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Pre-Surgery / Post Surgery

Pre-Operative Instructions

OK.  So you need a surgical procedure.    Take a deep breath and relax.  Over 50 million surgical procedures are done in the United States each year and the overwhelming majority go exactly as anticipated and have a wonderful and very positive outcome for the patient.  This sheet will answer some of the most common questions we see in the office as a patient prepares to have surgery:

Scheduling Your Operation

  • If your surgery is being performed electively, then our office will be scheduling the surgery directly with the hospital operating room boarding office for you.  Michelle Alverson, in our office, is a great contact person because she is in constant communication with this office.  If you have questions about the date and time of your surgery, Michelle can often answer these questions.
  • If you develop an infection or are unable to have the operation for any another reason, please call the office immediately!  This will not only help other patients get their procedures sooner, but will help us re-schedule you more quickly as well.

Pre-Surgical Testing

  • Before your surgery, it will be necessary to undergo some testing which often includes blood tests, EKG, Type and Screen, and on some occasions – more specific testing.
  • The Pre-Surgical Testing Office will call you and set up and appointment during which these tests will be performed at the hospital.
  • If you are 2 business days away from your surgery and you have not been contacted to come in for this testing, then kindly call our office and we will arrange it for you.

Preparing For Your Surgery

Many patients ask what they can do to prepare for their surgery.  It’s a team effort and we love the help! In general, there are three important things you can do to help ensure a smooth and successful recovery.

  1. Maintain your physical fitness.  It is important that you stay as active as you possibly can before the operation.  Go on long walks, climb stairs, and try to be as active as you can. Train for your surgery as if it were an athletic event and you will have an easier time afterwards.
  2. Maintain your nutritional status.   Eat a full healthy diet.  If you have a difficult time eating, use nutritional supplements like Boost or Ensure to supplement your caloric intake.  Do not attempt to diet or lose weight before surgery!
  3. If you haven’t done so already, stop smoking.  Please see our smoking cessation helpsheet and talk to Dr Sternberg for a specific plan to help you stop and stay of cigarettes.  It is possible!

The Day Before Surgery

  • Do not eat or drink anything after midnight the evening before your surgery.
  • Feel free to shave the surgical site if you wish within 24 hours of surgery.
  • The hospital will also contact you and notify you when to arrive at the hospital and here to check in.

The Day of Surgery

  • Do not eat or drink on the day of surgery!  We will provide you with intravenous fluid shortly after your arrival.
  • We advise that you shower as close to the time of surgery as possible.
  • See if your family can accompany you to the procedure.  If it is an outpatient procedure” you will be going home afterwards.  Please make sure someone accompanies you.  You cannot drive yourself home afterwards.     If you come to the hospital without a ride, the hospital will cancel the procedure.
  • If you are staying in the hospital after your procedure, bring only items that you will need after the operation with you.  If you choose to bring valuables like jewelry or electronics, make sure your family can hold it for you during your procedure.

Medications

  • It is OK to take aspirin, advil/motrin and tylenol right through the date of surgery.
  • If you are taking Plavix, Lovenox, Coumadin, or another blood thinner, it needs be specifically addressed during your appointment. If you are unsure of the plan regarding these medications, call the office.
  • It is often necessary to lower the dose of diabetes medication on the date of surgery so your blood sugar doesn’t dip too low.   It is also important to continue your beta blockers but not take certain other medications that lower your blood pressure.   This will be addressed during your pre-surgical appointment.  Again, if you are still unsure about this plan the day before surgery, call the office

Post-Operative Instructions

Pain

  • There will be some temporary discomfort associated with every procedure.
  • For procedures other than bronchoscopy, you will be given a prescription for a narcotic painkiller.  Usually this will be Vicodin, Norco, or Percocet.
  • Follow the instructions on the label of all medication.
  • Feel free to take additional ibuprofen (Advil or Motrin) if you feel you need it. You may stagger the ibuprofen and narcotic so the analgesic effect from either medication never wears out.
  • Please do not take any Tylenol (acetaminophen) with your narcotic.  Many narcotics also contain acetaminophen and you can easily take too much, which is dangerous.
  • Narcotic painkillers all cause constipation.  Please make sure to use a laxative while you are taking pain killers.  You should have a bowel movement every 2 to 3 days, if not more frequently.  You should never go more than 3 days without one.    Any laxative from a local pharmacy will do.  Miralax is particularly helpful.  If laxatives are not successful in helping you go, try a Fleets enema, also available at any pharmacy.  If you still cannot have a bowel movement, call the office.

Activity

  • In general, the only activity you need to increase after thoracic surgery is walking.
  • Try to spend as much time as possible out of your bed or chair.
  • The more active you are, the faster you will recover.  Increased post-operative activity also decreases the likelihood of complications after surgery.
  • It is OK to climb stairs and start exercising lightly when you feel you are ready.  Unless specifically told, there are generally no lifting restrictions after thoracic surgery.  If you have had a hiatal hernia repair, then you should specifically discuss postoperative activity & exercise with Dr Sternberg.

Bathing & Bandages

  • If your surgery was less than 48 hours ago, it is important that you keep your bandage dry.  If your surgery was more than 48 hours ago, feel free to take off the bandages and shower normally.
  • It is OK to use soap and water on an incision that is older than 48hours as it will keep the local bacterial count low and prevent infection.
  • No bandage should be on for more than 48 hours!
  • If you have a chest tube, the bandage will be replaced when the tube is removed.  This new bandage that is placed at the time of chest tube removal should stay in place for 48hours after tube removal.   Then you can remove it and shower normally, as with other bandages.  The chest tube site may sometimes leak clear fluid for a day or two after removal. If this happens, place a dry clean bandage over the site to protect your clothing.
  • If your incision is red and inflamed, please call the office.

PleurX Catheter

  • If you have a PleurX catheter, you will need to have home care assist you with drainage three times a week    If you are running low on supplies, your home care nurse will order another shipment for you.    Please see the PleurX instruction booklet and our Pleurx help sheet for more assistance with these catheters

Emergencies

  • You will have a follow up appointment with Dr Sternberg one to two weeks after surgery.
  • If you have a fever over 101, please call the office (248-676-2582).
  • If your incision is red and inflamed or you notice pus at the incision, please all the office.
  • If the office is closed, call the after-hours emergency line (248-738-2112 ) and ask to be connected with Dr Sternberg.
  • If you are having difficulty breathing, excessively light headed, or crushing chest pain -that is not related to your incision or surgery- call an ambulance (911).  After the ambulance is en route, please call Dr Sternberg as well.

Appointment

  • An appointment 1 to 2 weeks after your surgery will be made for you.  If you don’t have one, call the office.
  • If you will be staying at a rehabilitation facility, see if transportation can be arranged for your normal appointment.  Many rehabilitation facilities will transport patients to their surgeons. If not, kindly reschedule so you can see Dr Sternberg as soon as you are discharged from rehab.