If a patient needs an operation, the consultant will usually discuss this during your OPD clinic appointment and then arrange a suitable date and time for the surgery. You will have the opportunity to ask questions and discuss any concerns during the OPD visit. Any more questions and doubts may also be discussed on the day of the operation.
If indicated by the patient’s clinical condition, you may be asked to attend a pre-operative assessment by the physician for medical fitness before the surgery. During this, you'll be asked questions about your health, past medical history, existing medical conditions and medicines you may be currently on. This is to check if you have any medical problems that might need to be treated before your operation, or if you'll need special care during or after the surgery.
You may be advised to undergo investigations such as X ray chest, ECG, 2D echo and blood tests depending on the type of surgery, the kind of anaesthetic you're having and your pre-existing medical conditions such as diabetes, hypertension, etc.
These tests might include blood tests, urine tests and pregnancy test for women.
This assessment will usually happen one or more days before your operation.
Make sure you know the results of any previous tests, as well as all the medications, vitamins and herbal supplements you take.
It is important to understand the risks involved with any surgical procedure as well as the anesthesia you will be getting. The day before the operation it is important for you to confirm:
On the day of the operation, you will be required to sign consent forms for surgery and anesthesia. It is important that you go through the consent document in detail before signing it. You will have an opportunity to ask questions and clarify any doubts with the medical team. If you are not satisfied, you can approach the consultant to clear any doubts before the operation.
It is important that you don't eat or drink anything in the hours prior to the operation. This is because You need an empty stomach during surgery so you don't vomit while you're under anesthetic. The time of fasting varies according to the type of surgery and anesthesia needed.
For adults, typically 6 to 8 hours fasting is needed for routine surgery under a general anesthetic.
For children and babies, the times vary as follows:
Solid foods, Formula milk, cow’s milk – 6 hours
Breast milk – 4 hours
Clear water – 2 hours
It is important to confirm the fasting time with the doctor at the time of admission.
If you take insulin because of diabetes, you'll still need to avoid eating and drinking before surgery, but make sure your medical team is aware of your condition so appropriate precautions can be taken.
Some medications such as antihypertension drugs need to be taken on the morning of surgery. Make sure you confirm this with the medical team.
You'll need to remove all body piercings, make-up and nail polish before your operation. This helps reduce chances of infection and helps doctors to see your skin and nails properly to make sure your blood circulation is healthy. We also request that you have a bath or shower before coming in for your surgery to minimize the chances of infection.
If you're unable to attend your hospital appointment or don't feel well enough to have your operation, please let the hospital know as soon as possible. They'll be able to talk to you about rearranging the appointment.
Let your surgeon know if you develop a cough, cold or fever a few days before surgery. They'll advise whether your operation can go ahead.
Family or friends can usually stay with you until you leave for the operating theatre, at which point they can wait for your room. The visiting time for friends and relatives is as follows:
Morning: 10:00 am to 12:00 pm
Evening: 4:00 pm to 7:00 pm
We request you to restrict your friends and relatives to visit you during these hours only as patients need rest and allows smoother functioning of hospital.
You'll be asked to get undressed and change into a hospital gown. You also need to ensure you have removed all ornaments (Earrings, nose rings, finger rings, chains, bracelets, toe rings, etc.) before going into the operating suite. The details of the operation may be explained to you or your relatives. For many operations, a needle connected to a drip set (IV line) will be put into your hand. This allows fluids, nourishment and medicine to be given while you're under anesthetic.
You'll be given an anesthetic so you won't feel any pain during the operation.
A general anesthetic will be needed for a major operation, which means you'll be asleep throughout the whole operation. It'll be given to you via an intravenous injection or gas, which you breathe through a mask.
There's no need to be anxious about having a general anaesthetic: the anaesthetist will be by your side the whole time you're asleep, carefully monitoring you, and will be there when you wake up.
If you don't need to be put to sleep, you'll be given a regional anaesthesia. This is usually through a small needly in the the back (Spinal or Epidural). This means you'll be conscious throughout, but you won't feel any pain.
For smaller surgeries, you may be given a local anaesthetic, where a small area is numbed.
After surgery, you'll be moved back to the ward or a recovery room, where you'll be told how the operation went.
You may feel hazy or groggy as you come round from the general anaesthetic. A nurse may give you oxygen (through tubes in your nose or a mask) to help you feel better.
It's common to feel sick or vomit after you've been given general anaesthesia. Your nurse may offer you medicine to help with sickness. You may also have a sore throat and dry mouth.
Your blood pressure, saturation, heart rate and other parameters may need to be taken regularly to ensure good recovery from the anesthetic. This will either be done by a nurse or by using an automatic cuff that squeezes tightly at regular times. Your temperature will also be taken.
You'll always have some pain after having surgery. Tell your nurse as soon as you start to feel any pain so they can give you painkilling medication as soon as possible. This will stop it getting worse (medication can take 20 minutes to start working) and improve it.
The sooner you start to move around, the better. Lying in bed for too long can cause some of your blood to pool in your legs. This puts you at risk of blood clotting inside your veins. The clots can migrate into other organs of your body such as lungs and brain and cause serious problems. This is called Venous thromboembolism.
If possible, doing some leg exercises can help prevent a blood clot. These may be as simple as flexing your knees or ankles and rotating your feet.
You may be prescribed special support stockings to wear after surgery to help your blood circulation. Your nurse or doctor will explain how you should use these. Some people are given an injection to thin the blood slightly to help reduce the risk of clots.
Research shows the earlier you get out of bed and start walking, eating and drinking after your operation, the better. The hospital may offer an enhanced recovery programme if you have had major surgery. This rehabilitation programme aims to get you back to full health quickly. It is specially important after orthopedic surgeries, spine surgery and join t replacements. It may involve the use of active and passive physiotherapy.
Before you leave hospital, you may (depending on the type of operation you had) have an appointment with a physiotherapist. They'll be able to advise you about any exercises you need to carry out.
You'll also be given advice about how to care for your wound, any equipment you may require, such as dressings, bandages, crutches and splints, and maybe a dose of painkillers.
You may want to ask some questions before you leave hospital, such as:
Don't be surprised if you feel very tired when you get home, especially if you have had a major operation or a general anaesthetic.
You should only do as much as you feel able to in the days after your operation. But it's important to try to move around as soon as possible and follow your doctor's advice on getting active again.
This will encourage your blood to flow and your wounds to heal, and will build up strength in your muscles. Generally, try to get back into your regular routine as soon as possible.
Use this as an opportunity to make a fresh start: to eat more healthily, start exercising to stay in shape, and stop smoking if you smoke.
If you have a dressing on the area operated on, follow the instructions your nurse gave you to care for your wound at home.
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