Getting Ready For Surgery
Treat Your Risk Factors
Every person is unique. Depending on your specific lifestyle and body, there are different factors that will play a role in your surgery. In the tabs below, there are important risk factors. Take a look and learn how to mitigate them.
Smoking increases your chances of complications after surgery. You are more likely to suffer from infections, pneumonia, heart attacks, and strokes after surgery if you are a regular smoker. Learn more about why you should quit before surgery here.
If you can't quite quit entirely, then try to quit for at least some weeks before surgery. Ideally, you want to quit smoking 8 weeks before the day of the surgery. But quitting for any period of time is better than continuing to smoke.
Remember, you can't smoke in the hospital anyways, so it's best to try and get used to not doing it. You don't have to quit forever - though, those who do quit for surgery tend to quit forever.
If you smoke to cope with stress, and of course being scheduled for surgery can be stressful, then this may seem like a catch-22. However, there are resources that can help you. Take a look at some of the links below:
- Free Resources For Quitting Smoking
- How To Handle Withdrawal Symptoms And Triggers When You Decide To Quit Smoking
- The longest running cessation program
While some studies suggest vaping may be better than smoking, it is ideally best to stop altogether.
If your blood sugars are over 250 on the day of the surgery, your surgery may be cancelled. Why? Because having lots of sugar in your blood means having lots of food for bacteria in your body. This increases the risk of infection.
So don't "cheat" in the days leading up to your surgery. Minimize your sugar intake, and on the night before your surgery avoid all sweets.
If your blood sugar is higher than 140 in the week before surgery, call your family doctor. Blood sugar must be well controlled before surgery.
Cutting back on alcohol in the week(s) leading up to surgery, even if you are "just" a social drinker can help your surgical journey go smoothly.
Daily use of alcohol is often a “trigger” to relax. During your hospitalization, you will need alternatives to drinking in order to relax. Now is the time to practice relaxing; see the Stress and Anxiety tab to learn more on how to do this.
If you drink heavily, stopping suddenly can lead to alcohol withdrawal. Tell your surgeon if you have ever had signs or symptoms of withdrawal. A medication to prevent withdrawal during your hospitalization may be started.
Mild withdrawal symptoms may appear as early as 6 hours after the last drink. Symptoms may include:
- Shaky hands
- Poor sleep
12-24 hours after the last drink, some people hallucinate or have seizures. Finally, delirium tremens (DTs) may occur 2- 3 days after the last drink. These are severe symptoms that include hallucinations or delusions and sometimes:
- Very fast or irregular heart rate
Anxious before your Surgery? We call that normal.
Treating anxiety, though, can improve your surgical outcomes and get you out of the hospital faster. We recommend you practice mindfulness.
Mindfulness is a mental state achieved by focusing one’s awareness on the present moment and let any thoughts that enter your mind, pass through without judgement. Easier said than done, right? As with most things in life, though, practice really does help.
Here are three techniques to practice mindfulness:
- Sit or stand quietly
- Breath in to a count of 3 or 4 then breath out to a count of 3 or 4
- Pay close attention to the sensation of filling and emptying your lungs; consciously relax your fingers, toes shoulder and face
- With every exhalation, repeat a word – such a health, wellness, strength or calm (whatever works for you)
- Repeat 10 times
- This is a more “active” method of mindfulness.
- Sit quietly and focus on each of your 5 senses:
- Sight: Name 5 things in your vision
- Smell: Name 5 different smells
- Hearing: Listen for 5 different sounds
- Taste: Name 5 different tastes on your tongue
- Touch: Name 5 different things that you can feel
Full Body Relaxation
- Start in a lying down or sitting position
- Focus on your toes, tightly curl your toes and then with close attention to the sensation, relax your toes
- Move on to your feet, pull your feet up towards your nose and then relax
- Move up your body calves, thighs, stomach, hands, wrists, arms, neck and face
- Focus deeply on each body part
Our skin is covered with bacteria or germs; this is normal. Unfortunately, skin bacteria is the most common reason people get infections in their surgical wound.
Extra Cleaning of Your Skin Before Surgery
Cleaning your skin extra well with Chlorhexidine (given to you by your surgeon) or antibacterial soap or even a cup of bleach in a bathtub, may lessen your chance of having a wound infection after surgery
Just because we can operate, doesn’t mean we should. There are important conversations you need to have regarding how risky the surgery may be for you. Remember, there is such a thing as too risky. Take a look at the Patient Preferences tab below to learn more.
Have you considered how decisions about your health are to made when you can’t physically speak for yourself? Explore the Advance Directives tab below to learn about important forms that you should fill out before your surgery.
Before having surgery, it is critical to discuss the risk of surgery and anesthesia with your surgeon and anesthesiologist and ideally, with your regular doctor or depending on your age, a geriatrician (a doctor for people around 65 years and older).
Medicine has advanced to the point that doctors can get almost anyone through surgery but…that does not mean that you will have a desirable surgical outcome. For instance, the surgery may be small from the surgeon‘s perspective but, from an anesthesiologist’s perspective, you may still need a general anesthetic which has its own set of risks and complications. If you have many or severe health problems, such as heart or lung disease or poor nutrition, you may end up having surgery and then suffering from serious complications after surgery, such as being in the hospital for weeks or months, on a breathing machine or ventilator for an extended period or time, having a worse quality of life than before surgery, end up in a nursing home, having a heart attack or stroke and then dying. To sum it up, you may end up with significant suffering and a poor quality of life.
How do I have a meaningful discussion with my surgeon?
A Michigan vascular surgeon, Margaret ”Gretchen” Schwartz, is leading “The Patient Preferences Project.“ This project helps older patients who are considering major surgery make decisions that are in line with their values, goals and preferences. Check out this brochure to help you better understand the risks and benefits of having surgery: https://www.surgery.wisc.edu/wp-content/uploads/2018/02/QPL_baseline_021915.pdf
What are advance directives?
An Advance Directive is a form that describes what type of medical treatment a person wants or doesn’t want if/when an individual can’t make their wishes known about their health and medical condition(s).
Even more important than filling out a form is HAVING the difficult discussions about what you would want to happen if you can not make your own decisions.
There are basically 2 types of advance directives:
- Living Will A living will informs your family/your doctor about the kinds of treatment you want to receive when you can not speak for yourself. If you are seriously injured, very sick, or as you near the end of your life, you may not be able to speak for yourself and the living will will help others (your loved ones and doctors) carry out your wishes.
- HEALTHCAREPOWER OF ATTORNEY A healthcare or medical power of attorney lets you name a person to make medical treatment decisions for you when you can’t speak for yourself.
Where do I get these forms?
Some states combine a “Living Will” and ”Healthcare Power of Attorney.” The forms vary by state. Fortunately, AARP has a link for each state. Another terrific organization is PREPARE for Your Care, an online resource that helps people learn about and prepare for medical decision making. This evidence-based tool features video stories in English and Spanish, and guides users.
Prepare for the Big Day
Make sure you are ready for the surgery by double-checking the list below.
Under sedation or anesthesia, the muscles of your body relax- including the muscles that keep food in your stomach and keep food/drink OUT of your airway/lungs.
If you vomit under anesthesia, food goess into your lungs.
That my friend is an excellent way to get a pneumonitis or pneumonia.
You will likely require a breathing tube, and end up on a breathing machine (ventilator) in the intensive care unit.
So… a simple day / outpatient surgery may lead to an intensive care stay. Not fun and, you can die.
Here is a video explanation, https://www.youtube.com/watch?v=8fLraB3hUZE
Here is an animation explanation https://youtu.be/d_DT1uHxPBQ
Bring a photo ID and your insurance card to the hospital. or your surgery will be cancelled.
Get tested for COVID-19 within 72 hours of surgery. Make sure you bring a copy of your results with you.
For before surgery:
- Purchase nutritional supplementation
- Purchase bacterial decolonization wipes or chlorhexidine wash
- Pull up all free throw rugs
- Stock your fridge with healthy snacks
- Purchase any prescriptions needed for after surgery
For during your hospital stay:
- Hand sanitizer
- Your favorite face mask
- Hearing aids
- Earphones or ear buds
- Smart phone (like an iPhone or Galaxy) so that you can listen to music, a podcast or read while waiting to go back to surgery
- Lip balm
- Eye mask
- White noise generator
- Charging cords for personal electronic devices
- Photos (in a frame or even better, electronic frame to load hundreds of photos)
- Tooth paste
- Tooth brush
- Dry shampoo
- Antibacterial/viral wipes
- Snacks (hospital food/snacks may not be as nutritious or delicious as you may like)
For after surgery:
- Shower chair/bench
- Shower wand
- “Reacher” to get stuff out of reach
- “Sock assistant”
- Nutritional supplementation for 5-7 days after surgery
- Stool softener
- Prescription medications
- Walker, crutches or wheelchair if needed