Surgery: What to Expect


We look forward to providing you with a personalized experience during what we know can be a stressful time. On the day of your surgery you will travel through different departments that work together to care for you and your family. We are dedicated to making sure your surgery goes as smoothly as possible. The following is what you can expect throughout the process.

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Step 1: Before Surgery

The Surgical Consultation

The purpose of a surgical consultation is to determine whether there is a surgical procedure that can be offered to help you with your current medical condition. When you come in for your surgical consultation, please bring the following with you:

The Surgical Consultation: What to bring

Medications
A list of medications you're currently taking

A list of prior surgeries and any related issues (infection, bleeding, difficulty with anesthesia)
Allergies
A list of known allergies (medications and otherwise)
Questions?
Any questions or concerns that you may have
Feel free to bring a friend or family member for support!

Your surgeon will talk to you about any possible alternatives to surgery and discuss risks and benefits of these choices so you can make an informed decision. Please ask questions and tell us about your concerns. We want you to have enough information to make the best choice.

If you decide to proceed with surgery, we will ask questions to assess your risk of bleeding or clotting, determine whether you have sleep apnea or physical limitations, and learn about your nutritional needs. This information will help us plan your care and meet your personal needs.

Finally, depending on your surgery and individual needs, a Case Manager may contact you by phone to learn about how much support you have at home. To recover well from surgery, you need to have a good support system at home. This is particularly important for getting you home from the hospital as quickly and safely as possible, and it helps reduce your chances of returning unexpectedly after surgery.

While planning for your surgery, we will talk to you about pain management and medication. State law restricts the number of narcotic (opioid) pain pills that can be prescribed, and your surgeon must consider non-prescription medications before prescribing narcotics. A narcotic consent form is now required, which informs you of the risks of taking these drugs. Your primary care provider may also manage your postoperative pain medication in agreement with your surgeon. You may have an anesthetic injection or “block” around the time of surgery to help with pain relief.

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Step 2: Preparing for Surgery

Preparing for your surgery is one of the most important ways you can contribute to your recovery. By following a few basic health suggestions, you can improve your outcome and reduce the risk of surgical complications.

Getting to and from surgery

IMPORTANT - Getting to and from surgery

For your safety, you must have a ride home from the hospital. A taxi or bus is not acceptable unless you will be accompanied by a responsible adult. Your surgery may be cancelled at the last minute if you have not made these travel plans.

Stop Smoking

Stop Smoking

If you smoke up to the time of your surgery, you will have a higher risk of lung problems (such as pneumonia) and your surgical wound may not heal as well. Quit smoking before your surgery to reduce these risks. The UVM Medical Center offers smoking cessation classes to help you quit smoking. You can also work with your Primary Care Provider or contact a Tobacco Treatment Specialist at 802-847-6541. Another resource is the Vermont QUIT network at 1-800-784-8669.

Nutrition

Nutrition

It is important to eat healthy foods before surgery. Tell your doctor if you have trouble eating, have not been very hungry, or lost weight without trying. Supplements such as Ensure, Boost, and others are a good way to improve your nutritional status before a surgical procedure. If you have diabetes, liver, or kidney disease, you may need to avoid certain supplements. Ask your doctor which supplement is best for you.

Exercise

Exercise

Do not reduce your activity levels before surgery. It is important that you remain as active as possible. Consider adding a walking program prior to surgery.

Blood Sugar Control

Blood Sugar Control

If you have problems with blood sugar due to diabetes, work with your primary care provider to control your blood sugar as well as you can before your surgery. This will improve the healing process and reduce the rate of infections and other complications.

Medication

Medications

Your surgeon will tell you whether you need to stop or change any medications. If you have questions about medications, be sure to ask in advance.

Skin Preparation

Skin Preparation

Follow your surgeon’s directions for skin washing and preparation before your surgery.

Fasting

Fasting

In some cases, you may need to fast (not eat for a period of time) before your surgery. Your doctor's office will tell you if you need to fast before your surgery. If so, here are your fasting instructions.

Frequently Asked Questions

How long do I need to quit smoking?

Step 3: Day Before Surgery

Fasting

Fasting

In some cases, you may need to fast (not eat for a period of time) before your surgery. Your doctor's office will tell you if you need to fast before your surgery. If so, here are your fasting instructions.

Medical Devices

Medical Devices

Bring any medical devices that you would normally use during the course of your day. These items include, but are not limited to: insulin pumps, mobility aids and inhalers.

Medication

Taking Medications

You may take a sip of water to aid in swallowing oral medications, however, be careful not to drink more than is necessary. If you have other questions about your medications, contact the Surgical Office.

Skin Preparation

Skin Preparation

Follow your surgeon's directions for skin washing and preparation before your surgery. Taking a bath or shower before your procedure is recommended. Ensure you dress in clean, laundered clothing after bathing.

Getting to and from surgery

Confirm Your Ride To and From Surgery

Make sure your ride to and from surgery is still available and that they are aware of when you need to be dropped off and picked up. Directions are available for the following surgery locations:
Main Campus | Fanny Allen | Tilley Drive

Postoperative care arrangements

For many surgeries, and especially after any that requires anesthesia or sedation, someone may need to be with you for several hours or more when you go home from the hospital. Sometimes your mobility may be impaired and you will need help.

We will give you instructions on how to care for yourself after surgery and what to expect during recovery, including physical and work restrictions. Be sure to ask questions.

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Step 4: Day of Surgery

Where To Go

Registration

Step 1: Registration

This is the beginning of your hospital visit. When you arrive on the day of your surgery, first go to Registration to check in. They will tell you where to go next.

Surgical Waiting Area

Step 2: Surgical Waiting Area

This area is where family members can wait while you are in surgery. Your family will receive a pager so they can leave the waiting area and be notified when to return. The surgeon will meet with your family at the end of surgery.

Surgical Admissions

Step 3: Surgical Admissions

The Surgical Admissions area is where staff will get you ready to go into the operating or procedure room. Here, you will meet with a pre-operative nurse who will update your health history and start an IV (Intravenous fluid). If an IV is needed for a child, the pre-operative nurse and child life specialist will work with you and your child to place the IV. You will see your surgeon and also meet with a member of the anesthesia staff who will discuss your plan for anesthesia.

Prior to surgery, we will check the information on the consent form with you for accuracy.

In the Operating Room

Step 4: In the Operating Room

One of the first things we do when you get to the operating room is to check your identity (name and date of birth) and confirm your procedure. The leader of your surgical team will ask you various questions and will check with all members of the team to ensure everything is ready for your surgery. This is done using checklist, much like the ones airline pilots complete before takeoff.

Step 5: After Surgery

What to Expect

At the UVM Medical Center, our care extends far beyond your surgical procedure. We want to ensure you have a succesful recovery.

Post-Anasthesia Care Unit

Post-Anasthesia Care Unit (PACU) or Intensive Care (ICU)

After surgery you will go to the PACU (post-anesthesia care unit), or to the ICU (intensive care unit). You will be in the PACU until your surgical team, including your anesthesiologist, thinks you are well enough to go home – or until you are moved to a bed in the hospital. They will review how your surgery went and answer any questions you may have.

Family are welcome in the PACU two at a time. The staff will let family know when you are ready to see them. Cell phones are not permitted in the PACU.

Going Home

Going Home

Before you go home, we will make sure you know how to take care of yourself at home and what to expect during recovery. We will explain everything you need to know about taking care of your wound, review your medications with you, and explain which symptoms would require medical attention. Signs of infection will be discussed with you. You will receive a paper summary that provides a person to contact should you have any questions or problems after discharge. Please ask questions at any time.

Please remember, you must arrange for transportation home, and someone to go with you, in most circumstances.

Postoperative Care

Postoperative Care

Your surgeon’s office will plan your postoperative care. Usually you will return for a follow-up appointment, but feel free to telephone or contact your surgeon’s office via MyHealth Online with any questions. Pain control is important to us, but there are restrictions on the use of strong pain medication, and unfortunately, no one can expect to be pain free. Tell your surgeon’s office if you have pain that you feel is not reasonably controlled.

Outcome and Quality Programs

We track outcomes in an effort to keep standards high and continuously improve our quality. We collect information on clinical outcomes, patient experience, safety measures, effectiveness and efficiencies of care. You may receive a phone call from a nurse reviewer to ask you about any problems that may have occurred during your recovery. Any information collected will be kept confidential. Thank you in advance for your honest responses, which help us identify opportunities for improving patient care.

Contact Information & Frequently Asked Questions

Please contact the Pre-operative Office by phone with any questions or concerns. We welcome all feedback as we strive to provide the best service possible for our patients.

Phone: 802-847-5400
Toll Free: 866-526-7567
Fax: 802-847-4706

Office hours are Monday through Friday from 7:00am to 4:30pm. If you call while the office is closed, you can leave a message and will return your call the next day.


Who can bring me home?

Any adult that is willing to assume responsibility for your care between the hospital, and help you get settled once home can transport you for surgery.


Does my driver need to stay during my surgery?

They do not need to stay with you but need to be reachable during the surgery and within a short distance in case there is an emergency or change in status.


I received conflicting information about how to prepare for surgery. What do I do?

Sometimes in spite of our best intentions, patients receive information from the Anesthesia Department that is not exactly the same as what was said by the surgeon or their staff, or even their primary care provider. If there is any confusion about what you should be doing, please contact your surgeon’s office prior to the day of the procedure.


What can I eat and drink?

To avoid a delay, or cancellation of your surgery it is very important that you follow these instructions:

  1. Have no solid food or liquids containing fats, including milk, after midnight before your procedure.
    Note: Breast milk and formula are considered liquids containing fat
  2. On the day of your procedure, you should have only water or other clear liquids until 4 hours before the scheduled time of your procedure. Clear liquids include water, clear fruit juice (apple or cranberry) carbonated beverages, Jell-O, and black or sweetened coffee and tea.
  3. Take your medications as directed with small sips of water at any time prior to your procedure. (If a medication must be taken with something other than clear liquids or sips of water, please call the Preoperative Screening Clinic at (802)847-5400 for guidance.)
  4. Children under 1 year of age may have breast milk up to 4 hours and formula up to 6 hours before their procedure.


What foods and drinks should I avoid?

To avoid a delay, or cancellation of your surgery it is very important that you follow these instructions:

  1. After midnight the night before your surgery maintain clear liquids. Avoid foods with milk products or fat as well.
  2. Four (4) hours prior to your procedure nothing in your mouth including water, gum or hard candies. A sip of water with you medications as instructed is always fine. (If a medication must be taken with something other than clear liquids or sips of water, please call the Preoperative Screening Clinic at (802)847-5400 for guidance.


Can I drink alcohol before my surgery?

You should not drink any alcoholic beverages within 24 hours of surgery. Alcohol can interfere with medications you will be receiving during and after your surgery and can cause dehydration.


Remind me what to do with the medications I am taking?

During your prescreen phone call with the Pre-op Nurse you will receive instructions on what medications to take and stop taking for surgery. Please have your list of medications ready at the time of the call and write down the instructions as you review them for your reference.

On the day of surgery, the Pre-op Nurse will ask you the last time you took each of your medications. It is important to bring this information with you.


Do I need to bring my CPAP machine?

If you use a CPAP machine at home, please bring it with you on the day of surgery. Obstructive Sleep Apnea can worsen due to sedation and pain medications you may receive around the time of your surgery. Your CPAP machine may be used during your recovery period and our hospital equipment specialists will need to evaluate it to make sure it is in good working order.


How long do I need to quit smoking?

If you are a smoker, it is best for you to stop smoking before surgery, the earlier the better. Smokers have an increased chance of complications after surgery, including wound infections, pneumonia, decreased wound healing and heart attacks. If you cannot entirely stop smoking, you should cut down how much you smoke as much as possible, and stop smoking after midnight the night before surgery.


Why am I being asked the same questions again and again?

On the day of your surgery, you will be asked the same questions multiple times by different people. It may appear that your care is not well coordinated and that the people in Registration aren’t communicating with the people in the Pre-Operative area, and those people aren’t communicating with your surgical team. This is not the case.

Your safety is our highest priority and repeated questioning is one of the ways we ensure your safety. We want to make absolutely sure you are who we think you are and that we have you scheduled for the correct procedure. Although repeatedly answering the same questions may be frustrating, we hope you understand that this is a necessary component of keeping you safe.


When will I be able to see my family?

Once you are admitted to the Post Anesthesia Care Unit (PACU) and all immediate care has been provided, your PACU nurse will request your family. This typically occurs within 30-45 minutes.


Who will be on the Surgical Team in the Operating Room?

Your team will include the Circulating Nurse, Scrub Nurse or Surgical Technician, Attending Surgeon, and Attending Anesthesiologist. Working with the surgeon and anesthesiologist may be Advanced Practice Providers such as a Nurse Practitioner, Physician Assistant, Certified Nurse Anesthetist, or Anesthesia Assistant.

As an academic teaching institution we also support various disciplines in their educational journey whether it is a surgical fellow, resident, medical or nursing student.


How will my family be updated while I am in surgery?

Patient Tracking will help your family follow your progress through surgery. Your family will be given a unique patient tracking number that will let them know when you are in the OR, when the procedure has started, and when you arrive in the recovery area. Information can be viewed on monitors in the Surgical Waiting Area or accessed via a website.

Your family will also be given a pager to notify them when your surgeon is available to speak with them about how you are doing and when they are welcomed to see you in the recovery area.


When will I know the results of my tests?

If you are going home the same day of surgery your surgeon will go over all available results at your post-operative appointment. If you are staying in the hospital after surgery your surgeon will up-date you with your results as soon as possible.


Will I see my surgeon in PACU?

Upon the completion of your surgery, your surgeon will update your family or those waiting for you in the surgical waiting room.


When will I go to my room or home?

If you are staying overnight in the hospital you will be moved to your room following a post-anesthesia evaluation.

If you are going home the same day of surgery, you will be discharged once you are recovered from anesthesia, have met all requirements set by your surgeon and anesthesiologist, and your nurse has provided you with your post-operative instructions and prescriptions.


Can I be there when my child wakes up after surgery?

Yes as soon as possible, we call for parents to come to PACU. Most often parents are at the bedside prior to their child waking from anesthesia.