This is meant to provide you and your family with information regarding your surgery and recovery. Please share this information with your family.

Before Surgery:
For you, and for us, no surgery or procedure is minor. All Surgery requires careful preparation, your cooperation is very important. Research shows that people who have surgery feel better and return to normal more quickly at home rather than in the hospital. Early planning is the key for a successful surgical experience and meeting your home care needs. We encourage you to begin planning today by following general guidelines to help you preparing for your surgery. Your doctor may modify them for your specific needs.

Communication and cooperation are essential to the surgery process and its safety.
• Speak frankly.
• Ask questions.
• Follow instructions.
• Provide your nurse anesthetist with a medical history.
• Notify your nurse anesthetist or doctor immediately of any change in your physical condition prior to surgery.

New change in health status: If you become Ill (cold, cough, flu) have any recent health changes or must reschedule your surgery for any reason, notify you physician immediately.

To help us file for insurance, please bring your insurance indentification card with information. Contact your insurance company as soon as possible to inform them of your scheduled surgery. They can tell you how much of the costs your insurance will pay and what share you will have to pay.

If you routinely take medications for any condition, ask your nurse if you should take them on the morning of surgery. ”Supplements” or herbal medicine should be stopped ten days or two weeks before prior to surgery.

Medications
Aspirin: Stop 1 week before surgery.
Anti-inflammatories (e.g. Motrin, Advil, Ibuprofen, Aleve, Celebrex): Stop 48 hours before surgery. You may take acetaminophen (Tylenol) until the morning of surgery.
Coumadin: Stop 5 days before surgery. Notify the physician prescribing the Coumadin that you are having surgery. If the physician would like you to be on LOVENOX, please notify our office immediately.
Diabetics: Check with the physician managing your diabetes regarding appropriate management for the day of surgery.
OTHER Medication, e.g. blood pressure medications, should be taken with a small sip of water the morning of surgery.

Arrange for someone to drive you home after surgery. A responsible adult must drive you home. For you safety, you will not be permitted to leave unattended. You should plan to have a responsible adult at home with you for 24 hours after going home.

Evening before Surgery:

It is imperative that you follow specific pre- operative food and fluid instructions. Failure to follow these guidelines could results in the cancellation of your surgery.

Adults & Children may have absolulety no solid food after midnight the day prior to surgery. No chewing gum, mints, or hard candy, NO COUGH Drops

Your surgery time may be moved ahead. Be prepared to come in early if we call you. Also, emergencies may cause delays in your scheduled operating time. Please be patient.

Day of Surgery:

Special Medication Instructions:
Please take your morning (prescription only) medication with a sip of water. This includes blood pressure, heart and water pills.

If you are a diabetic, do NOT take insulin or other blood sugar medication on the day of surgery. Your blood sugar level will be checked when you arrive at the facility and medication prescribed as needed. But bring your medication with you.

Nothing to eat or drink on the day of surgery.

Shower or bathe, brush teeth and gargle, but do NOT swallow any water.

Do not apply eye make-up or body lotion.

Wear loose, comfortable clothing that is easy to get on and off. Please leave all jewelry and valuables at home. Do not bring valuables or money, except payment arranged through our busines office.

If you wear contact lenses, please bring your container and solution. It is best to wear your glasses.

WHAT to Bring:

Once You Arrive:

Arrive at time instructed.
Nurse reviews your health history and makes sure you are ready for surgery.
Discuss anesthesia choices / issues with the anesthetist.
IV( intravenous fluid) will be started.
Pain medication, antibiotics, or other medication may be given through IV
Discuss pain — rating scale with nurse.

The goal is for every patient to be as pain free as possible. Your level of discomfort will be evaluated before and after surgery. Your caregiver will ask you to rate your pain on a scale of 0-10, with 0 being no pain and 10 being the worst pain. See pain scale below.

0 = No pain
1 = Some pain but OK
2 = Mild pain worse
3 = Annoying pain
4 = Distracting pain
5 = Pain can't be ignored for more than 30 minutes/ Moderate pain
6 = Pain can't be ignored at all
7 = Pain makes it hard to think and sleep
8 = Pain limits activity; nausea with pain
9 = I cry out in pain
10 = Passed out / Worst possible pain

After Surgery while in the hospital:

Your doctor will talk to family/friends (if present) in the patients room.

Vital signs and surgical site are checked regularly.
Tell your nurse if you feel pain and /or have an upset stomach. These are many medications available to control these symptoms. Your nurses will provide medications and comfort measures as needed. You may have a PCA (Patient Controlled Analgesia) IV Pump for pain medication.

Simple foot/leg exercises aid circulation. A leg pump (SCD) may be used.

Leg and Foot Exercises
1. Lie on your back with legs flat on the bed.
2. Push the back of one knee into the mattress. Hold for the count of five. Relax. Repeat this with other knee.
3. Still lying on your back, point your feet toward the end of the bed, then up toward your head. Repeat ten times and relax.
4. Trace circles with your feet. Repeat several times with each foot.
5. Repeat these exercises every 2 hours while you are awake.

Urinary catherter will be in place if needed.

Do coughing / deep breathing exercises.
1. Hold both hands over your lower rib cage.
2. Breathe in as deeply as possible through the nose, moving your rib cage out as you breathe. Hold it in for the count of 3.
3. Breathe all the air our slowly through your mouth, pursing your month, pursing your lips as if you were blowing out a candle. Your should feel your ribs move in.
4. Repeat times with a short rest between each breath.
5. Do this every 2 hours while you are awake.
A device called an incentive spirometer may be ordered to help you take deep breaths. Deep breathing can help prevent pneumonia or other problems that could slow your recovery.

Turning
1. Lie flat on your back
2. To turn onto your side, place your right hand over abdominal incisions, bend your left knee, hold on to the side rail with left hand and turn.
3. Reverse to turn to the left.
4. Turn from each position every 2 hours while you are awake.

Criteria for discharge:

When you have met recovery guide lines, specified by your doctor, you will be discharged. For home or to the Med/surgery unit. However, you could still be sleepy, slightly dizzy, or nauseated. These are possible (and normal) side of effect of anesthesia/ and post operative pain medication. Can last for 12-24 hours after surgery.

A responsible adult must drive you home. For you safety, you will not be permitted to leave unattended. You should plan to have a responsible adult at home with you for 24 hours after surgery.

Home Care:
You will be given home care instructions by your doctor and nurse.
Once you are at home, Contact your doctor immedialety or Emergency Room, if you have any severe pain, nausea, or abnormal bleeding.

"Do's and Don'ts" After Anesthesia: A Quick Guide
• Don't drive a car for at least 24 hours.
• Don't operate complex equipment for at least 24 hours.
• Don't make any important decisions or sign any legal documents for 24 hours.
• Don't take any medications unless prescribed by or discussed with your physician.
• Don't drink alcohol for at least 24 hours.
• Do leave the healthcare facility accompanied by a responsible adult.
• Do remain quietly at home for the day and rest.
• Do arrange for someone to care of your small children for the day.
• Do take liquids first and slowly progress to a light meal.
• Do call the facility where you were treated if you have any questions.

DIET:
Do take liquids first and slowly progress to a light meal. Heavy foods can be difficult for your system to digest, thereby increasing the chance for discomfort. For your nourishment, start by taking liquids, and then eat light foods, such as broth or soup, crackers or toast, plain rice, Jell-o, and yogurt. A normal diet may be tolerated by some patients, but for others it may take up to three (3) weeks for the digestive system to return to normal. Listen to your body and eat what seems reasonable (you will be instructed about any needed restrictions).

Drink 6 glasses of fluids a day.

PAIN MEDICATIONS:
It is important to take your pain pills with food to prevent nausea.
Take over-the-counter pain pills such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) at regular intervals throughout the day to keep your pain under control and prevent intolerable “breakthrough” pain

Add prescription pain pills when ibuprofen or acetaminophens are not enough to control pain.

OTHER MEDICATIONS:
Ask your doctor about restarting your usual medications
May begin hormones (if indicated).

UPSET STOMACH/ CONSTIPATION:
Prescription pain pills often cause constipation, nausea, and vomiting. If this occurs, take over-the-counter pain pills and limit prescription pain pill use. Take a stool softener (docusate sodium) twice a day (unless otherwise directed). You may use milk of magnesia as a laxative if needed, unless instructed otherwise. Choose high fiber foods like bran and fruits.

ACTIVITY:
Increasing your activity level is the single, most important thing you can do to help your recovery.

Walking is a good way to promote a sense of well-begin and helping your body return to normal functioning. The earlier you begin walking, the better you will feel. Increase the distance and number of times you walk each day. (Minimal stair climbing, running,) Do not lift over 20 lbs.
Ask your doctor when you may begin driving.
Do not drive if taking prescription pain medication.

WOUND CARE:
Surgical incision may get wet in shower, unless otherwise ordered by your doctor. Pat dry. Do not scratch incision.
Leave tape/tape strips on until they fall off. If tape strips still present after two weeks, remove them.

CALL YOUR DOCTOR IF YOU HAVE:
Unrelieved or persistent nausea, vomiting or pain
Chills, fever over 101*
Wound is red, swollen, draining, gaping, or more painful.
Foul odor from the incision or dressing.
You have a reaction to your medication (itching, rash, and hives)
Excessive bleeding
Separation of the incision
Shortness of breath
Worries or concerns.
Thank you for choosing Lake Chelan Community Hospital