By this point, you’ve consulted with your surgeon and have decided to have surgery. Are there any questions that you wish you would have asked? It’s not too late. Just give them a call.
Now what? First, don’t stress out. You’ll come across a lot of people who will help you through this venture, but there are some important points that you need to consider regarding your surgery. Remember, personal responsibility plays a huge role in preparing for any surgery. There are three parts to the pre-operative period: First, the days or weeks before surgery. Second, the day and night before surgery. Third, the day of surgery.
Days or Weeks Before Surgery
During this time there are activities that are important for maximum benefit, best healing and faster recovery. There are three rules to abide by: exercise, eat better and stop using nicotine products.
- Aerobic exercise like daily walking, bicycling or swimming improves lung function. The idea behind aerobic exercise and deep breathing is to expand the tiny air sacs in your lungs called alveoli to their greatest potential. After anesthesia, the alveoli can collapse. This condition, atelectasis, can lead to fever and pneumonia. You can also practice deep breathing. For instance, repeatedly blowing up a balloon can be very helpful.
- Improving nutritional status will help your body heal faster. One way your surgeon will assess nutritional status is by testing the level of a protein called albumin in a routine blood test. Research has shown that low levels of albumin are associated with worse outcomes in patients undergoing surgery or hospitalization for an illness. Attention to nutrition is even more important for patients with diabetes. Blood glucose levels should be between 90 and 110. High glucose levels are toxic to cells, will disrupt normal wound healing, and are associated with an increased risk of infection.
- Nicotine use causes poor wound healing in two ways. First, blood vessels constrict, which decreases the oxygen-rich blood supply to the cells of the wound. Second, toxins in smoke can impair wound healing. This is a great time to kick the habit. You’ll heal faster and your scars will be less noticeable.
It’s very important to disclose all medications and supplements to your surgeon and anesthesiologist. If you’re on blood thinners such as Warfarin, aspirin, or Plavix, inform your surgeon. They’ll likely instruct you to stop taking these medications 5 to 7 days before surgery. Anti-inflammatory medications and certain vitamin supplements such as vitamin E, ginkgo-biloba, or garlic can also increase bleeding and/or delay healing.
Day/Night Before Surgery
- Don’t eat or drink after midnight. Patients are often told not to eat after midnight. Eating or drinking increases the risk of nausea and vomiting after surgery. After anesthesia, vomiting can result in aspiration into the lungs, which can potentially cause very serious issues like pneumonia.
- Bathe or shower with mild, unscented soap and wash your hair, unless your surgeon tells you to use a special or antibacterial soap. Follow instructions that come with this type of pre-operative scrub very closely.
- Don’t shave the area of your operation within 7 days before surgery. It can create an entry point for bacteria.
- If you have sleep apnea and use a sleep apnea device, bring your mask attachment and a record of the settings that you normally use. DO NOT bring the sleep apnea machine with you. Patients with sleep apnea may have to stay the night for monitoring and observation.
- Pre-admission testing is usually a day or two before surgery. The purpose is to draw labs and possibly do an electrocardiogram and/or chest x-ray. The night before surgery is a time to relax. Have a nice dinner or go see a movie. Remember, don’t eat or drink after midnight. No coffee the next morning. Your surgeon may instruct you to take your blood pressure medicine the morning before surgery. You may do so with small sips of water.
Day of Surgery
- Have someone accompany you to the hospital or surgery center. That person’s job is to be your advocate, help you ask questions before surgery, and help you remember the surgeon’s instructions after surgery.
- There will be a team of people taking care of you. The pre-operative nurse will settle you in. You’ll be seen by the anesthesiologist, the operating room nurse and the surgeon. Remind the team of any drug allergies because many patients are given antibiotics before surgery to help prevent a skin infection.
- Your lower legs may be fitted with compression devices to prevent blood clots.
- Ask your surgeon about recovery time and when you may safely resume activities of daily living and return to work.
Pre-Surgery Checklist
Remember, the best way to prepare for your surgery is to exercise, eat healthy and not use nicotine. Review the pre-surgery checklist to help your surgery and recovery go as smoothly as possible.
- Report any changes in your health (even minor ones such as a cold or cough or skin irritation at the site of surgery) to your surgeon or anesthesiologist prior to your surgery date.
- Follow orders given by your surgeon or anesthesiologist.
- Obtain any lab work or tests your doctors may have ordered prior to the day of surgery.
- If you suspect that you’re pregnant, notify your surgeon prior to the day of surgery.
- Refrain from using nicotine.
- Do not eat or drink anything after midnight.
- Bathe or shower and brush your teeth the morning of surgery.
- Remove all makeup, nail polish and contact lenses. If you must wear contact lenses, bring your storage case to use during surgery.
- Leave all jewelry, cash and valuables at home.
- Arrange for a responsible adult to accompany you, stay with you while you’re receiving care, and drive you home. You won’t be allowed to drive yourself and you’ll need someone to stay with you the first night following surgery.
- If you are admitted to the hospital, it’s best to have a close friend or family member stay with you as much as possible.
- Limit the number of people who accompany you.
- Bring all insurance cards and proper identification such as a driver’s license. It’s important for the facility to have current and correct information.
- Bring any paperwork your surgeon gave you at your office visit.
All in all, patients who are physically and psychologically prepared for surgery tend to have better surgical outcomes and a smoother recovery.
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