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If you are planning to have surgery, whether this be minor or major surgery or if it is to be performed in a hospital, clinic or health care provider's office, you need to know the basic facts. Each type of operation differs a little with each patient. The steps will vary depending upon the setting and the nature of the surgery. The major concerns you should have with your surgery should include:
Things you can do to help you plan & prepare for the surgery.
PLANNING AHEAD
You will need details once you have found out you need surgery. You will want to know where and when it will take place and what you should do in advance. Your health care provider can tell you where the operation will be done and any special things you should do or not do prior to the surgery. The setting may depend on the services available, your needs, and the type of surgery.
OUTPATIENT surgery does not always take place in a hospital. It may be done in a health care provider's office, surgical center, or clinic. The patient arrives for surgery and returns home on the same day. This is also called ambulatory or same-day surgery.
INPATIENT surgery takes place in a hospital. In most cases, the patient checks in on the day of surgery and remains for a few days or more after the surgery. In other cases, the patient may be brought in through the emergency room or may have been a patient in the hospital and ill for a time prior to the scheduling of the surgery. In these latter cases, planning ahead may be more difficult to do or limited.
If you are planning a surgery, here are some things you can do before your surgery to help it go smoothly and help you heal quickly.
- If you smoke, stop smoking before your operation. Any period of not smoking helps, but it is best if you quit at least 2 weeks prior to surgery. This is especially important if you are planning general anesthesia. General anesthesia will change the normal function of your lungs for a short time. If you quit smoking:
- Your lungs will be in better shape before the operation.
- You will adjust to the anesthesia better.
- Your lungs will be able to resume their normal function with less effort after the surgery.
- You won't cough as much (which is helpful in pain prevention in some types of surgery, such as abdominal surgery).
- The risk of infection is less.
- If you are taking medications, ask your health care provider if you should keep taking them before or after the surgery. Medications may be prescribed for you by your health care provider or may be bought "over-the-counter". This includes any herbal or nutritional supplements, as well. Some medications should not be taken before an operation and may actually increase surgical risks, such as excessive blood loss. Others may conflict with your other medications you health care provider may prescribe. These may have medication interactions with dangerous or potentially lethal results. Be sure your health care provider knows and understands any medication allergies you may have. The wrong medication may result in mild to severe allergy reactions.
- Follow carefully any special diet or nutritional program which may also include iron supplements, if your health care provider suggests it.
- Rest often, taking life easy in the days before the surgery. Do not overdo and become too tired. Surgery, no matter how minor, can be stressful to the body and you need all the energy you can come up for recovery after the surgery. Eat right, get proper rest and exercise as instructed by your health care provider. If you are not on a special diet before surgery, follow a well-designed nutritional dietary program for several weeks prior to surgery to build up your body's immune system and maintain adequate general health and well-being. This will assist in your recovery following the surgical procedure.
- Make plans for care for your family, pets, home, and workplace ahead of time. This may be especially important if you will be having inpatient surgery and may be in the hospital for a length of time for recovery. This reduces worry and concern for others, your property, and your employment.
Have any legal affairs taken care of ahead of time and in order. These may include Power of Attorney, Health Care Proxy, Living Will or Last Will & Testament. Although in most cases the surgery comes off without problems, there are those times when something does go wrong and you may not be able to make important decisions about your care, your property, or your death, if it were to occur. Even very minor surgery can develop serious problems (an example is when my daughter's mother-in-law went in for simple toe surgery for her diabetes, developed systemic sepsis, slipped into a coma and died within a few days of the surgery... it can happen and it does happen. Unfortunately, surgeons and health care providers make mistakes, patient's develop anesthesia complications, serious infections occur and patients' bodies give out on the operating table or soon after the surgery).
It is important to arrange at-home recovery care with your family or a home health care provider. This can sometimes be arranged through the medical facility, but usually these are very short term, costly (especially without medical insurance), and not always sufficient in services.
- If you drink alcohol and/or have liver disease, it is important to stop alcohol consumption prior to your surgery. Your liver needs to be in optimal working condition to metabolize anesthesia and other medications that you will be given before, during and after surgery. Discuss alcohol-related problems with your surgeon or health care provider prior to surgery. If you need help, ask for a referral to obtain it.
You may want to give blood before your operation if you are having inpatient surgery. In most major operations, you lose some blood. If the loss is great enough, you will need to be given blood to replace it. Ask your health care provider if you can donate your blood in advance. It will be set aside in case you need it.
Tell your health care provider about any changes in your health that occur before your surgery. Even tell your health care provider about minor colds or infections. These can cause problems with anesthesia and serious infections after surgery and may complicate an otherwise simple procedure and may need to be treated or the surgery postponed until you are feeling better.
BEFORE SURGERY
You will be asked to arrive early to prepare for surgery. You should have an empty stomach before an operation. It is best not to eat or drink for 6-8 hours before your surgery. If you have had something to drink or eat during this time, tell your health care provider.
Leave your jewelry or anything of value at home. It is unfortunate, but valuables do disappear in medical facilities. If you wear jewelry, you will be asked to remove it prior to surgery. If you will be staying the night, bring those items with you that you will need.
You will be asked to fill out some forms about how you will pay for the surgery. If you have medical insurance, it will help to have your insurance card available and ready. If you receive "free care" due to your income status, you will expect to have this cover the hospital only. The health care providers and anesthesiologist is not covered under "free care". You will receive bills from all health care providers, laboratory studies and any other services not covered under the hospital's "free care" policy.
You will be given an ID bracelet. It will include your name, your health care provider's name, and your room number. This is to be checked by each care giver before any procedure, blood draw, or medication is given to you. If it is not, you may have to make sure it is done, if possible. Mix-ups do occur and you do not want any procedure, operation or medication that may be intended for someone else.
Your health history, as well as any drug allergies, may be noted. Make sure they have been noted in your health records so mistakes can be avoided. Some routine tests may be done:
- Checks of your temperature, pulse and blood pressure.
- Blood tests.
- Urinalysis.
- Chest X-ray.
- Electrocardiogram (ECG), in which heart function is examined with an instrument that prints out the results as a graph.
- Ultrasound scanning or other imaging procedure.
INFORMED CONSENT
Your health care provider must explain what is involved in your treatment before you can agree to it. This process is called informed consent. You will be asked to sign a consent form before surgery. This form varies from health care provider to health care provider. Most consent forms spell out what your operation is, who will be doing it, what conditions it is meant to repair, and what the risks are. Read it carefully. Ask questions if there is something you do not understand. Do not be afraid to ask questions or question anything that is done to you. Do not be "bullied" by any health care provider or any member of the health care team into something you do not want or need. It is always wise to be an informed consumer. Know about your condition and what your options may be before consenting to surgery. This includes any alternative therapies that may be beneficial. Do not be afraid to ask for a second or third or more opinion from other health care providers of your own choice. If there is a procedure that you do not want, do not sign the consent form and discuss it with your health care provider. You have the right to refuse any service, procedure or medication that you do not want.
HEALTH CARE PROVIDERS
This will vary depending upon the type of surgery you are having and to your needs before, during or after the surgery. Find out who will be part of your medical and surgical care team and who will be performing the surgery. You have the right to have a board certified surgeon do your surgery instead of a medical student or resident-in-training. If you are nervous about who and where you will be placed before, during and after the surgery, see if you can make arrangements with the medical staff to do a "walk through" prior to the surgery to help you become acquainted with where you will be and meet some of the staff that will be caring for you. This may alleviate some of your concerns. Do not be afraid to ask questions about your care and what to expect.
PRE-OP PREP
This varies depending upon the type of surgery, type of anesthesia, and the protocols set up by your health care providers. This may include no foods or fluids for an extended period of time before surgery, changing medications you may be on, or removing you from certain medications that you may have been taking before scheduling your surgery (such as removing you from blood thinning medications for a required period of time before surgery to prevent excessive bleeding).
ANESTHESIA
Be sure to discuss this with your health care provider(s) and find out options and all potential side effects and complications that may arise with the type of anesthesia to be used. You should be able to meet with your anesthesiologist prior to the surgery. Be sure to inform them of any allergies you may have to certain medications to prevent adverse reactions and find out any alternative choices you may have. Again, ask questions and expect answers from your health care providers. Many surgeries are completed without problems, but then the patient has adverse reactions to the anesthesia and can have serious or fatal results.
POST-OP EXPECTATIONS
This will also vary depending upon the type of surgery you will be having, where it is performed, and the type of anesthesia you may have been given, along with any complications that may have arisen during your operation. Discuss with your health care provider the expectations they have regarding your type of situation and how long you will be expected to remain under supervised care (such as in ICU [intensive care unit], as well as what to expect with pain, drainage, wound repair, and any other concerns you may have.
RECOVERY
This, again, will vary with the type of surgical procedure you experience. However, as a general rule, if you have very minor surgery as an outpatient, expect to have a few days or more to recover from the procedure. For major surgery, expect longer, sometimes up to 4 to 6 weeks or more. Your age, overall health, dietary & nutritional status, chronic conditions or other factors will all effect your recovery time. Discuss with your health care provider about specific expectations for your individual situation and what to expect for recovery time. Any surgical procedure is a stress upon your body system. It takes time for your body to recover and regain homeostasis (balance). Read and follow your health care provider's instructions carefully.
GOING HOME
This will vary depending upon your surgery, the place in which it was performed and, unfortunately, your health insurance or absence of health insurance. Today, too many are sent home too early and are unprepared for the stresses of caring for oneself at home for many reasons. Insurances and hospitals tend to dictate how long a patient may stay under supervised medical care, instead of health care provider expertise and patient need. There may be no restrictions, except to avoid sexual relations until treatment is completed or restrictions may include lifting things, driving a car, or dietary restrictions.
Consult with your health care provider about what you can or cannot do and for how long. Depending upon your individual situation, home health care may be recommended for a period of time. This may also include rehabilitation therapy as well as nursing care and housekeeping needs. Usually, you will not be allowed to drive yourself home after a procedure. You will need to arrange to have a friend, family member or neighbor pick you up from the office, clinic, or hospital following release. Be sure to have any medications filled as soon as possible after going home and take any medications as indicated by your health care provider. Wound care should be discussed with you and your health care provider should instruct you about infections and what to look for and when to call the office for followup care. Keep your follow-up appointments with your health care provider.
If you have any problems with your care after you get home, consult with your health care provider and see if arrangements can be made for help. This is especially important if you live alone and do not have any family or friends that you can rely on for help.
FEARS & APPREHENSIONS
Fear and apprehension is normal. It is scary to undergo surgery for any reason. Be sure to make a list of concerns and discuss them with your health care provider before, during or after the surgical procedure. After the surgery, you may have concerns whether or not the symptoms you experience are normal or abnormal. If you are taking medications after surgery, it is important to report any side effects or unusual symptoms. Your medication dosage may need to be adjusted or changed to another medication that works better for you and your body.
Do not hesitate to call your health care provider if you need to have more information or if you feel you need to be seen before the required follow-up visit. If you feel it is serious enough and you need immediate medical attention, do not hesitate to go to the emergency room and have them take a look at you. This is very important. Your health and your life may depend on having yourself checked over if you are experiencing unexpected pain, drainage, odor, fever, faintness, nausea or other symptoms.
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
The following occur after treatment:
- The surgical area becomes infected (red, swollen, painful or tender).
- Signs of infection: fever, chills, headache, or muscle aches or a general ill feeling.
- Any symptoms that are unusual or unexpected. Medications taken after surgery may produce side effects.
- If you need extra help during recovery and need a referral to obtain at-home nursing care.
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