First Day Surgery Booklet
Date of Surgery: _____________________
Your Surgery: ________________________
Bring to Your Pre-surgery Clinic Visit
o Patient Health Profile form
o This booklet
o 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 hospital doors.
OutpatientSurgeryCenter, enter through the clinic door. Once inside the lobby, it is the 1st door on your left.
AmbulatoryProcedureCenter, 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: F6/354 – F elevator to the 3rd floor
Pulmonary Function: E5/520 – E elevator to the 5th floor
Inpatient X-Ray: E3/3 – E elevators to the 3rd floor
Welcome to University of WisconsinHospitaland 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
Phone Numbers........................................................... 12
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:
- Talk with you about surgery.
- Learn more about your health history.
- Do a physical exam.
- 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 out 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 9:00 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 answer questions.
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:
· Aspirin, Excedrin®, Ascriptin®and Ecotrin®
· Plavix®, Pradaxa®, Effient®
· Vitamins and herbal supplements
· Coumadin®or warfarin
· Ibuprofen, Advil®, Motrin®, Nuprin®, and Aleve®
If you take any of the pills listed above or herbs, please let us know.
It is all right to use acetaminophen (Tylenol®) if you can normally take it.
2. 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.
3. The night before, eat a light supper – small amounts of low-fat foods. 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. Clear liquids include water, soda, coffee and tea (no creamer), clear broths, clear juices (no orange juice because of pulp) and popsicles. Do not chew gum, tobacco, or have candy for 4 hours before surgery.
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. Shower twice before surgery using the Hibiclens® soap. Use it the night before and the morning of your surgery. You may get this soap during your clinic visit. First, shower with your own soap. Any special beauty treatments you do, you may want to do now as you may not be able to shower for a few days after surgery. Rinse. Pour the Hibiclens® soap on a damp, clean washcloth or new shower sponge. This thin soap tends to easily run down the drain. Wash (do not scrub) the area of the incision for 2-3 minutes. Rinse well. Do not use lotions, powder or perfumes. Do not use Hibiclens® on your face, hair, rectal area, or genitals; use your own soap in these areas. If you do not get Hibiclens® at your clinic visit, you can buy it at your local drug store or you may be able to use other soap as instructed by your clinic.
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 foot.
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.
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 of water.
If you have diabetes, you will be given details about your insulin or oral pills at your clinic visit.
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.
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. 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 surgery.
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. Enter using the Main Hospital Door the day of your surgery. See map on back of front cover.
After you arrive, you will be taken to a room to prepare for surgery. Your family member(s) will be given a pager and directed to a waiting area. A nurse will ask you questions about your health and help you get ready. An anesthesia doctor will meet with you and answer questions. You will have an IV (intravenous) placed in a vein of your hand or arm. An IV is used to give fluids and medicine. You may be given medicine to help you relax. Before you leave for the operating room (OR), we will page your family so you can meet with them again.
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, 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 are asleep.
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 and drains and other equipment such as:
- An IV (intravenous line) in your hand or arm to provide fluids and medicine until you are able to drink fluids well.
- A face mask or tube under your nose to give you oxygen.
- A plastic clip on your finger to check your oxygen level.
- 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.
- An NG (nasogastric) tube in your nose to your stomach helps prevent nausea and vomiting.
- Wound drains help you heal.
- Leg wraps inflate and deflate or elastic stockings to improve blood flow in your legs.
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 pneumonia.
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 the deep breath. Countinue to inhale, keeping the guide as high as you can for as long as you can, or as directed by your nurse or respiratory therapist.
4. Breathe out and relax.
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 Pain Pain
4. The goal should be at a level that will allow you to deep breath, 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.
- Eat foods that have helped you to relieve constipation in the past.
- 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.
- 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.
- 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.
- 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.
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?
- Put together a plan to prevent constipation and stick to it as long as you are taking your narcotic pain medicine.
- Do not stop taking your pain medicine even if it is harder to control the constipation than it is to control the pain.
- Aim for a bowel movement every second or third day rather than every day.
- 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
Fresh, canned, or dried fruits, especially those with skin or seeds (apples, plums, pears, peaches, tomatoes, berries, raisins, and dates)
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. 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
Spanish version of this HFFY is #5380
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 11/03/2011
Copyright © 10/02/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4538
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