Prepping for Pre-op and Post-op

Your cancer specialist has determined that surgery is the next step in your cancer journey. Depending on your type of cancer, it may be a simple and minor surgery, a complex and major surgery, or something in between. This article will discuss some things to do to prepare for your upcoming surgery.

Pre-admitting call from the hospital or surgery center:

Often you will get a phone call a day or so before your surgery from the facility where you will be having your surgery. They want to make sure that all the necessary information has been collected and that you have all the pertinent information to make your surgery as least stressful as possible. Some things to have on hand when they call are:

Your updated medication list. Include any prescription and over-the-counter meds you take as well as recreational drugs. This is important information for your anesthesiologist and your surgeon. This is also a time that you may be informed of any changes you need to make in your medication regimen before your surgery day.

Your medical history as well as any surgeries you have had in the past.

Any anesthesia or sedation reaction you have had in the past so these complications can be avoided.

Family history of malignant hyperthermia. This is a rare anesthesia reaction that can afflict some family members. Malignant hyperthermia is a severe reaction to certain anesthesia medications that can cause a  very high body temperature, very rapid heart rate, rigid muscles, and a few more symptoms. This condition is a true emergency that must be treated immediately.

If a family member has had this reaction, it is imperative to notify blood relatives of that person about this reaction because malignant hyperthermia can affect other blood relatives. If this condition runs in your family, your anesthesiologist will use a medication that does not trigger this reaction.

Social history including smoking, alcohol, and drug use history. Avoid all these the day before surgery and as directed by your surgeon which may be a longer period so as not to interfere with anesthesia, etc.

Confirm your insurance coverage:

Before your surgery, call your insurance company to find out some very important information about what is covered and how much you will owe to avoid any surprises when the bill comes.

Before you call the insurance company, get these details from your surgeon’s scheduling coordinator including:

Name of the surgery, CPT codes, and ICD codes. Just telling your insurance company the name of the surgery is not enough information. The CPT and ICD codes tell the insurance company exactly what surgery you are having done.

For instance, if you are having surgery for breast cancer, will you be having surgery on one or both breasts? Will you be having any reconstruction at the time of the surgery? All this information and more is what these codes tell the insurance company. With this information, your insurance provider can give you more complete information about what to expect on your bill.

Confirm your deductible with your insurance provider.

Ask what your co-pay amount will be.

If you have two insurances, the primary insurance will pay their portion first. After that, the remaining balance is sent to the second insurance to get their portion paid. Any amount left over is the out-of-pocket expense you will be required to pay. Many factors determine what your co-pay amount will be including:

How much the primary and secondary insurances each pay

How much your out-of-pocket cap is for the year.

How much of that co-pay amount you have paid for other treatments already performed for that year.

And a few more considerations such as if your provider gives you any discounts like a professional courtesy for example.

Your surgery center/hospital may require you to pay all or a portion of your out-of-pocket expense before the surgery. Call the facility to find out how much you should expect to pay.

Besides the fee for the facility where your surgery will be performed, there will also be fees to pay to the surgeon, the surgical assistant if your surgeon uses one, the anesthesiologist’s fee, and possibly some other fees like to the radiologist who reads your x-ray if you have any done during your surgery.

Notify your support team of your upcoming surgery:

You will need some additional help the first few days after your surgery. Your support team will be very important then.

Let them know the date, time, and location of your surgery

If you are going home the same day of your surgery, make sure you have someone to drive you home and stay with you for the length of time you are instructed. Anesthesiologists will not do the surgery if you don’t have someone to care for you afterward. It is too dangerous for you if you should become dizzy or ill and require immediate assistance, and they will not put their medical license on the line.

If you don’t have anyone to stay with you, let your surgeon know and see what arrangements can be made.

If you will be admitted to the hospital after your surgery, designate one person to be the spokesperson who will give others an update on your progress. This decreases the number of phone calls made to the nursing unit by several concerned family members to check on your status. At some hospitals, the nurse will call and give an update at a predetermined time. This is helpful for two reasons. 1. Your family member will know what time to expect the call and can be prepared with any questions they may have. 2. Your spokesperson can have any other family member present at the time of the call who wants to get the update. Just put the phone on speaker and everyone present can get the same information. This also cuts down on the number of calls your designated contact person must make to update all your concerned friends and family members.

Immediately after surgery, you may not feel like preparing meals, or you might have restrictions on your activity which will make it difficult to prepare meals. For this reason, have several days of meals planned out before going in for surgery. If you will be preparing your own food, plan for simple meals until you know how much you can do in the immediate post-op period. If folks will be bringing food in, make sure everyone is on the same page about who should bring meals on which day. Better yet, let someone from your support team handle these details.

Also, after surgery, you may need extra help with the housework. This can be difficult to ask for and to receive. Remember, your main job is to follow your surgeon’s instructions on how to best recover from surgery and heavy housework is usually not something you can do for a while after your surgery. Let your supporters support you.

Some other areas where you may need help are:

Childcare

Pet care

Someone to help if you are a caregiver to someone else

Even some simple, yet often overlooked tasks like taking the garbage can to the curb for trash collection, bringing in the mail if you must go to a common bank of mailboxes to get your mail, or even being available to receive packages, especially if they are heavy or bulky.

Follow pre-op instructions from your surgeon:

Read any material your surgeon’s office gives you before surgery, whether it is written information they give you at the office or any emails they may send you.

Some general pre-op instructions you need to have clarified include:

Do you need to stop your blood thinners? If so, how long before surgery should you stop taking them?

Do you need to stop any other medications or supplements such as herbs or diet pills? At the hospital where I work, patients must stop taking any diet medication that contains the ingredient phentermine for a week before their surgery, and herbal supplements for at least five days before surgery.

Do not stop essential medication like blood pressure medication unless you are specifically told to do so. Just stopping everything to be on the safe side does not put you on the safe side if you stop taking something vital and it may delay your surgery.

Be sure you are clear on any pre-op preparations. Does your surgery require bowel prep? Do you need to apply medical ointment in your nostrils for several days before surgery? Are there certain foods you need to avoid?

What are your bathing instructions before surgery? Do you need to take showers with a medicated soap to help get all the bacteria off your skin which will help reduce the chance of infection? If you are unable to shower, do you have supplies to clean up as prescribed without showering?

Let your surgeon’s office know if you come into contact with anyone who has a contagious illness. Also, let them know if you develop any symptoms of your own like a fever or vomiting before the day of your surgery.

Prepare for your homegoing before you even go to the hospital/surgery center

Make sure you have clean sheets on your bed. This will help decrease the chance of bacteria getting into any surgical wounds you may have.

Will you be able to lie down after surgery, or will you need to make other arrangements? If a chair, such as a recliner will be more comfortable, do you have one or will you need to borrow/rent one?

Do you have groceries on hand? Or do you have a meal delivery service set up?

Will you be having a guest stay with you to help care for you? If so, do you have a place prepared for them to stay?

Will you need to take any medication after surgery that you can get from the pharmacy ahead of time?

And lastly, some things you may not have thought about:

Put a small pillow in your car that you can put between you and the seatbelt if you are having surgery on your frontside, or one you use to prop up a limb if that is what you are having surgery on.

Which vehicle will you be going home in? Can you easily get into that vehicle? If it is a high vehicle, do you need to take a step with you to make it easier to get into the vehicle?

Perhaps you should sit in the back seat, if you have one, to avoid the airbag should you get into an accident on the way home.

Do you have pets at home? You will not want them to jump on you while you are still tender from surgery. Do you have some way to prevent them from doing this? When my husband had open heart surgery, his friend built a “cage” around his recliner so the dogs could not jump up on him, yet he was able to reach down and pet them.

How long will your trip home from the hospital be? If it is a long drive, do you need to have some drinks and snacks available? Do you have something available in case you get sick on the way home? If you are traveling in the winter, do you need to put extra blankets in the car in case you have car trouble on the way home?

Will you need any ambulatory aids to help you get into the house such as crutches or a walker?

Do you have steps to get into your house or stairs inside the house? Will you be able to manage these after surgery? Do you need to have a ramp built for the outside steps, or a chair lift system for inside the house?

Will you have any different bathroom needs to consider? It can be difficult to get on and off the toilet immediately after surgery. Do you need a raised toilet seat to help with this?

Something to think about is the amount of effort it takes to stand up from the toilet. One way to make this easier if you do not have grab bars installed in your bathroom is to turn a walker around backward and place it over the commode. This gives you a set of handles to help push yourself up on.

These are just some things to consider and plan for before your surgery day. Remember, these are only suggestions. Follow your surgeon’s instructions closely. If you do not understand any of their instructions, call their office to get your questions answered.

As a recap, we have discussed:

How to prepare for a pre-op call from your surgery facility.

Call your insurance company to find out how much you will need to pay for your surgery. Also, make sure all participants in your surgery are covered by your insurance plan.

Notify your support team of your upcoming surgery so they can make plans to help you.

Follow all pre-op instructions from your surgeon.

Think about any needs you will need after surgery before you go in. Ask your support team for help with these needs.

And finally, try to think of anything you will need after your surgery before you have surgery. When I had foot surgery, I knew I would not be able to stand on my foot for several weeks, so I practiced going up and down the stairs before I had surgery.

It is no fun having surgery, but I hope this article has helped you and your loved ones be better prepared for your upcoming surgery.

Wishing you all the best,

Kelly

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Yes, I am a nurse. No, I am not your nurse. The medical topics discussed in this, or any article on this site, are intended to be issues for you to discuss with your medical team if you feel they apply to you. None of the information you are about to read in this article is treatment advice for you from me. I do not have that authority.