Preoperative and Postoperative Instructions

Preparing For Surgery

  • STOP SMOKING: Smoking reduces circulation to the skin and impedes healing. It is best to avoid smoking, secondhand smoke, and cigarette replacements such as nicotine patches or gum in the peri-operative period. You should ideally stop smoking for 4 weeks before surgery and you should remain smoke-free during the recovery period. Please tell Dr. Hughes of any smoking history well in advance of surgery.
  • MULTIVITAMIN AND VITAMIN C ARE OK TO TAKE.
  • OTHER SUPPLEMENTS SHOULD BE STOPPED 1 TO 2 WEEKS PRIOR TO SURGERY
  • DO NOT TAKE ASPIRIN OR IBUPROFEN: Stop taking medications containing aspirin or ibuprofen at least 4 weeks prior to surgery. Review the list of drugs containing aspirin and ibuprofen carefully. Such drugs can cause bleeding problems during and after surgery. Instead, use medications containing acetaminophen (such as Tylenol).
  • AVOID VITAMIN E
  • IMPORTANT : IF YOU TAKE ESTROGEN CONTAINING BIRTH CONTROL OR HORMONES, THESE MEDICATIONS SHOULD BE DISCONTINUED FOR 1 MONTH PRIOR TO SURGERY AND FOR 1 MONTH AFTER SURGERY. THIS WILL REDUCE THE RISK OF BLOOD CLOTS.
  • CONFIRM SURGERY TIME: We will call you to confirm the time of your surgery. If you have not received a phone call the day before surgery, please call us to confirm at (310) 275-4170.
  • PRESCRIPTIONS: Make sure that you have FILLED ALL OF THE PRESCRIPTIONS and BRING THOSE MEDICATIONS WITH YOU TO THE SURGERY CENTER. Have the number for your pharmacy ready so that if Dr. Hughes and associates need to call in any special medications for you on your day of surgery, they will have that information readily available.
  • CLEANSING: The night before surgery, shower and wash the surgical areas with an antibacterial soap.
  • EATING AND DRINKING: Do not eat or drink anything after 12:00 midnight except for a small amount of water to rinse your mouth while brushing your teeth.
  • SPECIAL INFORMATION: If you take a daily medication, you may take it with a sip of water in the early morning.
  • ORAL HYGIENE: You may brush your teeth, but do not swallow the water.
  • MAKE-UP: Please do not apply moisturizers, creams, lotions, or makeup.
  • CLOTHING: Wear only loose-fitting clothing that does not go over your head. DO NOT WEAR TIGHT PANTS. Remove hairpins, wigs, and jewelry. Please do not bring valuables with you.
  • IMPORTANT : TAKE OUT ALL PIERCINGS and REMOVE ALL ARTIFICIAL FINGERNAILS AND ARTIFICIAL EYELASHES PRIOR TO SURGERY.
  • CHECK IN/PREPARATION: You should plan to arrive ABOUT 1 HR PRIOR TO THE SCHEDULED SURGERY TIME. DO NOT BE LATE.
  • CARETAKER: YOU MUST HAVE A RESPONSIBLE ADULT TO TAKE YOU FROM THE SURGERY CENTER AFTER SURGERY. SOMEONE SHOULD BE WITH YOU FOR THE FIRST 24 HOURS OR SO AFTER SURGERY. NURSES CAN BE PROVIDED FOR PATIENTS REQUIRING A NURSE OR FOR THOSE PATIENTS FROM OUT OF TOWN.

Post-op Instructions

Activity

  • The first week, you will need to rest frequently. You need to walk around the house as tolerated every 1 to 2 hours to help circulation and reduce the risk for blood clots. Avoid stairs.
  • There is to be no exercise or strenuous activity or bending/twisting motions for 6 weeks.
  • Avoid picking anything up greater than 15 lbs for the first 4 to 6 weeks.
  • You may not drive the first week or while you are taking pain medication.

Diet

  • Eat light for the first 24 hours. You may advance to a regular diet as tolerated.
  • Patients are instructed to eat 100 grams of protein each day. Premier Protein shakes contain 30 grams of protein and only 160 calories. 3 shakes a day with balanced meals should be sufficient to meet these requirements. Protein intake is essential to prevent healing complications like incisions opening and you must follow these instructions.
  • If you have persistent nausea, stick to a bland diet until it subsides.
  • The pain medicine may cause constipation. Drink plenty of fluids. You may take any over-the-counter laxatives or stool softeners as needed.

Medications to Avoid Before and After Surgery

Common Medications

  • Aspirin (Anacin, Ascriptin, Bayer, Bufferin, Ecotrin, Excedrin)
  • Choline and magnesium salicylates (CMT, Tricosal, Trilisate)
  • Choline saliclate (Arthropan)
  • Celecoxib (Celebrex)
  • Diclofenac potassium (Cataflam)
  • Diclofenac sodium (Voltaren, Voltaren XR)
  • Diclofenac sodium with misoprostol (Arthrotec)
  • Diflunisal (Dolobid)
  • Etodolac (Lodine, Lodine XL)
  • Fenoprofen calcium (Nalfon)
  • Flurbiprofen (Ansaid)
  • Ibuprofen (Advil, Motrin, Motrin IB, Nuprin)
  • Indomethacin (Indocin, Indocin SR)
  • Ketoprofen (Actron, Orudis, Orudis KT, Oruvail)
  • Magnesium salicylate (Arthritab, Bayer Select, Doan’s Pills, Magan, Mobidin, Mobogesic)
  • Meclofenamate sodium (Meclomen)
  • Mefenamic acid (Ponstel)
  • Meloxicam (Mobic)
  • Nabumetone (Relafen)
  • Naproxen (Naprosyn, Naprelan)
  • Naproxen sodium (Aleve, Anaprox)
  • Oxaprozin (Daypro)
  • Piroxicam (Feldene)
  • Rofecoxib (Vioxx)
  • Salsalate (Amigesic, Anaflex 750, Disalcid, Marthritic, Mono-Gesic, Salflex, Salsitab)
  • Sodium salicylate (various generics)
  • Sulindac (Clinoril)
  • Tolmetin sodium (Tolectin)
  • Valdecoxib (Bextra)

Herbal Supplements

  • Echinacea
  • Ephedra
  • Feverfew
  • Fish Oil
  • Garlic
  • Ginko Biloba
  • Ginger
  • Green Tea
  • Kava Kava
  • St. John’s Wort
  • Valerian
  • Vitamin E
  • Vitamin C (large doses)

Birth Control

  • Birth Control
  • Birth control pills
  • Estrogen replacement
  • Estrogen creams or patches
  • Blood Thinners
  • Coumadin
  • Warfarin sodium
  • Ximlagatran
  • Clopidogrel
  • Plavix