UCLA & Tests Before Mesh Removal Surgery
I have promised to write other blogs to help you understand the mesh removal process at UCLA so today I am tackling the three Urology tests that will either be performed a few weeks before surgery or the day before. I have been told that some insurance companies are requiring that the tests are done before a surgery date is set. I do not understand why they would do this when mesh is an issue. It makes the financial hardship even more difficult for women. Not all insurance companies do this and because I have Medicare, I know for a fact that they don’t. They accept that your consult with Dr. Raz or other surgeons at UCLA determines that you need this surgery. If you feel you cannot raise the funds for three visits to UCLA, please raise this problem with your insurance company.
Because I have Medicare, two days were set up at UCLA when I went for my consult. The day before surgery was to be the day of testing. My testing day was set to begin at 11 am and the first two tests are done in the same offices of Dr. Raz. I was met by a cheerful Asian man who led me to a room to remove my clothes and put on the required gowns and shoes. Don’t worry, you will wear two gowns and will be completely covered. I was given a cup to make a urine sample. That was an issue for me because of one thing. I had taken marshmallow root for two years and it kept my infections at bay. However the surgical instructions I had been handed at consult said I had to stop all vitamin supplements two weeks prior to surgery. I dreaded it because I had tried to stop once during the two years and within two days felt the infection signs and got right back on it, so I knew what would happen. I risked only stopping it one week before, hoping I could make it without the terrible pain of extreme UTI. By the time I arrived in LA it was rearing its ugly head. By the day of tests I was in agony and my urine flow was slowing down. However I managed to go just enough for testing. When the man heard what I had taken to last out for two years, he asked me to spell it out and he put it into his phone. He said so many women came there and antibiotics were not working, so he wanted to offer help. I explained that there had not been any side affects with me or the other women who have been on it long term. Because of the infection I had at testing time, the technician who did the test was concerned and went to ask the doctor about what to do. She came back after checking my allergies and gave me a shot. That shot helped me get through to the next day for surgery. If you want to know about this product, read this blog http://meshangels.com/2012/05/bladder-slings-uti-infections
Test # 1. I was led to the room where a urodynamics test was to be performed. This test determines how well your bladder empties. Small catheters are inserted so that the machine can register your response as you cough, push etc. You need a full bladder for this and they will fill your bladder with water, so don’t worry if you have just gone to the bathroom. I had had this test done in Houston before ever having the sling put in me, but the equipment used was far superior at UCLA than in Houston. You do the test standing which surprised me and the technician was wonderful. All three tests were done by women technicians. This test took about an hour in all. The test I did not find extremely painful, more uncomfortable and the technician caring and assured me she would be as careful as possible so I did not have too much pain. She was wonderful. You can watch how your bladder works on screen in front of you and I was shocked to see after the test was done that my bladder remained half full. No wonder we are all so sick with infections. You can read about this test here. http://urology.ucla.edu/body.cfm?id=478&ref=12&action=detail
Test #2. After that test was done, I was led through to another room for the cystoscopy test. This test is also computerized and a different doctor will perform it. A pleasant nurse got me ready for the test and then the doctor came in. She introduced herself and told me she was going to use lidocaine to deaden the effects of the instrument as it was placed through my urethra, into my bladder. The screen is where you can watch as the instrument is moved around inside your bladder. I did not have any erosion thank goodness. You can read more about this test here http://www.uclahealth.org/body.cfm?xyzpdqabc=0&id=477&action=detail&AEArticleID=003903&AEProductID=Adam2004_117&AEProjectTypeIDURL=APT_1
Test #3 was done in a building a short walk from the building and I had a short time to wait. This was the translabial ultrasound and the building is where all ultrasounds and x-rays are done. I was quite interested in understand all about this test, because it seems to be the test that no one but UCLA does and yet it is the most important to detect where the mesh is and what it has attached itself to. It will also tell the doctor if it has folded or bunched up into a ball. The lady technician was very nice and explained what she was doing. The test is not invasive and not bad at all. She uses 2 different heads on the probe and the first was the shorter one. It is always covered for hygienic purposes. She placed it on the outside of my labia area and began moving it and watching the screen. I could not see the screen however, which was quite disappointing to me. This test was uncomfortable because she has to press it against me but not painful. Once she had got the picture she wanted, she changed the head to a longer one. The she inserted it very slightly into my vagina and began moving it to get the best picture. Finally the test was done. I did research the UCLA site and this is all I could find about this test.
Innovative Imaging: Translabial Ultrasound to Evaluate Vaginal Mesh
With increasing frequency, we are referred patients that have experienced mesh-related surgical complications. Mesh is not visible on standard X-ray, CT or MRI imaging. UCLA Urology and UCLA Radiology have developed ultrasound techniques to correctly identify previously placed mesh when planning for corrective surgery.
Once that test was over, the instructions for the day was that I would then return to Dr. Raz office and see him to go over the surgery. However, he had come in to see me during the second test because of a meeting at the same time as my appointment. So I was able to go back to my hotel room and rest. Believe me the infection had made me feel tired and unwell, so I was very happy about that. It was 3 pm and I needed to rest before having surgery the next morning. You will be given a number to call to find out what the time of your surgery will be but you cannot call until after 3 pm. My daughter did it when we got back to the hotel and found out I was first in line at 7.30 am. I had to be there at 6.30 am.
I hope this blog will help you understand how and when these tests are performed. The paper I was given to understand it, left a lot to be desired and I had gone in the doctor’s office to ask questions the day before. I hope this saves you the confusion.