GENERAL PRE-OPERATIVE & POST-OPERATIVE GUIDELINES

Pre-operative Guidelines

1. STOP SMOKING AT LEAST 1 MONTH PRIOR TO SURGERY and at least 2 weeks AFTER surgery because smoking will interfere with healing and can lead to various post-op complications.
2. DISCONTINUE MEDICATIONS CONTAINING aspirin, ibuprofen, blood-thinners, Vitamin E, and ALL herbal supplements at least 1 week prior to and 2 weeks after surgery.  These medications can cause prolonged bleeding.  Your surgeon may also ask you to discontinue oral contraceptives.  Tylenol is SAFE to take just before and after surgery, if needed.
3. FILL YOUR PRESCRIPTIONS BEFORE your day of surgery and keep them at your bedside at home along with a notepad to help keep track of the medications you have taken.  Expect some forgetfulness up to 36 hours post-op and during narcotic use.  Also, have food in your stomach before you take your medications to minimize any nausea.  DO NOT drive or drink alcohol when taking narcotic pain medication.
4. IF YOU ARE PRONE TO NAUSEA OR MOTION SICKNESS let your physician know.  Routine anti-nausea medications will be given through your IV in the O.R. to prevent nausea as well as antibiotics, steroids for swelling, and pain medications before you wake up from surgery.  If necessary, medications can also be prescribed to prevent nausea at home.
5. CONSTIPATION IS NORMAL FOLLOWING SURGERY. General anesthesia slows down the GI tract and narcotic pain medication increases the likelihood of constipation.  It is okay to take a stool softener (such as over-the-counter Colace) or fiber bulkers (such as Metamucil or Fibercon) following surgery.  Drink lots of water and be sure to eat a well balanced diet including fruits and vegetables the days before and after surgery. 
6. WOMEN MAY EXPERIENCE A CHANGE IN THEIR FIRST MENSTURAL CYCLE following surgery.  It may be lighter and shorter.  Menstrual irregularity usually lasts just one cycle.
7. DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT the night before surgery.  This includes NO sips of water, gum or hard candy.  The only exception is that you may take your blood pressure and/or heart medications as directed.
8. ARRANGE FOR A RESPONSIBLE ADULT TO TAKE YOU HOME AND STAY WITH YOU FOR 24 HOURS after surgery.  Although everyone heals differently and has varied pain thresholds, expect some soreness, fatigue, mood swings and some fogginess for a minimum of 1 week post-op.  Swelling and bruising typically peak at day 4-5 post-op during the normal healing process.  Arrange child care if possible, and plan to be off work until you are feeling better and your doctor says it is safe to resume your activities.
9. PLEASE HAVE ANY NECESSARY PRE-OP BLOOD TESTS OR EKG RESULTS FAXED to our office at 303-790-7322 ASAP.  We should receive your test results at least 1-2 days before surgery.
10. PLEASE CALL IF YOU HAVE ANY QUESTIONS.  We are all here to make your surgical experience as comfortable as possible.

The Day Of Your Surgery

1. PLAN TO WEAR LOOSE FITTING CLOTHING (such as a jogging suit) and easy on/off shoes.  A top with front zipper closure or buttons works well if you are having upper body surgery.  Pants with an elastic waistband also work well, as you will be drowsy following surgery.
2. DO NOT WEAR ANY MAKE-UP, JEWELRY, OR BRING VALUABLES on the day of surgery.  You may wear socks in the O.R. and wear underwear IF it does not interfere with your surgical site and your physician approves.
3. YOU WILL BE ASKED TO CHANGE INTO A GOWN.  Your surgeon will mark the surgical site and your anesthesiologist will have you sign a consent for anesthesia.  You will have the opportunity to ask any last minute questions.
4. AN IV WILL BE STARTED IN YOUR HAND OR FOREARM in the pre-op area and a nurse will accompany you in the O.R. throughout your surgery.
5. ONCE IN THE OPERATING ROOM you will be asked to lie on the O.R. table.  The anesthesiologist will give you medication through your I.V. to relax you as soon as you are lying down.  These medications also help you to forget being in the O.R. 
6. MONITORS AND EQUIPMENT will be applied to your body.  This may include a blood pressure cuff on your arm, a pulse oximeter on your finger, 3 EKG pads on your torso, SCD pressure stockings to your calves (to reduce blood clots), and a grounding pad to your thigh (for the surgical electro-cautery machine).
7. YOU WILL DRIFT OFF TO SLEEP VERY COMFORTABLY.  A breathing tube will be placed AFTER you are asleep and will be removed BEFORE you wake up.  The only awareness you may have of the tube could be a sore, scratchy throat following surgery.  If your surgery is planned for more than 3 hours you will also have a FOLEY CATHETER in your bladder.  This will also be inserted AFTER you are asleep and removed before you wake up.  If you are staying overnight, the catheter will be removed in the morning.  You should be able to urinate normally within 6-8 hours after its removal.
8. YOU WILL BE TRANSFERRED TO THE RECOVERY ROOM ON A BED and can expect to stay for another 1-1.5 hours.  Most patients are fully awake with 15-60 minutes after surgery, but may not remember much due to the anesthetic drugs.  You will be released when your vital signs are stable and your nausea, bleeding, and pain are minimal.  A nurse will be with you while you are recovering.
9. YOU AND A RESPONSIBLE ADULT WILL BE GIVEN SPECIFIC DISCHARGE INSTRUCTIONS, necessary supplies, and a 1 week post-op appointment.  Ask questions anytime.
10. MOST IMPORTANTLY, REMEMBER TO LISTEN TO YOUR BODY…Rest when you feel pain or fatigue.  BE PATIENT with the healing process, and remember you may have good and bad days.

Post-operative Guidelines

1. TAKE YOUR MEDICATIONS AS DIRECTED.  Pain tolerance varies from one person to the next.  Stay on top of your pain by taking your medication regularly for the first few days.  Take your medications with food to decrease the chances of nausea.
2. REST FOR THE FIRST 24 HOURS following surgery.  DO NOT drive or drink alcohol while taking narcotic pain medication.  You may walk and climb stairs slowly.  No lifting anything greater than 10 pounds (approximately a gallon of milk) or any exercising for a minimum of 2+ weeks.  The exact guidelines for return to activity will be provided by your surgeon.  Elevate your head on pillows to decrease your swelling.  LISTEN TO YOUR BODY!  Everyone heals at different rates.
3. YOU MAY SHOWER 24-48 HOURS after surgery.  Keep your incisions clean and dry.  Your surgeon may remove your dressings and/or some stitches at your post-op visit.  You may use hydrogen peroxide to clean the incisions.  DO NOT submerge in a bath or swimming pool for a minimum of 3 weeks.
4. CALL IF YOU EXPERIENCE excessive pain, bleeding, swelling, discoloration at the incision site, fever over 101 degrees F, breathing difficulties, chest pain, or any other concerning symptoms.  Remember, scars take a year to fully mature and fade.
5. SPECIAL CONSIDERATIONS AS INDICATED:
   
   GARMENTS/BINDERS:  Garments (bras or girdles) help to reduce swelling and promote tissue retraction following certain surgeries.  Wear it for about 3-4 weeks, around the clock, under clothing.  The garment may be removed for bathing, or you may shower in the garment and blow it dry.  The garment may also be loosened or adjusted as needed.  These instructions will be provided by your doctor depending on the type of surgery you have.   Hand wash your garment and DO NOT dry it in the dryer.  (Bring your second garment to your post-op visit.)  Keep any dressings or steri-strips on as instructed.
   
   PAIN PUMP:  If you have a pain pump, local pain medication will infuse to provide pain relief for approximately 72 hours following surgery.  This helps to decrease the use of narcotic pain medication.  Expect some oozing at the tubing insertion site.  Gauze can be used to absorb any drainage.  A black hip pack will be provided to carry the bulb filled with your medication.  Tubing may be removed by the M.D., patient, or responsible adult after 72 hours.  (See pain pump pamphlet for more information.)
   
   DRAINS:  Drains may be inserted to reduce blood/fluid accumulation at the surgical site.  They should be emptied about 4 times per day, and more often if necessary.  The bulb should be compressed when emptied, then closed.  The drains can be massaged as needed to maintain patency.  Expect some oozing at the tubing insertion site.  Gauze can be used to reinforce the site.  The drain bulbs can be placed in the pockets of your jacket or safety pinned to your clothing.  Drains are typically removed 1-2 weeks post-op.  A drain record should be kept to record the amount of daily output.  (Bring the record to your post-op visits.)