Sunday, May 19, 2013

Getting ready for Surgery

So you've been told you're going to have to have an operation.  What do you need to know to get ready?  The most important thing is that there should be no eating or drinking for at least 8 hours before the scheduled time of your surgery, otherwise the anesthesiologist will refuse to put you to sleep.  This is to prevent a serious complication from aspiration of stomach contents or acid that could cause pneumonia.   Occasionally you will be asked to perform a bowel prep the day/night before to clean out the contents of your bowels.  If so, you will get written instructions on how to do that.  You will be informed which if any of your regular medications can be taken with a sip of water that morning.  You can brush your teeth, but just be sure to spit out the rinse water in the sink.

You will be asked to review your medical history with the surgeon in the office and again on the phone with the Pre-Op nurse.  You'll probably have to review it one more time with the anesthesiologist when you get to the hospital as well.  This serves as a series of checks and balances to make sure you have every opportunity to inform the staff about you and any health issues you may have that could affect how your surgery is done.

You will be required to sign an informed consent document prior to going back to the operating room.  This is to verify that you have been counseled by your surgeon regarding the main risks of, benefits of, and alternatives to your surgical procedure(s).  If you feel you have not received adequate counseling, do not sign the form until you are comfortable.  Your surgeon will see you before you go back to the operating room and give you a chance to do so.

Sometimes before performing vaginal surgeries, we will have a patient use local estrogen creams to help strengthen and improve blood supply to the tissues of the vagina so that they will heal better after surgery.  This is usually done for a number of weeks ahead of time.

Usually about a week before planned surgery we discourage the use of aspirin or other antiinflammatory medications like ibuprofen, naproxen, etc. which can contribute to bleeding.  Acetaminophen is usually fine, as well as narcotic medications for pain.  If you are someone who takes blood thinning medications like Coumadin, Plavix, Heparin, etc., you will be instructed how to wean this preoperatively and then restart afterwards.

After your surgery, you may or may not have a great memory for the events of the day, but the nurse discharging you from the hospital should give be able to give you a general idea as well as instructions for self-care at home.  She will have any prescriptions the doctor left for you to take at home (usually pain meds for the more major surgeries).  If a family member or friend is present immediately after surgery in the waiting area, we always stop by to fill them in on the details of how your surgery went.  We can always be reached by phone if you have any unanswered questions, but of course we always ask for you to schedule a postoperative follow-up appointment in the office in a couple of weeks.

After going home from the hospital, we want to hear from you if you have any signficant bleeding, pain, dizziness, nausea/vomiting or fever/chills.  Also, burning with urination, skin redness/drainage or pain on the back near the ribcage (over the kidneys) should be reported if it occurs.

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