Preparing For Surgery

Thank you for entrusting me with your surgical care. The following pages will answer many of the questions that you may have regarding your surgery. Please read through these instructions carefully so that your road from surgery to recovery may be as smooth as possible.

GENERAL INFORMATION

  • Dr. Ialenti typically performs surgery as an Outpatient (Same-Day). You will need to arrange for a ride home from the surgicenter following your procedure.

  • If you are having a procedure in the hospital (joint replacement surgery), you will likely stay in the hospital for one night and be discharged home the following day. You will need to arrange for a ride home from the hospital the day after surgery.

  • Insurance Coverage: Our insurance authorization department will call for pre-certification with insurance if required.  Please be advised that this process can take time. You should contact your insurance company directly with any questions regarding coverage and benefit information.

MEDICAL CLEARANCE

Depending upon the planned surgical procedure and your medical history, you may be required to undergo pre-admission testing, medical clearance, and/or obtain clearance from a specialist. This is typically not required for healthy patients younger than 40 years old undergoing outpatient surgery. You may be required to get labs or imaging prior to your surgery – if that is the case, please have these done 1 week before your surgical date.

  • Our surgical coordinators will help you arrange for medical clearance if needed. Please have all medical clearance records faxed to 954-961-1835.

  • Cardiologist Clearance: required if you have cardiac stents, a pacemaker, history of an arrhythmias, have had any kind of heart surgery, or have had a heart attack.

  • Hematology Recommendations: may be requested if you have a personal history of blood clot (DVT or PE) or a strong family history of blood clots.

  • Smoking: Smoking is not only harmful to your heart and lungs, but significantly increases the chance that you develop a complication, such as a wound infection, after surgery. Now is the best time to quit. If you need help with quitting before your surgery, you can call 800-NO-BUTTS (800-662-8887).

 

MEDICATIONS

  • Anti-Inflammatories: Do NOT take anti-inflammatories (Aspirin, Naprosyn, Aleve, Advil, Motrin, Ibuprofen, etc.) within 10 days of surgery.  These medications increase bleeding during surgery. Tylenol is OK.

  • Blood Thinners: If you take a blood thinner (Warfarin, Coumadin, Plavix, Clopidogrel, Aspirin, Heparin, Aggrenox, Lovenox, Enoxaparin, Xarelto, Rivaroxaban, etc.), you MUST have specific instructions from your prescribing physician regarding stopping and restarting of these medications.  In general, we recommended these medications be discontinued approximately 7-10 days prior to your planned procedure. Please follow your prescribing doctor’s recommendations.

  • Blood Pressure Medication: Continue to take your blood pressure medication unless instructed otherwise by your prescribing physician.

  • Birth Control: Oral contraceptives may increase the risk of developing a blood clot following lower extremity surgery. For your safety, it is recommended that you stop birth control until you are full weight bearing and are walking normally without crutches after surgery.

  • Narcotics: If you are currently on a narcotic (Vicodin, Percocet, Oxycontin, etc), decrease its use now. Your body gets used to taking this medication, making it difficult to control your pain after surgery.

 

PREPARING FOR SURGERY

  • Stop taking Aspirin, Anti-inflammatory medicines (e.g., Ibuprofen, Aleve, Advil), Fish Oil, or Vitamin E supplements 1 week before surgery. If you are on a blood thinner (e.g., Aspirin, Coumadin, Lovenox), please check with your primary care physician when to stop these medications.

  • Arrange Escort: Please make arrangements for a friend or family member to take you home.

  • Work/School: Make arrangements to take at least 1 week off work or school following surgery. Dr. Ialenti can provide you with a note if necessary.

  • Brace/Sling: If needed, you will be provided and fit with a brace or sling to wear after surgery in order to protect the surgical repair. If you are undergoing a reconstructive knee surgery, you may also be provided with a neuromuscular electrical stimulation system \ to help “wake-up” and re-educate your quadriceps muscle. You will likely be provided with a CPM (knee motion machine) following a knee replacement. These items are typically covered by insurance.

  • Ice Machine: Icing is very important and helps reduce inflammation and pain after surgery. You may wish to purchase or rent one of the commercially available ice machines (e.g., Ossur, GameReady). These are rarely covered by insurance, and the out-of-pocket cost typically ranges from $180-250. Most patients who purchase one of these ice machines are very happy with their investment. A vendor will reach out to you prior to your surgery.

 

DAY BEFORE SURGERY

  • You will receive a call from the surgical center or hospital informing you of your final and official time of your surgery. This call is usually made in the afternoon, anywhere from 2-7PM. Please note that changes/delays in your OR time may occur due to unforeseen circumstances.  Please be understanding of the dynamic nature of the OR schedule.

  • Do NOT eat or drink anything after midnight the night before your surgery. This includes gum, candy, mints, alcohol, Gatorade, and orange juice. Clear liquids (water, tea, black coffee without milk or cream, fruit juices without pulp) are allowed up to 4 hours before your surgery. You need to have a completely empty stomach for the safety of anesthesia.

  • If you take medications in the morning, please ask your doctor or anesthesiologist about whether or not to take these on the morning of surgery.

 

DAY OF SURGERY:

  • What to Bring:

    • Photo ID and Insurance Card

    • Glasses if you wear contact lenses

    • List of your Medications

    • Small Bag to store your personal items if you are staying overnight (will be securely stored during surgery)

    • Telephone numbers of family member or friend

  • Dr. Ialenti will meet with you before surgery to confirm the planned procedure, answer any remaining questions, and mark the operative site with his initials.

  • Anesthesia: You will meet with the anesthesiologist prior to surgery and have the opportunity to ask questions about the type of anesthesia you will be receiving.

    • Regional Anesthesia (nerve block): This is a technique where a portion of the patient’s body is rendered insensitive (numb) during surgery, like at the dentist’s office.

    • General Anesthesia: is when you are completely asleep during the procedure, and require a breathing tube.

    • Please let Dr. Ialenti or the anesthesiologist know if you are allergic or have had a bad reaction to pain medication or anesthesia in the past.

  

AFTER SURGERY:

For more details regarding after surgery, click here.

  • Recovery Room (PACU): The anesthesia team and nursing staff will monitor your postoperative care and your return to full awareness. Regardless of the type of anesthesia performed, you will stay at the surgical center or hospital until your condition is stable and you are safe to leave.

  • Postoperative Instructions: You will be provided detailed postoperative instructions after surgery. If you wish to review general postoperative instructions and answers to frequently asked questions, click here.

  • Prescriptions: You will be provided prescriptions for pain medication and any other required medications after surgery.

  • Crutches: If needed, crutches will be provided for you after surgery.

  • Discharge: In order to be considered safe to go home, you must be able to stand up and walk without feeling dizzy or lightheaded, tolerate food and drink, and be able to urinate.

  • First post-operative visit: Typically occur 10-14 days after surgery. If you do not already have an appointment, please call the office to arrange.