Surgical Candidates- General Information Regarding Your Surgery

SURGERY PREOPERATIVE INFORMATION

1 Week Prior to Your Surgery

• You will receive a surgical packet when you schedule you procedure that will include specific information regarding your procedure.
• PREOPERATIVE TESTING & MEDICAL CLEARANCE
        Hospital for Special Surgery
              Preoperative testing only needs to be done if you have a major medical condition, are
              over the age of 40 or are scheduled as an inpatient ..
              Our office will advise you if require such and schedule the appointments for you or give
              you a prescription for the necessary tests.
             HSS requires all labs and medical clearances to be done within 10 days of your procedure.
      New York Presbyterian Hospital - Weill Cornell Medical Center
            You will be scheduled for preoperative testing with Dr. Kelly 1 to 2 weeks prior to your procedure.
• 5-7 Days before your surgery, stop taking aspirin, or anything that contains aspirin or like medications. (Aleve, Advil, Motrin, Ibuprofen, V oltaren, Naprosyn, Feldene, Celebrex, Vioxx, etc) and nutritional supplements such as Vitamin E, Ginseng, Ginko, Biloba, Garlic & Ginger.
• If the patient is 18 and younger, they may require an immunization record, so please be advised that this document maybe requested on the day of surgery.
• All necessary durable medical equipment will be ordered for you and delivered to the hospital.

1 Day Before Your Surgery

• You will be notified the day before surgery of when and where to go the day of your procedure. If your procedure is scheduled for a Monday, you will be notified on Friday.
• Please do not eat or drink after midnight the day before your surgery. You are required to have an empty stomach the day of surgery or your procedure will be postponed or cancelled.
    If you have to take medication the morning of your procedure, please do so with only a sip of water. Please contact our office with questions regarding which medications are acceptable to take.

Day of Surgery

• Leave all valuables & jewelry at home.
• Please arrange to have a responsible adult escort you home after surgery.
• Do not wear your contact lenses on the day of surgery.
• Dress in comfortable and loose fitting clothing that are easy to put on and take off.
• You may be instructed to bring with you all of your medications in the original containers.
• You will be told to arrive at
  
  HOSPITAL FOR SPECIAL SURGERY
  535 EAST 70TH STREET
  BETWEEN YORK AVENUE & THE FDR DRIVE ADMITTING OFFICE
  
  Or
  
  NEW YORK PRESBYTERIAN HOSPITAL
  525 EAST 68TH STREET
  BETWEEN YORK AVENUE & THE FDR DRIVE ADMITTING OFFICE

Post Surgery

. Your post-operative appointment should be scheduled 10 to 14 days post surgery to remove sutures unless otherwise directed.
. Physical therapy appointments are extremely important to your rehabilitation and success. Please keep all your appointments and follow the protocols given.

Anesthesia

There are two options for anesthesia: General or Regional. We prefer the use of a spinal (regional), as it allows for pain control immediately post op, and tends to minimize anesthetic side effects including, but not limited to, nausea, vomiting, corneal abrasions, etc. Some patients that have spine pathology, or bleeding disorders may not be candidates for the regional block. In this case, general anesthesia will be used.

Spinal vs. Epidural:

In the majority of cases, a spinal block is sufficient as opposed to an epidural. The two blocks differ in the location of the medication into the spine and an epidural is convenient for long cases, where the anesthesiologist can continually dose, according to the time. A spinal block is typically adequate for our procedure as surgical time is usually always under three hours. The anesthesiologist will speak with each patient prior to the procedure to go over the pros and cons. Ultimately, the decision is made by the patient.
One of the most frequently asked questions is, "Will I be awake for the procedure if! use a spinal?" This decision is also made by the patient. Prior to the block, the patient is sedated so they feel very sleepy and unaware of the injection. In most cases, the patient prefers to sleep during the procedure, so after the regional block is completed, additional sedation will be given so the patient can sleep during the surgery. This should also be discussed with the anesthesiologist the day of surgery.

Length of Stay

Most of the surgeries that Dr. Kelly performs are outpatient procedures and require minimal time in the hospital on the day of surgery. Depending on your health and/or procedure you may require an inpatient observation stay. This will be discussed with you on the day of your preoperative appointment or noted in your surgery packet.

Post Surgery Precautions

Call Dr. Kelly's office immediately (212-606-1159) if you experience any of the following:
. Fever of 1 00.5°F persists after 1 week or is much higher during the 1 st
week after your procedure.
. Progressively increasing pain
. Excessive bleeding
. Reddened or painful calf
. Persistent nausea and vomiting
. Excessive dizziness
. Persistent headache
. Your anesthesia injection site is inflamed, reddened, swollen or oozes blood or fluid.

General Information After Your Surgery

. You will be advised of when you can begin driving depending on your procedure.
. Physical therapy should begin immediately following your surgery (day or two after) and continued as prescribed, unless directed otherwise.
. You may return to work/school when you are comfortable, usually 5-7 days post surgery depending on your working conditions. Some patients take up to 6 weeks off of work.
. Wear the prescribed sling, brace and/or use crutches as prescribed by Dr.
Kelly until you are notified by him or your physical therapist that you may do without.

Click here for patient info handouts for Post- Operative instructions.