Microsoft word - presurgical-faq.rtf
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1. When should I stop eating and drinking?
Stop solid food and liquids after midnight or at least 8 hours
before surgery. Includes candy, gum, milk,
juice, coffee, water, Jell-O, etc.
o Prevention of very serious anesthesia complication such as Aspiration Pneumonia
o If you violate the above, the anesthesiologist will cancel your surgery.
2. Should I take my usual medications the day of surgery?
Day of surgery, you may continue to take oral medication pills as usual with a small sip of water except
for the medications listed below:
o Do not take medicines that instruct you to: "Take with food or milk".
o "Bulk medications" such as psyllium (Metamucil, Citrucel, etc).
o Diuretics ("water pills"): Should not be taken the morning of surgery except when using for
o Inhalers for asthma or emphysema: Use as scheduled and bring these to the hospital for use
Stop 7 days before surgery (includes cardiac protection dose of 80-325mg/day).
Inform your prima ry care physician you are having surgery, and they will help guide
you through this. Plavix must also be stopped 7 days before surgery.
rugs) Stop 5 days before surgery.
and herbal remedies such as Garlic, Ginseng, Ginkgo
: Stop 10 days before.
(Coumadin): Prescribed “blood-thinning” agents.
Have prescribing physician lower dose and monitor until INR is lower than 1.3.
o This must occur before surgery.
o Surgery will be canceled if blood is still too thin (INR>1.3)
o Oral hypoglycemic agents (oral diabetic medicines such Glucophage, sulphonylureas, etc).
Do not want to decrease blood sugar too much, since you have stopped eating.
o Insulin: your dose the day of surgery may be determined by your anesthesiologist, primary
physician or surgeon. If you have not received specific instructions regarding your insulin by themorning of your surgery, then take one half your usual dose and monitor your blood sugarsclosely.
o Controlled substances: Narcotic pain medications and/or sedatives may not be brought into the
hospital. This is a violation of Federal and State laws. It is in your best interest to decreaseyour dose of these medications during the last 7-10 days prior to surgery as the level of painyou will experience after surgery is proportional to the amount of narcotics you were takingbefore surgery.
o Transdermal systems: Skin patches may be worn into the hospital. Includes narcotic fentanyl
(Duragesic) patches as well as hormonal, cardiac and nicotine systems.
Please notify surgical team and floor nursing staff so this medication can be
3. What are some standard medications that people usually take up to the time of surgery?
o Pain medications, which contain no aspirin.
o Acetaminophen (Tylenol).
o Muscle relaxers.
o Hormone therapy, anti-depressant/anxiety/seizure/Parkinson medicineso Cardiac/blood pressure/cholesterol medications (discontinue cardiac protective aspirin).
o Nutrient Supplements: iron, calcium, multivitamin, vitamin A, B, C, D; but excludes
4. What else can I do to make the pre-surgical process easier?
If you become ill within 7 days from surgery (fever, flu, cough, "colds") contact your physician.
Have an updated list of current allergies
with proper dose/frequency available for the
o Your medical history and surgical experiences will be discussed with the anesthesiologist when
you arrive at the hospital prior to your surgery.
o Important medical history such as high blood pressure, asthma, diabetes, or any other serious
conditions effecting brain, heart, lung, liver, kidney, gastrointestinal, skin and otherorgan/systems must be discussed with the surgical team.
Make sure you notify your Surgeon if you have had a history of skin
infection, abscess, or infection following a surgery you had in the
If you currently have a skin rash, a cut anywhere in your skin, a
resolving infection in your skin or a boil make sure to notify and
show it to your Surgeon when you get to the hospital – prior to your
Smokers: No smoking in hospital. You may want to consider nicotine replacement therapies prior to
Remember that smoking increases the risk of poor wound healing and inhibits new bone
formation, hence increases the chances of failure of spine fusion and failure of fracture
It is absolutely necessary for you to quit smoking before your spine surgery. Doing so will decrease
the risk of you having post-operative infection. And will increase the chance of your wound healingproperly and will also increase the chances of your spine fusion being successful.
This surgery could be just the motivation you need to really quit.
Make sure you bring with you on the day of Surgery, ALL the XRAYs, CT Scans, MRIs of your spine
that you have. Without these your surgery cannot proceed, and your surgery will be CANCELED. So
please remember to bring these diagnostic imaging studies with you to the hospital. It is EXTREMELY
If you have any further medical questions regarding your upcoming surgery, you may address it with yourprimary care physician, the anesthesiology team (during your pre-operative visit), and your Surgeon.
Remember – if you disregard the above instructions, your surgery may need to be canceled
Preparing for the hospital admission
* Bring all forms from your surgeon's office.
No mascara or body lotion: make up at a minimum
* Bring Insurance Card & Photo ID the day of surgery
* Leave all valuables at home (money, credit cards, jewelry)
* Bring storage case for glasses, contacts, hearing aids, dentures, etc
* Wear loose, comfortable clothing; easy wear after surgery
* Visits by family and friends are limited to the Pre-op Holding area * Visitors are not allowed in the recovery room area* Leave luggage/personal items in car. Family to retrieve after surgery *BRING YOUR X-rays/CT Scan/MRI with you
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