Tuesday, March 18, 2008

Tips for Surgery Patients

Some tips I give to surgery patients
Before Surgery
  • Stop smoking -- smoking reduces blood circulation to the skin and impairs the healing process.
  • Do not take aspirin. Stop taking any medications that contain aspirin 10-14 days prior to surgery. Aspirin may cause bleeding both during and after surgery.
  • Herbal supplements, Vitamin E, and weight loss products should be stopped 10-14 days prior to surgery.
  • Get active. It's good for your health.

The day before surgery
  • Do not eat or drink anything after midnight the night before surgery.
  • You may take your medications with a small sip of water the morning of surgery, unless given other directions. See above regarding aspirin, herbal supplements, etc.
  • Call if you develop any skin cut or burns that look infected. It may be best to change your surgery date.
  • The night before surgery shower and shampoo. Do not use hair conditioners or hair sprays. Some of these products are flammable.

The morning of surgery
  • You may brush your teeth, but do NOT swallow any of the water.
  • Please, do NOT wear moisturizers, creams, lotions, or makeup. It makes it difficult to get the grounding pad (electrocautery) and the EKG pads to stick.
  • Acrylic nails may stay on, but use light-colored or no nail polish. The pulse oxygen monitor has trouble "reading" through the darker colors, especially the reds.
  • Please, leave you jewelry at home. You will be asked to remove any you wear, and we would hate to lose it, whether because it is a valuable or just a sentimental piece.
  • Wear comfortable clothing the day of surgery. Imagine dressing yourself when "drunk" or "weak and unsteady".
After surgery
  • Arrange for a family member or close friend to stay with you the first 24-48 hours.
  • Keep your dressings as clean and dry as possible. Do not remove them unless instructed to do so.
  • Take it easy and pamper yourself. Avoid any straining or activities that would elevate your blood pressure.
  • Cold or ice packs may help to reduce swelling, bruising, and pain. Packaged frozen peas or crushed ice in a zip-lock bag work well without being messy. If the ice feels able, you may use less often.
  • If you are not nauseated, start with liquids and bland foods first. If these are tolerated, then you may progress to a regular diet. If nauseated, try carbonated soda and dry crackers. If it persists, you may need an anti emetic (ie Phenergan).
  • Alcohol should not be consumed until you have stopped taking the prescription pain medication. It is not good to mix the two. Also, alcohol will dilate blood vessels and could increase your bleeding.
  • The day of surgery walking to the bathroom and back to the bed or recliner or couch is enough movement. Over the next few days, you can begin to increase your activity as instructed.
  • You should not drive for 24-48 hours after general anesthesia. You should not drive while taking prescription pain medication. The medications may slow your response time and may lead to an accident. It is also considered driving while under the influence (DUI).
As you heal
  • Don't attempt to shower (even if allowed) until you can stand without dizziness for 45-60 minutes. It isn't worth a fall in the bathroom. Take a "sink bath" instead. The dizziness may be from the anesthesia, the pain medicines, or not being re-hydrated. Wait another day or two.
  • Some patients experience a brief period of "let-down" or post-surgery depression. Often this is due to a subconscious expectation of feeling and looking better "instantly". It takes time to heal. Give yourself "permission" to do so.
  • Pain medicine and decreased activity may constipate you. If it has been more than 2 days since your last bowel movement, take something like plum (or prune) juice, Milk of Magnesia, Exlax or Ducalax.
  • Panty liners make great dressings. They are packaged sterile and have a protective backing that will keep blood and other fluids from leaking through to ruin your clothing.
  • Avoid activities that would result in pulling your incision "apart". For example, reaching backwards or stretching for that upper shelf after breast surgery.
Some tips patients have given me to pass on to other patients
After a tummy tuck
  • Wear a pair of old panties while showering to "hold" the drains/collection bulbs rather than just letting them hang. You'll feel more secure.
  • Consider borrowing a walker. It will remind you to "stay bent" when walking.
After a thigh lift
  • Before surgery, buy a "soft" toilet seat to use after surgery. The "hard" seat is painful to sit on.
  • If you can, get a "soft and elevated" toilet seat. The raised seat will make it easier to "sit" and to "get back up".
  • "Tie" your ankles together (12-18 inches) to remind yourself not to "pull them apart". It is so easy to forget and this can lead to open areas in the incisions.


mark's tails said...

If I can be so bold to add a comment from someone who does a lot of 'pre-op' clearance consults. Smoking also increases the risk of post-op pulmonary complications. Current smokers have a 5.5 fold increased risk. If you quit for 2 months or less your risk drops to approximately 4 fold higher than a non-smoker, BUT after 6 months your risk is the same as a non-smoker.

Dr. Val said...

Fantastic tips, Ramona. I may need to refer Revolution Health consumers to this!

rlbates said...

Mark, thank you. I appreciate any tips that aid my care of patients. I would even welcome more tips from patient-to-patient.

Thanks Val.

SeaSpray said...

This is an awesome post! I am copying it to my word program for future reference.

Why do herbs or vitamin E need to be stopped prior to surgery?

I have experienced that post-op let down and never understood why because after all I got through the thing I was afraid of.

I am bad about the moisturizers. I shower, shave and moisturize the night before and then I just shower with bacterial soap in am.

rlbates said...

Seaspray, the Vit E (in large doses) can increase bleeding/bruising. The herbals--different things. Some bleeding, some arrthymias, etc. Read this post--http://rlbatesmd.blogspot.com/2007/06/herbal-suppliments-and-plastic-surgery.html

SeaSpray said...

Thank you Ramona...I will check it out.

SeaSpray said...

This really is such a good post!