Existing Patients

PREPARING FOR SURGERY

It is very important to carefully prepare for your surgery. This is for your safety and to help you have the best possible result. Please follow these instructions carefully.

UP TO ONE MONTH BEFORE SURGERY

HISTORY AND PHYSICAL:

Go see your Primary Care Physician for medical clearance and/ or your Cardiologist for cardiac clearance (if applicable) within 30 days before your surgery (make sure it is at least a week prior to surgery). You will need to see a doctor for a complete medical history and physical.

You will need the following pre-admission tests for medical clearance (if applicable):

• LABS – CBC and CHEM SCREEN (good for 30 days prior to surgery)
• EKG (good for 4 months prior to surgery)
• CHEST X-RAY (good for 1 year prior to surgery)

After the appointment with your medical doctor, ask to have a copy of the results and clearance sent to our office, clearance must be in four days prior to your surgery. Our fax number is 201-342-1030.

THE DAY BEFORE SURGERY

CONFIRMATION:

Our office will contact you a day before surgery. This is to confirm the time you should arrive for your surgery and answer your questions. If you know you will not be available then, please call us at 201-342-1010.

NO EATING:

You should not have milk, liquids or solid foods after midnight the day of their surgery. This includes chewing gum, hard candy and chewing tobacco. If there is food or liquid in your stomach, your surgery will be cancelled.

BATHING:

It is important to prepare your skin for surgery to reduce the risk of infection. You must take a bath or shower the night before and the morning of surgery.

HAIR:

Many hair products and hair pieces contain highly flammable products. Your safety is our first priority. That’s why we require that you wash your hair the night before or the morning of surgery using only shampoo and conditioner.

DO NOT use any other hair products after washing. This includes hair spray, mousse, gels, etc.

DO NOT wear wigs or hair pieces.

Because these products are highly flammable, they create a risk of fire during surgery. Your surgery may be cancelled if you arrive with hair products. Please help us keep you safe.

NO MAKEUP:

Do not wear makeup, especially eye makeup, when you come for your surgery. Your eyes could be injured from mascara flakes falling into them.

NO SMOKING:

Do not smoke or use chewing tobacco after midnight before your surgery. This helps reduce coughing and other irritations after surgery.

DAY OF SURGERY

MEDICATION:

If you take blood pressure, cardiac and seizure medication, you may take it with a small sip of water the morning of your surgery.

If you take blood thinners such as aspirin, Coumadin, Plavix, etc. you must have your cardiologist or primary doctor regulate it.

ARRIVAL:

OUTPATIENT SURGERY (Same Day Surgery) – Arrive 90 minutes before your surgery time.

INPATIENT SURGERY – Arrive 2 hours before your surgery time.

*Be aware and prepared, you may receive a call to come in earlier the day of surgery if the surgeon’s cases move up.

PERSONAL BELONGINGS:

Please leave all jewellery and valuables at home.

CONTACTS AND GLASSES

If you wear contact lenses or glasses, please bring the case. You will not be able to wear contacts or glasses into surgery.

CARE ARRANGEMENTS:

You must arrange to have someone drive you home. You may not drive, under any circumstances, for at least 24 hours after surgery.

REST AND EAT LIGHTLY:

Plan to rest for at least 24 hours after your surgery. Eat lightly and do not drink alcoholic beverages for at least 24 hours after surgery. Drink plenty of clear liquids after your surgery.

FOR COLON SURGERIES:

You will be given BOWEL PREP instructions to be taken the day before surgery.

 

IF YOU HAVE ANY QUESTIONS PLEASE FEEL FREE TO CALL THE OFFICE AT 201-342-1010

• Following these precautions will help prevent complications from your surgery. These basic suggestions to improve your recovery may be supplemented by other directions from the doctor and nurse.
• You MUST HAVE AN ADULT DRIVE YOU home from the facility. You will not be allowed to drive yourself.
• The effects of anesthesia can persist for more than 24 hours. You must exercise extreme caution before engaging in any activity that could be harmful to yourself or others.

MANAGING PAIN

• You will be given a prescription for a pain medicine before surgery. Have this prescription filled before the day of your surgery to have at home after you are discharged.  The medication given is a narcotic and intended for severe pain.  Taking too much may cause constipation.  Use a stool softener as constipation is not uncommon with some pain medication.  If the pain is mild to moderate you may use Tylenol or Advil
• Do not drive while taking pain medication.
• Do not take pain medication on an empty stomach. This may make you nauseated.
• If you no longer need your prescribed pain medication, you may take over the counter pain medication such as Tylenol (acetaminophen) or Advil (ibuprofen) for pain.

SURGICAL SITE CARE

Watch for any separation, bleeding, or signs of infection which include:

• Redness
• Swelling
• Heat at incision site
• Pain
• Drainage of fluid or pus
• Fever (which is usually a temperature of 101 ºF or higher)

If you notice any of these problems, call the office right away.

CARE OF YOUR INCISION:

Wash your hands before and after touching your incision(s). Hand washing is the best way to prevent infection.

• It is normal to have some numbness around the incision for some time after surgery. This may subside as the incision heals.
• If you have a clear see-through bandage over the incision, you may remove this bandage 24 hours after surgery.
• Staples or sutures are generally removed in 3 weeks.
• Many incisions will have buried absorbable sutures, which do not need to be removed.

STAPLES:

If you have been sent home with staples in your incision, then see the doctor in 3 weeks have your staples removed. You may shower with staples in place.

STERI-STRIPS:

If you have been sent home with sterile tape over your incision:

• If you have narrow white tape strips over the incision (steri-strips), keep them dry for 24 hours. Do not remove them, if you remove them, you risk pulling the incision apart.
• You may shower, but be gentle around the tape.Use regular soap and water. Wash your incision gently, and then pat the incision dry. Do not pull, tug, or rub the tape. Apply Bacitracin or Neosporin® to your incisions only after the tape has fallen off or has been removed by the doctor.
• It is not uncommon for some reddish fluid to accumulate under the bandage. This is no cause for alarm.

DRESSINGS:

Change dressings at least every other day to avoid infection.  If you have a gauze bandage over the incision, you may remove it in 24 hours. At that time you may shower.

SHOWERING:

• Showers are allowed 24 hours after surgery, unless told otherwise.
• Do not soak in the bathtub until instructed by the doctor.
• For procedures of the scalp; you can gently wash your hair 24 hours after surgery, unless told otherwise.
• You can go into the ocean and/or pool; however, please shower and use Bacitracin or Neosporin® right after.

DRAIN CARE:

If you have a drain (often called a Jackson-Pratt or JP drain), record the time and amount of drainage on a piece of paper. Empty the drain every few hours or as needed. The nurse will explain how the drain works before you are discharged from the hospital.

CONSTIPATION

After surgery it is important to have a bowel movement within a day or two. If you do not, you may take Dulcolax (over the counter) laxative or suppository two (2) times a day to encourage your bowels to move.Possible causes of constipation include: anesthesia and pain medications (which can slow the movement of the intestine); not drinking enough fluids; and abdominal surgery. Drinking fluids and eating fiber can help prevent constipation. Please notify your nurse or doctor if you are not passing any gas and have abdominal pain.

COUGHING

If you have an abdominal incision, splint the incision when coughing. Splinting an incision is a way to support the incision and surrounding tissues using a stiff pad or a small firm pillow placed over or against the incision on your abdomen. It is a way to immobilize or cushion those movements so that you can fully expand your lungs or cough with a little less discomfort and reduce pain during coughing. Coughing will not affect the incision.

ACTIVITY

After the procedure, and when the anesthesia has worn off, get up and be active as soon possible. This will help your muscles stay strong and will lead to a faster recovery. We encourage you to be active as soon as it is safe, which is usually in the evening after your procedure. We recommend that you walk, sit up in a chair, or at least turn frequently in bed.

Different surgeries require different limitations on activity. Generally, you should not lift objects heavier than 10 pounds for 6 to 8 weeks. Lifting heavy objects too soon may weaken your incision. The doctor will tell you specific activity instructions for your type of surgery.Plan your daily activity so that you can rest often. Do not expect your energy level to be the same as it was before surgery. Your body needs more energy to heal, and this may cause you to feel weak or need to take naps.

• If at all possible, have someone with you to help you.
• Going up stairs is not a problem.
• Listen to your body and rest when you are tired.
• Do not lift anything heavy (over 10 pounds) for 6-8 weeks

PREVENTING BLOOD CLOTS:

Blood clots are more likely to occur when a patient is not moving for a long time, such as after an operation or during recovery in bed. One of the best ways to prevent blood clots from forming is to start being active as soon as possible.

DIET

Resume your regular diet when you return home, unless the doctor has put you on a special diet. You may not feel like eating regular portions right away. It is normal to have less of an appetite after surgery. This could return to normal when your activity level increases. In the beginning, try eating small meals several times a day.  Choose high-protein foods to help your body heal. These may include such foods as chicken, fish, cheese, milkshakes, and ice cream.

Drink lots of fluids and include fiber in your diet, such as whole grain cereals, breads, pasta, and mashed potatoes. Eating these foods and drinking lots of fluids will help prevent constipation. They also promote normal bowel function, especially if you are taking narcotic pain medication.  Let the office know if you have nausea or vomiting that lasts longer than 24 hours.

DRIVING

Usually, you will be able to drive 48 hours after surgery. However, this can vary depending on the type of surgery that you have had. Never drive while taking narcotic pain medications.

PHYSICIAN FOLLOW-UP

Please call the office after surgery at 201-342-1010 to schedule a follow-up visit.  Follow-up visits will be three (3) weeks after surgery.  If you have any problems before then, do not hesitate to call.

These basic suggestions to improve your recovery may be supplemented by other directions from the doctor and nurse.

CALL THE OFFICE IF:

• Your temperature is 101°F or higher. It is not uncommon to have a low-grade fever after surgery.
• You have new redness around the incision or if pus drains from the incision.
• Severe bleeding occurs. Apply direct pressure to the area.
• Severe abdominal pain, vomiting, or jaundice occurs (yellow tint to eyes or skin).

IF YOU HAVE ANY QUESTIONS PLEASE FEEL FREE TO CALL THE OFFICE AT 201-342-1010