Pre/post Operative Instructions
The following information will help prepare you for your surgery at the Ambulatory Surgery Center. Please follow these instructions carefully. Call if you have questions (717-747-8306).
You will receive a call from one of the surgery center nurses the day before your surgery to review your health information, medications, and to provide you with instructions
(If your surgery is on a Tuesday, you will receive a call the Friday before).
Please have your medication list ready, including over the counter medicines and herbal supplements. **The surgery time is not final until the afternoon before the surgery day.
If you do not receive a call by 3pm, please call 717-747-8306.
Pre-Procedural Testing (Blood work, EKG, and/or Chest X-ray) – if ordered by surgeon.
- All tests (except INR) must be done no less than 1 week prior to surgery.
- Tests completed less than 1 week before your scheduled surgery may cause your surgery to be cancelled.
- Please report to Pre-Admission Testing, or the lab required by your insurance company, for your blood tests, EKG, and x-ray if ordered by your surgeon.
- All test results are reviewed by your surgeon and the anesthesia personnel. If there are test results in question, or if you have a significant health history, you may be asked to see your family physician or cardiologist for medical clearance prior to proceeding with your surgery.
- Please feel free to call your surgeon’s office (717-848-4800) or the surgery center (717-747-8306) with any questions you may have regarding pre-operative testing requirements.
- If you are a female patient of menstruating age, you will be asked to sign a pregnancy waiver or obtain a urine pregnancy test on the day of your surgery.
Eating/Drinking
For your safety, we have strict rules about what you should eat or drink in the hours before surgery. Anesthesia causes your whole body to relax. This includes the valve at your stomach that prevents stomach contents from backing up. During anesthesia, if there is food or drink in your stomach, it could travel into your lungs, causing you to have severe pneumonia. Please follow the eating and drinking instructions given by the pre-op call nurse very carefully.
If you will be receiving Anesthesia:
- Do not eat solid foods or milk products after midnight the night before your surgery. Also, no mint, candy, lozenges, chewing gum, or chewing tobacco.
- You may have clear liquids up to 3 hours before your arrival time. This will prevent dehydration. Clear liquids include: water, tea or coffee without cream or milk, soda, apple or cranberry juice. After that time, do not have anything to drink. The only exception will be sips of water to take essential medications (the nurse will review this with you during the call). Tooth brushing is allowed.
- Patients who are not able to fast for the required period of time because of medical reasons should call 717-747-8306 for a personalized review and recommendation by the anesthesiologist.
- If these instructions are not followed properly, your surgery may be cancelled for your safety.
- No alcoholic beverages for 24 hours before your surgery.
If you will NOT receiving anesthesia (Local anesthetic only):
- You may drink and eat on the day of surgery. Because you will be lying down during the procedure, we ask that your meals be on the lighter side to prevent nausea.
- You may take your usual medications, unless instructed otherwise by your surgeon.
Transportation and Escort:
You will not be permitted to drive yourself home after the surgery.
- You must have an adult (18 years or older) to drive you home.
- If you will be receiving anesthesia, you must also have an adult (18 years or older) to stay with you at home for 24 hours afterwards.
- If these requirements are not met, your surgery will be cancelled.
- If you have trouble with meeting these requirements, please call the surgery center for other options that may be available.
Medications:
The pre-op nurse will review your medications in detail during the pre-op phone call. It is very important that we have an up-to-date medication list. If we were not able to reach you, please bring a list of all prescription, over the counter medicines, and herbal supplements that you are currently taking.
Diabetes
If you will be receiving anesthesia – because you will not be eating on the day of surgery, do not take your diabetes medications (insulin or tablets) in the morning. If you take a long acting insulin in the evening, you can take 3 / 4 (75 percent) of your usual dose the evening before surgery. The nurse will review this with you on the pre-op phone call. Please follow the instructions carefully. Call your family doctor if you have concerns after talking to the nurse.
If you will not be receiving anesthesia (local anesthesia only) – because you will be eating as usual, take your diabetes medications as usual.
High Blood Pressure
Take your blood pressure medication at the usual time with a sip of water, unless otherwise instructed on the pre-op call. In general, you should not take your water pill. Some surgeries require that certain blood pressure medications are not taken in the morning. The nurse will discuss this with you during the pre-op phone call.
Heart Medications
Take your heart medication at the usual time with a sip of water.
Before stopping any heart medications, contact your family physician or cardiologist!
Blood Thinners
If you are on Coumadin or other blood thinner, the surgeon’s office will notify your prescribing physician or cardiologist for recommendations. You will be notified with specific instructions and if blood work (INR test) is needed.
If you are taking Plavix or aspirin because of a stent in the last year – DO NOT STOP your medication. The surgeon’s office will notify your prescribing physician or cardiologist for recommendations. You will be given further instructions.
Seizure Medications
Take your medication as usual with a sip of water.
Anti-inflammatory medications (including over the counter)
Do not take aspirin (unless you have had a stent in the last year), or anti-inflammatory medications such as Ibuprofen, Advil, or Aleve for 7 days prior to your procedure.
If you feel that these are the only medications that will help your pain before the surgery, please discuss this with your surgeon.
Please stop all herbal supplements and Vitamin E products two weeks prior to your surgery. This includes: garlic, fish oil, glucosamine, green tea, and St. John’s Wort. These products could thin your blood and cause excessive bleeding during surgery. Please discuss specific medications with your surgeon.
Antibiotics
Please notify us if you are taking an antibiotic for any reason.
Patients taking birth control medications: Antibiotics can cause your medicine to be less effective, which would require you to use additional protection (please discuss this with the prescribing physician).
Medication Patches
Medication patches may be used as usual, unless instructed otherwise on the pre-op call. Please notify us that you have a patch on, as well as the name and dose of the medication.
Asthma
Inhalers may be used as usual. Please bring your inhaler to the surgery center.
Jewelry
Please remove all jewelry, including your wedding band and body piercings, before coming to the surgery center. Metal on your body poses an injury, infection, and burn risk in the operating room.
Taping the jewelry does not decrease these risks. It only serves to protect your jewelry.
You will be asked to sign a waiver for jewelry that cannot be removed.
If you are unable to remove a ring on the limb that will be operated on, the surgery will be cancelled.
Swelling from the surgery may cause you to lose circulation in that finger.
We advise that you have the ring removed at a jeweler prior to the surgery, and have it resized after your surgery heals completely.
If you feel that a piercing will close, obtain a plastic spacer from where you got the piercing done. However, you will be required to sign a waiver.
General Instructions
- What to wear
Wear loose, comfortable clothing and flat shoes.
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For lower extremity surgery, we recommend wearing shorts, wide-legged pants, or pull-on pants. Avoid snaps, zippers, and belts.
For upper extremity surgery, we recommend a large button-down shirt.
- What to bring:
- Photo ID and insurance card
- Personal items to help occupy you while you are in pre-op. Otherwise, leave valuables at home.
- Reading glasses.
- Wear glasses instead of contacts. If you must wear contacts, bring your solution and case.
- Wear your hearing aids.
- Bring your CPAP machine if you use one and if you are receiving anesthesia.
- Children may bring a favorite blanket, toy, or stuffed animal.
- What’s not allowed:
- No metal such as hair pins and barrettes.
- No makeup, nail polish, hair spray, perfume, lotions, or powders.
- Remember to remove toenail polish for lower extremity surgery (foot/knee/ACL/ankle)
- Do not shave the surgical site. Shaving the area may lead to infection.
- If shaving is needed, it will be done with a clipper when you arrive.
- If you have a history of difficult IV access, we suggest that you drink plenty of fluids the evening before.
- For patients less than 18 years old, a parent or legal guardian must remain in the building at all times.
- Please check your messages the evening before surgery in case of a time change.
In case of illness
Please notify us if you develop a cold, sore throat, cough, or other signs of illness. Notify us if you are taking an antibiotic.
When you arrive for surgery
Enter through the main entrance to the office. The surgery center is straight ahead from the lobby door (Suite 210).
Recovery Time
Recovery time varies. In most cases, the surgeon will speak to your escort after the surgery is finished. Your escort will be brought back when you are awake enough.
If you have not received a pain medication prescription, it will be given to you before you go home.
You will have written discharge instructions.
The physicians and staff at the Center encourage you to actively participate in your care. You are reminded of the importance to disclose all relevant medical and health information to the physicians and staff to facilitate appropriate care delivery. Please report unexpected changes in your condition or health status to the physicians and staff. Finally, please question any variation in medications, treatment, or plan of care that may differ from the expectations of you and your family. If you have any questions, please feel free to call our staff at any time at 717-747-8306.
Pre-op contact number: 717-747-8306. 6am-5pm, Tues through Friday.
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