We encourage patients to partner with us in
optimizing their surgical and postoperative care, starting by asking them to
complete a pre-surgery check list as shown below.
Habits:
__Engage in three
hours of aerobic exercise per week if your primary care physician deems it safe.
__Avoid smoking
or use of any nicotine-containing products for three months prior to and after surgery.
__Avoid any
narcotic medications stronger than hydrocodone for three months prior to surgery. If heavier narcotics have been used,
tapering off under physician supervision should be accomplished three months
before the surgery.
__For three
months before surgery, restrict alcohol consumption to one drink per day for
women and two drinks per day for men
Planning:
__ A plan for
patient care after discharge needs to be in place well in advance of surgery,
recognizing that your shoulder may be less useful for a period after surgery
than it was before. Who will be with you and care for you when you are
discharged? How will you get home? Some find that they are more comfortable
sleeping in a recliner for several weeks after surgery; you may wish to
consider having one available.
__ Discuss with
your surgeon the limitations on your activities after surgery, such as
restrictions on driving, as well as the need for someone to be with you for
days or weeks after the procedure. If a stay in a skilled nursing facility
after surgery will be necessary, this should be discussed with your surgeon well
in advance of the procedure.
__Identify a
primary care physician who can manage non-surgical concerns and medications
after surgery.
__Understand and
plan for the rehabilitation program after surgery as well as the plan for
follow-up with the surgeon.
Physical and
emotional health
__Optimize dental
hygiene, including gum care. Dental concerns need to be tended to at least 2
weeks before surgery. Postpone any planned elective dental procedures for at
least 3 months after surgery.
__Identify any
skin lesions anywhere on the body, especially on the arm of the intended surgery.
These need to be completely healed at least two weeks before surgery. Be
particularly careful to check the skin in the armpit and under the breasts.
__Assure that any
infections are completely resolved and antibiotics discontinued at least 6
weeks prior to surgery.
__Optimize
control of sleep apnea, anxiety, depression, diabetes, hypertension, heart
conditions, as well as urinary tract function.
Communication
with the surgical team
__Discuss the
surgeon's personal experience with the problem and the procedure along with
possible risks, alternatives and anticipated outcomes
__Notify the team
if prior experience suggest that it will be difficult to establish an
intravenous (IV) line for surgery, if it has been difficult for an
anesthesiologist to establish an airway, if you have had any problems with
prior anesthetics, or if it has been difficult to control your pain after
surgery.
___Let the team
know if you or any family member or blood relative ever had a serious problem
with anesthesia, and if so, what was the problem?
__Discuss with
the surgeon heart conditions, strokes, kidney disease, liver disease, lung
disease, bleeding tendencies, prior surgical complications, reactions to
anesthetics, seizures.
__Document and
communicate all medical allergies, especially allergies to antibiotics and
latex.
__Could you be
pregnant? If so, we would recommend that you have a pregnancy test performed
before coming for surgery, and if you are pregnant, that you not undergo
elective surgery until after delivery.
__Compile and
share a complete list of all prescription and over-the-counter medications.
__Anti-inflammatory
medications and blood thinners (for example, aspirin, Advil, Coumadin,
Warfarin, Plavix, Ibuprofen) will increase the risk of bleeding and their use
may need to be modified well in advance of surgery. Let your surgeon know if
you are taking drugs to prevent blood clotting. These may need to be stopped or
modified before and after your procedure. Be aware that many over-the-counter
supplements can also increase the risk of bleeding. Please note any supplements
on your list of medications.
__Identify and
discuss any legal issues regarding the shoulder problem well in advance of
surgery.
__Verify your insurance
coverage well in advance of surgery. This is especially important for patients
living outside of Washington.
====
Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book
Click here to see the new Rotator Cuff Book
To see the topics covered in this Blog, click here
Use the "Search" box to the right to find other topics of interest to you.
Consultation for those who live a distance away from Seattle.
Click here to see the new Shoulder Arthritis Book
Click here to see the new Rotator Cuff Book
To see the topics covered in this Blog, click here
Use the "Search" box to the right to find other topics of interest to you.
You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and run, reverse total shoulder, CTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'