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Summary

If you are an informed consumer, you can help maximize the chance for success of a surgery, minimize the risks, and possibly save money. As you will see from this article, being informed includes a variety of subjects. Reading them all, particularly at one go, can be overwhelming. Instead, we suggest starting by scanning our information for an overview but only reading the area(s) of immediate concern. You, a family member or friend, can return as often as needed.

Before Agreeing To Surgery

Gather as much information as you can. For instance:

Before agreeing to surgery, consider getting a second, independent opinion from another doctor who is not in your doctor's same practice. Second opinions are so important that most health insurance covers them. To learn about second opinions, including how to get one, click here.

NOTE: Do not let fear keep you from having surgery. If fear is interfering with your decision, or becomes difficult after you agree to surgery, see: How To Cope With Fear Of A Treatment 

Once You Agree To Surgery 

Consider taking the following steps to help assure a positive outcome:

  • Choose the surgeon and the facility in which the surgery will occur with care. To learn how, click here. 
  • If you have a choice about when to have surgery, common wisdom suggests the following:
    • Ity is preferable not have surgery on a Friday or just before a holiday. Hospitals tend to have less staff on a weekend and during a holiday to tend to your needs and in the event of an emergency.
    • Avoid surgery in July. It is when the new medical school graduates start working at hospitals. 
  • Follow time tested tips to help assure a successful result. For example:
    • If there is time, do what you can to build yourself up physically and mentally before the operation. 
    • If you smoke, stop as soon as you can (at least 3 days before the operation). 
    • Give your surgeon a list of all the medications you are taking. Include those you recently discontinued. Also include over the counter medications, supplements and herbs.
    • For additional tips, click here
  • What to do and what not to do, and what to expect immediately before an operation
  • What to expect immediately after an operation
  • If the surgery will take place in a surgery center instead of a hospital
    • Keep in mind that surgery centers do not generally have the same safey standards as hospitals. They are also generally not required to have the trained staff and equipment needed to provide a lot of emergency care.
    • Ask about what happens if there is an emergency. Will trained staff be in attendance during your operation? Does the center just call 911?
    • Ask if your doctor has a financial interest in the center.  If so, it is particularly important to ask whether the center is the best option for you.
  • If the surgery will be in a hospital, it is worth taking a few moments to learn the following. If you do not want to take the time, consider asking a family member or friend to check for you. Knowledge can help prevent infection, medical errors and save you money. 

After the Surgery

 What you can do to avoid medical error related to the surgery.

  • Before the surgery: For instance, try to have the surgery scheduled for early in the week (not before a holiday) and early in the morning. Hospitals tend to be understaffed on weekends and holidays. An early morning operation is ideal because the surgeon will be fresher. It is also easier to get through the prep period without eating and delays are less likely. To learn about the rest of the steps you can take before surgery to help avoid medical error, click here
  • After the surgery: There are steps you can take to minimize chance of medical error after surgery. For instance, ask about the use of a spirometer (a breathing device). For additional tips, see: What you can do to help minimize chance of medical error after surgery.

it is worthwhile to learn about:

  • The questions to consider asking after surgery
  • What to do after discharge from the hospital.  
  • Find out what recovery will be like, how long you can expect recovery to take, and what you can and cannot do during that period of time. If changes will be needed in your home, make them before the surgery.  For additional questions to ask after surgery, click here.
  • Expect anxiety and possibly even depression or an anxiety attack before the surgery. Don't be surprised if there is a period of depression after the surgery. If the emotions interfere with your life, tell your doctor. He or she may prescribe medications. The articles in "To Learn More" describe non-drug methods to help in these situations.

NOTE: If you don't have a Will, or Advance Directives such as a Living Will, a Health Care Proxy or a DNR, now is a good time to consider executing them "just in case." Writing the documents does not mean that you will need them. On the other hand, if something does happen, you may be submitted to long term procedures and expense that neither you or  your family want.  If you already have A Will and/or Advance Directives, check to make sure they still express your wishes. See the articles in "To Learn More."

What To Do Once You Agree To Surgery

People who prepare for surgery have less pain, fewer complications and recover sooner. Consider the following, each of which are more fully discussed in our article about this subject:

With your doctor, discuss:

  • What is involved in the surgery and what to expect afterward
  • Meeting with your anethesiologist prior to surgery - even if it is in the operating room. The anesthesiologist can explain exactly what is going to happen in the operating room and later in the recovery room. Studies show that patients who know what to expect in the operating room require less pain medications and spend less time in the recovery room than patients who do not have this information.
  • Pre-operative tests. In addition to whatever tests your doctor needed to decide whether surgery was an option, there are routine examinations to be done prior to surgery. They can be done in the days prior to surgery, or on the day of surgery. Standard procedures include: 
    • EKG (Electrocardiogram) to evaluate your heart
    • Blood tests
    • A chest X ray for patients over age 40 
    • A complete medical history
    • A review of your medications. We provide a form to help you keep a list, click here.
  • Your thoughts about pain relief. If there will be a prescription for pain, try to get the prescription before going into the hospital so you don't have to scramble to fill it on discharge.
  • What you shouldn't do before and after surgery. For example, if you have more than one or two drinks of alcohol a day, is it ok?.
  • If you have anxiety about the operation that keeps you awake, ask for a sleeping aid..
  • Whether to bank your own blood which can reduce the slight risk of infection and reaction if a transfusion is needed during surgery.
  • The medical consent form: It is advisable to get a copy in advance of the form consenting to the surgery so you can think about the risks you see written on the form. It is not unusual for patients to learn about risks just before they enter the operating room when it is difficulty to say "no" or "let me think about this."  You'll also see information such as whether the form permits an ssociate of your doctor rather than your doctor to perform the surgery. (For information about Medical Consent Forms, click here.)
  • If you are going to stay in the hospital, ask if your doctor can arrange for you to have a sunlit room after surgery, particularly one facing nature if possible.  (it really does help).
  • If music calms you, ask whether during surgery you can listen to music that calms you even if you will be unconscious. You can listen to the music you want and the doctor can listen to his or hers if you can wear earphones during the surgery. 
  • Will you be able to drive yourself home? If not, will you just need a family member o friend to drive you or will you need a medically equiped vehicle such as an ambulance?
  • What you can do before and after surgery to promote healing. For instance:
    • Exercise
    • Food and liquid 
    • Supplements such as vitamins, minerals, herbs, antioxidants or other supplements. They may help, but they can also be harmful and interfere with the surgery or your recovery.
    • Stop smoking. Nicotine and other compounds in tobacco smoke constrict the small blood vessels which increases the risk of heart attack during surgery and restricts the blood flow needed for wound healing.  (For information about how to quit smoking, click here.)
  • What you can and cannot do after surgery and for how long. If you will need assistance, arrange for it ahead of time. If the assistance is more than friends and family can provide, speak with your doctor's staff about bringing professionals on board. (If you need to hire home health aides, decide whether to do it on your own or through an agency). If you will need special equipment at home, arrange for it ahead of time. Your doctor's office can help.

In general:

  • Use the scheduled surgery as an excuse to bring your Living Will and other Advance Directives to date. Remind your Health Care Proxy about your current values and thoughts.
  • If surgery is scheduled to be outpatient, check on the facility's emergency procedures. Also verify that your insurance covers.
  • Do what you can to reduce stress before the surgery. For example, do enjoyable things.
  • Anticipate your post surgical needs including the help you may need and changes in your physical setting (for example, to set up a bed on the first floor).

To Learn More

More Information

Prepare For Surgery

Related Articles

Home Health Care

What You Can To Avoid Medical Error Before Surgery

Tell About Medications, Allergies, Defribrilators and Pacemakers

  • Make sure that both your surgeon and anesthesiologist [the doctor in charge of administering the medication to make you sleep during an operation] know about:
    • All medications that you take currently - including over the counter medications, supplements, vitamins and herbs. If you stopped taking any drugs recently, let the doctors know about them as well.
    • Any allergies you know about.
    • All details about your present and past medical history.
    • If you have a defribrilator or pacemaker.
  • These questions will often be repeated just before you go into the operating room or just before administering the anesthesia. If you are not asked the questions just before surgery,speak up and inform them about your medications.
  • It will help if you have a can hand medical personnel a copy of a List Of Medications instead of trying to remember when you are anxious about an operation or possibly lightly drugged. (Side note: it is also advisable to carry a List of Medications with you at all times "just in case.")

If You Can, Schedule Your Surgery For Best Days And Times

  • Schedule your surgery for a Tuesday, Wednesday, or Thursday morning if possible. If you are operated on during the middle of the week, you will benefit from full hospital staffing for post-operative care. 
  • It is less likely that your surgery will be delayed if you are scheduled for the first surgery of the day.
  • If surgery is elective (at your choice), avoid June and July when doctors who are fresh out of school join a hospital. 

Ask that the site be marked.

  • Ask the surgeon to initial or otherwise mark your surgery site. A mark will help prevent the surgeon from operating on the wrong part of your body. The mark is not permanent. 
  • Don't be embarrassed to ask. The American College of Orthopedic Surgeons recommends this safety measure be followed. Recently, large medical centers have instituted this practice automatically. 
  • Remind the surgeon of the mark before the surgery.

Think about banking your own blood

  • Ask your surgeon beforehand if you are likely to require a transfusion of blood. The risk in the United States of receiving an infection or receiving the wrong blood type through transfusion is extremely small. Still, banking your own blood supply ahead of time completely eliminates the risk. It also helps retain our previous blood supply.
  • Banking your own blood may not be appropriate in some situations. Banking your own blood too close to your surgery date could actually increase the likelihood of your requiring a transfusion. Consult with your doctor if you are considering this option.

Watch for infection

  • Ask your surgeon if there is a significant threat of infection with your surgery. If so, consider asking to receive antibiotics in the hour before surgery, a timing that is not always followed.

Tell about your thoughts concerning pain

  • Work with your surgeon on a plan to control any pain that occurs after surgery ("post-surgical pain".) Studies indicate that adequate control of pain can speed recovery and the healing process. It  also helps to minimize post-surgical depression.

Ask about the room you will you be returned to after surgery

  • See if you can get a room with plenty of sunlight. Studies have shown that sunlight speeds recovery after surgery and can help with alleviating pain.
  • If you will be in a double room, it doesn't hurt to ask for the bed next to the window. If you cannot get it immediately, perhaps you can be transferred when a patient moves out.

Ask about new medical equipment

  • Prior to surgery, ask your doctor if any new medical equipment will be used during your surgery. If the answer is yes, ask how new the equipment is and how many times the doctor has used it. The use of new equipment with minimal training or experience on the part of the surgical team has recently resulted in a number of medical errors.

Ask about the post-surgical nursing staff

  • Check with the hospital to find out whether the nursing staff in the post-operative section are experienced and fully staffed. Several studies indicate that the staffing level of nurses was found to directly influence the incidence of adverse events following major surgery.

After surgery:

  • Ask about using a breathing device to clear your lungs.
  • Monitor use of a catheter.
  • Pay attention to an i.v. line. If it gets crimped or pulls out, let medical personnel know immediately.
  • Exercise as much as your doctor will allow.  You can take an i.v. pole with you as you walk in the hall.

 

What To Expect Just After Surgery

After surgery you will be moved to a recovery room or area. If you have been put to sleep during surgery, this is where you will wake up.

When you first wake up after an operation is over, you may experience any of the following temporary effects:

  • Dry mouth from medicine that stopped your saliva and mucus production. 
  • A sore or scratchy throat if you had a breathing tube in your throat during the operation. 
  • A feeling of nausea, or even vomiting, because of the anesthesia you received during the operation. 
  • A groggy feeling once the anesthesia wears off. 
  • Possibly a feeling of being disoriented or blurred vision. 
  • Discomfort or pain at the surgical site. 
  • Depression.
  • (For information about how to deal with these effects, see the documents in "To Learn More.")

Depending on the surgery, you will likely be hooked up to at least one tube. You may be hooked up to more tubes, including a catheter to remove urine from your system, and to one or more monitors.

  • Ask your surgeon what to expect.
  • After the operation, the nursing staff can explain what each tube and monitor are for. For example, one tube may be for pain relief. One may be delivery of an antibiotic to help prevent infection. A monitor may keep track of your heart function, or blood pressure.

After you recover from the anesthesia, you will be moved to a room in the hospital known as the recovery room or into an Intensive Care Unit (ICU).

  • Recovery room: The recovery room is an area where patients who do not need close monitoring recover from an operation prior to being moved to a regular room or being discharged from the hospital. Sometimes there may be an extended stay in the recovery room or area if there are no beds available in the hospital. If the surgery was done on an outpatient basis, you will be discharged and allowed to go home. You will likely need someone with you to take you home before you can be discharged.
  • ICU: The typical ICU is a part of a hospital with an assortment of life saving equipment, highly trained medical personnel and a high ratio of nurses and other medical personnel to patients. 

You will likely be asked to do breathing exercises. The exercises help decrease the risk of getting pneumonia, a potentially serious postsurgical complication.

If you stay in the hospital: don't be surprised if:

  • You are asked to get out of bed quickly, even if just to stand for a few minutes. Exercise and gravity help reduce the chance of additional complications. If you can't get out of bed, you may be given exercises to do in bed. 
  • You are limited to a clear liquid diet which consists of water, juices, fat-free broth, tea, coffee, gelatin, ginger ale or seltzer. As your bowels start to function, you will move on to soft, easily digested foods. Then you will move to a normal diet (or at least what hospitals and other health care facilities consider a normal diet.)

To Learn More

More Information

Nausea Dry Mouth

Related Articles

Pain 101 Depression

What You Can Do To Help Avoid Medical Error After Surgery

Ask about using a breathing device such as a spirometer

  • An incentive spirometer is an inexpensive small device that measures the air leaving the lungs. Blowing into the spirometer provides a lung-strengthening exercise that can significantly reduce the risk of pneumonia or other complications in the lungs following major surgery. 
  • Ask your doctor or nurse to teach you how to properly use it.

If you have one, monitor use of a catheter

  • If you require a urinary catheter [a tube inserted through the penis or vagina to remove urine from your body], ask your doctor or nurse how long it will need to remain in place.
  • The risk of urinary-tract infection increases significantly after two or three days.
  • If you still have the catheter in place 48 hours after surgery, find out when it should be removed.
  • If at any time you begin to feel urinary discomfort, ask the nurse to check whether the catheter is clogged. It should always be clean.

Pay Attention To An I.V. Line

  • Always tell your nurse if your intravenous (I.V.) line (a plastic line attached to a needle inserted in your vein, used for administering medication and other fluids.) begins leaking or if you develop pain, redness, or swelling in your arm or at the place where the needle enters your skin. Any of these symptoms could be a sign of a developing infection.

Exercise if you can and if you are allowed to

  • Ask your surgeon how soon after the operation you can engage in "light exercise." Studies indicate that too much "flat on your back" bed rest after surgery delays healing and may lead to other complications. For example:
  • You may start by sitting up in bed for short periods of time and then graduate to sitting in a chair. Sitting in an upright position minimizes your risk of complications with your breathing.
  • To keep arms flexible, you may be able to do easy range-of-motion exercises, like extending your arms and moving them slowly in circles.
  • Depending on the type of operation, it is usually recommended that you start walking as soon as possible after surgery. Walking can help reduce the risk of potentially dangerous blood clots in the legs.
    • Ask your nurse or advocate to help you take a stroll down the hall.
    • If you are overweight or have varicose veins, ask for a compressive device, such as elastic stockings, to wear during your recovery.  
  • If you are confined to bed and can not get up to exercise, with the doctor's prior approval:
    • Move your feet in circular motions and lightly lift them against the sheets. This helps with blood circulation.
    • Raise your arms back and forth.
    • Ask your doctor if you should be on blood thinners to prevent blood clots.
    • Consider other exercises. For instance, yoga in bed.
    • If you develop swelling in your legs or sudden shortness of breath ask doctor to make sure you don't have DVT (deep vein thrombosis) or a pulmonary embolism. 

To Learn More

Questions To Ask After Surgery

After surgery, it is advisable to at least ask the surgeon the following questions: (Feel free to print these questions):

  • Was there anything unexpected that happened during surgery? If so, what?  Will it complicate recovery? 
  • If there are stitches or staples, when will they come out?
  • What will I need at home to have a smooth recovery? If I need special equipment, who do I talk to about arranging it?
  • What should I do about the incision?  For how long? For instance:
    • Should I change the dressings? If so, when? Are there special instructions to follow when changing a dressing?
    • Are there dressings I shouldn't touch? There are some dressing that doctors want to fall off on their own.
    • Are there exercises you want me to do? If so, what exercise? Is there a specific way you want me to do the exercise? How often? How long each time?
  • What activities should I not do - and for how long? For example, walking up and down steps, lifting weights, going back to work part time/full time.
  • When can I resume having sex?
  • If I have questions outside normal business hours, what number should I call?
  • When should I schedule a follow-up visit? 
NOTE: If you want to know what happened during the operation, you can ask the doctor or the hospital for a copy of the report about the operation. The report
describes what the doctor did and what he or she found during the surgery. The report can be e-mailed, faxed or mailed to you. (You are legally entitled to a copy of the report just as you are entitled to a copy of all your medical records. For information about your medical records, click here.)

Comfort Tips Post Surgery

Coughing

If you have an incision in your upper body, when you cough, you may feel that your incision is going to break apart. A time tested tip is to use a pillow for support when you cough. 

  • If your incision is in the front, hold the pillow against your chest. Fold your arms across the pillow. Then cough.
  • If your incision is on your side, hold the pillow under your arm. Press the pillow against your side. Cough.
  • If your incision is on your back, lean against the pillow. Then cough.

Incision

  • If you are feeling more than discomfort in or near your incision, let your doctor know. There may be an infection or you may not be receiving enough pain medication. (For information about pain, see the Survivorship A to Z document about pain which includes information about medications).
  • Once the bandage is removed, consider applying a cream that will keep the incision site moist and help reduce the size of the scar. Speak with your local pharmacist.
  • Wear soft, loose clothing over the incision.
  • Women: if your incision is irritated by your bra, speak with an expert who works with bras for women with mastectomies. Many department stores and some pharmacies provide this service free of charge.

To Learn More

More Information

Home Health Care 101