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Know what to expect when preparing for surgery

Facing any surgery, whether inpatient or outpatient, can be a daunting prospect. But taking a little time in advance to prepare can make the entire process go smoother and more comfortable for all those involved.

Pre-surgical Evaluation

Prior to your operation, your doctor or surgeon will perform what's known as a pre-surgical evaluation. As part of this, he or she will review your medical history and ask about anything that could affect the outcome of the surgery, including existing medical conditions and allergies.

You may also undergo laboratory tests, particularly if you have other medical conditions or problems. These may include blood tests, an electrocardiogram and a chest X-ray.
If you have doubts about navigating the process of preparing for surgery on your own, consider having someone you trust, such as a spouse, a sibling or a friend, act as your medical advocate. This person can accompany you to doctor's visits, take notes, ask questions and see to it that you receive the care you need in the hospital.

Medications Review

Be sure to provide your doctor or surgeon with a list of all prescription and over-the-counter medications you are taking. This includes over-the-counter products that you might not think are important such as aspirin, dietary supplements and vitamins. Some medications can have a significant affect on your surgery, including how you respond to anesthesia.
Also remember to ask your physician for instructions on which medications to avoid or stop prior to surgery. If he or she directs you to suspend taking certain medications prior to surgery, confirm the dates on which you should stop. Do not stop taking medications you normally use unless you are advised by your doctor or surgeon to do so.
Bring medications in their original containers with you on the day of surgery. You will also want to bring X-rays, medical files or lab reports that may be in your possession with you on the day of the surgery.

Preparing Mentally and Physically

As your surgery date nears, your doctor will give you special instructions including bathing and showering, what you can eat and drink prior to surgery and medications to avoid. If you will be having anesthesia for your procedure, you may be told not to eat or drink the morning of or the night before surgery.
In the weeks before your surgery, prepare yourself physically for the rigor of surgery by eating a balanced diet and exercising regularly. Also, stop smoking and excessive alcohol consumption. If you are unable to quit smoking entirely, even cutting back on smoking can help. Avoid blood-thinning medications such as aspirin for one week before surgery.
You can help prepare yourself for surgery mentally by trying relaxation therapy, deep-breathing exercises and positive visualization techniques.
You should also stop using over-the-counter pain medication several weeks before your surgery. These drugs control pain by reducing inflammation and treat a wide variety of disease processes and all have one common property, the inhibition of platelet function, the cells responsible for clotting your blood.

Anyone undergoing surgery needs his or her blood to clot as well as possible. Failure to stop taking anti-inflammatories prior to surgery could lead to excessive blood loss. Even patients who take an aspirin each day to help prevent heart attacks should stop at least a week prior to surgery.
Your primary care physician should have a list of all of the prescription drugs you are taking, so you should ask if there are any you should stop prior to surgery. If you take over-the-counter medications, drop by your local pharmacy to determine if any of the products you use contain one of these drugs. It is important to know that many medications have more than one active ingredient, so you may not even know that you are taking one of these drugs unless you read all of the fine print on your medication bottles or ask a medical professional.
If you are forced to stop taking a product you use to control pain, you may consider switching to Tylenol preoperatively. Of all the over-the-counter medications designed to control pain, the active ingredient in Tylenol is the only one that does not inhibit platelet function. Of course, if you have an allergy to Tylenol or have a known liver disorder, this drug should be avoided as well.

Understanding Your Post-surgical Pain Relief Options

It is very important to control your post-surgical pain, not only because you will feel better, but also because your recovery could be shorter and smoother. It can also help avoid some common complications associated with surgery.
Uncontrolled pain, however, can keep you relatively immobile, interfering with the key elements of your post-surgical regimen by slowing the return to normal digestion and making it harder to do breathing exercises, which can lead to the onset of conditions like pneumonia.

Also, patients who can't get out of bed because of pain are more prone to forming blood clots. Patients in pain are also more likely to become depressed or feel stressed.
Before you enter the hospital for surgery, plan to talk with your health care professional about your post-surgical pain expectations.
It is important to know how much pain to expect following surgery, as well as how long it may last. Also ask what medications will be prescribed, as well as what side effects they may cause.
Consider asking your doctor if there are any alternatives to narcotics to control your post-surgical pain. Also, ask what the options are if the medication prescribed doesn't help your pain, or you can't tolerate the side effects.

Pain Treatment

Because pain is a complex combination of physical, chemical and emotional components, it often requires several approaches for successful treatment and management.
Pain management ranges from over-the counter and prescription medications to non-pharmacologic medical interventions and a host of alternative and holistic approaches.

Over-the-counter pain medications include acetaminophen, effective for mild to moderate pain and reduces fever while being gentler on stomach than aspirin. Patients may also take aspirin, which is effective for pain and fever, but may cause stomach irritation.
Prescription pain medications include stronger non-steroidal anti-inflammatory drugs, narcotics, antidepressants and local and topical anesthetics.
Continuous surgical-site pain relief (local anesthesia via a pain pump) involves giving a constant infusion of a local anesthetic medicine at a safe and slow flow rate directly into the surgical site. Pain relief is experienced directly at the incision site without the side effects of narcotics.

Other approaches to treating pain include physical therapy, lifestyle changes, ice or cold therapy, hypnosis, holistic approaches (acupuncture, acupressure, massage, biofeedback, cranial sacral therapy, homeopathy, hydrotherapy, meditation, relaxation), chiropractics, electrical stimulation, trigger point injections, nerve blocks, epidural steroid placement, spinal cord stimulators, intrathecal pumps and patient-controlled analgesia.
This involves the use of multiple pain relief options, with or without narcotics, including analgesics from different drug classes, regional or local techniques and non-drug strategies.
A new concept in acute pain therapy is preemptive analgesia. This concept is based around the idea that pain can be imprinted on the nervous system, later increasing the response to pain, and producing the sensation of continuous pain long after surgery.
During surgery your body is responding and becoming more sensitized to pain even though you don't feel anything under general anesthesia. Because of this the timing of surgical pain medicine is very important. One approach is to provide some type of local anesthetic in combination with general anesthetics, to numb the surgical site during surgery so you wake up with pain control already working.
There is no one right approach to the treatment of pain for each individual. However, there is growing evidence that pain is best managed using a combination of approaches or pain relief options, also known as multimodal therapy for pain relief.

Information provided by The National Women's Health Resource Center and The PreOp-Guide