Transcript Visit to Pre Admission Testing

Visit to Pre Admission Testing
The Center for Bariatric Surgery and Metabolic Disease
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Thank you for choosing our institution to
have your surgery.
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We want your experience to be as pleasant
as possible and will do what we can to
ensure this happens.
Testing
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Blood work
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EKG
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Chest X-ray
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Anesthesia questionnaire and evaluation
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Health history
Eating
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Liquid diet for the 2 days before surgery
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Can have broth, sugarfree juice, sugarfree
gelatin, decaffeinated tea, decaffeinated
coffee, protein shake
Eating(cont’d)
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Do NOT eat or drink anything after
midnight the evening prior to your surgery.
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Can NOT even have water, coffee, chewing
gum or mints after midnight
Bowel Prep
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One half bottle of Citrate of Magnesia
(Citroma)
 May want to try it chilled.
 May want to plan to be at home when
drink it.
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At 12 noon the day before surgery.
Medication
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Some medications are permitted the
morning of surgery and others are not.
Medications (cont’d)
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The anesthesiologist will instruct you about
which of your heart, blood pressure,
diabetes or asthma medications you can
take.
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Check with Dr. Teixeira’s or Dr. McGinty’s
office about how long to stop taking
medications that may cause bleeding such
as aspirin or arthritis medications.
Medications (cont’d)
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If you are instructed to take your regular
medications that morning, take them with
SMALL sips of water.
Medication to Avoid
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Aspirin
Alleve
Celebrex
Motrin
Naprosyn
Vioxx
Discuss with Dr.
Teixeira’s or Dr.
McGinty’s office if
you take:
 Coumadin
 Heparin
 Fragmin
 Plavix
Smoking, Alcohol and Drugs
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For at least 72 hours prior to surgery do not:
 smoke
 drink
alcohol (liquor, beer or wine)
 use recreational drugs
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These may interfere with the anesthesia
medications.
Illness
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If you develop a cold, virus, sore throat or
other illness during the week before your
scheduled surgery, please contact your
regular doctor for treatment. Also notify
Dr. Teixeira’s or Dr. McGinty’s office.
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It will be determined whether your
procedure should be rescheduled.
A Call to Confirm
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On the day before surgery patients are asked
to call the Ambulatory Surgery Unit (ASU)
between the hours of 5:30 and 7:30 p.m. to
confirm the time of your arrival for surgery.
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If your procedure is scheduled for a Monday
you are asked to call the Friday before your
surgery.
A Call to Confirm (cont’d)
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We will attempt to contact you. However,
we have found that we may not able to
reach patients at their home telephone
number the evening prior to surgery.
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Please call St. Luke’s Hospital ASU at
(212)523-3371.
What to Bring the Day of Surgery
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Presurgical forms and insurance information
(bring every time you come to the hospital)
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List of medications and allergies
What to Bring the Day of Surgery
(cont’d)
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Advance Directives which specify your
wishes regarding healthcare treatments in
the event of a situation in which you are not
able to make these decisions for yourself.
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Overnight bag containing a few personal
items.
Checking In
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ARRIVE ON TIME
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Go directly to the Ambulatory Surgery Unit
on the third floor of the Babcock Building.
Canceling Procedure
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If you find it necessary to cancel your
surgery, please call Dr. Teixeira’s or Dr.
McGinty’s office as soon as possible.
Personal Items
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On the day of surgery do not wear contact
lenses or body jewelry.
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You may wear eyeglasses, hearing aids or
dentures. However, these must be removed
prior to the surgery. Please bring your
containers in which you store these items.
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Do NOT bring any valuables or jewelry.
Clothing
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Before surgery, you will be given a hospital
gown and robe to wear.
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You will have a hospital ID bracelet put on
your wrist.
Anesthesia
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The anesthesiologist will meet with you
prior to your surgery to discuss your
anesthesia and answer any questions you
may have.
Anesthesia (cont’d)
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If you have had any experiences in the past
with anesthesia, please inform the
anesthesiologist.
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It is important that they have as much
information as possible to provide the best
anesthesia care to you.
General Anesthesia
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Uses medicines to put you to sleep and to
keep you asleep during the surgery
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Also involves medicines to relax your
muscles
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Uses techniques to support your breathing
Pain Management
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Always tell your doctor, nurse or other staff
member when you are having pain.
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Don’t be afraid to ask for pain medicine.
Pain Management (cont’d)
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You will be asked questions about the pain you
may be experiencing including:
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intensity (how strong)
 location
 type
(throbbing, burning, aching)
Pain Management (cont’d)
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You will be asked to rate the severity of pain
using a pain scale (0 = no pain to 10 = worst
pain).
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There is no right or wrong answer.
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Just rate your pain as best you can to give us
an idea of how close we are to making you
comfortable.
Pain Management (cont’d)
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The pain scale is used to evaluate your pain
and also to evaluate the effectiveness of pain
medicine and treatments.
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We will ask you often about your pain.
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Your answers will help us follow your pain
to see how effectively we are managing
your pain.
Pain Management (cont’d)
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Managing pain is an important aspect of
getting well after your surgery.
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Patients who have their pain well controlled
generally tend to recover better and faster.
Patient Controlled Analgesia
(PCA)
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A PCA pump is a machine that contains
pain medicine. The pump delivers the
medication through your IV tubing.
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The pump has a button that you can push to
give yourself a dose of pain medicine when
you need it .
PCA (cont’d)
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Once you push the button wait 5 or 10 minutes
to give the medicine a chance to work.
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After the 5 or 10 minutes, if you are still having
pain, push the button again.
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We want you to be comfortable. We don’t want
your pain to be more than a 3 or 4 on the pain
scale.
PCA (cont’d)
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If you are not sure if enough time has
passed to push the button again, go ahead
and push it.
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The pump is set with a limit so you will not
be able to give yourself medicine too often
or give yourself too much medicine.
Methods to Assist with Pain Relief
Relaxation techniques
 Hot or cold packs
 Rest
 Deep breathing exercises
 Proper positioning
 Distraction techniques such as music, TV or
visitors
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Facts about Pain Management
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Let health care providers know about your
allergies, previous experience with pain
medicine, other medicines you take and
your health history.
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Tell staff how strong your pain is and what
makes it better or worse.
More Facts - Pain Management
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Ask for pain medicine when you need it or
before doing an activity that may cause
pain, like getting out of bed. Don’t wait
until the pain is too strong!
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Give the pain medication time to work. Ask
when you can expect to feel some relief.
More Facts - Pain Management
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Use rest, deep breathing and other non-drug
treatments to help your pain. These will
work with your pain medicine to control
your pain.
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Tell the staff how you are feeling. Let them
know how effective the treatment is and if
you are experiencing any side effects from
the medication.
Post Anesthesia Care Unit (PACU)
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You will be connected to equipment to
monitor your heart rate, breathing and blood
pressure.
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You may receive oxygen through a mask
placed on your face. It is common to
receive oxygen for a little while after
surgery. It will likely be removed before
you leave the PACU.
Discharge to Step down Unit
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When awake from the anesthesia
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Pain from surgery is controlled
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Breathing, heart rate and blood pressure are
stable
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Cleared for discharge by anesthesiologist
Incentive Spirometry, Coughing
and Deep Breathing Exercises
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Incentive spirometry - perform 10 to 20
times every hour
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Coughing and deep breathing exercises perform several times every hour
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Helps clear your lungs and prevent
pneumonia
Out of Bed
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The first time you get out of bed the nurse
will be there to assist you.
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Do NOT get out of bed by yourself the first
time.
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Plan to get out of bed the evening of surgery
or by the next morning.
Out of Bed (cont’d)
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Getting out of bed and moving around helps
prevent many of the potential problems that
may occur after surgery and anesthesia like
pneumonia, blood clots and skin sores.
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It is the best thing you can do to help
yourself recover.