Surgery Instructions : Pre-Operative Patients


Preparing For Surgery
Medications to Discontinue before Surgery
Preparations for Your Hospital Stay
Pre-operative Classes
Useful Addresses
Helpful Phone Numbers

Please confirm the time of your surgery at the phone number listed below. Contact the Surgical Pre-operative Office after 2pm the day before your surgery. If your surgery is on a Monday, you need to confirm on Friday. Surgical Pre-operative Office: 212-844-8242

Preparing for Surgery

Pre-operative testing (i.e. blood work, chest x-rays, EKGs, stress tests, and pulmonary function studies) will be required prior to surgery. All testing must be completed 2 – 4 weeks prior to surgery.

If you decide to donate your blood, you must do so prior to your surgery (within 35 days of surgery). Iron pills, called Ferrous Gluconate or Ferrous Sulfate, must be taken upon beginning your donations, and can be purchased over the counter; however, you may experience stomach discomfort, constipation, and dark stool. If this occurs, it may be advised that you decrease the dosage. Niferex is a new iron supplement that is easier to tolerate and may be taken in place of traditional iron pills.

Antibacterial Soap – To minimize the incidence of infection, an antibacterial soap called Hibiclens will be provided for use on the two (2) days preceding your surgery. Cleanse your entire body, paying special attention to the area where your surgery is going to be performed. In the surgical area, use a wash cloth, cleansing for 5 minutes.

Your level of fitness and nutrition prior to surgery should be maintained to the best of your ability. Continue with any fitness activities that do not cause pain. Maintain a healthy balanced diet.

If you smoke cigarettes, it is strongly advised that you decrease the amount you smoke or stop smoking completely. Research indicates that smoking adversely affects bone healing and will thus delay or impede your full recovery following surgery. Inhalation of smoke irritates the breathing passages and may lead to respiratory problems during and after surgery.

Any errands (i.e. house cleaning and grocery shopping) should be completed prior to surgery. The fewer concerns you have upon discharge, the easier your transition home will be.

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MEDICATIONS TO DISCONTINUE BEFORE SURGERY

Please do not take any of the following medications for at least seven (7) days prior to surgery.

• Non-Steroidal Anti-Inflammatory Drugs (NSAID’s):
  Advil, Aleve, Anaprox, Ansaid, Arthrotec, Bextra, Cataflam, Celebrex, Daypro, Diclofenac, Feldene, Ibuprofen, Indocin, Ketoprofen, Lodine, Mobic, Motrin, Naprosyn, Naproxen, Oruvail, Toradol, Relafen, Vicoprofen, Vioxx, Voltaren
• Medications containing Aspirin:
  Alka-Seltzer, Anacin, Asprin, Bayer Arthritis, Bufferin, Darvon Compound, Ecotrin, Excedrin, Fiorinal, Pepto-Bismol, Percodan

If you have spinal fusion surgery, you will NOT be able to take NSAIDS or medications containing aspirin for about 3 months (until your doctor tells you that your fusion appears solid).

• Estrogen Products:
  All oral contraceptives, hormone replacement therapy
• Anticoagulants and Antithrombotics
  Aggrenox, Coumadin, Ecotrin, Fragmin, Halfprin, Heparin, Lovenox, Orgaran, Persantine, Plavix, Ticlid. You will need to consult your physician regarding plans for stopping these medications.
• MAO Inhibitors
  Nardil (Phenelzine) Parnate (Tranylcypromine)
• Herbal Medications and Supplements:
  - Echinacea
  - Feverfew
  - Garlic
  - Ginkgo Biloba
  - Ginseng
  - Siberian Ginseng
  - Kava
  - Ma Huang
  - Saw Pilmetto
  - Valerian
  - St. John’s Wort
  - (14 days before) Vitamin E
  - Multivitamins (containing Vit.E)
• The following medications MAY be taken prior to surgery:
  - Acetaminophen
  - Darvocet
  - Darvon
  - Dilaudid
  - Duragesic
  - Fioricet
  - Lorcet
  - Lortab
  - MS Contin
  - MSIR
  - Oxycontin
  - Percocet
  - Roxanol
  - Tylenol + Codeine
  - Tylenol
  - Vicodin (Hydrocodone)

This list of medications to discontinue is not complete. Other medications may contain these products as well. Please check with your physician if you are taking other medications.

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Preparations for your Hospital Stay

Have nothing to eat or drink after midnight prior to your surgery.

Eat lightly the day before surgery.

If you have young children or a family member for whom you are the primary care-giver, arrange for alternative care for them after your surgery. This will allow for a restful recuperation period.

If you are having extensive surgery, or if you are already having difficulty, it may be helpful to rent or purchase an elevated toilet seat. During the rehabilitation process, the occupational therapist will help you determine if you need any other adaptive devices or medical equipment before discharge from the hospital.

Suggested items to bring to the hospital:

• Two comfortable loose fitting outfits (i.e. jogging suit, nightshirts, bathrobe etc.). Comfortable shoes and socks and slippers.
• Toothbrush, toothpaste, comb/brush, and any other personal grooming items that you normally use daily.
• Personal stereo (Walkman) with relaxation tapes, favorite music, books on tape, books and magazines.
• Please leave valuables at home.

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Pre-operative Classes

Pre-operative classes are available at Beth Israel Medical Center to help you prepare for your spine surgery. At the hospital, you will have the opportunity to meet with a nurse and occupational therapist. They can address your questions related to your hospitalization, expectations following spine surgery, pain management, and discharge planning needs.

Once you have scheduled a surgical date for your spine surgery through the Spine Institute, you may attend a pre-operative class as early as 4 weeks before your surgery but no later than one week prior to it.

Classes are held every Friday at 9:30 am at Beth Israel Medical Center 1st Avenue at 16th Street on the 7th Floor Silver Building. To attend a class, please call (212) 420-2010 and leave your name, telephone number, and date you will be attending the class.

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