Pre-op Instructions

The following general preoperative instructions relate to most procedures we perform. If you have questions about preoperative preparations not answered here, please contact our office.

• Your preoperative interview will be conducted by the facility where your surgery is scheduled. It may be done over the phone or require a visit at the facility.
• Inquire during your preoperative interview about whether to take any of your daily medications the morning of your surgery.
• DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT UNLESS OTHERWISE DIRECTED DURING YOUR PREOPERATIVE INTERVIEW. If you are instructed to take oral medications before surgery, you may do so with a sip of water.
• Preoperative lab tests may be ordered and will be drawn at the facility during the preoperative visit or at an outside lab. These should be completed in a timely manner to ensure results are available before surgery.
• In most cases, stop taking aspirin or NSAID’s such as Advil, Motrin, or Aleve at least 7 days prior to surgery. If you are taking these medications, ask your surgeon for specific instructions.
• Inform your surgeon if you are on Coumadin (Warfarin), Plavix, Lovenox, Eliquis, Xarelto or other prescription blood thinning medications. Stop these medications only at the direction of a physician. In some cases, substitute medications will be prescribed around the time of surgery.
• Typically, you will be asked to arrive at the surgical facility 1 ½ – 2 hours prior to surgery, although in some cases you will be required to arrive earlier. Late arrivals may cause your surgery to be delayed or cancelled.
• Your surgery time may change, in which case you will be notified as soon as possible.
• Bathe or shower the morning of your procedure to reduce the risk of infection.
• Wear loose, comfortable clothing that is easily removed.
• Remove all body piercings.
• Leave all valuables at home including jewelry, watches, money, computers, etc.
• Bring cases for glasses, contact lenses, hearing aids, and dentures.
• If you are scheduled for outpatient surgery, arrange for a responsible adult to drive you home. We recommend you have a responsible adult stay with you for the first 24 hours after surgery.

You will either have a pre-op visit or phone call with the hospital or surgery center.

• For most surgeries, you will be instructed to take nothing by mouth (NPO) after midnight the night before surgery, except for necessary medications which can be taken with a sip of water.
• At a minimum, the anesthesiologist will require you to be NPO (except for medications) for 8 hours prior to undergoing anesthesia. This is for your safety.

• Blood thinners are usually stopped before surgery, but you must discuss this with your surgeon before surgery. Each patient’s situation is unique and this will be handled on a case-by-case basis.
• In general, when your blood thinner is being managed by a specialist such as a cardiologist, we will seek your specialist’s recommendations.

Your surgeon may want you to stop taking aspirin for 7 days prior to surgery. Please discuss this with your surgeon prior to surgery.

Your surgeon may order labs, x-rays, or other tests before surgery. The Medical Assistant can help you if you have questions about these tests.

You will be told what time to arrive during your pre op visit. Typically, you are asked to arrive 1 ½ or 2 hours prior to surgery, depending on the facility.

During your preop appointment, you will be instructed which medications to take in the morning before surgery.

If you are placed under anesthesia for your surgery, you cannot drive yourself home. You must have a ride home with someone you know. You cannot take a taxi or rideshare home.

Constipation is very common after surgery. If you tend to have constipation, start taking an over-the-counter stool softener like docusate sodium (Colace) twice a day for 3 days prior to surgery. Also, drink plenty of water during that time.

If you tend to have nausea or vomiting after surgery, please mention this to your surgeon. They can prescribe additional medications to help with this.

**PLEASE READ INSTRUCTIONS CAREFULLY**

MIRALAX AND GATORADE BOWEL PREP

Obtain the following from your pharmacy:

• *255gm bottle of Miralax (sold over the counter)
• *Four (4) Dulcolax (Bisacodyl) tablets (sold over the counter)
• *One (1) 64oz bottle of Gatorade (not red or purple)

The day before surgery:

You may have a regular breakfast and a light lunch (soup, salad, sandwich). At 3:00 pm take the 4 Dulcolax tablets. At 5:00 pm mix the 255 gm bottle of Miralax in the 64ox bottle of Gatorade. Shake the solution until Miralax is dissolved. Drink solution at a rate of 6-8ox every 10-15 minutes until finished. Continue to drink clear liquids until bedtime.

Clear liquids include carbonated beverages (with or without caffeine), black coffee, tea, fruit flavored drinks, plain gelatin (Jell-O), popsicles, fruit juices, clear broth, and bouillon. You should not have dairy products of any sorts, popsicles with fruit or juices with pulp.

ANTIBIOTICS

Your Surgeon will provide you with a prescription for your antibiotics. Take these antibiotics at 1:00pm, 5:00pm and 9:00pm the day before the surgery unless instructed otherwise by your doctor.

DRINK EXTRA WATER

You should drink four or five 8 oz glasses of water the day before your bowel prep and the day of your bowel prep.

THE DAY OF SURGERY

Arrive at the hospital at the time instructed by the hospital’s pre-op personnel.

**If surgery is in the morning, do not eat or drink anything after midnight.

**If surgery is in the afternoon, hospital pre-op personnel or anesthesia staff will let you know at your pre-op visit the latest time you’re able to take anything by mouth, and what you may have.