Preparing for your anesthesia and surgery Key considerations before your surgery At Kaiser Permanente Baldwin Park Medical Center, we want your surgery to go smoothly and safely, so we re here to let you know both what to expect and how to prepare. The more you understand about the surgical process, the more you ll be able to work together with your health care team to ensure a successful surgical experience and recovery. Presurgery medical assessment If you have an ongoing condition, such as diabetes or high blood pressure, your surgeon or your anesthesiologist may ask you to get a presurgery medical assessment. Based on this initial assessment, your examining doctor may then ask for more tests to evaluate your medical condition more carefully. Usually, all this can be done without affecting the scheduled surgery date. On occasion, we may need to delay your surgery in order to complete all testing. Medication schedule As you prepare for your surgery, you may need to change your medication schedule according to the following guidelines. If you have any other questions about your medications, ask your surgeon and anesthesiologist. 1. Prescription medications You can continue to take most prescription medications prior to your surgery, but you ll need to skip most of them on the day of your surgery unless otherwise instructed by your anesthesiologist. Your anesthesiologist can provide more specific instructions when you meet. The following medications have specific instructions: a. Blood thinners (for example, Warfarin, Coumadin, aspirin, ibuprofen, naproxen, and vitamins A and E) We usually recommend that you stop taking these medications at least five days prior to your surgery (except in the case of eye surgery). For certain high-risk patients, another medication may be temporarily substituted. Please consult with your pharmacist or personal physician. (continues)
Preparing for your anesthesia and surgery (continued) b. Diabetes medications You should not take your oral diabetes medications on the day of your surgery. Your anesthesiologist will give you specific instructions at your presurgery visit about adjustments to your insulin doses. If you feel that your blood sugar is too low on the day of your surgery, drink small amounts (less than 8 oz.) of apple or cranberry juice until you feel better. Don t drink orange juice. When you check in for surgery, your blood sugar will be checked and medications or an intravenous sugar solution may be administered as needed. c. Blood pressure and heart medications Most blood pressure and heart medications should be taken the morning of your surgery with small sips of water. Please ask your anesthesiologist at your presurgery evaluation for specific instructions. It s important that you remember to take these medications if you re instructed to do so. 2. Herbal medications and nutritional supplements Stop taking all herbal medications and nutritional supplements on the day of your presurgery visit. Do not resume taking them until after your surgery. Such supplements may increase bleeding and interact unfavorably with anesthesia medications. Smoking, alcohol, and drugs We recommend you stop smoking prior to surgery. For assistance quitting smoking, contact our Smoker s Helpline at 1-888-883-STOP (1-888-883-7867). Do not use alcohol at least two weeks prior to surgery unless otherwise instructed by your physician. Do not take illegal drugs. Pre-op education You will receive additional educational information about your specific procedure from your surgeon.
What to do the week before your surgery We understand the time leading up to your surgery can be busy. However, it s important to take care of the following key items the week or so before your surgery. (Talk to your doctor if there is anything here you don t understand.) See your surgeon for your presurgery appointment one day to two weeks before your surgery. We ll schedule the appointment for you, and let you know the date, time, and place of the appointment. Some patients may be given the option of a telephone presurgery evaluation. Please prepare an accurate list of all your medications, including prescriptions, over-the-counter drugs, and vitamins, and bring it to the presurgery appointments with your surgeon and anesthesiologist. You may also bring the actual medication containers with you to these appointments. On the same day as your presurgery appointment with your surgeon, we ll schedule a presurgery appointment with the anesthesiologist. The Anesthesia Pre-op Clinic is located on the second floor of the medical center. During your anesthesia presurgery assessment, lab work related to your surgery will be completed and, if needed, an EKG will be done. If you have a copayment/coinsurance,* it will be collected in the pre-op clinic on the day of your presurgery appointment.. If you are having same-day surgery, arrange for a friend or relative to drive you home. You will not be allowed to drive yourself home after having anesthesia. * If you have any questions about your copayment/coinsurance, call our Member Service Contact Center at 1-800-464-4000 or 1-800-777-1370 (TTY for the deaf, hard of hearing, or speech impaired), 24 hours a day, seven days a week (closed holidays). Disability insurance If you want to apply for state disability insurance, stop by the Insurance Department, located in the first floor rotunda of our Baldwin Park Medical Center, to obtain the necessary paperwork. If you have questions about this process, please call the medical records/disability information line at 626-851-7304, weekdays from 8:30 a.m. to 5 p.m.
What to do the day before your surgery To be fully prepared for your surgery, it is important that you follow these day-before-your-surgery instructions. (Talk to your physician if there is anything here you don t understand.) You will receive a phone call the day before your surgery (or, if your surgery is on a Monday, you will receive a call on Friday) from 3 to 6 p.m. A receptionist will provide you with your surgery check-in time. You can also get this information the day before your surgery by contacting our Surgery Coordination Center at 626-851-6267. We are open weekdays from 5 a.m. to 6:30 p.m. Confirm your transportation arrangements to and from the medical center. Please note that for safety reasons, you will not be allowed to go home after surgery if you do not have a responsible adult to accompany you. Don t eat or drink anything after midnight, including water (unless instructed otherwise by your anesthesiologist or surgeon). If you are the parent or guardian of a child who is having surgery, follow any special instructions the anesthesiologist or surgeon may have provided. Take nighttime medications, if advised to do so by your surgeon or anesthesiologist, with small sips of water. Prepare a list of your current medications, including dosage and frequency, to bring with you to the hospital. Make sure you ve filled any prescriptions that you were given during your presurgery visit. You may wash your hair and bathe. You may brush your teeth on the morning of your surgery. Do not shave the surgical area unless instructed to do so by your surgeon. If you need to cancel your surgery for any reason, call our Surgery Coordination Center at 626-851-6267, weekdays from 5 a.m. to 6:30 p.m. Please leave a message if you are calling between 6:30 p.m. and 5 a.m.
What to do on the day of your surgery Our goal is to make your surgery day a pleasant experience. We would ask that you follow these guidelines to assist us in making your surgery day go as smoothly as possible. Bring your Kaiser Permanente ID card with you to the medical center. Don t eat or drink anything after midnight, unless instructed otherwise by your anesthesiologist or surgeon. Bring your prepared list of current medications. You may brush your teeth, but don t swallow any water, and be sure to rinse thoroughly. Don t wear any jewelry (including body piercings), makeup, body lotion, or hairpins. Dress simply, and wear clothing that can be removed easily. You may bring eyeglasses, dentures, or hearing aids with you to the hospital. Bring a book or magazine to read in case your surgery is delayed. Bring only enough money for your copayment/coinsurance (unless you paid it during your preadmission visit) and for any prescriptions you may need after surgery. Give yourself plenty of time to arrive. Check in for your surgery at the Surgery Coordination Center s check-in desk, which is located to the right of the elevators on the second floor of the hospital building. If your anesthesiologist advises you to take your morning medications, do so with only a small sip of water.
Keeping you safe Your safety is the highest priority of all the doctors and staff at our Baldwin Park Medical Center. Therefore, after you check in for your surgery, we may repeatedly ask you to confirm important information such as your name, any allergies you have, and the procedure you re having done. We do this to help ensure your safety. Your surgery site may be marked with a skin marker by the surgeon as an additional safety precaution. Just prior to your surgery, all members of the surgical team will conduct a final safety briefing to verify critical information.
Your surgical team The following key personnel make up your surgical team and are committed to making your surgery experience a positive one: Your surgeon, and possibly a second surgeon or physician assistant to assist Your anesthesiologist An anesthesia technician A surgical nurse An operating room technician The pre-op and recovery room nurses and staff Many other staff members work together to support your surgical team and help make both your surgery and your surgical experience a success.
Your operating room and recovery room experience After you check in at our Surgery Coordination Center, you will be taken to the Pre-op Holding Center and given an ID bracelet. A nurse will ask you to change into a gown, check your vital signs, and start an intravenous drip in your arm. Your surgeon and anesthesiologist will meet with you before you enter the operating room to go over the anesthetic plan and answer any last-minute questions you may have. After your preoperative work-up is complete, up to two family members are allowed to join you in the holding center. They may remain with you until you leave for the operating room. Shortly before you are moved to the operating room, you will be given medicine that will relax you and make you drowsy. Once you enter the operating room, your surgical team will try to make you feel as comfortable as possible. Your anesthesiologist will administer anesthesia and monitor your vital signs during the entire surgery. After your surgery, you ll be moved to Recovery Room I. The recovery room nurse will take care of you and remain with you at all times. Most patients are fully awake within 30 to 60 minutes after surgery. If you are a same-day patient, once you are fully awake, you will be moved to Recovery Room II, where you can have visitors. Your stay in the recovery rooms may last up to three hours, depending on how soon you are ready to leave. Once you have been moved to Recovery Room II, up to two family members and/or friends may visit with you. If you are scheduled to be admitted to the hospital after surgery (in other words, if your procedure is an inpatient procedure), you will be moved to a patient room where family and friends may visit once you have recovered.
The waiting experience for your family and friends Some of your family members or friends may choose to accompany you on the day of your surgery. The information below may be helpful for them to know ahead of time. When you check in to the Surgery Coordination Center, your family member or friend will be given a flash pager. This will alert him or her of where you are in the surgical process. For refreshments and meals, a vending machine area and the cafeteria are available on the first floor. Cafeteria hours are 7 to 10 a.m. for breakfast, 11 a.m. to 3 p.m. for lunch, and 4 to 7 p.m. for dinner. Vending machines are available 24 hours a day, seven days a week. A gift shop on the first floor is open weekdays from 10 a.m. to 7 p.m. and weekends from 10 a.m. to 6 p.m., for snacks and other shopping. Your friends and family can visit our outdoor THRIVE walking path. Adult patients may not have visitors in Recovery Room I. However, upon arrival in Recovery Room II, family or friends may join you in preparation for discharge. Pediatric patients may be accompanied by parents or legal guardians in the recovery room at the discretion of the recovery room nursing staff. You may want to ask your family member or friend to pick up any prescriptions from the hospital pharmacy on the first floor before you go home. He or she can pick up your prescriptions with your Kaiser Permanente ID card. (continues)
The waiting experience for your family and friends (continued) If they don t meet you in the recovery room, your family members or friends can meet you at the main entrance when you are discharged. The main entrance is located by the information desk in the rotunda. A hospital chaplain is available weekdays from 8 a.m. to 4:30 p.m. and weekends from 9 a.m. to 6:30 p.m.
Returning home Please arrange for someone to drive you home from the medical center. After returning home, you can help your recovery by taking the following steps: Follow your doctor s instructions about the amount of physical activity you should get. Aim to move as much or little as instructed each day. Go to any follow-up appointments your physician has scheduled. Take medications as instructed by your surgeon. Do not smoke and avoid secondhand smoke. If you had outpatient surgery, you will receive a postsurgery call from a nurse within 48 hours to check on your recovery progress. You will be asked about your overall experience, any side effects of anesthesia (such as nausea and vomiting), and pain control. If you experience any problems or have any questions or concerns about your recovery process after returning home, please call our Appointment Call Center at 1-800-780-1277, weekdays from 7 a.m. to 7 p.m., and weekends from 7 a.m. to 1 p.m., to speak with an advice nurse or leave a message for your doctor. We wish you a speedy recovery and ongoing good health.
Member and Marketing Communications 84989 November 2012