean
    I had a tubal this summer and I reget getting it. My periods hurt worse and last longer; I am more moody, seem to bleed heavier. I should have made my dh do it.


    Angie

    Well considering the fact that i always assumed after/if we have child number 2 i would be getting this done, This post sure concerns me! i do not lie the sound of this! :uhoh21:
  2. by   BRANDY LPN
    Quote from jwk
    I've seen one local laparoscopy for a tubal. It was a lousy experience for all involved - patient and staff. Go with the general.
    Why was it a lousy experience? Can you give me some specifics? And related to pain can you give me a guess as to how bad it would be? Like on a scale?
  3. by   jwk
    Quote from BRANDY LPN
    Why was it a lousy experience? Can you give me some specifics? And related to pain can you give me a guess as to how bad it would be? Like on a scale?
    It takes an EXTREMELY motivated patient to even attempt this. Insufflating with CO2 is very uncomfortable. Most patients simply would not tolerate it, regardless of how much they think they can. On a scale of 1-10, it's easily a 10. We never did another one after the single one we tried. Obviously some others have.

    We do many hundreds of laparoscopic tubal ligations each year - always general anesthesia, always with an endotracheal tube. We don't even have a GYN on staff that would do it without general anesthesia, and I'm at one of the busiest OB/GYN hospitals in the U.S.

    Post-partum tubals can be easily done with spinal or epidural. Local with sedation is possible (never done one that way), but the local just numbs the skin and SubQ tissues, not the tubes or uterus, so I would expect that would be pretty painful as well with all the manipulation required to find and then ligate the tube.

    Lots of patients that are undergoing surgery are more worried about the anesthesia than the surgery. I'm not sure what the mortality rate is from a tubal ligation, but it's higher than the 1:250,000 for a general anesthetic.

    I would never recommend even attempting a laparoscopic procedure of any type under local+sedation or regional anesthesia.
  4. by   mishayla96
    You want my tubal story? :lol only because its kind of funny. My best friend at the time said that getting a tubal would be pretty easy...so I went ahead and did it. I can't use all the medical terms since I really don't know how yet but here it is in laymens terms I was a day "post-pardum" and my doctor told me (probably just so he could make more money from me looking back--sorry but I didn't like him!) that since I was already in the hospital it would be "easier" for me to have a tubal than to have to schedule something for my DH later on. Ok so anyhow, they took me in to do my tubal. I have no idea what they did to me (see told ya it was gonna be laymens terms ) but I was "awake" the whole time. I felt no pain...the WEIRD part was (and everyone always laughs when I tell this part of the story) I remember laying there on the bed and I could hear people talking and laughing and stuff but to this day I can not tell you what they were talkng about (It all sounded like a foreign language :chuckle ). Then to make matters worse, when they were done, I had no idea about the CO2 deal soooo I was drinking "coke". I had EXTREME pains (gas?) in my shoulder and NOBODY told me why. Finally a nice nurse (like I wanna be someday) said "ewe your drinking coke, your just adding to the gasses" and she told me thats why I was having that excrutiating pain in my shoulder...the gas! Geesh THANKS for SOMEONE finally tellin' me. As for my periods, they were worse for a while but have calmed back down (Jan. 17th was 3 yrs since surgery). Another issue I had was the wound though. My naval hurt like heck for WEEKS after my surgery. Maybe I just had a "bad" experience. Oh and remember the wonderful thing my doc told me when he came in to check on me a few hrs after surgery... Doc: "do tubals fail?"... Me: "yes, sometimes" Doc: "Thats right, one in three hundred fail".
  5. by   jwk
    Quote from mishayla96
    You want my tubal story? :lol only because its kind of funny. My best friend at the time said that getting a tubal would be pretty easy...so I went ahead and did it. I can't use all the medical terms since I really don't know how yet but here it is in laymens terms I was a day "post-pardum" and my doctor told me (probably just so he could make more money from me looking back--sorry but I didn't like him!) that since I was already in the hospital it would be "easier" for me to have a tubal than to have to schedule something for my DH later on. Ok so anyhow, they took me in to do my tubal. I have no idea what they did to me (see told ya it was gonna be laymens terms ) but I was "awake" the whole time. I felt no pain...the WEIRD part was (and everyone always laughs when I tell this part of the story) I remember laying there on the bed and I could hear people talking and laughing and stuff but to this day I can not tell you what they were talkng about (It all sounded like a foreign language :chuckle ). Then to make matters worse, when they were done, I had no idea about the CO2 deal soooo I was drinking "coke". I had EXTREME pains (gas?) in my shoulder and NOBODY told me why. Finally a nice nurse (like I wanna be someday) said "ewe your drinking coke, your just adding to the gasses" and she told me thats why I was having that excrutiating pain in my shoulder...the gas! Geesh THANKS for SOMEONE finally tellin' me. As for my periods, they were worse for a while but have calmed back down (Jan. 17th was 3 yrs since surgery). Another issue I had was the wound though. My naval hurt like heck for WEEKS after my surgery. Maybe I just had a "bad" experience. Oh and remember the wonderful thing my doc told me when he came in to check on me a few hrs after surgery... Doc: "do tubals fail?"... Me: "yes, sometimes" Doc: "Thats right, one in three hundred fail".
    1) You had a post PARTUM tubal ligation. These are done in the hospital before the mom goes home. They are easier from the standpoint that the tubes are much higher in the abdomen and easier to get to through a navel incision, which wouldn't be possible once your uterus shrinks back down. This is NOT a laparoscopic procedure - there is no CO2 gas used. It is done through a small incision in the belly button, the surgeon reaches in with a type of clamp, pulls the tube up where he can cut it / burn it / clamp it, lets everything slide back in where it belongs, a few stitches, and you're done.

    2) More than likely, they used the epidural you had for your delivery and simply redosed it to do your tubal ligation procedure. Some places might do it with local anesthesia and sedation, I don't know. Even with an epidural, you probably received some sedation.

    3) Drinking coke or any carbonated beverage after abdominal surgery is foolish, because of gas pain in your abdomen, and I'm surprised no one told you / warned you about this earlier. It increases the gas in your stomach and small and large intestines, not out free in the abdomen like the CO2 gas used in laparoscopy. Your intestines don't like someone messing with them, and they generally slow down or even stop their peristaltic movement for a short period of time. Gas just sits there and there's your pain. Your coke just put more gas into your digestive tract and made it that much worse.

    And no offense - you're tremendously uninformed, by your own admission, about surgery that you had on your own body. "I have no idea what they did to me" "Do tubals fail?" , etc. The time to ask questions is BEFORE surgery, not after. If you truly have no understanding of WHAT they're doing to you, WHY they're doing it, and the RISKS, COMPLICATIONS, and ALTERNATIVES to the procedure (that's called INFORMED consent) , WHY DID YOU HAVE SURGERY? And surgeons generally don't do surgery just to make a couple of extra bucks from insurance companies that often make it more of a hassle than it's worth.
  6. by   smk1
    Quote from jwk
    1) You had a post PARTUM tubal ligation. These are done in the hospital before the mom goes home. They are easier from the standpoint that the tubes are much higher in the abdomen and easier to get to through a navel incision, which wouldn't be possible once your uterus shrinks back down. This is NOT a laparoscopic procedure - there is no CO2 gas used. It is done through a small incision in the belly button, the surgeon reaches in with a type of clamp, pulls the tube up where he can cut it / burn it / clamp it, lets everything slide back in where it belongs, a few stitches, and you're done.

    2) More than likely, they used the epidural you had for your delivery and simply redosed it to do your tubal ligation procedure. Some places might do it with local anesthesia and sedation, I don't know. Even with an epidural, you probably received some sedation.

    3) Drinking coke or any carbonated beverage after abdominal surgery is foolish, because of gas pain in your abdomen, and I'm surprised no one told you / warned you about this earlier. It increases the gas in your stomach and small and large intestines, not out free in the abdomen like the CO2 gas used in laparoscopy. Your intestines don't like someone messing with them, and they generally slow down or even stop their peristaltic movement for a short period of time. Gas just sits there and there's your pain. Your coke just put more gas into your digestive tract and made it that much worse.

    And no offense - you're tremendously uninformed, by your own admission, about surgery that you had on your own body. "I have no idea what they did to me" "Do tubals fail?" , etc. The time to ask questions is BEFORE surgery, not after. If you truly have no understanding of WHAT they're doing to you, WHY they're doing it, and the RISKS, COMPLICATIONS, and ALTERNATIVES to the procedure (that's called INFORMED consent) , WHY DID YOU HAVE SURGERY? And surgeons generally don't do surgery just to make a couple of extra bucks from insurance companies that often make it more of a hassle than it's worth.

    this posts seems a tad harsh... she was just telling about her own personal experience and feelings from a non-medical/nurse standpoint. :uhoh21:
  7. by   MarySunshine
    Quote from SMK1
    this posts seems a tad harsh... she was just telling about her own personal experience and feelings from a non-medical/nurse standpoint. :uhoh21:
    Yeah, and if you (JWK) were paying more attention, it was the doc who was quizzing her about whether or not tubals fail. She answered correctly. Not everyone can be alert and oriented to all that is going on while they are SEDATED during a surgery.
  8. by   jwk
    Quote from MarySunshine
    Yeah, and if you (JWK) were paying more attention, it was the doc who was quizzing her about whether or not tubals fail. She answered correctly. Not everyone can be alert and oriented to all that is going on while they are SEDATED during a surgery.
    I re-read the post - I see the conversation and where I was mistaken. Of course it does seem like a strange conversation to have post-op. Was this a post-op quiz?

    However - she claims to be a medical assistant, wants to be a nurse, and again, by her own admission, didn't really know what they were doing. I would think either before or after, one would know how their procedure was performed (laparoscopic or open, there's a big difference) and what type of anesthesia was used (general, regional, MAC).

    The original thread was about someone wanting to know about tubal ligations. Since mishayla96's post had some factual errors and misconceptions about what happened to her, I simply offered an explanation. It wasn't meant to be harsh - hopefully it provides additional factual information for the original poster on which she can base her decision.
  9. by   mishayla96
    Quote from jwk
    I re-read the post - I see the conversation and where I was mistaken. Of course it does seem like a strange conversation to have post-op. Was this a post-op quiz? YES He asked me this AFTER the surgery to make sure I understood, which in fact I knew BEFOREHAND that there was a chance of a failure...

    However - she claims to be a medical assistant, wants to be a nurse, and again, by her own admission, didn't really know what they were doing. I would think either before or after, one would know how their procedure was performed (laparoscopic or open, there's a big difference) and what type of anesthesia was used (general, regional, MAC). OK so I told you I didn't know anything about the type of procedure that was done, and YES I should have asked but thanks for telling me, as now I know To be honest (and this probably sounds nieve and uif it does so be it) I did not realize there were so many ways to have a tubal done, all I knew is I had 3 kids and did not want to become pregnant anymore, so I opted for the surgery... We did not go into stuff like this when I was in school for medical assisting, so I would not have known from there, and I have not been employed since I graduated from MA so I am not experienced that way either!

    The original thread was about someone wanting to know about tubal ligations. Since mishayla96's post had some factual errors and misconceptions about what happened to her, I simply offered an explanation. It wasn't meant to be harsh - hopefully it provides additional factual information for the original poster on which she can base her decision.
    It came out harsh to me, and thanks to the two posters who thought so too. But it did shed some knowledge and I hope it helps the original poster, also. From now on I will shut up when I don;t know something, I am sorry for even replying since evidentally all I said was the wrong things!!
  10. by   apaisRN
    Quote from jwk
    However - she claims to be a medical assistant, wants to be a nurse, and again, by her own admission, didn't really know what they were doing. I would think either before or after, one would know how their procedure was performed (laparoscopic or open, there's a big difference) and what type of anesthesia was used (general, regional, MAC).
    I think you underestimate the ignorance of the general public. She knew they were tying her tubes, they would give her medicine so it wouldn't hurt, and it wasn't 100% foolproof. I didn't see where she said she didn't know if it was laparoscopic or open, and for the average person, a lap tubal versus a postpartum tubal with a small incision pretty much amounts to the same thing anyway. She says "I don't know what they did to me" as far as anesthesia, but really, would she know if they'd given her gas or just put O2 on her face? Or what they gave her IV? She's a medical assistant, not an OR nurse, she'd just had a baby, and she trusted the doc. She probably was not in a position to remember every detail of the consent form.
  11. by   MarySunshine
    I appreciated your first hand account Mishayla. Best of luck to you in your career aspirations! It's invaluable for healthcare professionals to have experienced what it is like to be a patient.

    JWK, what you posted was informative and useful, just overly harsh. So, thank you for the helpful stuff, truly.
  12. by   London88
    For the original Poster in reference to the anesthesia for BTL. If the procedure is laparascopic there are concerns about airway if they are insufflating the abdomen. So, many anesthesia providers want the pt intubated. Also, it is not uncommon to have such steep trendelenburg that the pt is almost standing on their head. I do not think I would like to be awake and be in that position! Like others have mentioned post partum tubal ligations are much quicker and easier for the surgeon as the structures are still enlarged and easier to access and can be done under a spinal without difficulty and from what I have seen are not laparascopic.
  13. by   RENAISSANCE RN
    I got one and havent had any problems. The GYN said it is has the same effectiveness as a tubal. No anesthesia, NO worries, Just check your string.

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