This column is a monthly feature of “Health & Exercise Forum” in association with the students and faculty of Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).
TIPS TO PREPARE FOR SURGERY
Guest Author: Megan Lombardi
2nd Year Medical Students at Geisinger Commonwealth School of Medicine (GCSOM)
Megan Lombardi is a second year medical student at Geisinger Commonwealth School of Medicine. Megan grew up locally in Dalton, PA before attending Penn State University for her undergraduate degree. Megan is exploring surgery as a medical residency following graduation in 2019.
SURGERY! Just the word can elicit very strong emotions from people including fear, pain, anxiety, lack of control, and the list goes on and on. While surgery is a very important part of medicine and can create apprehension, there are many things you can do to prepare if you plan on scheduling an elective procedure that will make your life and recovery much easier. Preparation for anything in life is crucial to its success and surgery or medical procedures are no different. It’s important to have a strong, trusting relationship with your surgeon so you feel comfortable having open conversations and asking questions. Surgeons want patients who are inquisitive and want participate their health and wellness. While your doctor will most likely give you a specific set of instructions prior to taking you to the operating room, the below tips will give you a framework of what should be done and what questions to ask to make sure your hospital and surgical experience as well as recovery are as positive as possible.
1) Smoking: You should stop smoking a minimum of 4-6 weeks prior to surgery and stay off cigarettes for at least four weeks afterwards; however the best situation would be to stay off of them forever. If you’re having some type of spinal fusion or orthopedic surgery, you should cut back a minimum of 3 months prior to the surgery. The different chemicals and toxins in cigarette smoke have been correlated with poor post-surgical outcomes including poor wound healing, poor bone fusion, anesthesia complications, blood clots, and infection, when compared with non-smokers.
2) Household Chores: Consider prepaying your bills if your surgery will fall around they’re due. No one knows how they’ll exactly feel afterwards and sometimes recovery is harder than people think. Paying bills in advance will allow you peace of mind and give you time to relax and recover. Also, consider going grocery shopping before your surgery and stock up on healthy, easy to make meals. Depending on the type of surgery you’ll be having such as hernia or back surgery, you may want to prearrange and ask for help around the house or be careful lifting heavy objects.
3) Food and Water: If you’re having a planned, elective surgery, start eating healthy with lots of fruit and vegetables 4-6 weeks prior. A balanced diet containing proper portions of protein, carbs, and fats can help get your body get in the best shape it can be prior to having your surgery. Drinking a lot of water for a few days before surgery will ensure you’re staying hydrated. You’ll want to make sure to drink water the day before surgery as a lot of surgeons will ask that you not eat or drink after midnight the night before the operation. This helps reduce the risk of getting sick when waking up from anesthesia and aspirating food or liquids into your lungs. Keep in mind that diabetics may have special considerations and instructions so make sure your surgeon knows your diabetic status. Also, avoid alcohol for at least for 24 hours prior to surgery, more if possible. A bowel cleansing preparation may also be required depending on your surgery. This would entail drinking a liquid medication that would induce bowel movements to help cleanse the colon making it easier for your surgeon to visualize the intestines. In most cases, you will be able to drink clear liquids up until midnight the night before the procedure.
4) Pre-Admission Testing: Your doctor will ask you to set up an appointment at the hospital to get any pre-admission testing done prior to your surgery. It is crucial that you make and keep this appointment as your surgery runs a risk of being canceled if it is not completed. Some examples of what might need to be done include blood work, x-rays, and other laboratory tests like a urinalysis. Take an updated medication (with dosages) and allergy list to the hospital so your chart is as up to date as possible which will help keep you stay safe during your hospital stay. This includes all vitamins and herbal supplements such as St. John’s Wort, fish oil, and Vitamin E, as well. Ask your surgeon what medications you can continue taking up through surgery and what medications should be stopped prior to as many medicines interact with blood clotting and anesthesia in a negative fashion.
5) Day of Surgery: Some of the most important things that you’ll want to take to the hospital with you include your ID, credit cards, medication list, and insurance card. Depending on your coverage, you may be asked to pay part of your bill the day of, so make sure you talk to the hospital or your insurance company so you know what to expect. This is all part of the pre-certification process for elective procedures and is very important in preparing for surgery.
Wear loose fitting clothing to the hospital, especially if you’re having a same day surgery and will be released from the hospital within a few hours. Make sure whatever clothing you wear is easy to get on and off. If you wear glasses/contacts, make sure to have both available as many surgeons will ask you to take your contacts out prior to surgery. If staying overnight, you’ll want to take a few comfortable outfits and pack all of your toiletries (toothbrush, toothpaste, brush/comb, retainers, etc.) as the hospital may be able to provide some, but most people are more comfortable with their own. Lastly, make arrangements for a driver to take you home from the hospital.
6) Cleanser: Preparing your skin for surgery is one of the most effective ways to reduce possible complications including post-operative infections. One of the most recommended cleansers is chlorhexidine gluconate soap (CHG) which is found in Hibiclens and other brands. This soap can be found in most pharmacies and stores like Wal-Mart and have special instructions. You may need to use some for up to three days prior to surgery to get a full benefit. However, it is important to remember not to use it on your face or sensitive skin areas. You may also want to avoid shaving your surgical area prior to surgery as shaving can cause micro-cuts that would allow infection to spread more easily.
7) Home Prep: Prior to surgery, you’ll want to discuss with your surgeon about any possible home prep you can do to make your life easier once you return home. Some examples of different home equipment or preparation you may want to consider include a stair lift, shower chair/handrails, moving into a first floor bedroom, or getting a hospital bed or portable commode for the first floor. Some patients who are undergoing shoulder surgery have found that sleeping on a wedge or in a recliner has helped reduce their pain and allow for more restful sleep. You can also get a wheelchair, crutches, or walker prior to surgery so it’s at home and ready if you will require one and a lot of insurance companies will help cover the cost of this. Calling your home health agency or physical therapist ahead of time may also relieve some post-surgery stress as you can set up your first few appointments and talk to them about what to expect.
Overall, surgery can be a stressful and frightening experience but preparing ahead of time and getting your questions answered can take away much of the stress. Asking the right questions to the right people, including your surgeon, physical therapist, insurance company, and others, allows you to know exactly what to expect prior to going to the hospital or surgery center. If you suffer from anxiety, it may be beneficial to look into relaxation and breathing techniques or meditation to practice the weeks prior and the day of surgery. Going to the hospital with a clear mind and good outlook can help improve not only your experience, but also help with your recovery. On a positive not, please remember, if you do forget anything or something unexpected comes up, the hospital has social workers and other professionals that will aid you in making sure you get the care/supplies that you need in order to make your recovery as smooth as possible. Surgery has advanced tremendously since it first began in the mid-1800s but going into the process with an open, peaceful, and prepared mind certainly can help as well.
Medical Contributor: Joseph Bannon, MD, Colon & Rectal Surgeon, Geisinger-Community Medical Center, Clinical Faculty, Geisinger Commonwealth School of Medicine.
Visit your doctor regularly and listen to your body.
NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”
This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: firstname.lastname@example.org
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine (formerly The Commonwealth Medical College).