Pre-Operative Information

Preparing for Surgery

• If surgery is recommended, we will expedite your surgery scheduling to the best of our abilities. Depending on any health conditions present prior to surgery,we may determine the need to obtain clearance from your primary care physician, cardiologist, or other specialists as needed. While this can take extra time in the scheduling process, it is an important safety step to ensure everything goes as safely and smoothly as possible for you during and after surgery.
• If you are taking any blood thinning medications (Aspirin, Plavix, Coumadin, Eliquis, etc.), these will need to be discontinued well in advance of surgery to minimize bleeding risk. This determination will be made depending on what surgery you are having, what blood thinner you are on, as well as the reason for being on a blood thinner.
• Please consider that you want to be in the best health possible prior to any surgery. Aside from reducing the risks of the surgery, being in good health will promote faster recovery, allowing you to get back to feeling well sooner. Ensure you are doing some sort of physical activity, such as walking at least three times a week before surgery. Also, ensure you are eating a balanced and healthy diet including adequate protein. If you are a diabetic, ensuring good glucose control before and after surgery will dramatically improve recovery while decreasing the risk of wound complications such as breakdown, poor healing, and infection.
• Avoid smoking before surgery. Consider this a good time to quit completely. Use of tobacco products has been repeatedly shown to increase the risk of complications including wound healing problems as well as decrease the rates of bony fusion. Simply put, tobacco use will hamper the potential results from your surgery.
• Your scheduled surgery date is based on the availability of the operating room and the surgeon. However, because of the nature of neurosurgery, there may be occasions when an emergency case may need to replace a scheduled elective case. We apologize in advance for any difficulties this may cause. If this occurs, we will try our best to reschedule your case as soon as possible.

 The Day Before Surgery

• Shower the night before surgery using Hibiclens shower solution provided at the pre-op appointment. Pay special attention to the surgery site.  If not provided, you may obtain this at most pharmacies.
• You should have nothing to eat or drink after midnight the night before your surgery
• Small sips of water are permitted to take routine medications the morning of surgery (except any blood thinners- see above)
• You will be given a standard hospital gown, but consider bringing comfortable clothing  and tennis shoes that will allow you to easily ambulate and participate with physical therapy in the hospital
  

What to expect in the hospital after surgery

• If your surgery is outpatient, you will be monitored for a period of time, allowed to eat/drink, and walked to demonstrate safe ambulation prior to discharge
• If your surgery is inpatient, you will be admitted to the appropriate unit after surgery
  • You will have pneumatic stockings around your calves. While they may be noisy, hot, and irritating, they are extremely important to help prevent blood clot formation in your legs
  • In addition to the stockings, you will be placed on a low dose blood thinner when deemed safe to further help prevent blood clots. This is given in the form of a small injection into an area of fat
  • You may or may not have a urinary catheter in place. This depends on the length of surgery as well as your expected mobility immediately following surgery. If done, this will be placed in the operating room after you are asleep. It will be removed as soon as deemed appropriate after surgery
  • A surgical drain may be present. This is commonly placed to help collect any leftover ooze after surgery. If placed, it is usually removed at the bedside at some point before leaving the hospital. Sometimes patients are sent home with the drain, and it will be removed in the office once the drainage is minimal. The physical therapy team will make several visits with you during your hospital stay to get you up and moving. While you may be in some discomfort and fatigued, it is important to fully participate with the therapists to the best of your ability daily. This will help facilitate your recovery and discharge as soon as safely possible
  • Pain is an expected part of recovery. However, while expected, we want it to be as little as possible. A combination of medications will be given after surgery to keep you as comfortable as possible. If you were on long-term pain medications before surgery, it may be more difficult to control your pain after surgery.
  • Keep in mind that while it is our goal that all patients go home from the hospital, some patients may need short stays at a rehab type facility prior to returning home in order to maximize their recovery and ensure a safe return home. This largely depends on your condition prior to surgery, how extensive the surgery was, and how you are doing after surgery. This will be discussed on a case by case basis both before surgery and the days following surgery.