First Day Surgery
UW Hospital and Clinics
600 Highland Ave
Madison Wisconsin 53792
Date of Surgery: _____________________
Your Surgery: _______________________
Bring to Your Pre-surgery Clinic Visit
Power of Attorney for Health Care, if
you have one.
Please bring all pills, vitamins, and herbs,
medical records (that have been given to you),
recent X-rays and test results.
First Day Surgery Unit
Valet parking is free and open from 5:30 am-7:00 pm. It is between the clinic and
Outpatient Surgery Center, enter through the clinic door. Once inside the lobby,
it is the 1st door on your left.
Ambulatory Procedure Center, enter through the hospital door. Follow the gray
stone path past the D elevator. Turn left when you see the APC sign.
First Day Surgery Unit, enter through the hospital door. Follow the gray stone
path to the D elevator. Take the D elevator to the 3rd floor. Turn left to the First
Day Surgery Unit door.
This is the 2nd floor…to get to the …
Cafeteria: H4/1 – H elevator to the 1st floor
ECG: Heart & Vascular Clinic, Atrium elevator to 4th floor
Pulmonary Function: B6/242 – B module, 2nd floor
Outpatient X-Ray: J module, 2nd floor
Welcome to University of Wisconsin Hospital and Clinics
Knowing what to expect is part of getting ready for surgery. This booklet helps
you to learn about:
Your Pre-Surgery Clinic Visit ......................................... 2
Getting Ready for Surgery ............................................... 3
The Day of Surgery ........................................................... 6
After Surgery .................................................................... 8
What Is First Day Surgery (FDS)
FDS means that you come in the day of surgery and stay until you are ready to go
home. Most often, you do not go home the same day.
Your Pre-Surgery Clinic Visit
Members of the surgery team will meet with you to:
ξ Talk with you about surgery.
ξ Learn more about your health history.
ξ Do a physical exam.
ξ Complete lab tests, EKG, Chest X-ray, and other tests, if needed.
This clinic visit may last 2 – 4 hours or more. You will learn how to prepare for
surgery and what you can do to regain your strength.
By law, we need to ask if you would like to complete an advance medical directive
(AMD). This is a Power of Attorney (POA) for Health Care or a Living Will. This
decision is up to you. A POA allows you to name a health care agent who could
speak for you if you were not able to do so. If you choose to complete an AMD,
you must be 18 or older and of sound mind. You have the choice to complete the
form or not.
If you choose to fill one out, complete it and have it signed and witnessed before
coming to surgery. There is not enough time to complete the forms that morning.
The two witnesses cannot be family members or UW Hospital staff. Exceptions are
chaplains, social workers and volunteers. The person you name as your health care
agent may not be a witness. We suggest you choose a neighbor or friend. If you
need help to complete this form or have questions, call our Patient Relations office
at (608) 263-8009.
You may wish to have a member of the Spiritual Care Services visit while you
are in the hospital. We can arrange it for you or you can call (608) 263-8574.
Getting Ready for Surgery
The time of your surgery will be set the day before surgery. We
will call you at the number you gave us, sometime after 10:00 a.m.
the day before your surgery (on the Friday before a Monday
surgery). We will tell you when to arrive, where to go, and
Before this call, please review details your clinic or anesthesia staff gave you
during your clinic visit. If you do not hear from us by 3:00 pm, please call
(608) 265-8857. We do need to talk to you before your surgery. Tell us where you
will stay the night before surgery.
If you have a cold, fever, or illness before surgery, call your doctor’s clinic. After
hours or on weekends ask to speak with the anesthesia doctor on call.
Steps for Getting Ready
1. Your doctor may ask you to stop taking pills that “thin” your blood. You may
need to stop these anywhere from 24 hours before surgery to 7 days before.
Ask your doctor when you should stop them. Blood thinners include:
ξ Aspirin, Excedrin , Ascriptin and Ecotrin
ξ Plavix Pradaxa , Effient
ξ Vitamins and herbal supplements
ξ Coumadin or warfarin or Jantoven
ξ Ibuprofen, Advil , Motrin , Nuprin , and Aleve
If you take any of the pills listed above or herbs, please let us know.
It is alright to use acetaminophen (Tylenol ) if you can normally take it.
2. The night before surgery, eat a light supper - small amounts of low-fat foods
unless you are given special instructions. You will be asked to stop eating solid
foods and milk-type beverages at midnight. Most patients are allowed to drink
clear liquids up until 4 hours before surgery. Do not drink any liquids after
midnight if your surgery is before 8 am. Clear liquids include water, black
coffee and tea (no creamer), and apple or white grape juice. Do not chew gum,
tobacco, or have candy for 4 hours before surgery. If you’ve been told to take
any pills, you may take them with sips of water.
3. Your surgeon may want you to take laxatives to empty stool from your bowel
before surgery. You will get details on the bowel prep at your clinic visit.
4. Do not drink alcohol after 8:00 pm the night before surgery. If mixed with
anesthesia, it can cause problems.
5. Try to stop smoking or at least cut back. It takes at least 3 days to rid your
body of carbon monoxide from cigarettes. If present in your body it will delay
wound healing. It can also increase the risks from anesthesia. If you’d like
help quitting, call the Quit Line: 1-800-QUITNOW (784-8669).
6. Refer to Health Facts for You #7938 Getting Your Skin Ready for Surgery with
Hibiclens® Chlorhexidine gluconate (CHG) Soap-Adult for skin prep
7. Do not wear make-up. Please remove nail polish from at least one finger. If
you are having hand or foot surgery, all the polish and acrylic nails should be
removed from that hand or foot and from one finger or toe on the other hand or
8. Try your best to have a restful night before surgery. If you are coming from
out of town, you may wish to stay in Madison. A Housing Accommodations
Coordinator, (608) 263-0315, can provide you with a list of nearby motels
and arrange for your stay at a discount rate.
9. The morning of surgery, brush your teeth and rinse, but do not swallow water.
10. If you are taking pills, we will tell you during your clinic visit whether you
should take them the day of surgery. If you take them, swallow with just a sip
11. Please leave all jewelry, rings, large sums of money, and credit cards at home.
You will be asked to remove all jewelry. Please remove all body piercings.
12. Bring along inhalers, CPAP, glucose meter, eye glasses, eye drops, hearing
aids, dentures, prostheses, and other special equipment that you will need. Be
sure these items are labeled and in a case, if appropriate. Please do not bring
bottles of pills with you the morning of surgery unless you have been told to
do so. You will be asked to leave your glasses, teeth, and hearing aides with
your family before you go to surgery.
If you have diabetes, you will be given details about your
insulin or oral pills at your clinic visit.
13. Please bring non-skid slippers or slip-on shoes and a few personal items. You
do not need to bring pajamas or a robe. You may want to bring a book or
something to do. TVs are in each room at no charge. Bring a calling card or
your cell phone if you wish to make long distance calls. You may bring in
your laptop; all of the rooms have patient internet access. Please have your
family member leave your belongings in the trunk of your car the day you
check in (please bring in your CPAP and inhalers). Once your room is
ready, they can bring your things to you. The hospital is not responsible for
theft of personal items.
14. Once you are home, it may take a few days or many weeks for you to get back
to your normal routines (work, child care, laundry, shopping). Make plans for
these changes. The length of time each person needs to recover varies. Plan to
talk about these details with us. You may need to make special plans before
15. Stop at Admissions the day of your clinic visit. If you cannot to do this, you
may call them. Please call them as soon as you can to get your paper work
started. Your family will get one parking pass for the length of your stay. It
can be picked up the day of your surgery by your family.
Admissions is open 7 am to 9 pm. (608)263-8770
The Day of Surgery
The First Day Surgery (FDS) Unit is open 5:30 am to 6:00 pm. The Main Hospital
door is open at all times. Please check in at FDS at your scheduled time. See map
on back of front cover.
While you are here in FDS, we will help you get ready for your surgery. You may
have family with you when you arrive. We welcome all family members on your
day of surgery; but due to limited space, you will need to choose one
person as your primary support person. This is the only person who may stay
with you from check-in time until you go to surgery. When choosing a primary
support person, keep in mind that this person will hear your private health
Other family members and friends will be in the waiting room while you are
getting ready. After the check-in process is complete, we are happy to bring them
into your FDS room for a short 5 minute visit. After this visit, we will show them
to the Surgical Waiting area on the 2nd floor. Your primary support person will
join your family and friends in the Surgical Waiting area when you go to the
In the Operating Room (OR)
You will be taken to the OR on a rolling cart. Once you
are in the OR, your nurse will answer questions and
make sure you are comfortable.
The staff wears masks, gowns, and hats. They will help
you move onto a narrow, firm bed. The nurse will place
a safety belt, like a seat belt, across your legs. They will
place ECG (electrocardiogram) patches on your chest, a
blood pressure cuff on your arm, and a plastic clip on
your finger to check your heartbeat and oxygen level. The anesthesiologist will
ask you to breathe oxygen through a soft plastic mask and medicine will be given
to you through your IV. After you are asleep, a breathing tube will be placed in
your windpipe to breathe for you. Other IVs and monitors will be added after you
A Note to Families
The amount of time your loved one spends in the operating room depends on the
type of surgery. You can wait in the Surgery Waiting Area (C5/2) on second floor.
If you have family that will be calling, please have them call (608) 263-8590. You
may want to bring along a book or something to do since the time may seem to
pass slowly. There are coffee, tea, reading materials, computers and TVs in this
waiting area from 7:30 am until 6:30 pm weekdays. If you wish to leave the
waiting area, please pick up a pager at the volunteer desk. The nurses will keep
you informed during surgery. After surgery, the surgeon will talk with you.
Sometime during the day, take your parking pass to the main hospital information
desk to have it stamped and to get one pass to be used during your loved one’s stay.
After surgery, you will go to the Recovery Room. Here,
the nurses check you often. Most patients wear an oxygen
mask or tube under the nose. You will have a tape or
plastic clip on your finger, toe, or earlobe to check your
pulse and oxygen level in your blood. You will have a
blood pressure cuff on your arm. It will tighten for a few
seconds every 10-15 minutes as it checks your blood
pressure. If you feel cold, tell your nurse. A heated blanket
or lamp can be used to warm you. You may hear beeps from the equipment.
Nausea and vomiting can happen. If you have nausea, tell your nurse. We have
medicine to help you feel better.
If you need to urinate, do not get out of bed. Call for help and the nurse will help
you. Some patients have a tube in the bladder to drain urine.
You may be in the recovery room an hour or longer. Family and friends are not
allowed in here. Once you are settled in your room, they may join you. You will
have your own room with your own bathroom. Some patients may go to an
Intensive Care Unit (ICU) for special care. The staff will tell your family and
friends about the visiting hours.
In your hospital room, your nurse will check on you often. You may have a few
tubes, drains and other equipment such as:
ξ An IV (intravenous line) in your hand or arm to provide fluids and
medicine until you are able to drink fluids well.
ξ A face mask or tube under your nose to give you oxygen.
ξ A plastic clip on your finger to check your oxygen level.
ξ A catheter to drain urine from your bladder. This tube continually drains
urine from your bladder. You may still have the urge to pass urine.
ξ An NG (nasogastric) tube in your nose to your stomach helps prevent
nausea and vomiting.
ξ Wound drains help you heal.
ξ Leg wraps inflate and deflate or elastic stockings to improve blood flow in
A nurse will help you to understand how these items work and how long they will
be in place.
You may not be able to eat right after surgery. At first, you may get only ice chips.
As your body allows, your diet will progress from clear liquids (juice and broth) to
full liquids (milk or ice cream) to normal foods.
Coughing and Deep Breathing
Once the breathing tube is out, nurses will ask you to breathe deeply, cough, and
use a breathing tool (incentive spirometer). Deep breathing helps you prevent
To cough and deep breathe
1. Place a pillow over your chest to lessen the pain while coughing.
2. Breathe in deeply and slowly through your nose. Hold it.
3. Exhale slowly through the mouth.
4. Repeat twice more.
5. Breathe in again; hold it, and then cough.
To use the incentive spirometer
1. Exhale and place your lips tightly around the mouthpiece.
2. Take a deep breath. Slowly raise the Flow
Rate Guide between the arrows.
3. Hold it. Continue to inhale, keeping the
guide as high as you can for as long as
you can, or as directed by your nurse or
4. Exhale and relax. Remove the
mouthpiece and breathe out as usual.
5. Slowly, repeat 10-15 times each hour while you are awake.
People used to believe that you had to put up with severe pain. This is not true.
We will work with you to prevent and relieve pain. Good pain control helps you
1. Heal faster
2. Leave the hospital sooner
3. Prevent problems
Drug and non-drug treatments can help prevent and control pain. Do not worry
about getting “hooked” or “addicted” to pain pills. This is rare unless you already
have a problem with drug abuse.
For best results
1. Talk with your doctor and nurses about the choices you have. You and your
doctor can decide which is best for you.
2. Take (or ask for) pain medicine when pain first begins. Do not wait. Pain pills
take 20-30 minutes to work.
3. You will be asked to rate your pain using this scale.
0-10 Number Pain Scale
0 1 2 3 4 5 6 7 8 9 10
No Mild Moderate Severe Worst
4. The goal should be at a level that will allow you to deep breathe, eat, walk, and
sleep. We need for you to rate your pain so we know how well your pain
medicine is working.
5. Tell us about pain that will not go away. Do not worry about being a “bother”.
Pain can sometimes be a sign of problems.
Pain medicine may cause you to become drowsy, dizzy, or lightheaded. Do not
drive, use machines, or drink alcohol while taking pain medicine.
Narcotic pain medicine can cause constipation. This medicine slows down bowel
movements moving through the intestine. This causes the stool to become hard. If
you have hard bowel movements, have trouble passing bowel movements, and the
movements are not often enough, then you have constipation.
This can be a problem. It may last as long as you are taking narcotic medicine.
So, it is important to learn how to prevent and treat constipation.
What can I do to prevent constipation?
Once you are home, you will need a plan to avoid this problem. Stick to the plan
as long as you are taking narcotic pain medicine. Review your plan with your
doctor or nurse. Here are some things to include in your plan.
ξ Eat foods that have helped you to relieve constipation in the past.
ξ Eat foods high in fiber or roughage. This includes foods such as uncooked
fruits, raw vegetables, and whole grain breads and cereals. Try prune juice.
Buy some unprocessed bran and add 1 or 2 tablespoons to your food. Keep
a shaker of bran handy at mealtimes and sprinkle it on foods. If you are not
hungry, do not force yourself to eat fiber.
ξ Drink plenty of liquids. Eight to ten 8-ounce glasses of fluid each day will
help keep your stools soft. Warm liquids often help your bowels to move.
Have a warm drink about half an hour before your planned time for a bowel
ξ Exercise as much as you are able each day or at least every other day.
Increase the amount you walk. Check with your doctor or nurse about the
exercises that are best for you.
ξ Plan your bowel movements for the same time each day, if you can. Set
aside time for sitting on the toilet or commode. The best time is after a
What about stool softeners and laxatives?
Many people taking narcotic pain medicine need the help of a stool softener. This
alone may not work. You may need to add a gentle laxative. Be sure to check
with your doctor or nurse before taking any of these on your own.
Your doctor or nurse may suggest taking a laxative on a regular schedule rather
than waiting for constipation to happen. There are many types and brands of
laxatives, and most need no prescription. Talk to your doctor about which may
work best for you, and at the best price.
What about bulk laxatives and fiber, like Metamucil ?
Bulk laxatives and fiber like Metamucil absorb water and expand to increase bulk
and moisture in the stool. They are not the best to use for constipation from
narcotics. They should only be used if you are able to drink plenty of fluids
throughout the day.
What about suppositories and enemas?
Both can be used as an added step to treat constipation. It is not a good idea to rely
on enemas as part of a regular plan to avoid constipation. Talk to your doctor or
nurse before using either of these options.
What are the important points in my plan?
ξ Put together a plan to prevent constipation and stick to it as long as you are
taking your narcotic pain medicine.
ξ Do not stop taking your pain medicine even if it is harder to control the
constipation than it is to control the pain.
ξ Aim for a bowel movement every second or third day rather than every day.
ξ Call your doctor before taking any stool softeners or laxatives.
What are examples of high fiber foods?
Cereals and flours Bran cereals, whole-wheat bread, rye bread and crackers,
wheat germ, corn, cornmeal, wild rice, brown rice, barley,
Fruits Fresh, canned, or dried fruits, especially those with skin
or seeds (apples, plums, pears, peaches, tomatoes, berries,
raisins, and dates)
Vegetables Any raw or cooked vegetable (not overcooked) such as
carrots, cabbage, peas, dry beans, and lentils
Fruit Pudding – (1-2 tablespoons one to three times a day)
Pudding recipe (in blender combine)
3 oranges peeled
4 apples with skins
2 cups raisins and dates
2 cups prunes
Add prune juice to consistency of sauce or pudding
Can keep in refrigerator 7-10 days, can be frozen
Bran Muffins – (1-2 muffins daily)
Bran muffin recipe
2 ½ teaspoons baking soda
½ quart buttermilk
2 ½ cups flour (1 ½ whole wheat; 1 white)*
1 cup sugar
½ package (15 oz.) Raisin Bran cereal
1 teaspoon salt
2 eggs slightly beaten or 1 cup egg substitute
½ cup oil
* ½ cup wheat germ may be substituted for ½ cup whole-wheat flour
Combine all ingredients. Bake in greased muffin pans at 400 degrees for 18-20
minutes. This makes two dozen muffins.
The length of your hospital stay depends on your surgery. You will need to have a
family member or friend learn about your home care before you leave the hospital.
You will receive prescriptions for pills. Please bring your insurance card if you
plan to fill these at the hospital.
Plan to leave the hospital by noon. You will need a responsible person to drive
you home and stay with you for 24 hours. It may be helpful to have someone stay
with you the first week you are home. Your case manager will help make plans for
Home Health, a nursing home stay, or Meals on Wheels, if needed.
Important Phone Numbers
To get admit paper work started, speak with a financial counselor or
confirm insurance ............................................................. (608) 263-8770
First Day Surgery Unit ...................................................... (608) 265-8857
Fax ..................................................................................... (608) 265-8858
Hospital Paging Operator ................................................... (608) 262-0486
Housing Accommodations ................................................ (608) 263-0315
Outpatient Pharmacy (E5/236) ......................................... (608) 263-1280
Patient Information (for room number) ............................ (608) 263-8590
Registration……………………………………………… (608) 265-0396
............................................................................................ (608) 263-8109
Spiritual Care Services…………………………………...(608) 263-8574
Toll-Free ............................................................................ 1-800-323-8942
Spanish version of this HFFY is #5380
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 2/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4538