Preparing for Surgery

The decision to have surgery is a very important one. You will need to be fully informed and prepared for the surgery, as well as for any special needs that you may have following your procedure. Your preparation can affect the outcome and the results. Your physician and the hospital will send you all important information prior to your procedure. Plan on a repetition of questions during the surgical process: Asking about and re-verifying important information at various points in the process is for your safety and well-being.

Review this checklist to assist you in preparing for your surgery:

• Make a list of questions to ask your physician/surgeon regarding the type of surgery recommended.
• Determine if the surgical procedure is right for you.
• Obtain a second opinion, if desired.
• Check with your health plan regarding costs and coverage of the procedure.
• Prepare lists of prescription medications, over-the-counter medications, herbal supplements that you take (or have recently taken) for physicians; review with the anesthesiologist and surgeons.
• Your physician will arrange for preoperative labatory tests and an interview with your anesthesiologist.
• Follow all instructions during the weeks and days preceding surgery.
• Discontinue indicated prescription or over-the-counter medications and herbal supplements prior to surgery, as directed by your surgeon/physician, with the dosages and times you take them.
• Arrange for necessary home care, equipment, etc., following surgery (this will be covered in your discharge plan).
• Sign all informed consent, and other legal forms, before surgery.
• Quit smoking to help in your recovery process.
• If you use a CPAP machine for sleeping, ask your provider for your settings so we may use them while you’re in the hospital.

It is important for patients to be informed about the surgery being recommended, particularly if it is elective surgery (an operation you choose to have performed), rather than an emergency surgery (also called urgent surgery). All surgeries have risks and benefits which you should familiarize yourself with before deciding whether the procedure is appropriate for you.

Here are some important questions you should review with your physician prior to surgery. Ask your physician to explain the answers clearly and ask for further clarification if you’re having trouble understanding an explanation and/or any medical terms. You may find also find it helpful to write your questions down ahead of time and review the information discussed before making a final decision.

It is important to remember that a well-informed patient tends to be more satisfied with the outcome or results of a procedure.
Q: What is the operation being recommended?
A: Your physician should clearly explain the surgical procedure, explaining the steps involved and providing you with illustrative examples. You should ask if there are different methods for performing this operation and why he/she favors one way over another.

Q: Why is the procedure necessary?
A: Reasons to have surgery may vary from relieving or preventing pain to diagnosing a problem to improving body function. Ask your physician to specifically explain why this procedure is being recommended for you and make sure you understand how this may improve your medical condition.

Q: What are my alternatives to this procedure? Are there other treatment options available based on my current medical condition?
A: In some cases, medication or non-surgical treatments, such as lifestyle changes, may be as helpful in improving a condition as surgery. Your physician should clearly explain the benefits and risks of these options so that you can make an informed decision about whether or not surgery is necessary. Sometimes “watchful waiting” is indicated, in which the physician will monitor your condition over a period of time to observe changes and the progression of a disease. You may still need surgery, or if your condition improves or stabilizes, you may be able to postpone surgery. After a period of “watchful waiting,” it may be determined that surgery is still the best option.

Q: What are the benefits of the surgery and how long will they last?
A: It is important that your physician outline the specific benefits of having surgery for you. You should also ask how long the benefits typically last. Some benefits only last a short time, and could possibly require a second operation, while others may last a lifetime.

Also, ask your physician about published information regarding the outcomes of the recommended procedure. This will allow you to make an informed decision and have realistic expectations about the surgery.

Q: What are the risks and possible complications of having the operation?
A: Surgery always carries some risks, so it is important to weigh the benefits against the risks before surgery. Ask your physician to outline the possible complications, such as infection and bleeding, and possible side effects that could follow the procedure. You should also discuss pain and ways to manage any pain that may follow the procedure.

Q: What happens if you do not have the operation?
A: If you decide, after weighing the benefits and risks of the surgery, not to have the operation, what will happen? You need to know whether the condition will worsen or if there is a possibility that it may resolve itself.

Q: Should I obtain a second opinion?
A: Many health plans now require patients to obtain a second opinion before undergoing elective surgery. Your physician should be able to supply you with the names of qualified healthcare providers who also perform the procedure.

Q: What is the physician’s experience in performing this procedure?
A: You can minimize the risks of surgery by choosing a physician who is thoroughly trained and experienced in performing the procedure. You may ask the physician about his/her experience with the procedure being performed, including the number of times he/she has performed it, and his/her record of successes, as well as complications.

Q: Where will the surgery be performed?
A: Until recently, most surgery was performed in hospitals. Today, however, many procedures are done on an outpatient basis or in ambulatory care centers. This lowers the cost of these procedures since you are not paying for a hospital room. Certain procedures still need to be performed on an inpatient basis. Be sure to ask your physician why he/she recommends either setting.

Q: What type of anesthesia will be administered?
A: Your physician should tell you whether a local, regional, or general anesthesia will be administered and why this type of anesthesia is recommended for your procedure. You should also ask who will be administering the anesthesia (such as an anesthesiologist or a nurse anesthetist; both of whom are highly qualified to administer anesthesia) and ask to meet with that person before your operation.

Q: What can I expect during recovery?
A: Ask your physician what to expect in the first few days following surgery, as well as in the weeks and months that follow. You need to know how long you’ll be hospitalized, what limitations will be placed on you, and if there are special supplies or equipment you will need when you leave the hospital. Knowing ahead of time what to expect will help you cope and recover more quickly following the surgery.

Q: What are the costs of this operation?
A: Because health plans vary in their coverage of different procedures, there may be costs you will be responsible for. You will need to know what the specific costs of the operation will be and how much your insurance or health plan will cover.

It is important to communicate your feelings, questions, and concerns with your physician prior to having surgery. The following suggestions may help to improve communication between you and your physician:

• If you do not understand your physician’s responses, ask questions until you do.
• Take notes, or ask a family member or friend to accompany you and take notes for you.
• You can also bring a tape recorder, so you can review information later.
• Ask your physician to write down his/her instructions, if necessary.
• Ask your physician where you can find printed material about your condition. Many physicians have this information in their offices.
• If you still have questions, ask the physician where you can go for more information.

It is important to have confidence in the physician who will be performing your surgery. Whether this is someone you have chosen yourself, or a physician/surgeon you have been referred to, you can make sure that he/she is qualified to perform this operation. This may include any/all of the following:

• Ask your primary care physician, your local medical society, or health insurance company for information regarding the physician/surgeon’s experience with the procedure.
• Ask about the physician/surgeon’s credentials and whether he/she has any additional certifications that make him/her more experienced in performing the procedure.
• Make certain the physician/surgeon is affiliated with an accredited healthcare facility.
• When considering surgery, where it is performed is often as important as who is performing the procedure.

It’s not unusual to experience some pain and discomfort following a surgical procedure. Our healthcare team is committed to managing your pain so you are as comfortable as possible. We’ll ask you to share the discomfort you are feeling so that we may take action. It is important to tell us:

• What “hurts”
• Where it hurts
• How much it hurts
• And how well we are managing your pain

Rating Your Pain
Your physicians and nurses will ask you to rate your pain. We use the zero – 10 scale with five being the most severe and zero being no pain. You should actively participate by asking your physician what to expect regarding pain and what options he or she will use to alleviate your discomfort.

Pain Control Options
Both drug and non-drug treatments can help to prevent and control pain. Sometimes a combination of treatments works to manage pain. You, your family and your nurse and doctor will work together to find what controls your pain.

Medications
Various medicines can be used to manage your pain. For mild pain, a nonprescription drug like aspirin, acetaminophen (Tylenol), or ibuprofen (Advil) may be helpful, and it’s important to speak with your surgeon to determine which is best for you. For more intense pain, a stronger prescription drug like morphine may be needed. Your need for medicine may change over time; this is normal. Don’t worry about getting “hooked” on pain medicines. Research studies show that this is very rare — nearly all people stop taking pain medicine when the pain stops.

Non-medication treatments
Many other treatments are used to treat pain. Some examples of non-drug treatments are:

• Use of heat and cold
• Rest or position change
• Relaxation methods
• Nerve blocks

Mobility & Recovery
It is important to keep yourself comfortable enough, so that you can move around, walk and increase your activity. Increased activity will speed the recovery time, and help prevent post-operative complications.