Preparing for Outpatient Surgery
Date of Surgery: _____________________
Your Surgery:________________________
Surgeon: ____________________________
Outpatient Surgery Center
Located in the Clinic Lobby
(608) 263-8803
Ambulatory Procedure Center
Off the D Elevator Lobby on Main Street
(608) 263-5775
(608) 263-6407
Toll-free 1-800-323-8942
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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 gray path past the D elevator. Turn left when you see the APC sign.
First Day Surgery Unit, enter at the hospital entrance. Follow the gray 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 1stfloor
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
Before your clinic visit, please
Bring the items listed below to your pre-surgery clinic visit
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Welcome to University of Wisconsin Hospital and Clinics
About Outpatient Surgery
At UW Hospital’s Outpatient Surgery Center or Ambulatory Procedure Center, you can have surgery and go home the same day. The time from your admission to your recovery takes place in one setting.
Having surgery may be stressful no matter how simple it is. The staff will help you through each step of your surgery while you are here. Your family and friends are part of the team helping you before and after surgery.
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Knowing what to expect is a key part of getting ready. This booklet helps you to learn about:
- Your Pre-Surgery Clinic Visit................................ 3
- Getting Ready for Outpatient Surgery................... 4
- Recovering after Outpatient Surgery..................... 8
- Important Phone Numbers..................................... 11
Your Pre-Surgery Clinic Visit
Members of the surgery team will meet with you to:
- Talk with you about having surgery.
- Learn more about your health history.
- Perform a physical exam.
- Complete any tests or procedures that are needed before your surgery. These may include 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 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.
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Getting Ready for Surgery
If you are having local (numbing) anesthesia, and receive medicine to sedate you, you will need to arrange for a ride home. You may also need a responsible friend or relative to stay overnight with you when you go home. This depends on the extent and type of surgery you have. A nurse will discuss this with you ahead of time 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. We ask this person to be with you when the nurse reviews your discharge instructions. 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 transportation home and overnight help, your operation may be rescheduled.
The day before surgery (or on Friday for 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) 263-8803. 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 you can.
Steps for Getting Ready
1. Your doctor may ask you to stop taking medicine that “thins” 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 alright to use acetaminophen (Tylenol®) for general discomfort or pain.
2. Your surgeon may want you to take laxatives to clean out your bowels. If this is the case, you will get instructions about the bowel prep. You will also learn what you can eat the day before surgery during 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. 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. 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® antibacterial soap on your incision site. Use it the night before and the morning of your surgery. You may get this soap during your clinic visit. If not, then use Dial® or Safeguard®. First, wash from neck to ankles with your usual soap. Then, wash (do not scrub) the part where your incision(s) will be for 2-3 minutes with Hibiclens®. Rinse well. Do not apply lotions, powder or perfumes. Do not use Hibiclens® on your face, hair, genitals or rectal area.
7. Please remove all make-up. Remove the nail polish from at least one finger. If you are having surgery on your arm, remove artificial nails and nail polish on that side. Please remove all jewelry and body piercings.
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.
10. A nurse from Outpatient Surgery will review your medicines with you and instruct you in what to take the morning of surgery. You may take them with a sip of water.
| If you have diabetes, you will be given special instructions about your insulin or oral medicines at your clinic visit. |
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.
13. Wear loose, comfortable clothing and shoes that are easy to get on and off. If you do not have slip-on shoes, please bring slippers or we will provide you with paper slippers..
14. You may wish to bring something to read, knitting, or something else to do while waiting..
15. When you return home, it may take a few days or weeks for you to resume your usual routine (for instance, going back to work, child care, laundry, shopping), so plan ahead. 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. Discuss the details with them. You may need to make these plans before surgery. Keep in mind that even the 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. Staff at the Clinic Information or Outpatient Surgery Center desk can stamp your ticket.
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. You will have an intravenous (IV) line 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 your questions and explain what is happening. The nurse will make sure you are comfortable.
You may have ECG (electrocardiogram) patches on your chest, and a blood pressure cuff on your arm. You may notice 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. Medicines will be given 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.
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. When your family arrives or leaves the Waiting Area, they should stop at the nurses' 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. At some point after surgery, your surgeon will talk with your family. Food may be purchased in the cafeteria.
Recovering after Surgery
If you receive local anesthesia, we will return you straight to your room. If for your surgery you needed a regional, spinal, monitored, or general anesthesia, you may go to the recovery room. The length of time you will be there varies.
Here, nurses will check your blood pressure, pulse, and surgical site. They will ask you how you are feeling. If you feel cold, tell your nurse. A heating blanket or lamp can be used to warm you. The time spent here may be an hour or more. This will depend on the extent of your surgery. You will hear noises from the equipment in the room. Family is not allowed in the Recovery Room.
You will be moved when it is time for you to return to your room. Nursing staff will keep checking on you often. At this time, your family and friends may join you. When you are fully awake, you will be offered fluids. You will be helped to walk before you can leave to go home.
Most patients stay 1-2 hours. You must meet certain requirements before you go home. These include control of pain and nausea. You will need to be able to walk or use of crutches, if needed. At this time you will learn about your care at home. Your primary nurse works with you, your family, doctors, and others to help you recover. He or she will review your special guidelines with you and the person who will care for you at home.
Pain Control
People used to think that pain was something you just had to put up with. That is no longer true. Today, you can work with your nurses and doctors to prevent or relieve pain. Good pain control helps you to:
- Enjoy greater comfort.
- Heal faster.
- Start walking, breathing and gaining strength more quickly.
- Leave the hospital sooner.
- 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 already have a problem with drug abuse.
For best results:
- Discuss your options with your doctor and nurses. Work with your doctor and nurses to make a pain control plan.
- Take (or ask for) pain relief drugs when pain first begins. Waiting until your pain becomes severe limits how well the medicine works.
- 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
- The goal should be at a level that will allow you to walk and sleep with the least pain. Rating your pain helps us to know how well your pain medicines are working.
- 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.
Narcotic pain medicine causes constipation in most people. 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 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.
- 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
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Fruits |
Fresh, canned, or dried fruits, especially those with skin or seeds (apples, plums, pears, peaches, tomatoes, berries, raisins, and dates)
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Vegetables |
Any raw or cooked vegetable (not overcooked) such as carrots, cabbage, peas, dry beans, and lentils |
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
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.
Going Home
Once you go home, you may feel weak and drowsy for up to 24 hours. Plan to take it easy. Keep in mind, this is not a good time to make big 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. You may stay for several hours or overnight. We ask that your friend or relative be present to learn about your care at home. As you get ready to leave the hospital, the nurse will give you supplies you will need. If your doctor orders medicine, you may have the prescriptions filled at the hospital. Group Health Cooperative members may need to fill prescriptions at a provider pharmacy. If you need a follow-up doctor visit, we can schedule it before you leave. We will provide you with the phone numbers so you may speak with someone 24 hours a day with questions or concerns. Our staff will try to contact you the day after surgery for follow-up.
We hope this booklet has been helpful. We strongly suggest you bring it with you when you come to your clinic visit.
Important Phone Numbers
If you have questions, please call. Our staff is here to help.
Ambulatory Procedure Center
(6:00 am to 5:30 pm, Mon – Fri) (608) 263-5775
(7:30 am to 7:00 pm, Mon - Fri) (608) 6407
Anesthesia Preoperative Clinic(608) 263-9483
(9:00 am to 5:00 p.m., 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)
(6 a.m. to 7 p.m., Mon- Fri.) (608) 263-8803
OSC FAX Number ( 608) 263-9279
Pastoral Care (608) 263-8574
Patient Information (for inpatient hospital rooms) (608) 263-8590
Patient Relations Office (608) 263-8009
The Spanish version of this Health Facts for You is #5300.
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 © 02/20/2009 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4549
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