Preparing for Your Surgery

Center for Reconstructive Surgery

UNIVERSITY OF WASHINGTON MEDICAL CENTER

About this Slideshow

In this slideshow, you will learn:

• How to contact the clinic

• How to get ready for surgery

- Things to do

- Medicine instructions

• What to expect after surgery

- Pain control

- Activity restrictions

- Recovering at home after anesthesia

- Constipation after your operation

- Deep vein thrombosis

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Calling Our Clinic

Our clinic is open weekdays from 8 a.m. to 5 p.m. We are closed on major holidays.

To reach your doctor’s nurse or the clinic, or to schedule your surgery, please call 206.598.4477 during clinic hours.

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When You Call the Clinic

Office staff will answer your call and take a message. A staff person who can answer your question will return your call as soon as possible.

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We do our best to return your call on the same day, but you may also be told to expect a call the next business day. The timing of your return call depends on how many calls we receive and whether we are dealing with urgent concerns.

Calling After Hours

For urgent medical questions after clinic hours, call 206.598.6190 and ask to talk with the resident on call for your surgeon. This is the best way to reach your surgeon’s team.

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Please keep our phones numbers handy, so you can find them easily when you want to call the Plastic and Reconstructive team.

You may also want to program these numbers into your cell phone.

Getting Ready for Surgery

To help you get ready for your surgery, please read these handouts carefully:

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• “About Your Surgery Experience”

• “Medicines to Avoid Before Surgery”

Meeting with Your Surgeon

During your first clinic visit before surgery, you will meet with a plastic surgeon and a team of resident doctors and physician assistants.

After your surgery, you will not always see your surgeon at your follow-up visits. You may meet with your surgeon’s support team instead.

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Your Surgery Date, Place and Time

Our Surgery Scheduler will call you to schedule a date for your surgery.

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Clinic staff will then call you the day before your surgery. They will tell you what time to arrive and where to check in for surgery. If your surgery is on a Monday, they will call you the Friday before.

If you do not receive this call by 5 p.m., please call 206.598.6334.

What You Should Know Before Surgery

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For Your Safety

If you do not follow these instructions, we may need to reschedule your surgery.

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• Do NOT eat anything. This includes gum and mints.

• Do NOT drink anything. This includes alcohol and all other liquids.

• Do NOT take antacids such as Maalox, Mylanta, Rolaids or Tums.

• If you need to take other medicines, you may have up to 4 tablespoons (2 ounces) of water to help swallow your pills.

After midnight the night before your surgery:

Special Shower Instructions

Before your surgery, we will give you a special soap called Chlorhexidine Gluconate (CHG). You will need to take two showers using this soap: one the night before your surgery and another the morning of your surgery.

If you do not receive this soap, you can buy it at most drugstores. A common brand is Hibiclens, but any brand is OK.

If you have sensitive skin, you may use Dial Antimicrobial soap instead.

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Special Shower Instructions

For your showers the night before and the morning of your surgery:

• Use the suggested soap to wash well from your neck to your toes, especially around the area of your surgery incisions.

• Do NOT use CHG on your face or to wash your hair. Use your regular soap and shampoo for these areas.

• Rinse well. Wash again the same way.

• Pat dry with a clean towel.

• After your morning shower, do NOT put on makeup, deodorant, lotions, hair products, or fragrances.

• Put on clean clothes.

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To Lower Infection Risk

To lower your risk of infection:

• Do NOT shave any part of your body that you do not already shave every day.

• If you normally shave near your surgical site, do NOT shave that area for 2 days before surgery.

• Remove all jewelry and body piercings.

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Day of Surgery

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Day of Surgery

You must have a responsible adult take you home after surgery and stay with you for 24 hours while you recover from the anesthesia.

Your ride must be ready 30 minutes before your discharge.

Your surgery may be cancelled if you have not made these arrangements.

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What to Bring

When you come to the hospital for your surgery, you must bring:

A photo ID

Your medical and pharmacy insurance cards

A list of all the medicines and supplements you take, including their doses

A way to pay for any co-pays on your medicines when you leave the hospital

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What to Bring

Also bring these items with you on your day of surgery, if

you have them:

A copy of your healthcare directive and durable

power of attorney for healthcare, if you want them

added to your medical record

Your Labor and Industry (L&I) claim number

Your CPAP machine

Your rescue inhaler

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What Not to Bring

When you come to the hospital for your surgery, do NOT bring:

• Your daily medicines

• Children without an adult to watch them

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Your Medicine List

Review your medicine list with the surgical team. Be sure to tell them if you are taking any of these medicines:

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• Aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin and others) and naproxen (Aleve, Naprosyn and others)

• Herbal remedies and supplements

• Oral diabetes medicines or insulin

• Warfarin (Coumadin)

• Blood pressure medicines

• Tamoxifen

Pain Medicines

Before your surgery, you may keep taking acetaminophen (Tylenol) and any prescription pain medicines.

If you have been taking prescription pain medicine for a long time, your surgeon may want to refer you to our Pain Clinic. The clinic will help create a plan to control your pain after surgery.

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Stop Taking These Medicines

One week (7 days) before your surgery:

• Stop taking aspirin, vitamins, and herbal or natural supplements. You can start taking them again 7 days after your surgery.

• Stop taking NSAIDs such as ibuprofen (Advil, Motrin and others) and naproxen (Aleve, Naprosyn and others).

• Stop taking prescription medicines like Celebrex or Meloxicam.

• Carefully read the labels on all your medicines and supplements. If they contain any of the medicines and supplements listed here, stop taking them before your surgery.

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Special Medicines

• If you have a cardiac stent or heart condition and are taking aspirin, coumadin, clopidogrel (Plavix) or other blood thinners, your surgeon will need to talk with your cardiologist or refer you to our Medicine Consult team to decide your best plan for surgery.

• If you are having a surgery that involves connecting blood vessels under a microscope (such as DIEP surgery), you will need to stop taking Tamoxifen for 2 weeks before and 2 weeks after your surgery.

Your surgery will need to be rescheduled if you do not follow these directions.

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Blood Pressure Medicines

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If you take any of these blood pressure medicines, stop taking them 24 hours before your surgery:

• azilsartan (Edarbi)

• benazepril (Lotensin)

• candesartan (Atacand)

• captopril (Capoten)

• enalapril (Vasotec)

• eprosartan (Treveten)

• fosinopril (Monopril)

• ibesartan (Avepro)

• lisinopril (Zestril, Prinivil)

• losartan (Cozaar)

• moexipril (Univasc)

• olmesartan (Benicar)

• quinapril (Accupril)

• ramipril (Altace)

• telmisartan (Micardis)

• valsartan (Diovan)

Diabetes Medicines

• exenatide (Byetta)

• glimiperide (Amaryl)

• glipizide

• glyburide

• metformin (Glucophage, Glucovance, Avandamet, Acto plus Met)

• nateglinide (Starlix)

• pioglitazone (Actos)

• pramlintide (Symlin)

• rosiglitazne (Avandia)

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Do NOT take these diabetes medicines on the morning of your surgery:

Diabetes Medicines

• aspart (Novolog)

• Regular human insulin

• glulisine (Apidra)

• Inhaled insulin (Exubera)

• lispro (Humalog)

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Do NOT take these fast-acting insulins on the morning of your surgery:

Diabetes Medicines

• Mixed insulin such as Humalog 75/25, Humalog 50/50 or Novolog 70/30

• Long-acting insulin such as glargine (Lantus) or detemir (Levemir)

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You will need to get special instructions for the morning of your surgery if you use certain types of insulin. Talk with your surgeon if you use:

Questions?

To talk with your nurse about these medicine instructions, please call:

206.598.4477

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Pain Control

Please make sure you have a primary care provider (PCP) who you will see after your surgery.

Your plastic surgeon will prescribe pain medicine when you are discharged from the hospital. You will be able to refill this prescription once.

After that, work with your PCP to control any pain.

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Pain Medicine Refills

Be sure to call the clinic 48 hours before you will run out of your pain medicine.

The pharmacy needs 48 hours to prepare your refill.

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For More Information

Please carefully read the handouts listed below. Links to these handouts are given at the end of this slideshow.

“Activity Restrictions and Physical Therapy”

“Recovering at Home After Anesthesia”

“Constipation After Your Operation”

“Deep Vein Thrombosis”

“Partners in Care”

“Methicillin-Resistant Staphylococcus Aureus (MRSA)”

Call your surgeon’s nurse if you have questions about anything in these handouts.

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Directions and Parking

Go online to find driving directions, floor maps, and information about parking at University of Washington Medical Center. The links are given at the end of this slideshow.

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Thank you for choosing UW Medicine

Links to Learn More

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Medicines to Avoid Before Surgery https://healthonline.washington.edu/document/health_online/pdf/Medicines-Avoid-Before-Surgery.pdf

About Your Surgery Experience https://healthonline.washington.edu/document/health_online/pdf/About-Your-Surgery-Experience.pdf

Pre-Surgery Checklist http://depts.washington.edu/anesth/care/anesthesiology/uwmc/pre-surgery-checklist.shtml

Anesthesiology Patient Care: Preparing for Surgery http://depts.washington.edu/anesth/care/anesthesiology/uwmc/surgery.shtml

How to Prepare for Surgery at UWMC (video) http://www.uwmedicine.org/patient-care/how-to-prepare/uwmc

Getting to UW Medical Center http://www.uwmedicine.org/uw-medical-center/campus/directions