Getting Ready for Surgery
Preparing for surgery may seem overwhelming. Patients are usually given a lengthy list of things that must be done or avoided before a scheduled operation, and frequently they forget to ask for explanations of preoperative procedures because they are preoccupied with the surgery itself.
Preoperative procedures are designed to improve the outcome of the surgery, decrease the risk for complications, and make the surgery as safe and effective as possible. The following are general guidelines for most procedures, but you should always follow the specific instructions provided by your surgeon.
Refrain from eating or drinking for at least 8 hours before surgery. For most operations patients are instructed not to eat or drink anything after midnight, on the night before the procedure. It may seem harsh, not to be able to have a sip of water, but this precaution minimizes the risk for complications such as vomiting during surgery.
To minimize bleeding risks, do not take aspirin or aspirin-like products for at least 48 hours before any planned surgery. Common over-the-counter products to avoid include Aspirin, Advil, Alka-Seltzer, Aleve, Ascriptin, BC Powder, Bufferin, Ecotrin, Excedrin, Goody's Powder, Ibuprofen, Midol, Motrin, Naproxen, and Nuprin. Also avoid prescription medications such as Diclofenac, Indomethacin, Lortab, Mobic, and Percodan. If you are not sure, check the label or ask your surgeon or pharmacist. Also, make sure your surgeon is aware if you take Fish Oil or Vitamin E supplements.
If instructed by your surgeon, discontinue any prescription medications that "thin" the blood. These medications include Coumadin, Plavix, and Pradaxa. Usually these medications are discontinued 5-10 days before elective surgery. Depending on the situation, your surgeon may choose to prescribe a temporary injectable blood thinner while you are not taking your regular pills. Whether a drug is held or administered is based on the patient's medical condition, the type of drug, and the type of surgical procedure planned. Always follow your surgeon's instructions; if you have any questions please contact us.
Operations involving the large intestine (colon) usually require special laxatives in preparation for surgery. This "bowel prep" ensures that the digestive tract is as empty as possible before surgery to prevent leakage of its contents into the abdominal cavity. To make this process as effective as possible, start with a soft or liquid diet for two days before the scheduled procedure. On the day before the procedure, carefully follow the steps outlined on your bowel prep instructions.
Arrival at the Hospital
If surgery is being done on an outpatient basis, you must arrange for someone to be with you upon discharge. Even though the anesthesia has worn off, grogginess can last several hours and it is unsafe to drive on the day of surgery.
After you arrive, time will be needed to process paperwork, prepare you for the procedure, start IV lines, etc. Sometimes, the time of surgery is changed due to cancellations or emergencies. We appreciate your understanding in the event of unforeseen circumstances.
All patients must sign an informed consent form acknowledging that they are aware of risks and complications, that they know they will be receiving anesthesia, and that the surgeon has explained the operation to them. The surgery will not proceed unless the consent form is signed.
Patients are usually asked to remove personal items (e.g., jewelry, eyeglasses, hairpieces, contact lenses, dentures) before surgery. This policy protects the patient and prevents the items from being lost or damaged. Depending on the procedure, eyeglasses or hearing aids may be worn.
Different staff members may ask the same questions. The clerk who checks the patient in asks several questions, as does the admitting nurse and the anesthesiologist. These questions may be the same or similar and this may seem tedious, but the information must be checked and double-checked to avoid errors and omissions.
The doctor who administers the anesthesia (anesthesiologist) performs a brief physical examination and obtains information about your medical history, medications, drug allergies, and any prior adverse reactions to anesthesia. This information helps the anesthesiologist select the most suitable anesthetic agents and dosages to avoid complications.
While you are in surgery, your family members will be directed to an area where they can wait in comfort. Your surgeon may provide updates to your family during your procedure if needed, and will discuss the procedure in detail when the operation is completed.