Pre-Op Care

Stop in advance

Unless you are told differently, stop these medications seven to ten days prior to surgery:

• Aspirin – (DO NOT stop if you have cardiovascular disease)
• Vitamin E, Multi-vitamins, Herbal medications, Fish Oil, Non-essential supplements Diet pills / Weight loss injections
• NSAIDs: Surgical team will instruct you exactly when to stop these: sulindac, ketorolac (Motrin®/ Ibuprofen®/ Naproxen/ Aleve®/ Advil®)
• If you are taking any of these blood-thinning medications – Aspirin, clopidogrel (Plavix®), ticagrelor (Brillinta®), prasugrel (Effient®), ticlopidine (Ticlid®), warfarin (Coumadin®), dabigatran (Pradaxa®) or rivaroxaban (Xarelto®) – please discuss with your surgeon and the physician who prescribes the medication whether or not you should stop them before surgery. If this conversation did not occur during your preoperative visit, please contact your surgeon. Notify your cardiologist or primary care physician about any changes to these medications.
• If you stopped taking blood-thinning medication, ask the surgeon when to resume it.
• If you’re on Immunosuppressants, notify your surgeon in case this needs to be stopped in advance.
• Do not take diabetes medication (pills) on the morning of surgery. If you are on insulin, someone will have reviewed instructions with you prior to the morning of surgery.
• If you are on medications such as methadone, Buprenorphine, naloxone or narcotic pain medications, you must notify your surgeon in advance in order to come up with a specic pain management plan tailored to you.

Continue

• If you are prescribed inhalers for breathing, bring them to the hospital.
• Do not bring your prescription medications unless indicated otherwise. We will help instruct you on which medications are to be taken on the morning of surgery with a sip of water.

Preparing for surgery can be daunting, and it’s normal to have many questions and feel a bit overwhelmed. Here we will break down the need-to-know info and our handy tips to ease your mind and prepare your body. We’ll be discussing all the essential stuff – what to do before surgery, how to manage those pre-surgery jitters, what to eat, and how to get set up for a smooth recovery post-surgery.

Health Optimization: Optimizing your nutrition and exercise prior to surgery will give your body the best chance for a successful outcome. Eating a balanced, nutritious diet, incorporating moderate exercise, and working with a physical or occupational therapist on pre-surgery exercises (prehab), all play a major role in your surgical outcome. Protein is an essential building block that will help with healing. Limit simple carbohydrates. If you are diabetic, you will want your A1C 8.0 or less to reduce risk of complications. Don’t forget to add ber to your diet, as post op constipation can have a negative impact on your recovery!

Key components to optimize prior to surgery:

• Neurologic conditions / Seizure disorder
• Heart disease / Arrhythmia
• Blood pressure
• Pulmonary Conditions
• Sleep Apnea
• Tobacco Use
• Kidney disease
• Diabetes / thyroid disorder
• Weight
• Anemia
• Dental Health
• Chronic Pain Syndrome
• Auto-immune Disease
• Edema or swelling
• Skin Conditions or open wounds

Lifestyle Adjustments: Possibly adjusting medications and supplements. Limiting alcohol intake and quitting smoking are two personal commitments you can take to set your post-surgical self up for an easier recovery. Tobacco use increases infection risk and possible healing complications. If possible, it would be best if you could abstain from marijuana products use for 3 days prior to surgery.

Home Preparation: Organizing your home for post-surgery recovery, e.g., arranging for easy access to essentials, and setting up a comfortable recovery area. You will want to have a couple ice packs or a cryo machine to help with post op inflammation and swelling.

You may have medication and/or DME prescriptions provided to you by your surgeon. Be sure to pick these up in advance.

Arrange Support: Coordinate with friends or family for assistance post-surgery. ere is growing evidence that for many patients, going home aer surgery is better than being discharged to a Skilled Nursing Facility (SNF). Key findings demonstrate that by going home there is fewer hospital readmissions, infections, and complications and patients at home oen regain independence faster.  Scheduling time to work and arranging transportation ahead of time can help you reduce your stress. Do you have a Healthcare Proxy?

Mental Preparation: Use relaxation techniques to manage anxiety, such as meditation or deep-breathing exercises. We share a few of these below.

Education: If you are having Joint Replacement Surgery at the hospital, you might be scheduled to attend the Class at the hospital.

If you are having Knee Replacement at the Outpatient Surgery Center, here is a link that may be helpful: www.youtube.com/@BNEOSC

If you are having knee replacement surgery at the hospital, here is a link that may be helpful: https://youtu.be/jBpHhrC1VXE

You will receive a phone call the day before surgery to verify your arrival/surgical time. Follow specific instructions regarding medication as well as food and drink intake. Confirm transportation and arrival times for surgery.

In case of Illness: If you develop a cold, persistent cough, sore throat, fever or any other illness within two days of surgery, notify your surgeon.

You will shower with the Hibiclens soap the night prior to surgery as well as the morning of surgery prior to going to the hospital. You may need to trim or shave your facial hair.

Packing for the Hospital: Prepare a bag with necessary items for your hospital stay.

• Bring a photo ID, insurance card, and check or credit card for your co-payment, if you have one.
• Comfortable and loose clothing and shoes will give you and your care team an easier time.
• Personal Care items for bathing, oral hygiene, or other daily hygiene items.
• Reading material, I-pad, cell phone, laptop, chargers.
• Bring an up-to-date list of all medications you take. Include the name, dose, and how many times a day you take each. Note the last date and time you took each medication.
• Bring your inhaler if you use one.
• If you have a pacemaker or debrillator, tell the preoperative nurse the name of the
  manufacturer (example: Medtronic). Bring a copy of the manufacturer’s card with you.
• If you have other implanted devices such as a spinal stimulator, it will need to be turned off prior to surgery. Make sure to tell your surgical team, bring your remote with you the day of surgery.
• You can bring dentures, hearing aids, and eyeglasses /glasses case — but you’ll need to remove them prior to surgery.

DO NOT:

• Do NOT Wear makeup or nail polish, including fingernail and toenail polish.
• Do NOT shave near the surgical site.
• Do NOT bring your medications unless specifically told to do so.
• Do NOT wear perfume, cologne, lotions, oils or deodorants.
• Do NOT shave near your operative site prior to your surgery. Shaving increases your risk for infection.
• Leave the following at home — Contact lenses, all jewelry, including wedding bands, all piercings (for example tongue ring), hair ties, clips, and pins

Hospital Arrival: Arrive at the hospital at your scheduled time so you can complete any required paperwork and preoperative assessments. You will meet with members of your surgical team and anesthesiologist before surgery. You will also sign the surgical consent with your surgeon.

• You may drink small amounts (up to 12 ounces) of clear liuids until two hours prior to your scheduled arrival time for surgery.
• If you are advised to take your medications, take them with a small amount of water and inform the anesthesiologist or nurse of what you took on the day of surgery.
• After the nurse has completed the admission process, you can have up to two family members stay with you until you go into the operating room.
• Do not eat anything, including gum, mints or candy after midnight on the night before your surgery.
• Patients with Diabetes. On the morning of surgery, do not take your diabetes medication. If you are on insulin, someone will go over those instructions for the morning of surgery. If your arrival time is aer 9 a.m. or you are not feeling well, immediately notify the check-in personnel that you are an insulin dependent diabetic. Also, if you take insulin and need to take bowel prep the day before surgery, check with your medical doctor about insulin doses.
• Patients with Asthma. You should use your inhaler the morning of surgery and bring it with you to the hospital. If needed, you may use your inhaler as directed by our physician.
• If you have any implanted devices, let your nurse know.