Preparing for your Procedure
This information pamphlet has been designed to give you a basic understanding of the considerations that need to be made when preparing for surgery. Please keep in mind that this material is a reference guide only and your preparation and recovery may differ from that described. If you decide to go ahead with surgery, you will need to learn what to expect from the surgery. Preparing mentally and physically for surgery is an important step toward a successful result.
Understanding the process and your role in it will help you recover more quickly and you will have a lower chance of having problems.
Some blood loss during surgery is inevitable and is expected. Sometimes the loss of blood can be large and fluid or blood replacement may be required. Discuss with your doctors the options for preparing for potential blood loss, prior to surgery.
Common blood-thinning medications such as aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), warfarin and clopidogrel should be stopped 7 days prior to elective surgery to decrease the expected blood loss.
You may require prolonged bed rest or limb elevation after your surgery. Arrange for someone to help out with everyday tasks like cooking, shopping and laundry. Put items that you use often within easy reach before surgery so you won’t have to reach and bend as often. Remove all loose carpets and tape down electrical cords to avoid falls. Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.
Eat a well-balanced diet, supplemented by a daily multivitamin containing iron. No food should be consumed within 6 hours of an anaesthetic. No water should be consumed within 4 hours of an anaesthetic.
Your suitability to drive after your procedure is discussed in detail at Driving After Surgery.
It is not safe to have food within 6 hours of an operation; water can be consumed up to 4 hours before your operation. For example, if your operation is scheduled for the morning - you should not have anything to eat after midnight, or any plain water after 04:00am. If your surgery is scheduled for the afternoon (starting at midday), you can have an early breakfast at 06:00am and plain water up until 08:00am.
Report any infections to your GP and to Dr McLean. Surgery cannot be performed until all infections have been treated appropriately. If an infection is suspected, antibiotics should be withheld until a specimen has been sent for analysis. If you have any tooth, gum, bladder or bowel problems, have these treated before your procedure to reduce the risk of an infection later.
Some medications interact with other medications prescribed doing surgery such as antibiotics and pain relief. Other medications can increase the expected blood loss or interfere with wound healing. Discuss any medications you are taking with your doctors to see which ones you should stop taking before surgery. Methotraxate should be stopped 7 days prior to surgery.
All surgery requires a cut (or cuts) through the skin. Any breach in the skin has a small risk of infection until the wound has healed. Some skin conditions or ulcerations around the surgical site can increase the risk of infection.
Smoking interferes with wound and bone healing. Cutting down will reduce your surgical risks and likely improve your outcome.
Being underweight can affect your body’s response to the anaesthetic, wound healing and the stress of surgery. Similarly, if you are overweight, losing weight before surgery will help decrease the stress placed on your body during the procedure and reduce the force through your joints during your rehabilitation. Patients with a BMI greater than 35 have an increased risk of complications including infection, wound breakdown, implant failure and revision surgery.
Confirm with Dr McLean and your employer how long you plan to take off work. After a procedure, a minimum of 2 weeks off work can be expected to recover from the anaesthetic and to protect the wounds. Longer periods may be expected if your work site has potential hazards, or if your employer requires "a full work clearance" before returning to full duties. To avoid disappointment, find out whether your employer is happy for you to return to work at modified duties or whether they require a "full work clearance". NB. It is important that you discuss this with your employer prior to surgery to avoid disappointment.
Preparing for Day Surgery
Have someone available to take you home - you will not be able to drive for at least 24 hours. Your suitability to drive after your procedure is discussed in detail at Driving After Surgery.
Do not drink or eat anything in the car on the trip home. The combination of anaesthesia, pain-relievers, food and car motion, can quite often cause nausea or vomiting. After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours.
Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait until your pain is severe before taking your medication, you will have more difficulty controlling the pain.
If you had surgery on an extremity (elbow, wrist, hand, knee or leg), keep that extremity elevated and use ice indirectly (do not apply ice directly to the skin). Place ice in a wet towel onto the skin for no longer than 20 minutes at a time. Keeping the "toes higher than the nose" will aid in returning fluid to the heart and help decrease swelling and pain.