BEFORE YOUR SURGERY
In some instances you will have several days to prepare for your upcoming surgery. It is important to make the most of this time to assure that you are well rested and remain healthy. Here are some suggestions to best prepare your body for surgery.
Eat, even if you are not particularly hungry. Eat a variety of foods each day. This will ensure that your body gets enough vitamins, proteins, and other nutrients. A patient with good nutrition will do better in every aspect of the surgical procedure and post-operatively. Use of a multivitamin and vitamin C may be especially helpful.
Never allow yourself to get too tired during the days leading up to your surgery. The more rested you are, the stronger your body will be.
Quit Smoking. This will make an important difference in your post-surgical condition and recovery. Smoking is harmful to your lungs and heart. It raises your blood pressure and makes your heart work faster through your smaller vessels. It also produces more mucous in your lungs. Quitting will decrease your time spent on the ventilator. You need to quit for at least 4 weeks before surgery to benefit.
Express your concerns or fears and doubts. This is normal and you should not feel odd if you have them. Talk with your family. It will bring out good feelings and help you to feel closer during this difficult time.
If you are scheduled to undergo heart valve surgery you need to get a preoperative dental exam.
Let your surgeon know immediately if your condition changes or you develop signs of a cold or the flu (fever, cough, phlegm). Should you become ill with fever or a cold, or experience any physical changes, please contact the surgeon’s office. Surgery will be postponed until your health has been optimized.
The Flu Shot
If your surgery has been electively scheduled, meaning you are waiting at home for your scheduled surgery, you have the opportunity to discuss with your primary care doctor whether or not you are a candidate for the flu and/or pneumonia vaccine. The cardiothoracic team recommends that you obtain these vaccinations if appropriate at least 2 weeks prior to your upcoming surgery. The flu vaccine is available October 1 of each year. To be properly protected you must be vaccinated yearly. The pneumonia shot will prevent you from a potential secondary infection of the flu (pneumococcal pneumonia). You will be asked on admission to the hospital if you have received these vaccines. If you have not, the nursing staff will obtain appropriate orders so that the injections can be given to you prior to your discharge from the hospital.
The potential need for blood transfusions during this surgery is an understandable source of apprehension for patients and families. Blood loss during your surgery is collected through special equipment, filtered and returned to your circulation. A small percentage of patients will require transfusion, especially if you are anemic prior to or after surgery, Your family members may want to be designated blood donors for you.
The cardiothoracic team adheres to the following measures to prevent infections from occurring:
- Hand washing is the single most important way to prevent infection
- Ordering mupirocin/bactroban pre-operatively to prevent methicillin staph aureus infections.
- Instruct patients to use preoperative skin preparations the night before and the morning of surgery, with chlorhexidine soap to remove dangerous bacteria from the skin.
- Maintain meticulous mouth care while patients are on the ventilator.
- Use antibiotics when appropriate.
- Remove urinary and intravenous catheters as soon as possible.
- Vigorous monitoring and treatment of blood sugar levels.
Ventilator-Associated Pneumonia (VAP) is a lung infection that can happen to patients who are on ventilators (machines to help them breathe). The infection is very serious. The doctor and nurses help prevent VAP by taking the following steps:
- Raise the head if the patient’s bed between 30 – 40 degrees.
- Administer medication to prevent stomach ulcers and blood clots
- Check daily to see if the ventilator can be removed.
Families and patients can assist us in the preventing infections as well. The following are steps you can take to protect yourself from a hospital infection:
- Ask that the hospital staff including your doctors wash their hands before treating you. Hands need to be washed first before and then again after the gloves are used.
- Before your doctor/nurse uses a stethoscope to listen to your heart ask that the diaphragm is wiped with alcohol. Stethoscopes are contaminated with dangerous bacteria.
- Ask your physician for their infection rate. You should be able to compare hospital infection rates as well which is available through the internet.
- Stop smoking well in advance of your surgery. Smokers are three likely to develop surgical site infections; have a slower recovery and a longer hospital stay.
- Do not shave the surgical site as razors can create small nicks in the skin in which bacteria can enter. Hospital employees will clip hair that needs to be removed.
- Inform any family member or friend with a cold or infection not to visit you during your hospital stay as well as during your recuperation at home.
QUESTIONS TO THINK ABOUT BEFORE SURGERY
Who will drive to the hospital? How will I get home?
Now is the time to talk to friends if family is not available.
Who can I call if I have any questions regarding my surgery?
Call the cardiothoracic surgery office at 215-456-8543.
Who will be at home with me during my recuperation?
If family or friends are not available think about inpatient rehabilitation.
What rehabilitation centers are available to me?
If there is a specific rehab center near your home that you prefer then please discuss this with the social worker and case manager during your hospital stay.
Do I have a living will or healthcare proxy?
If so then please make sure you bring it with you to the hospital or have a family member bring it in for you.
Who in my family will make decisions for me if I cannot?
Does my family understand what I want?
Will I be able to afford my medications?
Will I stay on the same medications that I currently take?
Your nurse can contact the physician assistant to inquire.