Preparing for Surgery

Preparing for Surgery

Before Surgery

There are a number of things you can do to prepare for your surgery. Taking the proper steps prior to your surgery can have a significant impact on your recovery.

Nutrition

A healthy, balanced diet is important, as the body uses food for fuel and to repair itself. Good nutrition in the weeks prior to your surgery will aid in the healing process and keep your immune system healthy, decreasing the chance of infection.

Eating right will also give you the extra-added energy you will need to recover. Being overweight can also have an adverse effect on your surgery. Excess weight can place unnecessary stress on the spine, which can hinder the healing process and increase post-operative pain. In addition, being overweight can make the surgery more technically difficult. A healthy diet and moderate exercise are the best ways to shed those additional pounds. Of course, having back problems can make exercise difficult. Back pain can limit mobility and lead to a sedentary life-style.

Ask your doctor for specific instructions regarding the type of exercise, if any, you are allowed to participate in. Drastic weight loss before a surgery can be dangerous. Instead, a carefully planned weight reduction program will help you achieve results in a healthy, more realistic manner. Losing that excess weight really will have a positive effect on your recovery and overall health.

Smoking

If you smoke, quit now! It is one of the most important things you can do. Smoking takes a huge toll on your body's ability to heal. It will increase your chances of an unsuccessful operation and can lead to a multitude of complications, such as blood clots and pneumonia. For those having spinal fusion, smoking increases the chances of a failed fusion. The importance of quitting before your surgery cannot be stressed enough.

Medications

Your surgeon, primary care physician and anesthesiologist will advise you on taking your regular medications. Generally, blood-thinning agents need to be discontinued two weeks prior to your surgery. Blood thinners include aspirin, and antiplatelet medications, such as Coumadin and Heparin Do not stop these medications, however, until you have discussed it with your doctors. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen should also be discontinued.

Discuss any vitamins and supplements you may be taking with your surgeon. Many vitamins and herbal supplements have the effect of thinning your blood. Some can interact with the anesthetic agents.

Your doctors will work with you to discontinue any medications that may be harmful, and find appropriate substitutions when necessary. Make sure you provide your doctor with a complete list of all medications, including over-the-counter medications, and all vitamins and supplements you are taking.

Prepare Your Home

Preparing your house prior to your surgery will make you return home much smoother. Stock up on all the essentials you will need - food, toiletries, reading materials. Prepare meals ahead of time and freeze them. Organize your refrigerator and cupboards so that the things you use most are within easy reach. Get bendable straws so you can drink while lying down.

Autologous Blood Donations

Autologous blood donations allow patients to use their own blood, should a blood transfusion be necessary during surgery. Your blood will be drawn and stored in the weeks prior to your surgery. Donations need to be completed one week before your surgery. If multiple units are needed, donations are scheduled one week apart. Your doctor will determine if you are a candidate for autologous blood donation.

The Night Before Surgery

Do not eat or drink anything after midnight, including water. Do not suck on, chew or swallow any substance, even chewing gum. When you brush your teeth, spit the water out. Do not smoke. These instructions are very important for your safety. Anesthesia can cause nausea and vomiting if the stomach is not empty. Your doctor will advise you on the need to have an empty bowel. You may be instructed to take a laxative or suppository.

What to Bring to the Hospital

Bring a list of current medications, as well as the amount and frequency with which you take them. You can have your pharmacist print out the information for you. Keep a list of important phone numbers with you, as well as a long distance telephone calling card. Also bring your insurance information and any documents the doctor may have given you. Pack only what is necessary-a bag of toiletries, robe, slippers, glasses, dentures and hearing aid. Leave valuables at home, including cell phones, laptops, jewelry and cash (bring only a few dollars). The hospital cannot assume liability for these items.

The Day of Surgery

If you are instructed by your doctor to take any oral medications, take them only with a small sip of water. Arrive at the hospital early. Generally, an hour prior to your procedure is sufficient. You will be given specific instructions on when and where to report. After you complete the admitting process, you will be taken to the preoperative area, where you will be prepped for surgery. Your family member or significant other will be directed to the waiting area.

Your anesthesiologist will review your medical history with you and discuss the type of anesthesia that that will be used. An intravenous line will be placed to deliver medications, and you will be taken to the operating room where the anesthesia will be administered. A catheter will also be placed in your bladder to drain your urine.

Recovery

When the surgery is completed, you will be moved to the recovery area. A nurse will monitor your vital statistics and the anesthesiologist will oversee your recovery. As the anesthetic wears off, noises may sound louder than usual. You may have blurry vision, a dry mouth, or the chills. Your vital signs (temperature, pulse, blood pressure, and respirations) will be checked at regular intervals for several hours after surgery. Sensation and movement of your legs or arms will be checked. The nurse will be checking your surgical dressing. You will be encouraged to breathe deeply and move around in bed.

While you are in recovery room, your surgeon will talk to your family or significant other to let them know how you are doing and to answer any questions. Your level of pain will also be monitored and every effort will be made to keep you comfortable. The average stay in the recovery room is about one hour. The nurse and anesthesiologist decide when you can leave the recovery room. Many patients, still groggy from the anesthesia, do not remember much of this period. After you are sufficiently recovered from the anesthesia, you will be transported to your designated hospital room.

Your Hospital Stay

During your hospital stay, our staff of skilled health care professionals will make you as comfortable as possible and make sure you are getting the best possible care. Your doctor visits you in the hospital to check on your progress, and may order follow-up tests. He will let you know when you can go home. Other hospital staff members are also very involved in assuring optimal care for patients. This staff includes occupational and physical therapists, social workers, clergy, and discharge planners. Please do not hesitate to ask your team questions regarding you care or condition. We want you to be an informed patient.

Your Discharge

Your doctor will determine the day of your discharge and your healthcare team will help plan it. Please make arrangements for your transportation home prior to this day. If you are having difficulties arranging for transportation, a social worker can assist you. Please notify your nurse. During your stay, your healthcare team will discuss the details of your post-discharge care with you or your family, including your medications, wound care, instructions on specific activities, and any special dietary needs. They will also provide you with information on the resources and services available to assist you with your during your recovery.

Tips for Returning Home

Following spine surgery, returning home can present many challenges. You will likely be limited to the amount and type of activities you can perform. You may not be able to bend, twist, lift, or sit for long periods of time. This may make getting around the house a difficult proposition. Some things you will just have to forgo, but with modifications and assistance, you will be able to make life a little easier.

The Car Ride Home

Have the person picking you up from the hospital place a plastic garbage bag on your seat. This will assist you in getting in and out of the car, because you can slide instead of twist.

Bathing Tips

Use a bath mat so you won't slip. Place a shower chair inside the shower, if possible. It will make showering much safer since you won't be so steady on your feet. A long handled back brush will make it easier to scrub those hard to reach places. Instead of a bar of soap, use soap-on-a-rope or liquid soap. It's too easy to drop a slippery bar of soap. Put your bathing necessities in a shower caddy, in an easy to reach place. That way, everything you need while bathing is in one place, within arm's reach. A raised toilet seat will assist you in getting on and off the toilet with less discomfort.

Clothing

Wear loose, comfortable clothing. Put elastic shoelaces in your shoes that tie, so you don't have to tie them, or wear slip-ons shoes. A long handled shoehorn will help you get your shoes on with less effort. You can also get a device which helps you put your socks on.

Bedding

Make sure you have a good mattress. It could be one of the best investments you make. Your doctor may want you to use a hospital bed, which will be arranged while you are still in the hospital. If not, you might want to put your bed up on blocks. This will make it much easier to get in and out of bed. Keep extra pillows on your bed to prop your back up when lying on your side. You can also buy a special pillow that fits between your knees to make sleeping more comfortable. Make sure you have a bedside table that allows you access to your things without reaching.

Other Tips

Put fresh batteries in your remotes. One item that will make your life so much easier is a grabber. This indispensable device allows you to pick things up without bending down. Remove throw rugs from the floor, so you won't trip over them. Keep all of your necessities close to your bed-walker or cane, phone, important phone numbers, reading materials-whatever you will be using frequently. If you have a computer, you'll want to keep that next to your bed, too. That way you can use it without having to sit up. Most importantly, don't be afraid to ask for help. Family and friends can assist you by cleaning, doing laundry, cooking, pet care, errands-anything you are unable to do. It may be difficult to ask for, or to accept help, but strict compliance with your doctor's orders will aid in a faster and more complete recovery.

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