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Preparing for your procedure

 

One week before surgery

Prescriptions for pain and sleep will be given to you at your pre-operative visit in our office.  Please have them filled at your pharmacy prior to your surgery.

Arrange transportation home from the surgery center since you must be discharged to someone you know.

Arrange for transportation to our office the next day – typically to arrive  between 9 and 10 a.m.  You will be here for at least two hours.  At this time we will change your dressing, evaluate your pain level, x-rays/MRI will be taken if ordered, and you will see one of our physical therapists.

Arrange physical therapy appointments at our office or at a therapy office near your home/work.  We encourage you to arrange for three times a week for six weeks and then a strengthening program with our strength coach until you are fitter, stronger, and faster than you were before your injury.

Day before surgery

San Francisco Surgery Center’s Pre-Operative Nurse will phone you the day before your surgery.  If you do not hear from them by 3:00 p.m., please call the surgery center at 415-393-9600.    

Do not eat or drink anything after midnight the night before surgery.  This includes water, gum or candy.  If you do so, your surgery will be cancelled.

Morning of surgery

Please shower with an antibacterial soap, such as Dial, the morning of your surgery.

Please bring or wear baggy sweat pants or shorts for knee/ankle surgery OR a loose open front shirt for shoulder surgery.  This is to accommodate the large dressing and/or brace.  It is also helpful with shoulder surgeries to wear elastic waist band pants.

You should take any blood pressure medications the morning of surgery with only a sip of water, if normally taken at that time.  If you are a diabetic patient, please call the surgery center for instructions.

Please remember that someone you know must bring you home from the surgery center; however, there is limited space in the waiting area for family and friends.

Items to bring with you to the surgery center on the morning of your surgery

Crutches, ice machine, or brace if you have them.

A book or something to read in case they are running late.

Your insurance card and driver's license.

Glasses / contacts if needed for the sign-in forms at the surgery center.  

A case to put your contacts into during surgery. Patients who have general anesthesia cannot wear their contacts during surgery.  This is to prevent a corneal abrasion.  Please discuss this with your anesthesiologist if you have any concerns.

Do not wear jewelry or bring any valuables to the surgery center.

Items to purchase at the store

81 mg Baby Aspirin – take one tablet daily for TEN days OR UNTIL ACTIVE starting the day AFTER surgery. This is to prevent blood clots and is VERY IMPORTANT. Highest risk is 5 – 7 days after surgery.

Stomach Protectants: Over-the-counter Pepcid, Zantac, and Axid to inhibit acid secretion and protect your stomach.  Please take this for 1 – 2 weeks following your surgery or as long as you are taking NSAIDs regularly.

Large bandages – You will need approximately 30 bandages for the 2 weeks following your surgery to change your dressing at home.

Ice – for the ice machine.

Metamucil or Colace – over-the-counter medications for constipation.  Some patients may experience constipation from the anesthesia, pain medications, and decrease in activity.

Saltine Crackers, Ginger Ale, Coca Cola, or Root Beer – as needed for nausea.

Backpack – if you will be on crutches for any length of time.

Information on medications

Tylenol (acetaminophen): This can be an excellent pain reliever. We recommend 2 Extra Strength (500mg) tablets every 6 hours.  It will not make you tired nor nauseated.  Take it every morning as a first approach to address your pain, then other medications if there is not enough pain relief.  You should not exceed 4,000 mg per day (or 8 Extra Strength tablets).

Ketorolac (Toradol): This is a very strong and effective pain reliever and anti-inflammatory. Ketorolac is non-narcotic and it does not make you tired or nauseated.  It can be given by injection or can be drunk by mixing it in juice, every 12 hours.  Rarely, however, it can cause kidney failure and thus we use it for only 5 days.  Take with an over-the-counter antacid such as Pepcid, Zantac, or Tums.

Norco aka Vicodin (hydrocodone): This is a narcotic pain medication with 325mg of Tylenol in it.  It is strong and effective.  Take 1 or 2 only if the pain is not controlled with Tylenol alone, every 4-6 hours.  It makes most people tired and sometimes nauseated as well. It takes approximately an hour to take effect.

Ambien: This is prescriptive sleep medication.  Take one the night before surgery if needed to help get a good night’s sleep.  Use it the first week after surgery if you are having trouble sleeping.

Aspirin: Please take one 81 mg  baby aspirin a day for 10 days or until you are fully weight bearing.  Most people over 50 should probably take one for life as it diminishes the chance of a heart attack or a blood clot.

Glucosamine: 1500 mg each day helps lubricate the tissues and joints and helps in tissue and cartilage repair.
Non Steroidal Anti-inflammatory Drugs (NSAIDs):  Ibuprofen (Advil and Motrin), and Naprosyn (Aleve) are some of the anti-inflammatories that help with pain and inflammation.  They may inhibit bone and cartilage healing and may upset some people’s stomachs.  Use them sparingly if you find them effective.

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