Surgery: What to Expect

You will have an appointment with your surgeon, Opens dialog before your surgery. Take along a list of questions about the surgery to help you understand your treatment.

Talk to your surgeon about any concerns you have about the surgery. Your surgeon will explain why you need the surgery, what it will involve, what its risks and expected outcomes are, and how long it will take you to recover. You may also want to ask about treatments you might try other than surgery.

Talk to your surgeon about what kinds of surgery you've had in the past. Describe your recovery period, and be sure to mention any problems you may have had.

Describe any health problems you have, such as:

• Diabetes.
• Heart problems. Also tell your doctor if you have a pacemaker.
• Lung problems, such as COPD.
• Sleep apnea.
• Asthma.
• Any allergies to foods or any substance, including latex, tape, adhesives, anesthetics, Opens dialog, or other medicines. You may also be asked if any family members have had reactions to anesthetics.
• Any bleeding problems or use of aspirin or some other blood thinner, Opens dialog.
• A current—or recent—cold, flu, or fever.

It's important to tell your doctor about any tobacco, alcohol, illegal drugs, or medicines you use. This includes over-the-counter medicines, vitamins, and supplements, such as St. John's wort and diet aids. Your use of substances or medicines may affect your reaction to anesthesia, Opens dialog or pain medicines.

Talk about any physical restrictions you have, such as an artificial joint or limited range of motion, Opens dialog of your neck, arms, or legs.

Let your doctor know if you have any metal implants or fragments in your body.

Tell your surgeon if you are or might be pregnant.

Most surgery centers and hospitals also have a before-surgery form for you to fill out. This form usually includes questions about your past and current health. This information helps the surgical team prepare for your surgery. You most likely will complete the form 1 to 3 days before your surgery.

Tests before surgery

Before surgery, you may have an exam or tests. These tests are to make sure that surgery isn't likely to be too hard on you. The tests may include:

• Blood tests, Opens dialog.
• Urine tests, Opens dialog.
• Blood clotting tests.

You may also be scheduled for other tests if your surgeon thinks you need them before your surgery. These may include X-rays, Opens dialog or an electrocardiogram, Opens dialog (EKG).

Your surgeon may want to include other doctors in your care, depending on your other medical conditions. For example, if you have heart problems, your surgeon may discuss your care with a cardiologist, Opens dialog.

If you know before surgery that you might need a blood transfusion during your surgery, you may wish to donate your own blood. This has to be done several weeks before your surgery.

Preparing for surgery

Before your surgery, your surgeon or nurse will remind you to do these things:

• Follow the instructions exactly about when to stop eating and drinking. If your doctor has told you to take medicines on the day of surgery, do so using only a sip of water.
• Do not use aspirin or other nonsteroidal anti-inflammatory medicines, Opens dialog (NSAIDs) for 1 week or as instructed before your surgery.
• If you are having same-day surgery, arrange for someone to take you home.
• If you will need it, make plans for someone to stay with you for the first 24 hours.
• Shower before surgery as instructed. Don't use lotions, perfumes, or deodorants.
• Leave all valuables, such as money and jewelry, at home.
• Remove all nail polish and body jewelry, such as piercings.
• Gather these items and bring them with you:
  • Have a picture ID ready to take with you. Your ID will be checked before your surgery.
  • Any X-rays or other test results that you may have.
  • Personal items you'll need after surgery, such as your inhaler if you have asthma, your CPAP machine if you have sleep problems, or a cane or walker if you use one.
  • Your insurance information.

Just before surgery

When you arrive for your surgery, your nurse will:

• Check your name, your birth date, and your signed consent for surgery.
• Check the correct body area for your surgery.
• Check your vital signs. (These are your temperature, heart rate, blood pressure, respiratory rate, and oxygen level).
• Measure or ask about your height and weight.
• Make sure you haven't had anything to eat or drink for the length of time your surgeon told you.
• Check your medical chart for any allergies you have and any medicines you take.

Your nurse will also explain to you what will happen and will reassure you to help you stay calm. The nurse may go over a pain scale, Opens dialog. This may be used to help see how you are doing after surgery. If you have any last-minute questions, ask to discuss them with your surgeon.

Your surgeon or the surgical team may also give you some information on what will happen after surgery. You may learn if you'll have special equipment, like a urinary catheter, Opens dialog or wound drains.

The nurse will have you:

• Urinate and change into a hospital gown.
• Remove any dental work, such as dentures or plates.
• Remove any hearing or visual aids, such as hearing aids or contact lenses.
• Remove all piercings or jewelry.

Just before surgery, the nurse will give you any medicines ordered by your surgery team, such as:

The nurse may also give you an intravenous (I.V.) line, Opens dialog in your arm or hand, if ordered by your surgeon or anesthesiologist. This gives you fluids and medicines before, during, and after your surgery.

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Watch

A special surgical team helps the surgeon with your surgery. This team usually includes:

• A surgical technician (scrub). This person passes tools to the surgeon.
• A registered nurse, Opens dialog, who helps in many ways. The nurse writes the details of your surgery in your medical chart.
• A nurse anesthetist or anesthesiologist, Opens dialog. He or she gives you medicines and watches your vital signs.
• Other medical personnel, such as an X-ray technologist, Opens dialog, who may be needed for your surgery.
• Another surgeon to help your primary surgeon, if needed.

In university or teaching hospitals, doctors with different levels of surgical training may watch or help with your surgery. But your surgeon will be in charge.

The surgical team is trained to provide you with safe care during your surgery.

Before the surgical team starts your surgery, the team members will double-check your name. They'll check what type of surgery you are there for and what part of your body is to be operated on.

Anesthesia

If you are having general anesthesia, Opens dialog, a breathing tube (endotracheal tube, Opens dialog) is placed in your windpipe. Or a special airway (laryngeal mask airway, or LMA) is placed in the back of your throat. These things help you breathe during the surgery.

Keeping things sterile

The place on your skin where the incision will be is washed with a special liquid to remove bacteria. All tools used during your surgery are sterilized to reduce your risk of infection.

Pain control

Pain control is an important concern. Near the end of your surgery, your surgeon may inject a long-acting pain medicine at the site of your surgery. It will ease your pain for 6 to 12 hours after surgery.

In the recovery area

Right after surgery, you will be taken to a recovery area where nurses will care for and observe you. A nurse will check your vital signs and bandages. He or she will also ask about your pain level.

When you wake up, you may have a small tube just below your nose that supplies oxygen to your lungs.

You will most likely stay in the recovery area for 1 to 4 hours. Then you'll be moved to a hospital room or you'll go home. You may get medicine or fluids through your vein (intravenous, or I.V., Opens dialog) while you are in the hospital.

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