BEFORE SURGERY
Don’t stress out!
I forgot to ask something at my appointment?
If you think of any questions or concerns, write them down and bring them with you. I will be happy to answer any questions when I visit with you. Having a family member or friend helps capture details as well. If it can’t wait, give our office a call.
Do I take my usual medications?
Most of your usual medications can be continued. Exceptions include: blood thinners-these need to be stopped in accordance to your instructions (2-7 days before surgery). Please, make sure you understand your instructions for these. Also, any long-term immune suppressing medications like steroids or injectables need to be reviewed. If you are diabetic on multiple medications or insulin, please check with your primary care physician about adjusting those.
Do I need pre-operative testing?
Yes. Most patients need basic labs, pregnancy urine test for women and sometimes chest x-ray and EKG. These can be done at our office. COVID-19 testing requirements are frequently changing, so we will let you know what they are when you are scheduled. If you are young and having a simple procedure, you may only need COVID-19 testing.
What do I bring?
Current list of medications. Contact information for emergency contact. Information about your pharmacy. Container for glasses, contacts, dentures, removable piercings. For overnight patients, CPAP machine if you have one. If you are on any complex medications like seizures cancer prevention, do bring those with you in case they are not immediately available in our pharmacy.
DAY of SURGERY
Take it easy.
When do I have to stop eating?
Most morning surgery requires you to stop eating solid food at midnight. You may continue water/vitamin water with sugar until two hours before your surgery time (clear liquid is see through, no coffee, no cream/milk etc.)
What do I wear?
Comfortable clothes that store in a bag, you will have to remove all clothing and wear a gown to the Operating Room. All jewelry will need to be removed as well. If possible avoid contact lenses and wear glasses. Avoid heavy make-up and ideally thick nails or nail polish-it interferes with anesthesia monitoring.
Will I have to stay in the hospital?
Many surgeries are now outpatient, meaning you will stay for 1-2 hours in recovery and then go home. Some bigger operation on stomach, bowel, breast, and thyroid may require 1-2 night stay.
Can I drive myself?
You can arrive on your own, but will need to be picked up and taken home by someone else. It is recommended that you do not stay a lone in the house the first night. If you live alone, have someone stay over with you for a night.
AFTER SURGERY
Stay active.
What do I eat?
Day surgery patients have no diet restrictions. However, be mindful that on day of surgery anesthesia may make you nauseated and I encourage lighter, smaller meals. Patients who had surgery on their bowel often stay the night and may have some restrictions at discharge.
What do I take for pain control?
Outpatient surgery does not require narcotic pain medication. Please take regular Tylenol every 6 hours, and ibuprofen 200-400mg every 6 hours, but stagger them so you are taking one of them every 3 hours. Most patient need this regiment for first 2-3 days. Then you can slowly decrease as you see fit. Narcotics tend to exacerbate abdominal bloating, constipation and discourage appropriate activity, resulting in more pain and prolonged recovery. However, if you have a special circumstance or concern please let me know and I will be happy to personalize our post-op plan as needed. Please, do so before surgery, Federal Drug Administration requires electronic prescription of any narcotic medication directly to pharmacy and needs to be done during business hours.
Can I Shower?
Yes. You may shower and let soap run over all incisions sealed with glue. Avoid bath or soaking for two weeks. Avoid pool or hot tub for 6 weeks. Exception is made for patients with drain or suction dressing, you will have to sponge bathe until they are removed-usually within a week.
What activity is allowed?
There is no limit on ‘body weight’ activity, meaning any activity without extra machines/weights/objects. You are encouraged to walk, stretch and be on your feet at least 3x/day. After 2 weeks, you can gradually build up your strength focusing on core strengthening. At 4 weeks you can slowly increased to your prior level, with full clearance at 6 weeks for those needing heavy weight lifting. However, people heal at different speeds, so if it hurts back off and try again in a few days.
What if I have sutures/staples/drains/Vacuum dressing?
Dermabond (Glue): no dressing care or removal needed, it should peel off at ~2wks. If it persists much past then, can be removed with Acetone/Nailpolish remover.
Suture/staples: if you have black sutures or silver staples, they will be removed at two weeks. This is done at the office and quick with minimal discomfort.
Vacuum Dressing: This is a single use device and will run out of batteries at about7 days. Try and avoiding moisture or tension on the area. If the device begins to alarm but the suction still works. You can ignore it (put it under the pillow) if you can and call our office in the morning. If you notice the sponge inflates with air, it has stopped working. You can turn it off by holding the single button (hold for a while until stops buzzing). Then you may peel off the clear tape and toss the entire thing out, or stop by our office and we will do it for you.
Packing: if your surgery invloved an infected field, you will have to pack the area with gauze. You may buy regular (non-sterile) gauze, wet it with water or saline, and place it to fill the wound. A dry gauze is applied over top. Hold it in place with tape. Avoid air tight sealing dressing.
Please, avoid any topical creams.
WHAT DO I WATCH FOR
When do I call?
Call immediately or go to the ER of the hospital you had surgery at if: You began to have sudden, new, and severe pain that is unrelieved by medication and is worse or different then your pain after surgery. Or if you have severe bleeding, become unconscious, have bleeding that won’t stop.
Call office in the morning if: you have fever of 101 or more, you note redness, increasing pain or drainage at incision, decrease in appetite, yellow eyes or dark urine, not able to keep liquids down, have not had a bowel movement for 3+ days.
What if there is fluid or swelling at incision?
Many surgeries could result in a seroma-sterile fluid at site of resection. As long as there is no redness, drainage or increasing pain this is normal and will slowly absorb back down.
What if I have a rash all over the skin?
This can result from reaction to cleansing material used in OR. It may require steroid cream or steroid pills. Please call our office during regular time.
Will I need sutures removed?
Most elective and minimally invasive surgery patients will have absorbable sutures. Emergency surgery incisions can often have staples that will need removal. It is generally fast and results in minimal discomfort. Rarely, high tension closures will need suture removal, those are usually black and can be seen clearly. These are also removed at follow-up rather quickly .
Try to relax and let our team take great care of you!
Dr. Linda Bergal 