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NOTICE OF PRIVACY PRACTICES

Pre & Post-Operation Instructions

Pre-op instructions/information:

These are basic instructions or guidelines for most general surgery procedures.  Note that you may have additional instructions depending on your type of procedure.

In the days/weeks before the procedure you should increase your protein intake (chicken, turkey, tuna fish, peanut butter, protein drinks, etc.), stay hydrated by drinking plenty of water, take a multivitamin, and avoid tobacco products.  This will promote wound healing.

Blood thinners such as Coumadin/warfarin, Plavix, Xarelto, Eliquis, Brilinta, should be stopped a few days before the procedure.  Check with your surgeon about the timing of stopping your medication.

Most NSAID’s (Advil/Motrin/ibuprofen, Excedrin/aspirin, Mobic, Celebrex, Aleve/naproxen), fish oil, turmeric, and any herbal supplement with the name “root” should be stopped 5 days prior to a procedure unless authorized by your surgeon.

Avoid the use of alcoholic beverages one week before and after surgery.  It can increase the chance of bleeding.

Do not eat or drink anything after midnight the night before your procedure unless directed by the Anesthesiologist.

If you are having colon surgery or a colonoscopy, you will need to be on clear liquids the day before and undergo a bowel prep.  See bowel prep instructions.

You will have a pre-operative interview, either on the phone or in person.  Labs, X-rays, and EKG may be obtained.  This would be the time to ask about any morning medications taken the day of surgery.

You will arrive about 2 hours prior to your procedure.  Late arrivals may result in your procedure being rescheduled.  Your procedure time may change – you will be notified as soon as possible if this is necessary.

Shower the morning of surgery.  You may be supplied with an antibacterial soap at your preop appointment.  This will reduce the chance of infection.  Do not remove any hair near the operative site (the operative team will do this for you).  Wear loose comfortable clothes that are easy to put on.  Remove all body piercings and jewelry.  Leave valuables at home.

If your surgery is an outpatient surgery, have a responsible adult available to drive you home.  You may want a responsible adult to stay with you for the first 24 hours.

Please call with any questions:  (615)757-3451

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Post instructions/information

Care for your incision(s):

Many incisions today are covered with skin glue and do not require a bandage or any special attention.  You may shower the following day.  Avoid getting into water (tub, pool, lake, river, etc.) for at least a week.

If your incision has external sutures or staples requiring bandage changes, wash your hands before and after changing the bandage.  This will reduce the chance of infection.

Some bruising and mild redness is expected.

Applying an ice pack on or near the incision for 30 minutes at a time during the first day or two will reduce pain, swelling, and bruising.

Diet:

Your diet postoperative will depend on the type of procedure performed.  It is a good idea to increase your protein intake to promote wound healing.  If you have diabetes, it is important to maintain good control of your blood glucose level to promote wound healing and prevent infection.

Activity:

Your level of activity will be dependent on the type of procedure performed.  It is important to walk around frequently to avoid blood clots and pneumonia.  Walking up and down stairs is fine.  No driving for 3-4 days following most procedures or while taking any pain medication.

For most hernia surgeries, you should avoid pushing/pulling/lifting anything over 20 lb. for 4-6 weeks.  Any quick twisting motions – golf, tennis, bowling, kickboxing, etc. – should be avoided as well.

Medication:

Your surgeon will direct you on when to resume any blood thinner medication.  The pain medication, if prescribed, will only dull the pain.  It will not remove all the pain.  You may find taking some ibuprofen may help decrease the pain.  Do not drink alcohol or drive while taking pain meds.

Bowel movements:

It is quite common to become constipated after any surgery (pain medication, limited walking, etc.).  Most patients will be sent home with a stool softener.  It is important to drink plenty of water.  You may want to take some MiraLAX as well.

Concerning symptoms:

Things to be concerned about would include: a high fever (101.5 or 102), persistent nausea and vomiting, severe pain (not relieved with pain medication), jaundice (whites of the eyes turning yellow), severe redness of the incision(s), and foul-smelling drainage.

If you having any questions or concerns, please call the office:  (615)757-3451

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MIRALAX/GATORADE BOWEL PREP INSTRUCTIONS

** READ ALL INSTRUCTIONS**

(You must bring someone with you to drive you home safely, due to sedation)

FIVE (5) DAYS BEFORE:  If you take aspirin or NSAIDS such as Advil, Motrin, Celebrex, or Ibuprofen, you may continue to take them as usual unless otherwise instructed by your physician.  You should discuss this with your physician in advance of the procedure.  Ask your doctor for specific instructions if you take a blood thinner like Plavix, Pradaxa, Coumadin/warfarin, Effient, Lovenox, Xarelto, or Prasugrel.

THREE (3) DAYS BEFORE:  Stop eating all nuts, seeds, and popcorn.

PURCHASE THE FOLLOWING SUPPLIES AT YOUR LOCAL PHARMACY:

4 DULCOLAX LAXATIVE TABLETS (containing 5 mg of bisacodyl each) – NOT Dulcolax stool softener

1 – 8.3 oz bottle MIRALAX (238 grams)

64 ounces Gatorade, G2, or Powerade or Powerade Zero (no red, blue, or purple)

THE DAY BEFORE PROCEDURE:  Clear liquid diet all day (breakfast/lunch/dinner). NO SOLID FOOD.  Nothing red, pink, blue, or purple.  No milk or milk products and no non-dairy creamer.

Clear liquid:  Gatorade, Pedialyte, Powerade, clear broth or bouillon, coffee or tea (no creamer), clear soft drinks, fruit juices (no pulp), Jell-o, popsicles, hard candy.

Not clear liquid:  No red or purple items, no alcohol, no milk, no noodles or vegetables, no juice with pulp, dark drinks.

AT NOON:  Take 4 Dulcolax tablets with 8 ounces of water.  Mix 64 ounces of liquid (Gatorade) with 8.3 ounces of Miralax and place in the refrigerator.

AT 2 PM: Drink 8 ounces of the MiraLAX/Gatorade solution and continue drinking one 8-ounce glass every 15 – 20 minutes until the mixture is gone.  Set a timer for every 15 – 20 minutes to keep pace.

DRINK NOTHING AFTER MIDNIGHT

PLEASE CALL WITH ANY QUESTIONS (615)757-3451

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