My Day Surgery Experience At Tan Tock Seng Hospital

This post is to record and share my experience from pre-op to op to post-op. Day surgery is where you can go home on the same day after the procedure while inpatient surgery is where you have to stay for at least one night for recovery and supervision. I will be covering day surgery in this article. If I am lucky/unlucky in the future, I will write about inpatient surgery too.

Your experience might differ due to the hospital and type of surgery. In my case, I had my day surgery done at Tan Tock Seng Hospital. If there are any inaccuracies, please let me know as my memory of that day is not 100% and I wasn’t able to record a lot of what is going on on my phone.

Pre-Operation – Before The Day Surgery Date

Before the actual day of the day surgery, there are certain steps regarding the briefing on the operation and check my eligibility for the surgery.

Referral For Day Surgery

You will either get a referral from a specialist or polyclinic to undergo a day surgery during the checkup for your ailment. If your ailment is very urgent, you can walk in directly to the A&E department to have your surgery done.

They will set a date for surgery with you and I recommend that you get a date early in the week so that you will be able to visit the polyclinic for wound care as polyclinics are only open for half a day on Saturdays.

The number of days between your visit to the doctor and the day surgery date can take a few months. It will take so long as I chose to go to a public hospital. My insurance only covers public hospitalization bills.

If time is really valuable to you, you might want to opt for private hospitalization insurance. However, the private insurance premiums have been increasing like crazy. I remember my colleague getting hospitalized for 8 hours at a private hospital although her ailment does not need hospitalization. She is hospitalized just so that she can claim from her insurance.

This is one of the reasons why private insurance premiums keep climbing. I switched to public hospitalization insurance after I see my premium increase by an unreasonable amount. I do not want to pay for people who abuse the private insurance system.

Financial Counselling

This financial counselling step is to brief me on the potential costs of my day surgery hospital bill. The financial counselling will be done by a Care Cost Advisor.

It can be done either via a

  1. Physical visit to the hospital or
  2. Phone call

If done via a phone call, they will send you the estimated costs in a PDF (Care Cost Form) via email in advance so that you can look at the cost document as they brief you.

They gave me a range of estimated costs for a base case and another case if the surgery is more complicated than expected. The estimated costs are based on past bill sizes of the same situations.

consumelesslife TTSH care cost form

Tan Tock Seng Hospital Care Cost Form

The estimated cost provided is before any deductions.

Three deductions can lower your final bill that needs to be paid with cash.

  1. Government subsidy that lowers costs for up to 65%
  2. Medical insurance if you have any
  3. MediSave balance

If the bill size is likely to change significantly due to the development of your medical condition and/or increase in length of stay, the hospital will provide an updated care cost.

After going through all the potential costs, I had to sign a Care Cost Form to acknowledge that the cost briefing.

Anaesthetic and Operation Briefing

Similar to financial counselling, they will also give you a choice to do the anaesthetic and operation briefing either via a physical meeting or Zoom. This was done one day after the financial counselling. Doing it via a Zoom call is convenient and is safer during this Covid period.

For those that are not confident in using Zoom, a Word document with detailed instructions is also provided.

For the anaesthetic briefing, they briefed on what to expect, common and uncommon side effects and risks of undergoing anaesthesia.

As for the operation briefing, they will confirm my day surgery date and brief you about various requirements listed below.

  1. Documents to bring (e.g. IC)
  2. No cosmetic enhancements (e.g. Nail products, contact lenses, fake eyelashes, make up)
  3. Do not wear any jewellery
  4. Do not bring excessive cash
  5. Don’t drive on the day of the surgery

The actual reporting timing will only be known the day before the surgery.

Your day surgery is either done in the morning or the afternoon and there are two sets of instructions for each timing.

Day Surgery (Morning)

Day Surgery (Afternoon)

Fasting from midnight onwards

Fasting from 7 am onwards

Food intake before 7 am

  • Only 2 slices of plain bread or biscuits with no spread
  • 1 cup of plain coffee or tea without milk
  • No dairy-containing drinks are allowed

Drink water up to 2 hours before the surgery

The fasting and dietary requirements are to prevent any issues of food or liquid going up your gullet and affect breathing or even entering the lungs during the operation. Please be honest as your own life is at stake.

The Operating Theatre staff will call me one day before my day surgery to confirm the time of arrival and fasting instructions.

PACE Clinic

The Pre-Admission Counselling and Evaluation (PACE) Clinic is located near the B2 entrance. I had to go to the PACE clinic as they decided I need to do certain medical tests to see if you are fit for the day surgery.

I had to do the following tests

  1. Blood test
  2. Blood pressure test
  3. ECG

As all the briefing was done online already, I was in and out of the PACE clinic after doing the 3 tests within 15 minutes.

If you did not do the financial counselling and briefings virtually, you will do in at the PACE clinic.

If the medical personnel decide that you do not have to undergo further tests, you just need to do the anaesthetic and operation briefing via Zoom at home and not need to go to the PACE clinic.

Operation – On The Day Surgery Date

I entered the hospital at about 11:45 am and left only at 8:20 pm so you need mentally prepare to get ready for a long day ahead. I stopped eating from dinner the night before and stopped drinking water before I left my house at 10:30 am.

Report And Registration

My reporting time was at 12:30 pm and I reached around 11:50 am. Due to Covid, I had to wear a surgical mask. I was wearing a reusable cloth mask so they provided me with a surgical mask to put on.

Try not to reach too early or else you would be sitting there to wait. I recommended going alone if possible as nobody else can wait in the day surgery clinic beside the patient. I could only leave the day surgery centre at about 7:30 pm, 7 hours after my reporting time.

That is why I recommend that they do not go with you to the hospital at the start and only come and pick you up during discharge. Sitting at an F&B outlet for 7 hours is no joke.

They will also ask for a person as a contact to inform them to pick you up. I asked if I can go back myself by the registration staff says that I will need someone to pick me up after surgery. If I didn’t have anyone to pick me up, I will need to stay in the ward for one night for safety purposes because of going under general anaesthesia.

I feel that something can be improved using this step. Those alone are usually the most vulnerable and cannot afford one more night in the hospital. This also takes up valuable hospital beds. Can a social worker send home the patient instead?

Waiting At The Ward

I was brought to the ward at 12:30 pm to prepare and wait for the day surgery’s timing at 2:30 pm.

The first thing I had to do was to change into scrubs and put on a scrub cap. Next, a nurse will come and give you three plastic bags.

  1. Your bag
  2. Valuables like wallet, phone, watch, etc
  3. Footwear

If you are wearing spectacles, if you do not have a spectacle case that you can place in your bag, you will put your spectacles together with your valuables.

The plastic bag for your valuables will be placed into a sealable tamper-proof bag and you will need to sign a form to acknowledge the deposit of your items. They will keep the bag with your valuables while the two other bags with your bag and footwear will follow you all the way, even into the operating theatre.

My bags were left at my feet together with me on the bed to make sure I don’t lose anything. The beds will be shifted about and you might not return to the same place after surgery.

Fleet Enema

Source: Progress.com.sg

After you are settled, the nurse gave me an enema to clear bowels before surgery. It is a bottle of liquid with a nozzle that they will stick up your butt and squeeze the liquid inside. Within 10 minutes, I went to the toilet to pass out whatever I can.

I asked for the estimated time of discharge and they say it should take 3 – 4 hours so I can tell my mother the estimated time to arrive. As mentioned later, the nurse will call your contact 30 minutes before discharge but you can tell your contact to prepare to come to the hospital about 3 – 4 hours after your surgery time.

Briefing By Anaesthesia Doctor

Although there was a briefing done via Zoom previously, the doctor briefed me again about the potential side effects of undergoing general anaesthesia and check whether I have any metals/implants inside me and if I have any loose teeth. After undergoing anaesthesia, they will place a tube in my throat so if I have any loose teeth, they have to take extra care when placing the tube down my throat for breathing.

After the briefing, I had to sign a form to acknowledge the briefing.

Starting from entering the ward up till just before the surgery, they kept asking for my name and IC and sometimes also what kind of procedure am I undergoing today. I think they do this is to make sure that they 100% perform the correct procedure on the correct person.

The constant checking of your identity was also done during the clinical trials I underwent.

Transportation From Ward To Operating Theatre

From the moment you leave the ward, you are transported on the bed to the operating ward. You cannot walk by yourself as I think they are worried about the safety of the patient. The poor nurse had to push me all the way to the operating theatre. She also had to keep adjusting the direction of the bed as it kept hitting the wall and corners.

There are only medical personnel and no civilians along the way. I was reminded of drama shows with family members sitting outside operating theatres waiting for the doctor to come out, which is impossible as there is no waiting area outside the actual operating theatre. It might not be the same for all operating theatres, if you all have seen any operating theatres in Singapore with waiting areas directly outside, leave a comment and let me know.

Inside The Operating Theatre Holding Area

I reached the operating theatre holding area at about 2:40 pm. There is a small holding area right before entering the actual operating theatre.

They did some briefing on anaesthesia and confirmed my identity and the procedure being done today. A doctor then placed an IV on my left hand for anaesthesia purposes.

The doctor doing the operation asked if I had any questions about surgery and he answered them patiently.

In The Operating Theatre

At around 3 pm, I was pushed into the operating theatre and I had to shift myself onto the operating table. They fastened my legs using some belt to prevent them from moving. They placed a breathing mask and asked me to breathe deeply. I remember feeling drowsy within my first few breaths then I blacked out.

Temporary Holding Area After Day Surgery

My memory of this stage is very fuzzy as I have just come off general anaesthesia. I remember them asking me if I feel any pain twice and I said yes both times. They injected pain killers twice to help reduce the pain.

At The Recovery Ward

When I next wake up, I am already at the recovery ward. They gave me back my belongings and valuables. Remember to check your valuables before signing the form for the collection.

The nurse told me that my surgery was completed at about 4:40 pm.

They have water, milo, biscuits and sandwiches. As the cheapskate that I was, when they offered sandwiches, my eyes lit up but the nurse recommended just eating biscuits. In the end, I asked for water and biscuits. After the surgery, my throat was a bit hoarse and very dry. I couldn’t swallow the biscuits without drinking water. I finished the cups of water in one go and still felt very thirsty so I asked for the entire jug.

The purpose of the water and food is to make sure that the patient can pee and keep food down. This is the requirement that I am ready for discharge. Due to the painkillers, there might be some difficulty in controlling your muscles so peeing might be a problem at the start. Drink more water and when you feel that you are ready, you can slowly make your way to the toilet to try to pee.

Once they confirm that I can pee, keep food down and everything is ok, I can leave in about 1 hour at 7:30 pm and they will contact ur contact 30 minutes before discharge. The nurse called my mother at about 7 pm. Once my mother arrived, the nurse will start briefing about post-operation matters like wound care and the medicine to take.

Collection At Pharmacy

I left the day surgery clinic at about 7:50 pm. The pharmacies at the usual places are already closed so we had to go to the A&E department to collect my medicine.  I collected my medicine at 8:20 pm and left the hospital. No payment is required as everything will be included in the hospital bill.

Post-Operation – After The Day Surgery Date

After the operation, I will need to take care of my wound, finish my medicine and go back to the hospital to check if everything is ok.

Sore Throat From General Anaesthesia

I got quite a bad sore throat from the general anaesthesia tube being place down my throat. Every time I swallowed my saliva, there is a sharp pain. The nurse recommended I drink more water and take lozenges. I forgot to ask for lozenges during discharge so I had to buy my own.

I also tried honey lemon water but I realized that I should avoid citrus. The acidity of the lemon made my sore throat worse. Honey water would work better.

What really made me feel better was eating vanilla ice cream. The cold ice cream really soothed my throat and the pain was gone during eating and I ate 75% of the entire tub. Buy ice cream and keep it in your fridge before your day surgery so you can eat it when you get home.

Polyclinic Dressing

You will need to visit a polyclinic or private clinic to clean your wound and change your dressing. The hospital gave me a memo to pass to the people doing the dressing so that they know what is going on.

Ask your insurance agent which options do you have. My policy only covers polyclinic dressing charges.

I had my surgery on a Friday so it was difficult to get an appointment for dressing services the next day on Saturday where the polyclinic is only open for half a day. I couldn’t make an appointment due to the lack of slots so I went down at 7:30 am to get a queue number. The slots in the morning were fully booked so they asked me to come back at 11 am.

You will need to let a professional help clean your wound and change your dressing every 1 – 2 days for maybe 2 weeks.

Remember to keep all your receipts for your insurance agent to process your claim.

A tip is to not use your own dressing product at the polyclinic. Let them open a new packet/tube when you visit so that they can include it in the dressing receipt. When I bought my supplies from the pharmacy, those cannot be claimed. So you should only buy those items that the polyclinic cannot issue you. It is also cheaper if they include it in the dressing receipt.

For example, a tube of Octenisept wound gel (20ml) costs $8.50 at the pharmacy and if they include it in the dressing service, it is only $5.20 PLUS I can claim from insurance.

Disclaimer: Please don’t abuse this and get a new product every time. Just get enough and don’t hoard the medicine like collecting pokemon.

Hospital Bill Payment

I received my hospital bill about 2.5 weeks after my surgery date.

Consumelesslife TTSH hospitaliztion tax invoice breakdown

Tan Tock Seng Hospital Tax Invoice

The estimated cost was S$19,42.36 and my actual total charges were S$1,822.52. After the government subsidy of S$1,161.02 (63%), the amount payable is S$661.50.

100% of the payable portion is covered by my insurance policy so I didn’t have to pay a cent. Everything is processed between the hospital and the insurance company. As a bonus, I also received S$50 as a hospitalization cash incentive 10 days after surgery. According to my agent, after renewing the policy this year, this benefit is removed.

If you do not have insurance, the amount payable should be covered via MediSave.

Hospital Check-Up

Someone from TTSH called me after 2.5 weeks to check if everything is ok and to ask if I had received the message for the appointment for a check-up.

According to my discharge summary, I was supposed to go back for a check-up in two weeks but I received the message that my appointment is only after 6.5 weeks.

The fees for the check-ups at the hospital can be claimed so remember to keep the receipts.

TL, DR

Undergoing a day surgery can be a long process from the day you visit a doctor till the day you fully recover. It is both physically and mentally exhausting. Take care of yourself as prevention is really better than the cure. If I am employed, I cannot imagine how stressful it would be. Only bring what you need to the hospital. Go to the hospital by yourself if your conditions permit and try to have someone pick you up after the surgery or else you will have to stay for an additional night in the hospital ward.

Remember to check with your insurance agent if you have one, to see what items can be covered by your policy. Don’t use your own dressing products and let the polyclinic issue them as you can claim them.

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