Patient Information

General pre-operative instructions

The following instructions should be followed closely except when overruled by specific procedural instructions.

2 weeks prior to surgery

• No medicines containing aspirin or ibuprofen as it interferes with normal blood clotting.
• If you are taking blood thinners (Coumadin, Pradaxa, Plavix, etc) talk to your PCP or Cardiologist to determine how long prior to surgery you can stop these medications. Please have your physician/physicians office send us their requests regarding these medications.
• Please discontinue all herbal medications as many have side effects that could complicate a surgical procedure by inhibiting blood clotting, affecting blood pressure, or interfering with anesthetics.
• Please discontinue all diet pills, whether prescription, over-the-counter or herbal as many will interfere with anesthesia and can cause cardiovascular concerns.
• No “Megadoses” of vitamin E, but a multivitamin that contains E is just fine.
• No smoking because nicotine reduces blood flow to the skin and can cause significant complications during healing.
• You may use Tylenol or generic forms of this drug. These do not interfere with blood clotting or healing.
• Start taking a multivitamin each day and continue taking through your recovery. The healthier you are, the quicker your recovery will be

One week prior to surgery

DO NOT take or drink any alcohol or drugs for one week prior to surgery and one week after surgery as these can interfere with anesthesia and affect blood clotting. DO report any signs of cold, infection, boils, or pustules appearing before surgery. DO NOT use any cough or cold medications without permission. DO arrange for a responsible adult to drive you to and from the facility on the day of surgery, since you will not be allowed to leave on your own. For outpatient surgery, DO arrange for a responsible individual to spend the first 24 hours with you, since you CANNOT be left alone. Please note that a cab or bus driver will not be allowed to take you home after surgery. On arrival, be sure we know your driver’s name, phone number, and how we will be able to reach them.

Night before and morning of surgery

DO NOT eat or drink anything (not even water) after midnight the night before your surgery. Also, no gum, candy, mints, or coffee the morning of surgery. Do not sneak anything as this may endanger you. If you are on regular medications, please make sure to hold any medications that are on the list. At your pre-op appointment you will be given verbal instructions on how to bathe the day before and day of your surgery. DO NOT apply any of the following to your skin, hair or face the morning of surgery: makeup, creams, lotions, hair gels, sprays, perfumes, powder, or deodorant. Using any of these products will add bacteria to the skin and increase risk of infection. You may brush your teeth the morning of surgery but do not drink anything. DO NOT wear contacts to surgery. If you do wear glasses, bring your eyeglasses case. DO wear comfortable, loose-fitting clothes that do not have to be put on over your head. The best thing to wear home is a button-up top and pull on pants. You will want easy-to-slip-on flat shoes. DO NOT bring any valuables or wear any jewelry (no rings, earrings, chains, toe rings, other metal piercings or watches). We will need to tape wedding rings if worn. If you are not recovering at home, it is very important that we have the number where you will be after surgery

General post-operative instructions

The following instructions should be followed closely except when overruled by specific procedural instructions. You must follow your surgeon’s instructions as indicated for your specific surgery. Notify our office of any unusual changes in your condition and feel free to call the office with any questions.

1. You MUST HAVE AN ADULT DRIVE YOU home from the facility. You will not be allowed to drive yourself or use public transportation.
2. After surgery you Must HAVE A RESPONSIBLE ADULT STAY WITH YOU a  minimum of 24 hours. You CANNOT be left alone. The 24 hours begin when you are discharged from the office or hospital. Have everything ready at home PRIOR to surgery. Make arrangements for someone to stay with you. Let the person or persons know you cannot be left alone. This is important because of the danger of falling and you may lose the concept of time for the day and overmedicate yourself.
3. The effects of anesthesia can persist for 24 hours. You must exercise extreme caution before engaging in any activity that could be harmful to yourself or others.
4. DRINK fluids to help rid the body of the drugs used in surgery. If you have straws in the house you will tend to drink more fluids the first few days after surgery.
5. Diet may be as tolerated. Eating foods that are bland and soft for the first day or so – foods like after you have had the flu – may be best tolerated. You must eat more than crackers and juice; otherwise you will continue to feel weak and will not heal as well. REMEMBER to take the medications with a little something to eat or you will get sick to your stomach.
6. Please avoid use of alcoholic beverages for the first 24 hours (it dilates blood vessels and can cause unwanted bleeding) and as long as pain medications are being used (dangerous combination).
7. Take only medications that have been prescribed by your surgeon for your postoperative care and take them according to the instruction on the bottle. Your pain medications may make you feel “spacey.” Therefore, have someone else give you your medications according to the proper time intervals.
8. If you experience any generalized itching, rash, wheezing or tightness in the throat, stop taking all medications and call the office immediately, as this may be a sign of a drug allergy.
9. You can expect moderate discomfort, which should be helped by the pain medications. The greatest discomfort is usually during the first 24-72 hours. Thereafter, you will find that you require less pain medications.
10. Call (585)-758-5700 if you have: SEVERE PAIN not responding to pain medication; swelling that is greater on one side than the other; incisions that are RED OR FEVERISH; FEVER or if any other questions or problems arise.
11. Keep any DRESSINGS ON, CLEAN AND DRY. Do not remove them until instructed to do so. There may be some bloody drainage on the dressings. If you have excessive bleeding or the bandages are too tight, call the office immediately.
12. After surgery it is important to have a bowel movement within a day or two. If you do not, you may take over the counter laxatives to encourage your bowels to move.
13. Minimal activity for the first 48 hours. No house cleaning, furniture rearranging, etc. Relax, be pampered, and let your body heal. The less energy you use on doing things, the more energy your body can focus on healing.
14. Limit lifting, pulling or pushing for 14 days.
15. Position after surgery is different with different types of surgery. If your surgery is from the waist up we ask that the head of the bed be elevated 45 degrees. This requires a pillow under the upper back, two pillows under the shoulders and head, and if you have a pillow under each elbow you will relax and stay in position.
16. You are requested to remain within a reasonable traveling distance of the office for approximately 10 days.
17. Once cleared to shower you may do so every day. Please do not use the bathtub for 2 weeks.
18. NO SMOKING for the first 14 postoperative days. Any cheating will delay healing.
19. You may drive two days after anesthesia, once you are off the pain pills, and when you experience  no pain with this activity (you need to be able to react quickly).
20. All surgeries involve some scarring, which can take up to a year to fade. No matter how small they may be, we will still want them to heal as well as they are able. Exposing red scars to the sun can cause permanent discoloration. A good sunscreen (SPF 30 or higher) can help and will protect the surrounding tissue that might not feel sunburn developing while the nerves are healing. Sunlight can even reach scars under a swimsuit, so take adequate precautions.
21. Mederma may be applied once sutures are removed if the incision area is healing well.
22. DO NOT use a hot tube for 4 weeks.
23. AVOID sports or strenuous activities 4-6 weeks or until your surgeon gives you clearance during your post-operative visits. This is to avoid any unnecessary complications (bleeding, bruising, swelling).
24. You may return to work when you feel able and are cleared to do so by your surgeon.
25. Feel free to call upon us at any time. We want you to be as comfortable as possible during your healing period.
     

Your surgeon will also provide more guidelines specific to your procedure.