What You Should (and Shouldn't) Do in the Final Countdown to Surgery

Hospital Guide, Part 3: Remember to follow orders: No eating before surgery; leave jewelry at home.

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The weeks leading up to surgery are a time for attending to a plethora of details. A large one is the possibility of a transfusion. If the surgeon thinks the chances are more than about 1 in 10 you could need one and the operation is several weeks off, you might inquire about pre-donating blood to yourself. The risk is minimal, and the safest blood of all is your own.

Changes by the surgeon to the medications you usually take are often especially confusing, so review those instructions—as well as the ones you got at the preadmission appointment—at least a week and a half in advance. Some medications may need to be halted more than a week prior to surgery. Many surgeons feel so strongly about aspirin that if you pop one anytime during the week before the operation, you risk being sent home when you show up.

You might need to shelve your blade, too. "Using razors can cause little microscopic cuts in the skin and increase the risk of infection," says the Institute for Healthcare Improvement's Fran Griffin, meaning that your surgeon could ask you to stop if the operative site includes an area you normally shave such as your face or legs. You should be told when it's time to quit. The current concern over hospital-acquired infections clearly outweighs any embarrassment you might feel about unsightly hair. At Sentara Heart Hospital in Norfolk, Va., presurgical preparation involves clipping rather than shaving the hair around the incision site. Patients are asked not to trim ahead of time so that staff can get a closer clip just before the procedure.

Food and beverage rules are strict, with nothing permitted in the hours just before surgery, typically from midnight on. Sentara patients who are told they can or should take medication the morning of surgery are instructed to do so with the tiniest possible sip of water, says Jennifer Chiusano, director of cardiac nursing services.

The danger is that anything you ate or drank before surgery could find its way into your lungs. During intubation, when the breathing tube is put down your airway, you could inhale the contents of your stomach. That could trigger a cascade of events leading to severe pneumonia or even death. So no midnight snack.

Before leaving the house, remember to leave behind your watch and all jewelry and accessories (including body studs). The hospital won't take responsibility for them, they are reservoirs of bacteria, and you don't need an instrument snagging on an overlooked earring.

Continue reading: Hospital Guide, Part 4: Pre-Op>>

This story was originally reported on 7/15/07.