How long to schedule surgery?

Day Before Surgery Checklist

If you fail to follow these instructions, your surgery may be canceled.

What to Do:

  • Arrange to have a responsible adult (at least 18 years of age) to drive or to accompany you home (if using public transportation). We recommend that person stay with you for 24 to 48 hours after the surgery. If you are unaccompanied on the day of surgery, your surgery will be rescheduled or canceled.
  • Plan to bring your government-issued photo identification (for example, driver’s license, state ID, passport), insurance information, prescription information and co-payment if needed.
  • Payment will be needed for parking if not receiving outpatient surgery. Learn more about parking and entrances at MedStar Washington Hospital Center.
  • Follow physician and/or ATC instructions about which medications you are allowed to take and not take.
  • Plan to leave valuables, large amounts of cash, credit cards and jewelry at home or with a friend for safe keeping. The hospital is not responsible for lost/stolen items.
  • Remove all makeup, nail polish, piercings/jewelry, etc. from your body.
  • Have storage cases for contacts, glasses, dentures, etc. during surgery.
  • Call your surgeon’s office if you are feeling ill.

What Not to Do:

  • Do not smoke, eat, or drink anything, including water, candy, gum, mints and lozenges after midnight on the night before surgery. If you do not follow these instructions, your surgery may be cancelled or delayed.
  • Do not shave your surgical area before your procedure. It will be done by the hospital staff.
  • Avoid bringing any sort of baggage or valuables with you to surgery. If you want belongings for your inpatient stay, have a friend or family member bring them after your surgery. The Hospital Center is not responsible for the loss of items.
  • Do not bring any dependents with you. Plan for someone to care for all dependents (children and adults) during your surgical stay.

What to Expect:

  • Your surgeon’s office will call you the day before surgery.

Contact Us
If you have any questions, please call the Admission Testing Center (ATC) at 202-877-7169.

Hospital Tips: The Small Stuff Can Add Up

by Louise Ladd and Alison Woodman

I wanted to help Alison prepare for her trip to the hospital. As a veteran of six surgeries, I started out with one tip, then another, and another. After her surgery she had a few more suggestions, then we asked a couple of other vets to add their experiences and we pulled it all together. We hope you find these tips useful in making your hospital stay and recovery more comfortable.

Planning:

If at all possible, schedule your surgery for early in the week. That way you should have the regular staff taking care of you during the major part of your recovery. Once the weekend comes you may find a number of new faces, plus your doctor might be off, his partner covering for him. Normally all will go smoothly but in case of problems, I find it’s better to recover during the weekdays.

Also request the first operation of the day, if possible. Your doctor and the OR team are freshest, and complications won’t delay the start of surgery. The only time I accepted the second appointment of the day I had to wait 4 hours when the patients ahead of me tied up all the operating rooms.

Before the operation:

Stop aspirin/ibuprofen, etc. two weeks prior, to help control bleeding.

Stop vitamin C and E for the same reason.

Ask ahead for the post-op pain prescription so you can have it filled and waiting, to prevent a gap between when you leave the hospital and someone bumbles to the pharmacy.

Delegate a friend to call or email people with news about the operation, visiting info, and when you’ll be released.

Put important papers where they can be found or leave a note as to where they are.

(Note, some of this info is for girls. Guys might have other things they care about. Like bringing their electronic games? I don’t know!)

Do all the personal grooming that requires bending over or reaching, as it will likely be a while before you’re able to this again in comfort. For instance, shave your legs if you do, and have a pedicure if needed

Shampoo your hair as close to departure as possible. There is nothing worse than greasy hair when you can’t wash it. Shortly before surgery have it cut or highlighted etc. because you won’t feel up to dealing with such procedures for some weeks. Some who wear their hair short prefer to have it trimmed extra short, as it means less to deal with during recovery.

If you are a having bowel clean-out, get some Gatorade or Pedialite (NOT red) to drink. It replaces potassium which is lost in the process. Hemorrhoid ointment (better than cream)is useful if delicate areas are irritated.

If you are able to manage it, do any housework or chores that require bending or stretching up, trying to anticipate future needs for a month or two. For instance, take down a few vases from high storage, as you may have flowers to put in them if friends don’t send pre-made arrangements. People don’t realize that arranging flowers in a post-op condition is not as pleasant or easy as it is when you feel well.

In sum, put anything you usually need where you can easily reach it when you get home.

Before you leave for the hospital, put clean sheets on the bed, or arrange for a friend to do so. Nothing beats coming home to your own bed with fresh sheets. Same with towels. Put out your thickest, most luxurious, and forbid anyone else to touch them.

Stock up on essentials, of course. You’ll probably have people to run errands, but some things you want to do for yourself, such as choosing products that you’re particular about. Make sure you have enough on hand so you don’t have someone shopping for you and bringing home a disappointment.

Suggestions on what to take in your purse and toiletries bag, in totally random order:

  • Notepad and several pens
  • Glasses and case
  • Phone numbers or your address book.
  • Cell phone or phone card. Hospital phones sometimes allow only local calls. Note: cell phones don’t work in certain hospitals.
  • Earplugs
  • Mask for eyes
  • Nail scissors/file
  • Skin cream/lotion
  • Hairbrush/comb
  • Watch (leave all expensive jewelry at home)
  • Small mirror
  • Mini-flashlight
  • Length of string
  • Heavy socks. Feet can get cold walking around in halls. (Hospitals sometimes provide socks, but not all do.)
  • Your own pillow, and maybe your own sheets. (see below)
  • Nightgown, robe and slippers
  • Comfortable clothes that you can easily get into for the return trip. Slip-on shoes, loose-hanging shirt/pants/dress, etc.
  • Small supply of any necessary daily meds. (see below)
  • Your house key, so if a friend takes you home you can get in!
  • A good book
  • Perhaps a little radio that you can tuck in the night table drawer in case you want to listen and not watch TV. CD players may disappear.

Some of these items seem might unnecessary, but the
mirror can help you see around your bed space if you drop something, or check areas you can’t see with the fixed mirrors in bath and bedtable. The string can tie objects to the bed so you can retrieve them, and the flashlight will help you see without waking a roommate.

Usually you can take your own pillow to the hospital with you. If your skin is ultra-sensitive like mine, you might want your own sheets. Sometimes the hospital sheets are lovely and worn and soft; sometimes they feel like sandpaper. Better to have your own softest to put on the bed once you’ve stopped bleeding or otherwise messing up the hospital bedding.

Living in those hospital johnnies makes you feel (and look) more like a patient, not a person. Take a soft, pretty nightgown with short sleeves that don’t interfere with IVs, spring or summer-weight because most hospitals are very warm and dry. (Some hospitals don’t allow them.) Pack a non-bulky robe for walking the halls, and slip-on but secure slippers. A bed jacket is nice, if you have one, or a light sweater or shirt can substitute.

Important: the instant you think of a question for the doctor, write it down immediately on your notepad. Amazing how these important questions slip away when faced with a surprise 6 AM visit. Doctors always seem to arrive when you least expect them, and they don’t stay long, so grab your list of questions and ask them quickly, but don’t settle for incomplete answers. One question I’ve recently added to my list: “Doctor Blank, what questions haven’t I asked that I should be asking?” I try to rewrite my list the night before, placing the most urgent questions first. A friend/caretaker can help with this, if needed.

Take along small doses of any meds you normally use. The hospital staff should have orders to give you the meds you require but if orders get messed up the busy doctor must authorize anything that has been missed. Better to take your own, in case, rather than waiting a day or two for them to get around to arrangements.

I keep my purse or toiletries bag in the bed with me. Tuck it under the covers or use it to plump up a pillow, and that way you always have your notepad and pen, glasses, nail scissors (which can also cut tape, string, paper, etc.)-–your vital needs–where you can reach them without a stretch or fuss.

This is vital! Do not allow anyone to move your nightstand or bedtable with the phone, your cup—whatever important is on it—without putting it back where you can easily reach it. This is the most valuable piece of advice my mother gave me, as a veteran of surgery herself. And she was so right. Six inches or a foot can be a chasm you can’t cross when the phone rings, or you need whatever you’ve stored there. Draculas arrive to suck your blood with needles, nurses fuss over IVs, room cleaners come through, and they all shove the table out of their way, then leave, and you’re stuck. No matter how sleepy you are, ask them (nicely) to replace the table.

Nice is the key word when dealing with nurses, and all the staff. If they like you, you might get better attention. And if you only buzz them when you really need help, they’ll appreciate it. I’m sure you know this, but sometimes it’s hard to apply when dealing with difficult people, or you’re feeling awful. Be polite and you’ll come out ahead. If they see you understand their needs and respect the demands on their time, they might come to you before answering some else’s buzzer. I also try to learn their names, if possible.

One trick I’ve never used, but has been recommended, is to ask people to bring you big tins of cookies or candies to share with the staff. They’re often overworked and don’t have time to eat properly. If they’re hungry, your room will be a magnet.

Try to arrange to have a family member or friend with you as much as possible. They can fetch more ice or juice, open or close the blinds, add or take away blankets, chores that spare the busy staff a lot of small stuff that makes a big difference to you, but is a burden to them. More importantly, if they are trained to be your advocate, they can make sure you get the right meds, on time, and oversee your care in many ways so you can lie back and relax, go with the flow, and not struggle to stay awake and alert when all your body wants is rest and sleep. This is another bit of advice I wish I’d taken. I really needed this sort of help after the last operation, but was so used to being in control I paid a price for it.

Going home:

Sometimes a nurse will help you time your pain medication so you have received a dose that will be in effect during the drive home. If they don’t offer, ask. If you have pre-filled pain meds with you, you can use them instead, or in case (shudder) you have a flat tire on a long drive home. Remember, staying ahead of the pain is far more effective than allowing it to build up, then starting all over again.

If you have a car with good suspension use it, and make sure there are 2-3 soft pillows to help cushion the many bumps you will now discover in the road. Warn whoever collects you to drive smoothly, with no delays. Witness: “The first time my son drove me home in his car, I cannot begin to tell you how bad it was. After the second surgery we used my car and it was a far smoother ride. You feel every tiny bump.” And… “My friend picked me up, drove like a maniac, hitting every bump in the road, then stopped for gas because she could save a few pennies, while I waited in agony. All I wanted was to get home!”

We hope you find this helpful. Sometimes it’s the small stuff that can make a big difference.

— Louise Ladd & Alison Woodman

    10 things to do before surgery

    Antonia Mariconda is a beauty coach and founder of The Safety in Beauty Campaign. Here are her 10 must-do rules before getting cosmetic surgery

    Studies have shown that the UK’s cosmetic surgery rate is skyrocketing, but being safe before getting surgery is key to a healthy procedure and results.

    1. Make it your decision Probably the most important aspect in the process of any cosmetic surgery is ‘Making the decision’ to have cosmetic surgery for the right reasons. Only make the decision for you and no one else, with much careful reflection and with a network of supportive friends and family, Emotional experts, such as Norman Wright from thewrightinitiative.com, can give advice and help you make a final decision on enhancements.

    2. Find a good surgeon Always check your surgeon’s qualifications and what experience they have. You can do this via the GMC avoid ‘flying surgeons’ they have a tendency to go AWOL, as they are not based in the UK, opt for a BAPRAS or BAAPS registered surgeon. UK standards of training have a certain level that requires continuous professional development.

    3. Look around Are there any certificates visible to see in your surgeon’s office? If not, ask why?

    4. Ask questions How many procedures they have performed, experience speaks volumes.

    5. Find out about licensing Are the premises licensed for what they are doing? Ask. If it is not, then be very cautious.

    6. Ask for evidence Being told a particular treatment is ‘the best’ is great, but ask for evidence to back up a claim (like before and after photos) and clinical studies. Your provider will be less likely to mess you around with ‘sales tactics’ if you appear prepared and well informed.

    7. Find out about their complications procedure Ask how they handle complications and what’s built into the cost of your treatment and surgery. This is an absolutely essential question.

    8. See more than one professional This will help you decide who is the right surgeon for you. Just because the surgeon you have seen ‘seems’ to be the right one, don’t stop there, seek at least three consultations to have a broad choice of expert to choose from.

    9. Be prepared to pay – there are no bargains when it comes to health. If it sounds too good to be true, it is. As well as preparing psychologically and physically, please prepare financially, don’t go out of your financial comfort zone it will only add pressure and stress during a time where it is not needed or welcome as you will need to recuperate from your operation. If you can’t afford it, save up and then come back to the option later when more financially prepared.

    10. Meet your surgeon – always Don’t ever have a procedure if you haven’t met your actual surgeon first. Don’t be swayed, pressured or talked-into any cosmetic surgery procedures by a sales representative – only make a decision when you have spoken to a surgeon and preferably the one that will operate on you and you feel comfortable.

    Antonia Mariconda is beauty coach and founder of The Safety in Beauty campaign. She is presenting The Safe Guide to Nip & Tuck on Friday February 28th at 9pm and The Ultimate Anti-ageing TV Show on Friday March 28th at 9pm on Sky Fitness and The Beauty Channel 282. For more information please visit www.thecosmediccoach.com

    Preparing for surgery can feel overwhelming or scary if you don’t know what to expect. You may have some unanswered questions and worries that make you feel this way. Knowing what to expect will help you feel less nervous and more in control. Be sure to get specific questions answered by your health care provider(s).

    What is the difference between day surgery and inpatient surgery?

    Day surgery is when someone comes to the hospital (usually in the morning) for a minor surgical procedure, and leaves the same day. Inpatient surgery is when someone stays in the hospital overnight after his/her surgery. Sometimes people who are staying overnight will be admitted to the hospital the day before their surgery. In most cases people who are staying overnight will be admitted the morning of their surgery.

    What should I do before my surgery?

    This will depend on the type of surgical procedure you’ll be having, but your doctor/nurse will usually ask that you not have anything to eat or drink after midnight the night before your procedure. This means that you can’t have anything to eat or drink by mouth—no food or liquids of any kind; not even mints, candy, or chewing gum. Having an empty stomach before surgery decreases the risks of anesthesia, so it’s very important to follow this rule. You can brush your teeth in the morning, but DO NOT swallow water after rinsing your mouth. If you forget and eat or drink before your surgery, be sure to let the nurse or doctor know right away. Most likely, your surgery will need to be rescheduled.

    If you take prescription medicine, ask your nurse or doctor if you should take your medicine with a tiny sip of water or wait until after the procedure.

    I’m having day surgery—what will happen on the day of my procedure?

    Depending on the hospital where you are having your surgery, the order of events may be different, and some advice that we list may not apply.

    • Time to arrive—One or two days before your surgery, you will receive a call from the hospital to let you know what time to arrive. Usually this is 1-2 hours before the procedure. Both you and your parent(s) or guardian(s) will need to sign a consent form (a document that gives the doctor permission to do the surgery and for anesthesia). Sometimes the consent forms are done before the day of your surgery.
    • ID Bracelet—When you check into the hospital, you will be given a bracelet that will have your name and your hospital identification number printed on it.
    • Day Surgery Area—After you have checked in with the admissions department, you will go to the Day Surgery Area, where you will be assigned a nurse who will take your blood pressure and ask you questions such as if you had anything to eat or drink before arriving at the hospital. He or she will probably ask you some private questions about your lifestyle, such as whether or not there’s a chance you may be pregnant, or if you use drugs or alcohol. You should answer these questions truthfully, because the doctors, surgeons, and anesthesiologists need to know if there’s anything they should be aware of that could complicate your surgery.
    • Urine Test—Most hospitals require teen girls/women to have a urine pregnancy test. This routine and mandatory test is done on everyone over the age of 12 (or younger if they are menstruating) even if you are not sexually active. You will have private time with your nurse so that you can ask questions. If there is a chance you could be pregnant, it’s VERY IMPORTANT to let your nurse of doctor know.
    • Nail Polish—Please remove any nail polish before arriving at the hospital. If you are wearing nail polish and haven’t removed it yet, you will be given nail polish remover to take it off. This is done because the doctors/nurses need to be able to see your natural finger nail to check your circulation. Nail polish may also get in the way of the pulse oximeter which is a small machine that gently clips onto your finger to keep track of your pulse and how well you are breathing.
    • Acrylic nails—Most hospitals require that you remove at least 2 acrylic nails (one on each hand) so that the pulse oximeter can be used.
    • Jewelry—All jewelry will need to be removed especially nose, lip, and belly button rings, before your surgery. Leave your jewelry at home so you won’t worry about losing it at the hospital.
    • Makeup and Hair Products—Don’t wear any makeup to the hospital. While you are under anesthesia, you don’t have a blink reflex so small particles of makeup (especially mascara) can injure your eyes. Also, makeup, hair products and nail polish can be flammable and should not be worn when you are having surgery.
    • Clothing—While you are a patient in the hospital your clothes will be placed in a bag with your name on it. You will be given a hospital gown to wear during the operation and while you are recovering. When you are ready to be discharged from the hospital, you will be able to change into your own clothes. It is a good idea to have loose fitting clothes so that you are comfortable on your way home.
    • Mouth Appliances–You’ll need to remove all dental appliances (such as a retainer or elastic bands from your braces) if you have any.

    Why does everyone keep checking my ID bracelet? Don’t they know who I am?

    You name, date of birth, and the planned procedure will be reviewed with you and your parent(s)/guardian(s) many times while you are in the day surgery area. The medical staff knows who you are, but these are safety checks to make sure that your surgeon always performs the right operation on the right person.

    What’s the “pre-op holding area” and what happens there?

    The “pre-op” holding area is where you’ll stay before you go to the operating room. This is where a nurse or anesthesia care provider will likely start an IV. This is a plastic tube that delivers certain medicine to your body throughout your surgery. It is inserted with a needle, but then the needle is removed so that only the plastic tube remains. The IV is usually placed in your hand. You will receive medicine through your IV to make you feel relaxed. If the anesthesiologist gives you a choice of which hand to put the IV in, choose the hand you don’t write with.

    What if I’m afraid of needles?

    If you are nervous about getting an IV, let your nurse know as soon as possible so that he/she can help you. You may be able to have a numbing cream placed on your hand which will numb your skin and lower the feeling of pain when the IV is inserted. The numbing cream takes time to work, so it’s important to ask for it as soon as possible. Another option is to have a small injection of numbing medicine in the area where your IV will be placed. When your anesthesiologist or nurse anesthetist comes to start your IV, try to stay as relaxed as possible. You can do this by taking slow, deep breaths, concentrating on something pleasant, or having your parent(s) or guardian(s) distract you with conversation. After your surgery, you will be taken to the recovery room (also known as the PACU, or Post Anesthesia Care Unit, in some hospitals). When your nurse and/or anesthesia care provider feels you are taking fluids well after your surgery (and you are ready to go home), the IV will be removed.

    What happens in the operating room?

    You will be attached to a heart monitor. It is attached by 3 small, white circular patches that stick to a few areas on your chest. These white sticky patches are usually removed before you wake up. You will be given more medicine through your IV that will make you very sleepy. You will drift off to sleep and you will stay asleep during your surgery. After what seems like a few minutes, you will wake up in the recovery room, and the surgery will be over.

    What exactly is anesthesia?

    Anesthesia is the medicine that puts you to sleep and makes you feel no pain during your surgery. There are two different types of anesthesia: “local” and “general.”

    Local anesthesia is special numbing medicine that is applied only to the area of your body where you are having a procedure. You are awake during the procedure. Sometimes you might also have an IV so you can be given medicine to help you relax. With this medicine, you may get drowsy, and even fall into a “light” sleep.

    General anesthesia puts you to sleep during your procedure. This type of sleep is a “deep” sleep; you are sleeping so soundly that your anesthesia care provider helps you breathe. With this type of anesthesia, most people wake up feeling sleepy when the surgery is over.

    If you have any worries or concerns about the type of anesthesia that you will be receiving, ask your health care provider or nurse to answer your questions. Also, it’s very important to let your health care provider/anesthesiologist know if you or any family members have ever had problems with anesthesia in the past, such as severe headaches, nausea, or a very sleepy feeling that took a long time to wear off. Unless you require emergency surgery, you should know which type of anesthesia you’re going to have in advance.

    What happens after surgery?

    After your surgery you will be taken to the recovery room. There, your nurse will check you often, and take your blood pressure, temperature, and pulse, and give you any medicine that your doctor orders. It is common to feel cold or chilly after surgery. Don’t be shy—ask your nurse for a warm blanket. If you’re thirsty and your HCP has said that it’s okay to have something to drink, your nurse will offer you a clear liquid such as ginger ale, water or apple juice. Before you can go home, you will need to pass urine (pee). Your nurse will offer you a bedpan or take you to the bathroom. After a little while, when you are fully awake and comfortable, your nurse will help you get ready to go home. You will probably have your IV removed at this time.

    Will I have a scar?

    Whether you will have a small, medium, long, or no scar at all depends on whether your doctor needs to make an incision (a cut in your skin). Some surgical procedures can be done without any cuts. Other types of surgeries require your surgeon to cut the skin to remove something. For example, an appendectomy requires a small size cut on your belly to remove your appendix. Sometimes, the cuts and stitches are made inside. One example of this is a tonsillectomy (removal of tonsils).

    If I have an incision, how long will it take to heal?

    Most incisions (where the skin was cut) appear red after the stitches are removed, or dissolve. Dissolving stitches get absorbed by your body and do not need to be removed, but fade over time. About 4-6 weeks after the surgery, the scar from your incision should be much lighter than it was after the operation, but it takes up to a year for it to heal completely. It’s very important to keep the area where you had the surgery out of the sun, because the skin is tender and may burn more easily and cause a more noticeable scar over time. If you can’t help being out in the sun, be sure to use a sunscreen with a high (30+) SPF (sun protection factor) or higher on the healed incision area, to prevent burning. It is important to use sunscreen on your incision for a year–this will help minimize scarring. Most incisions heal well, and the scar will hardly be noticeable. Sometimes though, people develop a thicker type of scar that has extra fibrous tissue. This is called a keloid scar.

    What can I do to make sure my incision heals well?

    The most important thing to remember if you have an incision is to keep it clean. If you have an incision with stitches, you will receive instructions when you are discharged. The instructions will be specific to the type of surgery that you’ve had.

    In general, you should call your doctor if you have:

    • A temperature of 101 or higher
    • Any blood or drainage from your incision after the first 24 hours
    • Redness at the incision area
    • A bad odor coming from the incision
    • Severe pain in or around the incision

    You will most likely be scheduled for a follow-up or “post-op” appointment with your surgeon so that he/she can check to see if you are healing well. It is important to keep this appointment even if you feel terrific.

    What should I bring to the hospital?

    Since you are having day surgery, you really don’t need to bring very much with you. Most people wear the same clothes home that they wore to the hospital. It’s a good idea to bring or wear casual and loose fitting clothing so that you are comfortable on the ride home.

    What if I get bored while I’m in the hospital?

    You probably will be on your way home before you know it—in less than 4 hours, but if you think you might get bored while you are waiting, you can bring a book, tablet, or music to listen to if you wish.

    What should I do about the school work I’ll miss?

    Helpful Tips:

    • If your surgery isn’t an emergency and your doctor is available, it might be possible to schedule your procedure during a school vacation week, or during the summer. That way you won’t be worried about missing any school.
    • If your surgery is scheduled during school time, you can ask your teacher(s) about getting homework assignments ahead of time. Try to get as much of your work done before your surgery without getting too stressed out. Teachers will usually understand your situation if you take the time to explain that you will be having surgery and you will be home recovering for a few days.
    • If your surgery is an emergency, ask a parent/guardian or friend to get your school work for you. Many teachers will give you some extra time to make up your assignments. You shouldn’t have to worry. If a teacher seems too demanding, speak with your guidance counselor or principal when you return to school.
    • Ask your doctor or nurse for a note to excuse your school absences for your surgery and for your recovery time at home.

    What if I have my period while I’m in the hospital?

    Don’t worry – It’s okay if you have your period the day of your surgery or while you are in the hospital! This will not cause your surgery to be rescheduled.

    Most likely you won’t be allowed to wear a tampon while in surgery. Instead, you will be given a pad to wear. If needed, an operating room nurse will change your pad while you are sleeping.

    What if I’m still nervous on the day of my surgery?

    It’s completely normal to feel a bit nervous, but knowing what to expect will make you feel less afraid. Try not to worry too much. Your doctors and nurses are there to answer any questions you have. They will take good care of you and keep you comfortable while you are in the hospital. If possible, try to talk with someone else who has had the same procedure. This may be a friend, relative, or someone your doctor or nurse arranges for you to talk to.

    Once you are home recovering from your surgery, it’s important to rest, drink water and other liquids to stay hydrated, eat healthy foods, and take care of your incision (if you have one). Our bodies are amazing, but everyone needs time to recover from surgery. Ask your doctor/nurse exactly what you can and can’t do so that your recovery is fast and without complications. Remember to talk with your surgical team to learn more about specific instructions for your surgery.

    What to Expect on the Day of Surgery

    What do I expect the day of surgery?
    It is normal to be nervous as the day of your surgery gets closer. It is important that you understand the procedures involved in your stay to make your recovery safe and as speedy as possible. Please keep in mind that the surgical treatment of each person is different. Although you may be having the same operation as someone else, the way you will need to prepare and the things that will need to be done before, during, and after surgery may be special for you.

    If you get a cough, cold, flu-like symptoms, fever or any strange symptoms before your surgery, let your doctor know right away. On the day of surgery, you will meet with the team involved in your surgery. This may include your surgeon, anesthesiologist, nurse anesthetist, preop holding nurse, operating room nurse, postanesthesia care nurse and various other healthcare professionals.

    How do I prepare for my surgery?

    • As a general rule, you should not eat or drink anything after midnight before surgery. In some cases, you may be allowed to drink clear liquids up to a few hours before your anesthesia. This may seem strict, not being able to have a sip of water or coffee, but this decreases the risk for problems such as vomiting during surgery.
    • You may brush your teeth and rinse your mouth with a small sip of water, but do not swallow any of it.
    • If you have been told to take medicine the day of surgery, take them with just a small sip of water.
    • Stop smoking for at least twenty-four (24) hours before surgery.
    • Do not drink alcohol for at least twenty-four (24) hours before surgery.
    • Do not chew gum on the day of surgery.
    • Bathe or shower the day of surgery. Do not wear makeup, lotion, powder, deodorant or nail polish. It is important to remove your nail polish so that the doctors and nurses can see your true color during the surgery and in the Post Anesthesia Care Unit. The color of the skin and nail beds is an important sign of blood circulation.
    • Clothing should be loose fitting, comfortable and appropriate for wearing after the procedure you will be having.
    • Do not wear jewelry, including wedding rings and body piercing (including tongue piercing), or bring money or valuables with you. Rings may be cut off, if unable to remove to lower the risk of problems such as swelling during surgery.
    • No hairspray or hairpins should be worn.
    • You may be asked to remove your glasses, contacts, hearing aids and dentures. Please bring your eyewear case, your hearing aid case and/or a denture cup.
    • If you have a C-Pap or Bi-Pap machine ask if you should bring it the day of surgery.
    • Bring items such as your inhaler if you have asthma or a cane if you use one, to have ready if you will need them after surgery.
    • Patients returning home following their surgery must be driven home by a responsible adult. You may be asked to provide the driver’s name and phone number.

    If I did not receive a pre-anesthetic interview or testing, what are important things do I need to pay attention to or bring on the day of surgery?

    • Bring a list of all the medicines you are taking, the reason you are taking it, the dose you take and how often you take it. Include prescriptions, over-the-counter medicines, and herbal remedies (visit www.asahq.org for additional information on herbal remedies), recreational drugs, tobacco, and alcohol. The American Society of Anesthesiologists,(ASA) recommends that everyone stop herbal medicines at least two (2) to three (3) weeks before your surgery to avoid the possibility of unwanted interactions and side effects. This information will help your anesthesia provider to select the best drugs for you to avoid the unwanted drug interactions. It is important that you also bring a list of any known food or drugs to which you are allergic.
    • You will be asked to give a detailed health history and family history. This will include any problems with anesthesia and allergies.
    • This information is important for your safety.,If you do not follow instructions about not eating or drinking before your surgery, your surgery may be delayed or even cancelled.

    10 Things Your Doctor Won’t Tell You Before Surgery

    Your doctor tells you or a loved one that you need surgery and has helped you find a surgeon. You’ve read all you could find about the procedure. But here are 10 things your doctor may not have mentioned, and that you should be sure to do for yourself to be prepared and feel empowered.

    1. You need the most experienced surgeon you can find. When it comes to surgeries, practice makes perfect — and so the more experienced the surgeon, the better the results are likely to be. Ask directly: How many of these surgeries have you done? Consider looking for someone who’s been doing surgery for more than five years with over 30 surgeries each year. Compared to a surgeon who’s immersed in patient care, the clinician researcher may be more involved in research than in day-to-day surgery, cautioned Alexander Marmureanu, MD, a cardiothoracic surgeon at the California Heart & Lung Surgery Medical Center in Los Angeles.

    2. I might have been sued by former patients. Contact the state medical licensing board for your state, or the county clerk’s office in your area to find out about medical malpractice lawsuit cases involving your surgeon (or any doctor). This is public information you have the right to know.

    3. My hospital may not be up to snuff. Try this Medicare tool to compare hospitals based on their surgical records. You might discover that your hospital is better than average — or worse — for care before, during and after surgery. You can also check that your hospital provides high quality care at , and for to see that they’re accredited organizations. This means a hospital or outpatient clinic meets strict patient quality and safety standards.

    4. Schedule surgery during banking hours. You might think having surgery on a weekend or at night is a great idea. Wrong. These are off hours for regular healthcare staff who are essential for a successful surgery, including the most experienced nurses, a patient advocate or a social worker. For the best care, schedule your surgery during the week — Monday through Thursday — between 9 and 5, recommends Dr. Marmureanu.

    5. I’m great…but you still need a second opinion. Do you really need surgery now? Always confirm the necessity to have surgery with more than one source. Unless you’re having emergency surgery, you’ll have time to weigh your options. Get the name of a second surgeon by asking your primary health care provider, the first surgeon, or a service like Grand Rounds. A second surgeon’s opinion — and even a third — will help you decide what’s best.

    6. Don’t mind my lousy bedside manner. You want a surgeon who’s confident and great at his or her job, but you’re not going to spend a huge amount of time with them. Clear communication and skills are more important than a great personality.

    7. Ask me all your questions…and make sure you get answers. What are the risks and benefits of the surgery? How long will the benefits last? What are the alternatives to surgery? What if we skip the surgery? How long will it take to recover from surgery? If the surgeon doesn’t welcome questions, you should look around for someone qualified who will. Put questions in writing, and follow-up by asking the attending nurse.

    8. Your incision size could be negotiable. Your condition may have surgery options that are less invasive and come with fewer risks. This can mean a shorter hospital stay, quicker recovery, and even lower cost for you. Ask about different ways to get the same end result. Minor surgery, like laparoscopic surgery, might work as well as major surgery.

    9. Get a friend to take notes. Support of family or a friend when you discuss surgery options with the surgeon can make all the difference. Bringing an assertive companion with you for these visits — as your patient advocate — can help you raise your voice and be heard. They can ask questions and even take notes for you, recommends Carolyn M. Clancy, MD former Director of the Agency for Healthcare Research and Quality, AHRQ, Center for Outcomes and Effectiveness Research in Rockville, MD. But what about when you don’t have that special someone to come along with you? Reach out to ask for a patient advocate from the hospital or hire one from a private service. A professional patient advocate may be a social worker, a nurse, or even a chaplain.

    10. Forgo makeup and nail polish. It’s important to shower with antibacterial soap or medicated soap from your doctor before surgery. In addition, you’ll want to remove makeup and nail polish (even if it’s clear polish) because clinicians look at your nails for clues to your oxygen levels while you recover.

    Below you will find some frequently asked questions. We hope that these will provide some answers for you. However, it is always good to write your questions down and bring them to your appointment with you so your doctor can address them for you during your visit.
    TESTS
    1. How long should I wait to hear about any appointment that is to be scheduled for testing?
    A. It usually takes about 24-48 hours to hear from the facility that will be scheduling your test.
    2. How will I get the results of my test?
    A. Once your tests have been scheduled, please call our office to schedule your follow-up
    appointment. Your physician will go over your results at that appointment.

    SURGERY INFORMATION
    1. How long does it take to schedule surgery if it is needed?
    A. It can take from 2-6 weeks from the time of your appointment to schedule a surgery date. It is
    based on a combination of the doctor’s schedule and the availability of the hospital operating
    room. Emergency cases are handled accordingly.
    2. Can I shower after surgery?
    A. You can shower after surgery, however- NO baths and try to keep the water from hitting the
    incision area directly.
    3. How much should I be walking after surgery?
    A. For back surgeries; short walks of 5-10 minutes at a time and as you feel better the walks can be
    longer.
    4. How long should I expect to be out of work after surgery?
    A. This varies according to your case. The physician can answer this better for you.
    5. What is the hardware the doctor will be using in my surgery made of?
    A. The hardware will depend on the type of surgery you are having, but most instrumentation is
    made of titanium. As always check with your doctor.
    6. When will I be able to drive?
    A. Again, this is determined by your doctor and the type of surgery you are having.
    Here are a few examples: For a Lumbar Fusion it can range from 4-12 weeks. Again this varies by procecdure and physician and will be addressed after the recommendation for surgery.
    7. How long will I have to wear this brace?
    A. This is patient specific, only the doctor can answer this for you.
    8. Are there any general post-op restrictions I need to be mindful of?
    A. NO bending, lifting OR driving. These are common precautions and will each be assessed at your
    post- op appointment and adjusted accordingly.

    The day of your surgery – adult

    At home on the day of surgery:

    • Follow instructions about not eating or drinking. You may be told not to eat or drink after the midnight before your surgery. Sometimes you can drink clear liquids up until 2 hours before your operation.
    • If your doctor told you to take any medicine on the day of surgery, take it with a small sip of water.
    • Brush your teeth or rinse your mouth but spit out all of the water.
    • Take a shower or bath. Your provider may give you a special medicated soap to use. Look for instructions for how to use this soap.
    • DO NOT use any deodorant, powder, lotion, perfume, aftershave, or makeup.
    • Wear loose, comfortable clothing and flat shoes.
    • Take off jewelry. Remove body piercings.
    • DO NOT wear contact lenses. If you wear glasses, bring a case for them.

    Here is what to bring and what to leave at home:

    • Leave all valuables at home.
    • Bring any special medical equipment that you use (CPAP, a walker, or a cane).

    Plan to arrive at your surgery unit at the scheduled time. You may need to arrive up to 2 hours before surgery.

    The staff will prepare you for surgery. They will:

    • Ask you to change into a gown, cap, and paper slippers.
    • Put an ID bracelet around your wrist.
    • Ask you to state your name, your birthday.
    • Ask you to confirm the location and type of surgery. The surgery site will be marked with a special marker.
    • Put an IV in.
    • Check your blood pressure, heart rate, and breathing rate.

    Seeing a specialist


    Having an operation (surgery)

    • What are the different types of treatment for my condition?
    • What are the benefits, side effects and risks of each of these treatments?
    • Why are you recommending I have this operation?
    • Are other types of non-surgical treatment possible for my condition?

    If an operation is necessary, this will be your chance to find out what the operation involves, why it’s needed, and whether it’s suitable for you.

    Below are some questions you may want to ask:

    • Who will perform the operation?
    • What qualifications and experience do they have?
    • What exactly does the operation involve, and how long will it take?
    • What type of anaesthetic will I need?
    • How long is the waiting list for this operation?
    • How will I know if the operation is a success?

    Don’t be afraid to ask practical questions, such as:

    • Will I need stitches, and will there be scarring?
    • How long before the operation will I need to stop eating and drinking?
    • How long will I need to stay in hospital?
    • How long will it take me to recover and get back to normal?
    • Will I need time off work and, if so, for how long?

    Make sure you discuss any concerns with the consultant.

    You may wish to ask if there’s any written information about the operation or procedure you can take away with you.

    At the end of the session, your consultant may book your operation or ask you to come back for a further appointment.

    Once booked, you should receive a letter with details of your operation asking you to confirm you’re happy with the proposed date and time.

    News & Stories

    For decades, anesthesiologists advised patients not to eat or drink at all after midnight the night before their surgery—a guideline referred to in the medical world as “NPO after midnight.”

    But experts are now revisiting the old standard. New research suggests that the “NPO after midnight” rule is unnecessarily strict for patients scheduled to undergo surgery. In both 1999 and 2011, the American Society of Anesthesiologists issued NPO guidelines that permitted the consumption of clear liquids until two hours before surgery for all healthy patients undergoing elective procedures requiring general anesthesia, regional anesthesia or sedation/analgesia.

    Despite the recent recommendations, many anesthesiologists continue adhere to “NPO past midnight” rule for all surgical patients.

    “We have good evidence that drinking clear liquids until two hours before surgery is safe, but we continue to have this dogma about not eating or drinking anything after midnight, which is just a number picked out of the air,” said Anesthesiologist Joyce Wahr, MD, FAHA, the director of the new University of Minnesota Health Preoperative Assessment Center (PAC).

    We spoke with Wahr to discuss the new take on the longtime approach.

    Why have doctors traditionally recommended that patients fast before surgery?
    In the 1950s, two research papers were published regarding pregnant women who received heavy anesthesia during delivery, then died when they aspirated the contents of their stomachs. As a result, anesthesiologists were very concerned about patients having any food in their stomach before receiving anesthesia. When patients receive general anesthesia, they are unable protect their own airways or keep them clear. For that reason, the care team needs to prevent the contents of the stomach from entering the lungs. Today, we use an endotracheal tube to accomplish that, but the studies from the 1950s were based on outdated anesthesia techniques. Doctors at the time simply put a mask on the patient’s face and used ether, which makes many people sick.

    What changed?
    Around 2000, there was a large review of 30 or so separate studies. The review demonstrated that patients drinking fluid until two hours before surgery actually had emptier stomachs during the procedure.

    Many patients go into surgery in the afternoon and are therefore required to go 18 hours without food and drink under the old standards. Clearly, the guidelines have to be individualized for each patient and the time of the surgical procedure. This idea has been the official practice of the American Society of Anesthesiologists since 1999, but there’s still some stigma attached to it.

    What kind of fluids are we talking about that are OK to consume before surgery?
    Clear liquids—something you can see through. Some options include apple juice, Gatorade, black coffee, or tea without any milk or cream.

    Are certain foods also being considered?
    Only a few studies have been published about a patient’s ability to eat food before a procedure. For that reason, we still ask patients to refrain from drinking milk or eating any food for eight hours prior to the surgery. Milk is a protein and still has a lot of fat in it, so the digestive system takes longer to process it than other fluids. If a patient wants to eat before the procedure, we recommend toast and crackers, and we recommend that this be eaten 8 hours before the procedure.

    What differences do you see in patients based on the different approach?
    A number of studies show that patients do much better if they’re allowed to drink up to two hours before surgery. They use less IV fluid, and depending on what they drink, they have better metabolism. It’s also less difficult to control a patient’s sugar levels following surgery.

    Learn more about the University of Minnesota Health Preoperative Assessment Center.

    How does the Preoperative Assessment Center incorporate this research—and other advancements—into its preoperative care?

    As anesthesiologists, we know that better preparation allows for a better recovery. We’re always incorporating that idea into our care. We advise patients about being active and getting up and moving. We talk about “prehabilitation”—instead of rehabilitation. In other words, they should stay active before surgery, so that they’re in good condition entering the procedure. Surgery is like running a marathon. You put a lot of stress on your body, so it helps to do a little training program beforehand to prepare your body. We also have these conversations before the procedure. That way, after surgery, patients are prepared and informed, and we are not trying to train a patient who is groggy or in pain.

    What to do the day before your surgery

    The information on this page is designed to serve as a guide to prepare you for your trip to the hospital. Please read carefully and feel free to ask any questions during your pre-surgical screening call.

    Bathing Before Surgery

    Instructions for Cleansing with Chlorhexidine Before Your Surgery

    All people have germs or harmful bacteria on their skin. These germs may be more likely to cause an infection. To help prevent an infection, it is important that your skin be as germ-free as possible, before your surgery. Washing with a special soap that contains chlorhexidine gluconate (CHG) will help kill germs and prevent infection. It is important to wash your body with this special cleanser the night before and morning of your procedure.

    Please note:

    • It is important that all of your body is washed with CHG soap. Wash your head and face with regular soap/shampoo
    • Do not get CHG soap in any open wounds, your eyes or your ears
    • If you are allergic to CHG, do not use it. Another anti-bacterial soap (Dial or Safeguard) can be used
    • If you feel you are having a skin reaction, stop using CHG and call your doctor or seek medical attention

    Steps to follow:

    For best results, have someone wash any body part(s) you cannot reach. Hard to reach areas may include your back, legs or feet. It is important that you wash all of your body parts. Don’t skip – ask for help.

    The night before surgery:

    1. Take your usual shower. Shampoo your hair if you desire
    2. Rinse hair and body completely to remove any shampoo residue
    3. If your skin is visibly dirty, bathe first with a non-CHG soap before using the CHG soap
    4. Apply CHG to a clean, moist washcloth. You will need to use 4 ounces of the CHG on your body. (This is the entire contents of small 4 ounce bottle)
    5. Liberally apply the solution to your body from the chin down. Wash your entire body, especially the surgical site(s)
    6. Allow CHG to sit and soak in to the skin for 1 to 2 minutes, then lightly rinse the CHG from your body. This cleanser will continue to kill germs even after you lightly rinse
    7. Do not apply any lotions, powders or deodorants to your skin after showering. These items may prevent the cleanser from killing germs
    8. Make sure you have clean, fresh linens on your bed

    The morning of surgery:

    1. Rinse your body with plain, warm water
    2. Apply CHG to a clean, moist washcloth. You will need to use 4 more ounces of the CHG on your body. (This is the entire contents of small 4 ounce bottle)
    3. Liberally apply the solution to your body from the chin down. Wash your entire body, especially the surgical site(s)
    4. Allow CHG to sit and soak in to the skin for 1 to 2 minutes, then lightly rinse the CHG from your body. This cleanser will continue to kill germs even after you lightly rinse
    5. Do not apply any lotions, powders or deodorants to your skin after showering. These items may prevent the cleanser from killing germs
    6. For best results shower with CHG rather than taking a bath. Studies prove that showering removes more germs than a tub bath

    Do:

    • Do brush your teeth, do not drink the water
    • Do remove fingernail polish and acrylic nails (tips are okay as well as clear polish). It is vital that we are able to see your nail beds. If you are having surgery on your leg or foot, remove polish from your toes

    Don’t:

    • Don’t chew gum, sucking on breath mints, hard candy or ice
    • Don’t smoke or use smokeless tobacco, Vape or chewing tobacco for 24 hours before surgery
    • Don’t drink alcohol for at least two days before surgery

    Eating and Drinking Before Surgery

    For most surgeries, it is important not to eat and drink for several hours before the surgery. Instructions before surgery and can vary based on health conditions that you may have. You will receive instructions specific to you from your surgeon. This information will also be reviewed by a nurse during the pre-surgical screening call or at your clinic visit with the staff in the Pre-Anesthesia Screening Clinic.

    What to Bring to the Hospital and What to Leave at Home

    Leave These Items at Home

    • All jewelry including rings, earrings, watches and body piercings.
    • Make-up, nail polish, hair clips and other accessories.
    • Any valuables such as money and credit cards, unless you are specifically told to bring them to make a co-payment.

    Bring These Items to the Hospital

    • If you have a living will or power of attorney for healthcare, bring a copy with you
    • Wear your glasses or bring them with you. You may need them during your pre-op preparation. The glasses will be removed before you leave the pre-op area
    • If you are wearing contacts, bring a contact lens case with you
    • Wear your dentures; however, you may need to remove them shortly before surgery
    • Wear clothing that is easy to get on and off. The clothes you choose should be comfortable to wear home after your surgery. Examples:
      • If your surgery is on your head or neck – wear a shirt that buttons up and doesn’t have to be pulled over your head
      • If your surgery is on your abdomen – wear loose-fitting pants with an elastic waist
    • If you already have crutches and will need them after surgery, bring them along with you
    • If you would like your prescriptions filled at your local pharmacy, bring the phone and fax number of that pharmacy
    • Bring your insurance pharmacy card
    • Any items of value should be locked up with security or sent home with your family. The hospital is not liable for lost personal items
    • If you use a CPAP machine for sleep apnea, please bring the machine, mask and tubing to the hospital. You may need to use the machine after surgery when you are waking up

    Preparing for Surgery

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