What To Expect On Day Of Surgery

The following are commonly asked questions about what to expect about your surgical procedure. As you scroll down the list, simply click on the question and it will link you to the corresponding answer in the body of the text below. At the end of each question you will have the option to return back to the top of the page.

What if I become ill before my procedure date?
What do I need to do for my Pre-Surgery Testing Appointment?
What if I do not need pre-surgery testing because I am under the age of 50 or have no pre-existing medical conditions?
What questions will I be asked during my PST visit or phone call?
What should I do beforehand to prepare for my surgery?
What kind of anesthesia will I have?
What do I do the morning of my procedure?
Do I take my morning medications?
My child is having surgery. Is there anything special I should do?
What do I bring with me on the day of my procedure?
When should I arrive?
Where should I go?
Where can my family and friends wait for me?
How do I fill any prescriptions as a result of the surgery?
What if I need crutches?
Will my surgeon talk to a family member after my surgical procedure?
Are there public telephones?
Is there WiFi service available?
What if I have an open wound or skin irritation on the extremity I’m having surgery on?
When will I receive discharge instructions?

What if I become ill before my procedure date?
If you become ill with a cold, fever, or other unforeseen illness, it is best to call the Orthopaedic Surgery Center at 603. 228.7211 and speak with a nurse. Depending on the kind of procedure you have scheduled, it may have to be rescheduled to a time when you are feeling well.

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What do I need to do for my pre-surgery testing appointment?
If you are scheduled for a pre-surgery testing appointment in the Orthopaedic Surgery Center, you should report to the center at the pre-arranged time. You do not need to fast for your pre-surgery testing appointment. Eat and drink as you normally would. Please remember to bring all medication you are taking in their original containers or a current list of the medications (including herbal supplements) and dosages at the time of your pre-surgery testing visit. The nurse will review your medical history, perform an EKG and draw blood for necessary laboratory tests. The nurse will also review instructions for you to follow the morning of surgery.

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What if I do not need pre-surgery testing because I am under the age of 50 or have no pre-existing medical conditions?
If pre-surgery testing is not indicated because you are under the age of 50 or you have no pre-existing medical conditions, you will receive a telephone call from one of the Orthopaedic Surgery Center nurses to discuss your medical history, medications, allergies, and any special needs you may have.

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What questions will I be asked during my pre-surgery testing visit or phone call?

• Have you had surgery before? What and when?
• Do you have past and current medical problems, i.e. heart, lung, circulatory system, neurological, diabetes, high blood pressure, etc.
• Have you recently had blood work done, or an EKG or stress test performed? If so, at what facility was this done?
• What medications are you currently taking, including herbal supplements? Please have a list of all current medications and dosages available.
• Do you have any allergies or reactions to drugs, foods, or the environment? What reaction do you have?
• Have you or any member of your family had any problems with anesthesia, or been told that they should be tested for malignant hyperthermia?

You can expect to hear from us by telephone approximately two weeks prior to your scheduled surgery date. If we miss reaching you, please call us back at 603.228.7211 and let us know the best time and way to reach you in advance of your scheduled surgery date. At the time of this call, we will review your medical history and preoperative instructions and ensure you are medically cleared for surgery in a timely manner.

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What should I do beforehand to prepare for my surgery?

You will want to be physically and mentally prepared for surgery. Here are some recommendations to consider.

• Prepare your home for your post-surgical experience. If you will be on crutches, be sure you have a clear path to get around. If your bedroom is upstairs, you may want to consider relocating to the first floor for a day or two. You may want to relocate scatter rugs that may cause a tripping hazard when using crutches.
• Have your rest area prepared ahead of time. You may want extra pillows, books or magazines and the TV remote to be close on hand.
• Stock up on ice. We will provide you with a refillable ice pack. It is helpful to have ice available to refill this. Some patients also find it helpful to use a bag of frozen vegetables, such as peas, instead of an ice pack.
• You may feel great the first and second day post-operatively. Do not take this as a sign that everything is okay and you can return to normal activity. It is common for patients to think everything is back to normal and they can resume normal activity. Avoid the temptation and don’t over-do!
• It may be helpful to prepare meals ahead of time so they can be easily heated after surgery.
• The length of time you will be out of work or school varies based on the surgical procedure. This is something you may want to discuss with your surgeon prior to surgery.
• If you are having leg surgery, you may need crutches postoperatively. If you do not own crutches, they are available for purchase or rental at pharmacies or Hannaford grocery stores.
• If you are having shoulder surgery, it is best to have oversized button down shirts that will be easier to get in and out of.
• For your safety, we strongly recommend that you have someone available to stay with you the first night after surgery.

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What kind of anesthesia will I have?
Prior to the surgery, your surgeon will determine if the procedure can be performed with our without anesthesia. Based on this determination, on the day of surgery, the anesthesiologist will meet with you to discuss the different anesthesia choices available to you. The type of anesthesia recommended will be based on the type of procedure being performed, what part of the body is being operated on, the need for post-operative pain management, and your preferences or medical history.

There are five different types of anesthesia that can be administered at the Orthopaedic Surgery Center.

1. General Anesthesia: The patient loses consciousness and is unaware of their surroundings. This is accomplished by administering intravenous medications and/or inhalation of anesthetic gases.
2. Spinal Anesthesia: The anesthesiologist injects the anesthetic agents into the spinal area of the lower back. The lower extremities temporarily lose all sensation. The patient maintains awareness during the procedure. The anesthesiologist may also administer medications to relax you during the procedure.
3. Epidural Anesthesia: The anesthesiologist injects the anesthetic agents through a catheter in the epidural space of the lower back. Generally, epidurals are used for longer surgical procedures and are less commonly performed in the Orthopaedic Surgery Center. The patient maintains awareness during the procedure. The anesthesiologist may also administer medications to relax you during the procedure.
4. Nerve Blocks: This is accomplished by injecting a local anesthetic into or around the nerves that supply the surgical area. They are used to treat pain during and after the surgical procedure and are performed prior to surgery. Nerve blocks can last up to 24 hours post operatively, thereby assisting in pain control after your procedure. Nerve blocks are often combined with general anesthesia.
5. Local Anesthesia: For patients having their procedure with local anesthesia, the surgeon will inject an anesthetic into the operative site. The anesthetic will last for a few hours following the procedure. No sedation is administered and the anesthesiologist is not involved.

Anyone having anesthesia MUST have someone available to drive them home after their procedure. Although patients having strict local anesthesia can drive themselves home, it is best if you have someone accompany you to drive you home.

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What do I do the morning of my procedure?

If you are having a surgical procedure with anesthesia, do not eat or drink anything the morning of surgery. The only exception to this is if you have been instructed to take your daily morning medications. The nurse will review this with you during your pre-surgery testing appointment or telephone call. Nothing to eat or drink means no coffee, tea, water, gum, chewing tobacco or mints. Not following your preoperative instructions can cause your surgery to be canceled. Other considerations are:

• Brush your teeth as you normally would, but do not swallow any water.
• Do not wear nail polish or makeup
• Remove all jewelry. A plain wedding band can remain on provided you are not having hand or arm surgery on that extremity.
• Please wear comfortable loose fitting clothing. If you are having shoulder surgery, you should bring an extra-large front-buttoning shirt to wear afterwards. Sweat pants or shorts work well for surgery on your leg or foot.
• If you are having leg or foot surgery, please bring crutches with you and wear sensible shoes to facilitate crutch walking. We discourage flip-flops.

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Do I take my morning medications?
You will review your current medications with the nurse during your pre-surgery testing appointment or telephone call. The nurse will advise you as to what medications to take the morning of surgery. You may be instructed to bring your medications with you to the facility. If you normally carry an inhaler for your asthma, you must bring this with you.

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My child is having surgery. Is there anything special I should do?
Children require some extra tender loving care and attention. It is especially important that you monitor your child to ensure they do not eat or drink anything the morning of surgery. Also remember:

• A parent or guardian must accompany anyone under 18 years of age. A parent will need to sign the appropriate consent forms. This cannot be delegated to a relative. We require the parent or guardian to stay at the center while the child is having surgery.
• For young children having surgery first thing in the morning, it is best to bring them to the center still in their pajamas.
• For school-age children, we recommend they bring a Game Boy, Nintendo or iPod or iTouch to help distract them before surgery. We encourage young children to bring their favorite stuffed animal or blanket for security. If your child will have a cast put on after surgery, we encourage the child to think of what color they would like that cast to be. They will be able to choose the color beforehand.

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What do I bring with me on the day of my procedure?
Keep in mind that you’ll want to prepare ahead for your surgical procedure. On that day of the procedure:

• Bring crutches, if you are having leg or foot surgery. If you do not own crutches, they are available for rental at pharmacies or Hannaford grocery stores.
• Anyone having anesthesia MUST have someone available to drive them home after their procedure. Although patients having strict local anesthesia can drive themselves home, it is best if you have someone accompany you to drive you home.
• Bring a picture identification, such as a driver's license, your health insurance card and enough money to obtain your prescriptions after surgery.

Plan to leave your money with the person who has accompanied you to drive you home. This person can also be helpful to you in getting your prescription filled while you are having your procedure done. We find, and patients agree, going directly home after being discharged, without having to make a stop along the way, is more desirable.

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When should I arrive?
When you speak with the nurse to review your medical history, you will be given an arrival time. You will receive a phone call the day before your procedure confirming your arrival time for the next day.

Please be sure we have a telephone number where we can reach you the day before surgery. It is also important we know how to reach you the day of surgery. Unforeseen circumstances may necessitate your arrival time being changed to an earlier or later time.

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Where should I go?
The Orthopaedic Surgery Center/Concord is located downstairs in the Concord Orthopaedic building at 264 Pleasant Street, Concord. Once you enter the building, please take the elevators directly to your right or the stairs directly to your left and proceed to the lower level. As you enter the Orthopaedic Surgery Center, you will check in at the Reception desk.

The Orthopaedic Surgery Center/Derry is located at 14 Tsienneto Road, Derry. The Orthopaedic Surgery Center is located immediately to your left as you enter the building.

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Where can my family and friends wait for me?
Both centers have waiting room or atrium areas for your loved ones comfort. In Concord there is a café open to the public from 7:15 AM to 3:00 PM offering light refreshments. Family members can also visit the Karner Blue Café located on the first floor of the Concord Hospital Main Entrance or the Concord Hospital Cafeteria located on the 3rd floor.

At this time, there are no vending services available in our Derry facility.

Complimentary pagers are available so family and friends can leave the facility and visit several coffee shops in the area, if they choose to do so.

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How do I fill any prescriptions as a result of the surgery?
You can use any pharmacy to have prescriptions filled including The Prescription Center which is located on the Concord Hospital campus. It can be helpful to have the person who is accompanying you fill any prescriptions during your surgical procedure time so that upon being discharged you can go directly home.

In Derry, there are pharmacies located in close proximity to the Orthopaedic Surgery Center.

We will ask for a telephone number or cell phone number for the person who is accompanying you should we need to call them and let them know you are ready for discharge. As a reminder, if the patient having surgery is under the age of 18, we require the parent or guardian to stay at the center while the surgery is being performed.

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What if I need crutches?
The Orthopaedic Surgery Center does not supply crutches. If you will require crutches postoperatively, they are available for purchase or rental at pharmacies or Hannaford grocery stores.

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Will my surgeon talk to a family member after my surgical procedure?
Surgeons talk to family members after the procedure. If your family or loved one plans on leaving the facility during your surgical procedure, we can provide them with a beeper or have them leave a phone number so that we can contact them when your surgery is complete.

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Are there public telephones?
In Concord, there is a courtesy telephone located in our lobby, on the main floor behind the elevators. In Derry, ask the receptionist to assist you.

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Is there WiFi service available?
WiFi is available at both locations.

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What if I have an open wound or skin irritation on the extremity I’m having surgery on?
If you experience an injury, a rash, poison ivy or have an open wound on the area or extremity where you are to have surgery, please call the center to discuss this with a nurse prior to the day of surgery. In some cases, the surgeon may want to see you prior to the day of surgery.

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When will I receive discharge instructions?
Each physician has specific discharge instructions pertinent to the type of surgery performed. These will be reviewed after surgery with you and the person caring for you when you are discharged home.

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