EUA - Exam Under Anesthesia

Not familiar with that one. Will follow the post to hear what it is and what it entails. Hugs!

Oh, it's easy. I have this done annually, if not more often.

You'll fast and probably have to do an enema beforehand, then be put to sleep, and then wake up with the job done. Because it's a general, you'll most probably need someone to take you home and stay with you overnight.

They may give you the option of having it done with some sort of spinal block, which means you're awake but don't feel anything. I've never chosen that option, mainly because I don't trust surgeons and anaesthetists to start fiddling with my back, no matter how safe they say it is.

Please feel free to ask if you have more questions.

Ivy.

You know, I don't really understand the reason for a general anaesthetic either. I used to think it was to spare us from the embarrassment of being awake while someone fiddled with our bottoms, but that's obviously not right, seeing as I've been given the option of having one of those spine block thingies. That might be a question to ask your surgeon, and if you do find out, I'd love to know the answer too .

Why do I have it done? Sometimes the surgeons just like to take a look at the fistulas and see what's going on with them; sometimes it's to change a seton and to take a look around while they're at it. My hospital seems to be weirdly pernickity about fistulas and setons: they like them to be regularly examined, and setons to be changed at least annually.

I do suspect that they would treat a fistula with a seton or whatever if they did find one. Back when I was newer to this and a lot more anxious, I asked my surgeon what would happen if they needed to do anything more drastic than put a seton or whatever in, and he said they'd wake me up and talk with me about it, and then put me back to sleep when I felt comfortable with what they were needing / wanting to do, and agreed with it. I daresay they will discuss this with you before your EUA, and if they don't, please make sure you ask them about it so you feel fully informed.

I'm without a seton just now but still have a fistula, and was booked in for an EUA last July and was supposed to be admitted in about September, and am still waiting for them to find a bed LOL. However, I've had an MRI so the surgeons will have a better idea of what they'll be looking at when they go in properly. Why they need to do an examination when they have the benefit of something as advanced as an MRI is beyond me, but there you are.

I tend to think of them as a good thing, though. These days, I can have the EUA at least annually, and then only do a scope every two years or so. Less bowel prep is always a good thing!!!!!

Yes, it is generally an outpatient procedure. (I often have mine done as an inpatient, though, as I need to travel a long way to have it done and my hospital is - sometimes! - kind). My feeling is that, if you went down to Theatre at about 7am, you'd be ready to be discharged by 12pm, maybe 2 at the latest... but, once again, this is something you might want to discuss with the hospital and the doctors.

If you're travelling, you might like to be aware that you *may* be sore afterwards. I am usually ok after my EUAs, but there have been times when I'm bruised and sore over the whole area, and bleeding a bit too, and travelling can be uncomfortable, so you might like to make sure you are set up with pain pills and maybe some extra underwear and pads too. All of this may be unnecessary and you may be no sorer (and maybe even less sore) than you are after a colonoscopy, but it's best to be prepared.

I've only just woken up so I'm probably rambling, but I hope this helps .

Ivy.

ps. Oh! Take some nice, soft, toilet paper to hospital with you, to use after the enema. If your hospital tp is anything like ours, you may as well wipe with plain writing paper.

If they're wanting to work out where the fistula is going and whether it's exiting anywhere, you may find that the surgeons will be thinking of injecting a bit of dye into the bit of fistula they can see, and then watching to see where it goes and where (whether) it comes out.

My feeling is that it's better to get fistulas examined and treated. They're nasty little things, and treatment (even if with seton) might be able to stop it from tunnelling its way into organs or other nasty and inconvenient places.

EUA bed - I gather the problem is with the surgeons rather than the hospital. I don't know what the problem is, though: I've never had an issue like this before; or at least not for so long...

Anyway, as far as the fun things that this disease throws at us goes, I think of an EUA as one of the easier ones: nothing nasty to drink; minimal side-effects afterwards.

Ivy.

I have had two EUA's for my recto-vaginal fistula that STILL eludes us.  They were quite easy.  I did have some prep the night before, but was under general anesthesia for both.

I did feel like maybe they repositioned me or something because I had some muscle pain for a few days.  Maybe that is why they put you out, so you don't really know what they are doing. LOL!!

Wishing you the best!!

Anne

My RV fistula is still with me and yes after several attempts to find the tract my docs both colo-rectal surgeon and my uro-gyno doc could only find what they think is the opening of the tract but not the tract itself!!! Very frustrating since I KNOW what is there, but we can not find it.

I was under for about 1 hour to 1 1/2 hours approximately.  Since they could not locate it, it took longer than it probably would if the tract were more defined.

Afterward I recovered for several hours before going home.

Wishing you the best!!

Anne

An update - a year+ later! I'm scheduled for my EUA on June 1 at Cleveland. Dr. Hull will be performing it.

Ivy, I did ask the reason for being put out during the exam - I told her I've never been sedated, never had a problem with pain, etc. - she explained that she'd be doing some hard poking with hard instruments to try to find the fistula hole(s), and that it would probably be too painful if I were awake. Other than not eating/drinking from midnight on, no prep.

As for why an EUA when MRIs have been done - this gets complicated, at least in my case: I've had 2 MRIs done in about a year, each one showing different interpretations of what's going on inside. The first MRI reads as though there's one fistula with 2 fistulas branching off, the 2nd (Cleveland) MRI reads as though there are 3 separate fistulas with - yes - 3 separate holes in my jpouch, although those holes were not seen on MRI (apparently, the actual holes are not always seen on the MRI, from my understanding). As all my symptoms point towards Crohn's, and therefore, "things can change every 3 months", according to the doc., they're doing a 3rd MRI prior to the EUA.

If only one hole is found, a seton will likely be inserted. If more than one fistula "hole" is found, out comes the jpouch. This would not make me happy, but none of this is making me happy right now.

Spookyh - wondering how your fistulas are doing? Still no other treatment outside the meds? And the rest of you - any fistula updates?

I'm just glad things are starting to get moving seriously on these fistulas. Too much fiddle-fartin' around with them, time to get serious.