Pre Surgery Preparation

Everyone is anxious before they undergo surgical procedure. Level of anxiety varies person to person. Understanding the procedure, preparing yourself before the surgery and understanding post operative recovery helps to alleviate the anxiety. This section helps you to achieve this.

Taking brief notes, referring to a useful website or information booklets and discussing with other patients who have had the procedure will supplement information you have already acquired during the consultations with the surgeon, Preoperative assessment staff, physiotherapists, and occupational therapists. Based on all these information gained, setting up regular simple goals will aid smooth preparation and recovery. It is important to realise that recovery speed varies from person to person.

Preparation yourself and home

Health (preparing yourself)

  1. Eating well balanced diet is essential to maintain good health especially prior to undergoing surgery.
  2. Regular exercises withing pain limits before surgery helps to recover better. Familiarising yourself with the exercises you are expected to do after surgery also helps. Most hospitals will give you the list of exercises you are expected to do after the surgery.
  3. Maintaining healthy weight before surgery helps better recovery and reduce the risks of complications during or after surgery.
  4. Smoking increases the risk especially related to chest. So, it is better avoided completely. If not, it should be avoided for at least six weeks before surgery and until you have made good recovery. Alcohol consumption should be as minimal as possible in the weeks before surgery. You might be advised to avoid taking alcohol because of certain drug interactions after surgery.
  5. All pre-existing medical conditions should be well under control. You should take the medications regularly. Patients with Diabetes should make sure their blood sugar control is optimal to reduce the risk of infection and other complications. Correctable condition such as Anaemia will need to be addressed prior to the surgery to expedite recovery and minimise complications. Advice regarding stopping some medications such as blood thinners around the time of surgery will be given by the surgeon, anaesthetists, and preoperative clinic staff. Patients will be advised to stop taking supplement medications because of unknown cross reactions with medications that have to be given during perioperative period. Oestrogen containing pills might have to be stopped to reduce the risk of Deep Vein thrombosis/ Pulmonary embolism.
  6. In the days before operation patients should take precautions to avoid infections. Skin damage from scratching, shaving or minor injury can lead to infection which can delay surgery. Care should be taken to avoid other infections such as chest and bladder infections

Preparing Home

  1. Preparing home to aid smooth recovery and avoiding accidents is advisable. Please make sure every room you have to use in your home after surgery is well organised. Please make sure there is enough space to move around smoothly while walking with crutches, place essential items like medications, phone, chargers, remote controls etc at a convenient place to reach without putting yourself at risk, remove all trip hazards, plan how you will move within the house with or without support etc. You will be given information on the chair and bed height, equipment like toilet seats etc by the preoperative assessment team. Please ensure they are in place. Some equipment will be provided by the hospital.
  2. You will need support at home after discharge. It is better to think about how much help you have at home after discharge for activities like transport, self-care, mobilisation, cooking, cleaning, shopping etc and make sure you have enough support. You will need someone who can support you to be with you at home the first few days. As you recover you will need less and less help. You will be given information in the pre assessment clinic what you will be or not able to do after surgery. You can clarify your doubts to prepare for smoother recovery at home. You can set simple goals based on information gathered, your ability and support at home which will help you at recover safely and swiftly.

Preoperative assessment by multidisciplinary team

Patients will be seen in the preoperative assessment clinic by the staff. They might be asked to fill in health questionnaire and bring the details of current medications to the clinic. Known allergy will be carefully noted. Procedure will be confirmed. There will be a general health assessment to make sure they are safe and ready to proceed with the planned procedure. Pulse rate and blood pressure assessment, blood tests, ECG, screening for specific bacteria like MRSA in the body, urine tests etc will be carried out. They will be given some information on the procedure, anaesthetic type, pain control, exercises to do before and after operation etc.

They will make sure your medical conditions are as well controlled as possible to aid good and safe recovery. Special blood tests or investigations might be necessary depending on one’s pre-existing or newly identified medical problem. Where the medical condition needs optimising such as diabetic control, blood pressure control, improvement in blood haemoglobin appropriate advises, directions or support will be given to achieve this and then proceed with surgery. On occasions this might delay the planned surgery in the best interest of the patient.

Medication to be taken until you arrive at the hospital on the day of surgery will be discussed. Certain medications like blood thinners, certain medications given for conditions like rheumatoid arthritis will have to be stopped few days before the surgery. These can be discussed at the time of initial consultation with the surgeon and during preoperative assessment.

Review by Consultant anaesthetist might be necessary before the day of operation for medically high risk group patients.

The staff will also gather information to make sure you have safe environment to return to after surgery to aid good and safe recovery. Certain equipment such as crutches, toilet seats will be provided and advise given to get your home ready for you to return. Patients can ask questions to clear their doubts regarding the procedure and recovery at this stage. It is patient’s responsibility to make sure they have support at home when they return to support their recovery. Extent and duration of this support varies from person to person.

Some hospitals run joint school where you can discuss the procedure, recovery etc with physiotherapist, occupational therapist in a relaxed environment.