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/clinical/pted/hffy/surgery/4549.hffy

201710284

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UWHC,UWMF,

Clinical Hub,Patient Education,Health and Nutrition Facts For You,Surgery

Preparing for Outpatient Surgery (4549)

Preparing for Outpatient Surgery (4549) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Surgery

4549






Preparing for Outpatient Surgery

Date of Surgery: _____________________

Your Surgery: _______________________

Surgeon: ____________________________

UW Hospital and Clinics
600 Highland Avenue
Madison, WI 53792

Outpatient Surgery Center
Located in the Clinic Lobby
(608) 263-8804
Ambulatory Procedure Center
Off the D Elevator Lobby on Main Street
(608) 263-5775

Toll Free: 1-800-323-8942

To go to the Outpatient Surgery Center, enter at the clinic entrance. Once inside the lobby, it’s
the 1st door on your left

To go to the Ambulatory Procedure Center, enter at the hospital entrance. Follow the slate
path (Main Street) past the D elevator. Turn left when you see the APC sign.









Before your clinic visit, please:

 Read this booklet
 Fill out a Power of Attorney for Health Care form, if you wish.

Bring this booklet, your medicines, vitamins, and herbal supplements, any medical records
that have been given to you, recent X-rays and test results to your pre-surgery clinic visit.

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Highland Ave


Valet Parking is open 5:30 am to 7:00 pm. It is located between the clinic and
hospital doors.

Outpatient Surgery Center, enter at the clinic entrance. Once inside the lobby,
it’s the 1st door on your left.

Ambulatory Procedure Center, enter at the hospital entrance. Follow the slate
path past the D elevator. Turn left when you see the APC sign.

First Day Surgery Unit, enter at the hospital entrance. Follow the slate path to
the D elevator. Take the D elevator to the 3rd floor and turn left to the First Day
Surgery Unit entrance.

This is the 2nd floor…
To get to the …

Cafeteria: H4/1 – H elevator to the 1st floor
ECG: In the Heart & Vascular Clinic - Take Atrium elevator to the 4th floor.

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Welcome to University of Wisconsin Hospital and Clinics

About Outpatient Surgery

Today, surgery doesn't always mean a long hospital stay. At UW Hospital's
Outpatient Surgery Center or Ambulatory Procedure Center, you can have surgery
and go home the same day. Everything from your admission to your recovery
takes place in this comfortable environment.

Having surgery may be stressful no matter how simple it is. In the Outpatient
Surgery Center or Ambulatory Procedure Center, professional staff will help you
through each step of your surgery and immediate recovery. At home, it’s best if
your family and friends are part of the team helping you before and after surgery.



Knowing what to expect is an important part of getting ready for surgery. This
booklet helps you to learn about:

ξ Your Pre-Surgery Clinic Visit .................................... 3
ξ Getting Ready for Outpatient Surgery ...................... 4
ξ Recovering after Outpatient Surgery ........................ 9
ξ Important Phone Numbers ......................................... 12



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Your Pre-Surgery Clinic Visit

Members of the Surgery team will meet with you to:
ξ Talk with you about having surgery.
ξ Learn more about your health history.
ξ Perform a physical examination.
ξ Complete any tests or procedures that are needed before your surgery, such
as a chest X-ray, ECG (electrocardiogram) or blood tests.

This clinic visit may take 2-4 hours or more to complete. The risks and benefits of
your surgery will be explained. You will be asked to sign a consent form stating
that you understand and wish to have the operation. You may also meet with the
Anesthesia staff either at your clinic visit or the morning of your surgery.

By law, we are required to ask if you would like to complete 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 advance medical directive, you must
be 18 or older and of sound mind. You have the choice of completing the
document or not. It is a voluntary action.

If you choose to fill out a document it must be completed, signed and witnessed
before arriving the morning of surgery. There is not enough time to complete the
forms that morning. The two witnesses cannot be family members or UW Hospital
employees, except chaplains, social workers or volunteers. Also the person you
named to be your health care agent may not be a witness. We suggest you choose a
neighbor or friend. If you need help in filling out this form or have questions, call
our Patient Relations office at (608) 263-8009. A videotape that explains advance
directives can also be viewed in the Learning Center located at E5/684, just off the
D elevator on the 6th floor.


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Getting Ready for Surgery

Your Personal Caregiver

If you are having local (numbing) anesthesia, and receive medicine to sedate you,
you will need to arrange for a ride home. The extent of your surgery will
determine whether you will need a responsible friend or relative to stay overnight
with you when you go home. A nurse will discuss this with you before your day of
surgery so you can make plans.

If you receive regional, spinal, monitored or general anesthesia, you must have
someone drive you home and stay with you overnight; preferably someone over
the age of 16 who could drive you to the ER or make a phone call should you need
something after surgery. We ask this person to be with you when the nurse
reviews your discharge teaching. Be sure to ask the nurse about what time this will
happen so your friend or relative can be present. If you cannot arrange for
transport home and overnight help; your operation will be rescheduled.

Two (2) business days before surgery (or on Thursday for a
Monday surgery), a nurse will phone you at your home or place
of work. The nurse will let you know when to arrive at the
hospital and where to go the morning of surgery. If you do not
hear from us by 3:00 pm, please call 608-263-8804. We can be
reached until 7:00 pm. You are welcome to call us any time after 9:30 am.

If you have a cold, fever or illness the day before surgery, please call the
Outpatient Surgery Center as soon as possible.

Steps for Getting Ready

1. Your doctor may ask you to stop taking medicine that “thins” your blood.
These include:

Seven (7) days before surgery, you may be asked to stop taking aspirin or
products that have aspirin in them. This includes Excedrin , Ascriptin and
Ecotrin . You may also need to stop taking Plavix , vitamins and herbal
supplements.

If you are on Coumadin or warfarin, you will be told if and when to stop
taking it.

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You may be asked to stop taking anti-inflammatory medicines such as
Ibuprofen, Advil , Motrin , Nuprin , and Aleve . Celebrex is one drug
that does not need to be stopped unless your surgeon has told you to do so.
Your surgeon will let your know.

If you take any of these medicines listed above or herbal supplements, please
let your surgeon or nurse know.

It is okay to use acetaminophen (Tylenol ) for general discomfort or pain.

2. Your surgeon may want you to take laxatives to clean out your bowels
before surgery. If this is the case, you will get instructions about the bowel
prep and what you can eat the day before surgery during your clinic visit
before surgery.

3. The night before surgery eat a light supper – small amounts of low-fat foods.
You will be asked to stop eating solid foods and milk-type drinks at
midnight the night before surgery. Most patients are allowed to drink only
clear liquids up until 4 hours before surgery begins. Examples are:
ξ water
ξ apple or white grape juice
ξ black coffee or tea
ξ protein water

If your surgery is the first of the day (before 8:30am); you should have
nothing to eat or drink after midnight. Morning medicines may be taken
with a sip of water. The clinic staff will tell you which to take.

Do not chew gum, tobacco or have candy for 4 hours before surgery.

4. Do not drink alcohol after 8:00 pm. When mixed with anesthesia, it can
have serious effects on your body.

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 which delays wound healing and
can increase 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
instructions.



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7. Remove all make-up and fingernail polish from at least one finger. If you
are having surgery on your arm, remove artificial nails and nail polish on
that side.

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 please do not
swallow any water.

10. Your surgeon or primary doctor should have told you which daily medicines
to take on the morning of surgery. Take them with a sip of water. If you
have not been told by the day before surgery what medicines to take, we will
arrange for someone to call you back to answer your questions.




11. Please leave all jewelry, rings, larger sums of money and credit cards at
home.

12. Bring along any inhalers, CPAP machines, your glasses, crutches, hearing
aids, dentures, prostheses or other special equipment that you will need
during recovery. Be sure these items are labeled and in a case. Bring them
into with you when you check in. Do not leave them in the car.

13. Wear loose, comfortable clothing and shoes that are easy to get on and off.
If you do not have slip-on shoes, you may want to bring slippers.

14. You may wish to bring reading material, needlework or something else to
do while waiting.

15. When you return home after surgery, it may take a few days or weeks for
you to resume your usual schedule (for example, returning to work, child
care, laundry, shopping), so plan accordingly. The length of time you need
to recover depends on the type of surgery. During your clinic visit, nurses
and doctors will give you special plans on how to take care of yourself at
home. Plan to discuss the details with them. You may need to make

If you have diabetes, you will be given special instructions about your
insulin or diabetes pills at your clinic visit.

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special arrangements before surgery. Keep in mind that even most minor
procedures are still surgery. You should plan to take it easy for a while
when you return home.

16. Parking in the visitor's ramp is free of charge for the day of surgery. When
you enter the ramp, you will receive a parking ticket. Persons at the Clinic
Information desk can stamp your ticket. Valet parking is available between
the hours of 5:30am-7pm, Monday through Friday.



The Day of Surgery

When you arrive, go to the Outpatient Surgery Center or the Ambulatory
Procedure Center as you have been told to do. A nurse will ask you questions
about your health and help you get ready for surgery. If you are to receive
anesthesia, a member of the anesthesia staff will see you before surgery. You will
have an intravenous (IV) tube started. You may also receive medicine to help you
relax. You may see staff wearing gloves, goggles and masks. Family may stay
with you until you are taken to the procedure room or the operating room.

You will be taken to the Operating Room or
Procedure Room on a rolling cart. Once in this
room, you will be asked to move onto a small
narrow bed. A nurse will be with you to answer
questions, make sure you are comfortable and
explain what is happening.

You may have 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 levels. An anesthesiologist
will ask you to breathe oxygen through a soft plastic mask and medicines will be
given to you through your IV. After you are asleep, if you are having a general
anesthesia, a breathing tube (endotracheal or ET tube) will be placed in your
windpipe to breathe for you. Other lines and monitors may be added while you are
sleeping.


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A Note to Families

The amount of time you spend in the operating room depends on your type of
surgery. Family members and friends should wait either in your room or they may
be brought to a Waiting Area where they will be comfortable. When your family
arrives or leaves the area, they should stop at the nurse’s station to obtain a pager
so they may be reached if needed. There is space for only 2 family members or
friends in your room. We suggest that children be left at home if at all possible as
they become easily bored and restless. At some point following surgery, your
surgeon will talk with your family. Food may be purchased in the cafeteria.


Recovering after Outpatient Surgery

If you receive local anesthesia, we will return you straight to your room. If your
surgery requires regional, spinal, monitored or general anesthesia, you may go to
the recovery room. The length of time patients are in the recovery room varies.


In the Recovery Room, nurses will check
your blood pressure, pulse and surgical area
carefully. They will keep you as comfortable
as possible. The time spent in the Recovery
Room may be an hour or more depending on
the extent of your surgery. You will hear
noises from the equipment in the room.
Family and visitors are not allowed in the
Recovery Room.

When your time in the recovery room is
complete, you will return to your original
room. Nursing staff will continue to check
you often. At this time, your family and friends may join you. Your care after
surgery depends on the type of anesthesia and surgery you had. When you are fully
awake, you will be offered fluids and helped to walk before you are discharged.

Most patients stay 1-2 hours after surgery is done. You must meet certain
requirements before discharge. These include pain control, home care instructions,
control of nausea if present and walking (use of crutches, if needed). Some
patients may need to be able to empty their bladder before they go home. Your
primary nurse works with you, your family, doctors and other caregivers to help
you recover. He or she will review special instructions with you and the person
who will care for you at home.

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Pain Control

People used to think that severe pain was something you just had to put up with.
That’s no longer true. Today, you can work with your nurses and doctors to
prevent or relieve pain. Good pain control helps you to:
1. Enjoy greater comfort.
2. Heal faster.
3. Start walking, breathing and gaining strength quicker.
4. Leave the hospital sooner.
5. Have better results and avoid later problems.

Drug and non-drug treatments can help prevent and control pain. Don’t worry
about getting “hooked” or “addicted” to pain medicines. Studies show that this is
very rare – unless you have had a problem with drug abuse.

For best results:
1. Discuss your options with your doctor and nurses. Work with your doctor
and nurses to make a pain control plan.
2. Take (or ask for) pain relief drugs when pain first begins. Waiting until
your pain becomes severe limits how well the medicine works.
3. You will be asked to rate your pain using this scale:

0-10 Number Pain Intensity Scale
________________________________________________________________
0 1 2 3 4 5 6 7 8 9 10
No Mild Moderate Severe Worst
Pain Pain
Possible

4. The goal should be at a level that will allow you to walk and sleep with
minimal pain. Rating your pain helps us to know how well your pain
medicines are working.
5. Tell the nurse or doctor about any pain that won’t go away. Don’t 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 prescription pain pills.

Narcotics often cause constipation. To help prevent this when you go home, you
may want to increase your daily water or fluids to 6-8 (8 ounce) glasses. It may
help to increase the fiber in your diet also.


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What can I do to prevent constipation?

Once you go home, you will need a plan to avoid this problem. Stick to it 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
movement.

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
meal.

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.






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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,
popcorn

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






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High Fiber Home Recipes


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

These can keep in refrigerator 7-10 days or 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.










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Going Home

Once you go home, you may feel weak and drowsy for up to 24 hours, so plan to
take it easy. Keep in mind, this is not a good time to make important decisions or
sign legal papers. Also, you may want to eat lightly and avoid fatty foods.

You will leave the hospital when your doctor and nurses
think you are ready to go home. If they feel that you are
not ready, you may be admitted to the hospital for several
hours or overnight. We ask that your friend or relative be
present to receive instructions before you go home. As
you get ready to leave the hospital, the nurse will give
you supplies you will need at home. If your doctor
orders medicine, you may have the prescriptions filled at
the hospital while you recover. (Group Health
Cooperative members may need to fill prescriptions at a
GHC pharmacy.) If you need a follow-up doctor
appointment, we can schedule it before you leave. We
will provide you with phone numbers so you may speak
to medical staff 24 hours a day with questions or
concerns. Outpatient Surgery staff will try to contact you
the day after surgery for follow-up.

The staff at UWHC is dedicated to giving you the best care possible. We hope this
booklet has been a helpful start. We strongly encourage you to bring this booklet
with you when you come to your clinic visit.




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Important Phone Numbers

If you have questions about Outpatient Surgery or any related service, please call. Our staff is
here to help.

Ambulatory Procedure Center (608) 263-5775
(6:00 am to 5:30 pm, Mon – Fri)

Hospital Paging Operator (608) 262-0486

Housing Accommodations (608) 263-0315

Outpatient Pharmacy (E5/236) (608) 263-1280

Outpatient Registration (608) 263-8766

Outpatient Surgery Center (OSC) (608) 263-8804
(6 a.m. to 7 p.m., Mon- Fri.)

OSC FAX Number (608) 263-9279

Patient Information (for inpatient (608) 263-8590
hospital rooms)

Patient Relations Office (608) 263-8009

SAFE Clinic (Anesthesia) (608) 265-1800
(9:00 am to 5:00 pm, Mon – Fri)

Spiritual Care Services (608) 263-8574

Toll Free Phone Number (800) 323-8942





The Spanish version of this Health Facts for You is #5300





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 © 5/2015 University of Wisconsin Hospitals and
Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4549