Preparing for surgery? What you need to know

It's official. You need surgery.

You may have many thoughts and questions running through your head, whether it is a minor, same-day procedure or a complex operation that requires you to stay in the hospital overnight. You may even feel anxious, confused or scared.

While these emotions are normal and expected, there are things you can do to feel more comfortable and calm your nerves.

Review the answers to 6 common questions as you prepare for your surgery:

1. How can I make sure I am healthy and ready for surgery?

As you prepare for surgery, do what you can in the weeks and days before to prepare mentally and physically.

Here are some things you can do to ensure you're ready:

• Attend all appointments and educational seminars as directed by your surgeon.
• Take your medications as directed.
• Reduce or quit smoking.
• Eat healthy foods, such as fruits, vegetables, lean meats and whole grains, and drink enough fluids to stay well-hydrated.
• Get plenty of rest.
• Arrange support from family or friends during and after surgery, including transportation to and from the hospital.

2. Does everyone need a physical exam before surgery?

No. Your surgical team will determine if a physical exam is required before your surgery.

Generally, a physical exam is not required for patients who are scheduled for a low-risk surgical procedure; are not taking any prescriptions; and don't have chronic health conditions, like high blood pressure, diabetes, obesity or heart disease.

If you don't have a physical exam before surgery, a member of the anesthesia team will meet with you on the day of your surgery to answer questions and gather information about your overall health.

3. Why do some patients need a physical exam before surgery?

A preoperative physical exam helps your surgical team determine if you are healthy enough to undergo anesthesia and surgery. This is sometimes referred to as being optimized for surgery.

The exam gives your surgeon and anesthesiology team important information about your health so they are prepared and can tailor your surgical care to your specific medical needs. It also could identify problems or issues that may complicate or delay your planned surgery. In these situations, other health problems could be addressed before proceeding with surgery to ensure you have the safest possible operation.

Your primary care provider should complete a preoperative physical exam within 30 days of your scheduled surgery date. A Preoperative Exam Clinic, also called POE, is an option at some Mayo Clinic Health System locations if you do not have a primary care provider or cannot schedule an appointment with your primary care provider during this time frame.

4. What happens during a preoperative exam?

Your preoperative exam will:

• Measure your height, weight and vital signs.
• Review your medication list, with recommendations for how to take your medications prior to surgery.
• Review your medical, surgical and family history.
• Include a physical exam.
• If necessary, complete additional preoperative testing following your exam, including blood tests, urine tests, X-rays or an EKG.

5. What should I bring with me to the hospital?

Just as you would for a weekend getaway, take time to pack necessities and a few comfort items when you have surgery.

These items will make your surgery safe, smooth and comfortable:

• A list of all medications you take or medications in their original bottles.
• A list of materials or medications that you are allergic to or that have caused adverse reactions, such as latex or iodine.
• All current insurance cards, pharmacy and drug benefit cards, medical device identification cards, and driver's license or other photo identification card.
• A copy of your advance directive or living will, if you have one.
• Information about your pacemaker or internal defibrillator, if you have one.
• Any special equipment that you use, such as a cane, walker or continuous positive airway pressure machine (CPAP), as well as ostomy or insulin pump supplies.
• Comfortable, loose-fitting clothing to wear home or during your hospital stay.
• Slip-on walking shoes or nonskid slippers.
• Items to help pass the time while you wait, such as a book, music, phone or magazine.

Remove and leave jewelry, including body piercing jewelry, at home. Also, arrange for children or family members who require supervision to stay at home during your surgery.

6. What can I expect on the day of my surgery?

A nurse or care team member will call a few days before your surgery with information about your procedure, what you can eat or drink, visitor guidelines and how to be notified of your arrival time for surgery. You may have received this information at your preoperative physical exam in the POE clinic. Follow all directions carefully.

Most patients need to arrive at the hospital at least one hour before the surgery start time. Your surgical team will do their best to avoid long wait times, but please understand delays or changes in the operating room schedule could affect your surgical time.

After check-in, you are taken to a preoperative area, where a member of your care team will gather information like your health history and vital signs. They also will be available to answer your questions. You will wait in this area until the operating or procedure room is available.

After your surgery, you will be brought to the Post Anesthesia Care Unit, also known as the PACU or the recovery room. Care team members will monitor your vital signs, alertness, pain or discomfort, and the need for medications. How long you stay in the PACU is determined by the anesthetic you received, the time it takes for you to wake up, and room assignment if you are staying overnight in the hospital. If you are going home the same day, you may return to the preoperative area. Most patients stay here for at least two hours after their surgery is complete.

After surgery, it's important to follow your surgeon's instructions carefully. This may include information on activity restrictions, medication instructions, dietary restrictions, incision care, follow-up appointment information and more.

Remember that recovery is a gradual process. Allow yourself time to recover after your surgery or procedure. Let family and friends help you if you need it and talk with your surgeon if you have questions.

Elizabeth Cumberland is a nurse practitioner in Anesthesiology in Mankato, Minnesota.