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Thursday, May 22, 2014

The Day of Surgery

The day of surgery usually begins at 12 midnight. You will be asked not to eat or drink anything after midnight. Your stomach will need to be empty for at least eight hours prior to surgery. This means nothing should pass your lips. No gum, hard candies or smoking. You may brush your teeth but don't swallow the water.  This is to avoid your stomach from producing increasesd gastric juice for the digestion of food that is not coming. It is also an attempt to ward off postop nausea and aspiration (ingestion of emesis into the lungs). You should take certain medications with as little water as possible to get the pills down. Especially of note are blood pressure medications as long as it does not induce diuresis (an increase of urine production)and seizure control medications. You will need to find out from your doctor how to manage your Insulin or Diabetic pills. If your surgery will be late in the day you may be told to have a light breakfast eight hours before your procedure. All these points will need to  be discussed with your doctor.

Many people are now marking their own surgical sites prior to arrival to the surgical area to prevent surgery on the wrong limb, eye or site. To prevent wrong surgery site medical facilities have instituted controls against this, namely the time out.  Prior to making any incisions the surgical team will stop everything and verify identity of the patient, surgery to be done and surgical site as well as surgical side, right or left. Prior to surgery the doctor may have verified site with the patient and placed a mark on it.

Once you arrive at the surgery center you will be registered and asked to fill out a medication reconciliation form. This will ask for the names, form and doses of all medications as well as any allergies. You will have a band placed on your arm with your identifying information on it. Anytime an employee approaches you to perform any produres, give any medications, etc. he or she should verify your identity to be sure you are the correct person to receive the procedure, medication, etc. You may also be given an additional armband if you have allergies.

Once you enter the preop area you will be asked to remove your clothing and don a hospital gown. You will be asked to remove any removable false teeth, jewelry, and hairpins. You should keep glasses, contact and hearing aids in place until you have signed all consents. These things should then be removed and will be give back promptly after surgery as soon as appropriate.

Now you will be asked many questions in usually mutiple interviews to be sure it is safe to proceed. You will speak to the preop nurse who will be interested in how you prepared for surgery, last time you ate or drank, medications taken and allergies. Be prepared. You will be asked  these questions many times over. Everyone wants to know, the preop nurse, the operating rooom nurse, the anestesiologist and the surgeon. This is for the safety of the patient. After the preop nurse interviews you she will insert an IV catheter if indicated for administration of fluids and medications. 

You will speak with the Surgeon who will verify the procedure with you, give information about the procedure-benefits and risks as well as answer all questions you may have. The surgeon will then have you sign a consent for the procedure with the presense of  a witness. The surgeon will also mark the surgical site.

You will speak with the Anesthesiologist. This will be a doctor or a nurse. You will be asked a lot of the same questions. A mini physical will be done to evaluate your airway, lungs, heart, blood pressure and diabetic issues to name a few.  You will be given information about what type of anesthesia is planned, benits and risks. All your questions will be answered. You will be asked to sign a consent for administration of the anesthesia.

The operating room nurse will also  come out and make an introduction. You will be again asked about allergies and to verify your identity and surgical procedure and site.

It's almost time to enter the operating suite so you will now need to remove your glasses or contacts. Your doctor may want you to keep the hearing aid a while longer if you have a tremendous hearing deficit without it.

The anesthesia person and nurse will now escort you to the operating suite either by stretcher or walking. See you after your surgery.

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