A. PREPARATION FOR SURGERY

1. Preoperative laboratories will be drawn, including complete blood count, serum chemistries, twelve-lead EKG and any other appropriate orders, in addition to routine type and screen versus type and crossmatch (for possible transfusion), in accordance with routine instructions from our office nursing staff.
   
   
2. Patients should take nothing by mouth other than sips of water after midnight the night before surgery. Take your usual evening meal the night before, but nothing by mouth after midnight other than sips of water with your daily medications the morning of surgery (which should be taken, particularly with regard to any and all cardiac medications). For diabetic patients, half of your usual insulin dose or half of your usual a.m. oral medication should be taken the day of surgery. No matter who else directs otherwise (including anesthesia), no intake of clear liquids or other diet should be taken. Even if you are scheduled late in the afternoon, the operative schedule is quite fluid and you may be operated on sooner than expected; therefore, NPO (nothing by mouth) to minimize any potential aspiration of gastric contents.
   
   
3. Please thoroughly scrub and shower the night before surgery to minimize any risk of wound infection, etc.

 

B. ADMISSION

1. Patients are usually admitted the day of surgery, the exact time per instructions from our nursing staff but, in general, TWO HOURS PRIOR TO THE ANTICIPATED TIME OF SURGERY. While that may seem a bit early, the case before yours may conclude early and your presence will help keep the operative schedule from being interrupted.
   
   
2. Please take your medications with sips of water on the day of surgery. It is a good idea to bring your medications in their containers so that all dosages may be checked to ensure that we are continuing you on your usual daily doses of medication. Those same medications may then be taken home by the family or, if you prefer, remain with you to be taken under direction of the hospital nurses after you have awakened satisfactorily, sometimes allowing significant cost savings to yourself.

 

C. DAY OF SURGERY

1. The family should wait in the main waiting area on the ground floor, versus families of patients already hospitalized prior to surgery, who should wait in the main lobby on the Tower 1st floor. The surgeon, upon conclusion of surgery and dictation of the operative report, will meet with you to review the patient's status, the findings of surgery, the nature of the operation employed and answer any questions. In addition, all x-rays will be returned, and should be kept for any early follow-up consultations outside the hospital to avoid having to track down the x-rays later, which can be a frustrating and time-consuming process.
   
   
2. Surgical patients (depending on the nature of the patient's preoperative health status, the type of surgery employed, the time of completion of surgery, and the speed with which the patient emerges from anesthesia) may stay in the Post Anesthesia Care Unit overnight, or be transferred to the Intensive Care Unit for overnight observation. Most often, patients are transferred to the thoracic surgical floor.

 

D. POSTOPERATIVELY

We advise active walking (4-6 times/day) beginning the day after surgery or, for very early morning cases, beginning the afternoon or evening of surgery. In this regard, all family and friends can be of significant help in aiding the patient to walk, maintaining the patient's balance while he or she gets over the effects of anesthesia, all of which ultimately makes for a less-complicated recuperation from surgery and an earlier discharge. Sitting for any extended period of time is discouraged as venous pooling occurs in the dependent extremities, thus patients are better served by frequent walking (the distance is not nearly as important as the number of times a patient walks during the day). We appreciate every effort you can make to lend a hand.

 

E. QUESTIONS/PROBLEMS

If there are any questions that you have, or problems that you perceive in the care of the patient, do not hesitate to call my office
(703-280-5858) so that I can respond appropriately. I will go over the final pathology, just as I go over the frozen section pathology at the time of surgery, as soon as the report is available.

Finally, comments you may wish to make with regard to the level of care by me, the nursing staff or the surgical team are appreciated. We look forward to both constructive criticism to help improve the delivery of care to our patients, as well as any expression of appreciation. The best thing to do, in addition to telling me directly, is to write a letter in care of the Chief Executive Officer of the hospital with a copy sent to the floor nurse and supervisor, and a copy to me as well.

Hoping that your surgery and recovery go uneventfully, and that you're delighted with your care, should anything be otherwise, please, do not hesitate to call me at any time through the office (703-280-5858) or via the hospital (703-764-7310 - pager #86480).

 

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