Patient’s 16-hour fast causes sickness
Dear Dr. Roach: Why is it that no matter what time a surgery is scheduled, the rule is “no food or drink after midnight”? My recent procedure was scheduled for 12:30 p.m. I was told I could have no food after midnight. My procedure would take two hours and recovery was for two hours. That’s over 16 hours without eating! When I told the scheduler that I would have a sick headache due to no food for 16 hours, I was told that was the policy. Period. “Besides,” she said, “they will give you something to eat in recovery.”
Well, as it happened, they gave me nothing in recovery. I ate when I got home, but I was sick for hours. Why the one-size-fits-all policy? The food cutoff time should be tailored to the surgery time.
M.B.
Answer: I agree with you that 16 hours without food is both cruel and unnecessary. The American Society of Anesthesiologists, like most expert societies, recommends for adults no heavy food (including fats and meat) eight hours prior to surgery; fasting from any solid food or milk six hours prior to surgery; and fasting from clear liquids two hours before surgery.
In your case, with a procedure scheduled at 12:30, you should certainly have been able to wake up early (say, at 6 a.m.) and have a light breakfast; then been allowed water, black coffee or tea until 10:30 am. I can’t say why your surgical center was so dogmatic.
Dear Dr. Roach: My recent echocardiogram indicated that I had 50% heart function. I’m a 74-year-old male who exercises two to three times a week on a treadmill, spending 45 minutes at 3.5 mph covering 2.6 miles. Can exercise increase heart function?
M.C.
Answer: Ejection fraction measures the amount of blood ejected by the left ventricle every cardiac cycle. The normal range is 50% to 75%, but 75% isn’t necessarily better.
What is more important than any heart measurement is how much you are able to do. You are exercising pretty well. If you increased your speed, you would likely get accustomed to the higher speed as your heart function improved.