MEDICATIONS TO AVOID Do not take Aspirin (acetylsalicylic acid) or products containing Aspirin 2 weeks prior to surgery unless otherwise directed by your surgeon.
The following is a partial list of products and medications containing Aspirin:
Some new products or medications not listed above may also contain aspirin. When in doubt, consult your surgeon or pharmacist. Please note that it is your responsibility to verify if the medications you are taking contain or do not contain aspirin.
Do not take anti-inflammatories unless otherwise instructed by your surgeon:
Stop taking all flu medications such as Tylenol Sinus, Advil Sinus, Reactine, cough syrup, etc.
Stop taking birth control pills two (2) weeks prior to surgery.
You should also avoid all natural and homeopathic products, garlic, vitamins and products that contain garlic. Despite their natural qualities, they may induce bleeding or delay healing.
If you are taking heart, blood pressure, or diabetes medication, continue to do so until the day of your surgery. To know whether to take your medication or not on the morning of surgery, please refer to the section entitled The Day of Surgery – Medications to Take or Skip on page 7 of this document.
You can however safely take certain medications such as Atasol and Tylenol to relieve pain.
TOBACCO Toxic substances in tobacco have a negative impact on blood circulation. These substances can cause small blood vessels to tighten and lead to skin loss (necrosis) in the area of intervention. These substances can also affect healing, as well as cause nausea, vomiting, and excessive coughing that increase the risk of bleeding after surgery as well as increasing the pain that you feel. We strongly advise you to stop smoking for two (2) or three (3) weeks prior to your surgery as well as for the two (2) weeks that follow it. Nicotine substitutes (Nicorette, etc.) have the same harmful effects on blood circulation as smoking does and are therefore also inadvisable during this period.
PREPARING FOR SURGERY
Advil, Ibuprofen, Celebrex, Indocid, Motrin, Naprosyn, Orudis, Vioxx, Voltaren, etc.
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ALCOHOL Avoid alcohol consumption for one (1) week prior to your operation and two (2) weeks following your operation. Combining alcohol and medications can cause unpredictable reactions and modify the effect of medications.
HAIR DYE It is important to avoid applying an hair dye ten (10) days before and thirty (30) days after a facelift surgery.
PLAN YOUR RETURN HOME NOW Choose an adult companion for your return home as you will under no circumstances be allowed to drive your car. Pack loose-fitting clothing and comfortable, easy-to-slip-on shoes for your return home. Choose a responsible person to be by your side for your first 24 hours at home to help you move around, with your personal care, and with your daily activities. Have a thermometer at home to check your temperature if required. To facilitate rest, prepare meals in advance; enough to cover the first few days of your return home. Remember to ask your surgeon about claiming a leave of absence from work and, if applicable, to suspend any gym memberships.
DIET In order to accelerate the healing process, it is important to incorporate fibers and proteins into your diet before and after surgery. A balanced diet also improves immune function, providing you with better protection against infection. Canada’s Food Guide is a good reference for food and nutrition. You can ask the nursing staff for a copy of the Guide.
CHANGES IN YOUR HEALTH If on the day of your operation you have a fever, flu, sore throat, diarrhea, or are pregnant, it is best to postpone surgery. If, for whatever reason, you must postpone your operation, directly notify the Centre Métropolitain de Chirurgie nursing staff by calling 514-332-7091, extension 200. If your call is not answered, you can leave a voicemail.
IMPORTANT Your surgeon may have requested laboratory tests prior to performing your surgery. If, for whatever reason, you must postpone your operation, please note that these tests are valid for a period of:
6 months for blood tests;
12 months for an electrocardiogram.
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PREPARING YOUR SKIN PRIOR TO SURGERY In order to reduce the risk of infection during the postoperative period and to reduce the number of bacteria on your skin, it is important to take a bath or shower the night before as well as the morning of your surgery. You must use a chlorhexidine-based sponge to wash the operated area. This product is available in drug stores. Be sure to carefully follow the instructions supplied with the product and avoid contact with your eyes and ears. You must not apply cream or lotion on the skin.
SHAVING The evening before your surgery, you must shave the operated area in accordance with your surgeon’s instructions.
FASTING You must fast starting at midnight the night before your surgery; do not consume any solid food and drink nothing, including water. Do not chew gum or suck on candy. You can, however, brush your teeth and rinse your mouth. If your surgeon instructed you to take your regular medication on the morning of your surgery, you may do so with a sip of water only (about 15 ml).
REMOVE MAKEUP, ARTIFICIAL NAILS AND NAIL POLISH During surgery, the colour of your skin is a good indicator of oxygen level in the blood. In addition, the equipment used to measure your oxygen levels may be unable to read results if your fingernails are coated with varnish or if you wear artificial nails. Please have varnish and artificial nails removed. Research has shown that nosocomial infections are transmitted mostly by hands. Hand hygiene is the fundamental measure of prevention and control of infections for the health care team as well as the client. Wearing artificial nails or nail polish on fingers increases the amount of microorganisms and promotes the establishment of bacteria. They can be the cause of nosocomial infections.
REMOVE ALL JEWELLERY, CHAINS, EARRINGS, RINGS, BODY PIERCING, AND HAIR TIES
THE DAY BEFORE SURGERY
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WHAT TO BRING ON THE DAY OF YOUR SURGERY Space to store your personal effects is extremely limited. This represents a small carry-on suitcase measuring approximately 23 cm x 40 cm x 55 cm (9 in. x 15.5 in. x 21.5 in.) with wheels and handles, weighing about 10 kg (22 lb.).
The morning of your surgery, you will need to bring: o If you have received it, this Information Guide; o Your health insurance card; o An up-to-date list of your medications, all of which MUST be in their original containers. o We cannot accept medications in dosettes prepared by a pharmacist. o Your inhalers and aerochambers if necessary; o Your glasses case, denture case and hearing aid case; o Your case and solution for contact lenses; o Slip-resistant slippers; o Sanitary napkins, if applicable; o Loose-fitting, comfortable clothing adapted to your surgery for your return home; o Books and silent entertainment (iPod, laptop, etc.).
ADD - if you are staying at the CMC: o A robe, nightgown or pyjamas; o A personal hygiene kit (toothpaste, toothbrush, soap, etc.).
For clients staying at the CMC, a safe is available in your room. However, we strongly suggest you leave money, jewelry, and other valuables at home. For day surgery [hereinafter “DS”] clients, you can leave your personal belongings in a locker that you can lock.
The Centre Métropolitain de Chirurgie is not responsible for the loss of valuables or money that you keep in your possession.
PREPARING YOUR SUITCASE
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REMINDER: You must have taken a bath or shower and removed all makeup, jewellery, nail polish, piercings, etc. Also, if applicable, remove your tampon and use a sanitary napkin instead.
MEDICATIONS TO TAKE OR SKIP On the day of surgery, do not take any medications (including heart, blood pressure, and diabetes medications) before seeing the anesthesiologist. She or he will determine which medications to take or to avoid. If in doubt, please check with the nursing staff at the CMC by calling (514) 332-7091, extension 200.
Inhalers must be taken on the morning of your surgery even if you normally only use them as needed. REMINDER: If your surgeon instructed you to take your regular medication on the morning of your surgery, you may do so with a sip of water only (about 15 ml).
WHERE TO GO At the time designated by your surgeon, please present yourself for admission at the reception desk of the Centre Métropolitain de Chirurgie, 999 De Salaberry Street, Montreal, QC, H3L 1L2
** Please note that your admission time and surgery time are not the same. ** Only one person is authorized to accompany you for your admission.
ADMISSION: Upon your arrival, a member of the nursing team will admit you. Your questions will be answered and you will be asked to fill out a health questionnaire. You will also be asked for:
1. An up-to-date list of your medications. These medications MUST be in their original containers. We cannot accept medications stored in dosettes prepared by a pharmacist.
2. Your health insurance card.
The nursing staff will take your blood pressure, pulse, and temperature, as well as confirm that all required information is in your medical file. They will ask you to sign a consent form for the surgery and anesthesia. Should you have any questions, do not hesitate to ask.
The nurse will provide an identification bracelet and direct you to your room or to the day surgery room. For women of child-bearing age, a urine sample will be required the morning of the operation for a pregnancy test. We will ask you to wear a hospital gown, remove your underwear, dentures, glasses or contact lenses, and replace your tampon with a sanitary napkin.
Additionally and if necessary, the nursing staff will administer a premedication in the form of pills designed to reduce postoperative pain and the risk of nausea and vomiting. The anesthesiologist will meet with you on the morning of your surgery. When the time comes, an attendant will bring you to the operating room’s waiting room. Your surgeon will come and meet with you, after which you will be brought to the operating room for your surgery.
THE DAY OF SURGERY
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IN THE OPERATING ROOM A member of the operating room nursing staff will again verify your identity and your medical file. Should you have any questions, do not hesitate to ask. Upon arrival in the operating room, we will assist you onto the operating table. The operating room is cool and has many devices with special lighting. You will be affixed with various devices in order to monitor your condition throughout the surgery, such as your heart rate and blood pressure. For general or regional surgeries, an intravenous infusion will be introduced by a member of the anesthesiology team to keep you hydrated and to administer medications during your surgery. Generally, the team present in the operating room is made up of your surgeon, an assistant (if necessary), an anesthesiologist, a member or members of the nursing staff, a respiratory therapist, and an attendant.
ANESTHESIA The anesthesiologist will meet with you prior to your surgery to decide, together, based on your medical history and planned surgery, which type of anesthesia to use. General: The anesthesiologist will introduce enough medication intravenously to make you sleep completely. Local (spinal anesthesia): This type of anesthesia is aimed at one part of the body only. Medication is used to eliminate feeling and motor function in this part of your body. You will not feel anything while remaining awake. Medication to help you relax may be administered. Local with sedation: Only the operated region will be affected by the injection of anesthesia. Medication will be administered and you will be semi-conscious and extremely relaxed throughout your surgery. Local WITHOUT sedation: For this type of anesthesia, the presence of an anesthesiologist is not required. Only the operated region will be insensible to pain following injection of local anesthesia by your surgeon.
RECOVERY ROOM For all surgeries under general or local anesthesia, a stay in the recovery room is mandatory and can vary from 45 minutes to two hours depending on the type of surgery and your ability to recover. Up until the time that you have awoken completely, you will be monitored continuously by the nursing staff who will regularly check your pulse, blood pressure, respiration, your dressing, etc. If you experience nausea, pain, or discomfort, please notify the nursing personnel on site. Once you are awake, your condition stabilized and the pain under control, you will be ready for transfer to the care unit or day surgery unit. Prior to your transfer, the recovery room nursing staff will provide all information about your surgery to the receiving unit.
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DAY SURGERY Upon exit from the recovery room, you will be brought to the care unit or the day surgery room for a period of approximately three (3) to four (4) hours, after which you will be allowed to leave and return home with the person you designate as your companion. The duration may vary depending on your ability to recover.
HOSPITALIZATION Upon your return from the recovery room, you will be transferred to your room where an attendant will help you from your stretcher and into bed. Nursing staff will check your pulse, blood pressure, respiration, dressing, pain, etc. Edema, swelling, and bruising of the affected area are often present and will disappear during the subsequent weeks.
PAIN Postoperative pain varies from person to person. Generally, pain is more intense during the first 48 to 72 hours following surgery. It will decrease gradually over time. It is essential to relieve your pain, to rest, and to gradually resume your daily activities. Unrelieved pain can slow recovery and have a negative impact on sleep, digestion, and anxiety. The nursing staff will ask you frequently to describe your pain on a scale of zero to 10, 0 meaning a complete absence of pain and 10 indicating the worst pain. Remember that the more intense the pain is and the longer you wait, the more difficult it is to completely relieve it.
RETURNING FROM THE RECOVERY ROOM
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DIET You will begin with a light diet when you start to eat again. If you do not have nausea, you can gradually resume a normal diet.
MOBILITY A few hours after your arrival in the care unit, the nursing staff will help you to stand for the first time. Afterwards, you will be encouraged to move around very often to prevent circulatory and pulmonary complications.
REST Upon arrival in the room, you will need to rest in order to maximize your recovery. To this end, and in order to respect other patients’ rest and recovery, please note that only one person at a time will be allowed to visit you. Additionally, we ask that you avoid noise and loud conversations. Visiting hours are from 9 am to 8 pm.
A NIGHT AT A HOTEL If you do not live near the CMC, we recommend you spend the first night at a nearby hotel. Please discuss options with your surgeon’s secretary.
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You must be accompanied in order to leave the CMC and during the first 24 hours following your surgery. Medications used during anesthesia and for pain relief can impair your senses and cause drowsiness. It is therefore strongly advised that you avoid operating a motor vehicle for 72 hours following surgery. For the same reasons that apply to driving, you must postpone all important decisions until a later date. Anesthesia can also cause you to feel more sensitive and irritable than usual for a few days.
BEFORE LEAVING THE CMC The nursing staff will assess your condition in accordance with certain criteria and plan your departure. Following this, your surgeon will sign for your release. You will be given prescriptions to leave with, including the required information. You will also receive personalized instructions from the nursing staff according to the type of surgery you underwent. Documents with postoperative care instructions specific to your surgery will be provided for you to keep. Finally, you will be allowed to leave the CMC with the person accompanying you. If you have been hospitalized, your departure must take place before 10 am.
RESUMPTION OF REGULAR MEDICATIONS Unless otherwise directed by your surgeon, you may resume taking your regular medications as soon as you go home. You should avoid medications containing aspirin for 15 days following your surgery in order to reduce the risk of bleeding. Please see the section entitled “Preparing for surgery; Medications to Avoid”.
EATING AND DRINKING Following surgery, it is recommended to eat a light diet in order to avoid nausea. Food suggestions include broths, soups, crackers, Jell-O, etc. Gradually increase what you eat until you attain a regular diet.
It is important to drink plenty of liquids in order to foster good intestinal and urinary elimination, as certain pain relief medications can cause constipation. We also recommend eating foods containing fiber.
PERSONAL HYGIENE Take a bath or shower after your surgery according to your surgeon’s recommendations.
RETURNING HOME AFTER SURGERY
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POTENTIAL COMPLICATIONS, SIGNS AND SYMPTOMS
Wound infection Redness
Heat
Discharge
Swelling
Pain
Fever (higher than 38.5°C) and chills
Complications
Heavy bleeding
Loss of consciousness
Inability to urinate
Pain not relieved by pain medication prescribed by your surgeon
Persistent nausea or vomiting
Fever (higher than 38.5°C) and chills
These complications are rare but can occur. In this case:
Contact your surgeon or;
Go to the emergency room of the nearest hospital or;
Call 911.
REST It is normal to feel fatigued following surgery. You must rest to ensure adequate recovery. You should, however, resume daily activities as soon as possible and according to your level of tolerance. Walking stimulates blood circulation in the legs and prevents the stagnation of blood in your veins, which can cause blood clots (thrombophlebitis). A balance between rest and activities is essential.
FOLLOW-UP APPOINTMENT It is important to go to your follow-up appointment with your surgeon. This represents an opportune time to discuss any persistent difficulties, your concerns, and the timing of your return to work.
POSTOPERATIVE RESOURCES Your surgeon: _______________________________Telephone Number____________________ Info-Santé health consultation services: 811 Emergency services: 911
HAPPY RECOVERY!
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PRE-SURGERY REMINDERS
- BEGIN FASTING AT MIDNIGHT THE NIGHT BEFORE YOUR SURGERY (DO NOT EAT OR DRINK);
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