Before and After Surgery

Surgery Options
At Carle, surgeries can take place in two locations. You may have surgery at Carle Foundation Hospital or at one of the Carle SurgiCenters. You and your doctor will decide where your surgery will take place based on your needs.

Carle Foundation Hospital
Your doctor may suggest that you have your surgery done at the hospital. You will be asked to come to the One Day Surgery Center on the day of your surgery. After surgery, you may be able to go home that same day or, if needed, you may stay in the hospital to begin your recovery. Your doctor will decide what is best for you. If tests or procedures are needed for your surgery, they will be performed several days before your operation. If you are having surgery and know you will be staying overnight in the hospital, you will also come to the One Day Surgery Center on the day of your surgery. In some cases, patients are admitted to the hospital the night before surgery to help us prepare for their care. Your doctor will decide when you need to be admitted to the hospital.

The Carle SurgiCenter
The Carle SurgiCenters, located in Champaign and Danville, are designed for generally healthy people who need outpatient surgical procedures. There are fewer restrictions and family members are allowed in the pre-op and recovery areas when a loved one has surgery. Most patients leave the SurgiCenter within one to two hours of their surgery. But, if your doctor thinks you need overnight recovery care, you may be admitted to the Recovery Center, located next to the SurgiCenter. Patients receive the same level of quality care provided at the Hospital. Experienced nurses monitor the patient's care and patients may stay at the Recovery Center up to 72 hours, if medically needed. Each suite also includes a pull-out bed for a family member who may want to spend the night. Ask your doctor if the SurgiCenter is an option for your procedure.

Before Your Surgery
Several appointments will be needed before your surgery. A staff member will give you information about your appointments, where to report for surgery, and when the surgery will take place. Depending on your age, general physical condition and the surgery you need, you may or may not need to have a pre-operative exam and a variety of tests. If you are scheduled for an exam and tests, please be sure to wear comfortable shoes and clothing. Tests needed may include:

• A physical screen to review your health history; blood and urine tests to see how your body and kidneys are working
• An EKG to let us see how your heart is beating
• A chest X-ray to let us see your lungs

Before surgery, you will meet with your surgeon who will talk with you about the operation you will undergo. This discussion will include the side effects, risks and desired outcome of the surgery. This is a good time to have all your questions answered. You should be prepared to talk about your health and the health of your family members. It is important to tell your surgeon about previous illnesses and surgeries, allergies and the possibility of pregnancy. Your primary doctor and surgeon will also ask for a list of the medications you take.

Advanced Directives
If you have a Living Will or Advance Directives, let your doctor know so copies can be included with your chart. If you do not have a Living Will or Advance Directives, you may get information about both from Hospital Registration. Please note that Advance Directives can not be witnessed by staff members. This needs to be taken care of before the day of your surgery.

Important Instructions

Information About Insurance
Call your insurance company to find out whether the surgery to be performed needs to be pre-certified or approved in advance.

Hospital Admittance
When checking in at the Hospital or SurgiCenters bring the following:

• Appropriate insurance and/or Medicare identification cards
• Social security number of responsible policy holder
• The name, address and phone number of the adult who will be driving you home.

Medicine
Please tell your doctor and surgeon about any and all over-the- counter or prescription drugs you are taking, including ibuprofen, aspirin, blood pressure, blood thinning or diabetes medicine, inhalers and eye drops. Your doctor will tell you when and what over-the-counter or prescription drugs you should stop taking before surgery. Some medicines can be dangerous because they can slow blood clotting. You may want to use the following lines to write down the medications you take now.

Things to Know Before Coming to the Hospital or SurgiCenter
The day before surgery (or on Friday if your surgery is on Monday) you will receive a phone call from the pre-op nurse to tell you when and where to come for your surgery. You will also be given any other specific instructions you need. If you did not speak with an anesthesiologist, the nurse will give you special instructions about eating, drinking and medications you may or may not take.

General Instructions
You should bring all medications that you are currently taking with you to the Hospital or SurgiCenter in their original containers. This includes over the counter drugs. This helps ensure that we give you the correct dosage of your medicine and avoid any harmful reactions. Make sure your driver or family member can pick up any prescriptions you might need.

There are some general instructions that apply to everyone having surgery:

• First, if you are going home the same day of surgery you must have someone drive you home.
• You may also need to have someone stay with you for the first 24 hours after you go home.
• Showering before surgery is important in order to remove make-up, lotions, perfumes or powders. These keep tape and special monitoring equipment from sticking to your body.
• Please remove false nails and nail or toe polish to make it easier to check your circulation.
• You may brush your teeth in the morning, but do not swallow the water. If you wear dentures, a case will be provided.
• If you wear glasses or contact lenses, bring a case for them.
• Wear loose, comfortable clothing to allow room for any dressings, braces, etc., you may need after surgery.
• Leave all valuables, including large amounts of cash, credit cards and jewelry at home.
• Write down your calling card number and bring it with you, if you will need to make long distance calls. Or, ask your family or friends to notify others of your progress after surgery.
• If you are traveling a long distance, you may wish to stay in a local hotel the night before surgery. A Hotel and Restaurant Guide is available at Carle's Information Desk located in the Hospital's Main Lobby.
• Although gowns are provided, you may want to bring a bathrobe and slippers.
• Depending on your length of stay, you may want to request that friends and family send flowers or get well greetings directly to your home.

Important Tips

Before your surgery, you can take the following important steps to aid in your comfort and recovery. If you do not follow these instructions, your surgery may be canceled.

Try To Stop Smoking
Smoking can be harmful to your recovery. Try to stop smoking at least two weeks before surgery. This will improve your lung function and circulation which will help you heal more quickly. Carle has resources to help you reduce or quit smoking. If you are interested in help, ask your nurse for more information about Carle's programs. Carle Hospital is a smoke free environment.

Ask Your Doctor About Medicines You Currently Take
Aspirin, ibuprofen or naproxen sodium (Aleve) are over the counter medicines that may slow blood clotting. Check with your doctor to determine when or if you should stop taking these medicines before surgery.

Avoid Alcohol
You should not drink any alcoholic beverages at least two days before surgery. Alcohol can react with the medications you may take, interfering with recovery and causing serious complications.

Follow Diet Instructions
You may receive special diet instructions prior to surgery. If so, it is important to follow them carefully. Be sure to follow the anesthesiologist's advice regarding the specific time to stop eating or drinking prior to your surgery. Eating or drinking anything (water, candy, gum, etc.) may result in the need to cancel your surgery.

Tell Your Doctor About Your Current Health
It is important to tell your doctor if you have any type of infection (especially on the skin where surgery will be done), dental infection or tooth abscesses, cold, flu, rash, fever or loose bowels.

Surgery Day
We know that on the day of your surgery you might feel a little uneasy. That's why we think it's important that you know what's going to happen. Before your operation, a staff member will tell you where to park and where to report on the day of surgery.

A staff member will explain visiting hours to you. Your family and friends may want to wait for you while you are having surgery. A Carle staff member will show your visitors to waiting areas and explain where they might get meals or something to drink. Waiting in these areas makes it possible for the surgeon to talk to your family as soon as possible, after your surgery. There are lockers in the Hospital's Main Lobby for coats and other personal items. If you have a long surgery, your family and friends will also be updated on the progress of your surgery during and after the surgery.

In preparation for your surgery, you will change into a hospital gown and you will be given a special identification bracelet to wear on your wrist. The area of your body which will be operated on will be prepared, if needed. This may include shaving and washing the area with a special soap.

Your medical history, pulse, temperature, blood pressure and breathing will be checked to make sure nothing has changed since your doctor's appointments. An intravenous or IV tube may be inserted into a vein in your arm to supply fluids and medicines to your body. You may also receive special medication to help you relax.

The Operating Room
Next, you will be moved to the operating room where your surgery will take place. This is a safe, sterile environment where your doctors will perform your procedure. When it is time for your surgery, family members may be able to go with you part of the way to the operating room. They will then be shown to a waiting room where they can wait while you are in surgery. A parent or legal guardian must be with an underage child or adolescent who is having surgery. This person must plan to stay in the building during the surgery and be nearby, in case of an emergency.

Before anything is done, the medical staff will explain all the things that will happen to prepare for your surgery and what will happen during surgery. The following information will be explained to you:

• In order to help keep the room germ-free, everyone will be wearing masks.
• The room will be cool and you will be given warm blankets if you are uncomfortable.
• An anesthesiologist or a specially trained registered nurse called an anesthetist will give you anesthesia.
• If needed, tubes may be inserted to drain fluids from your bladder and stomach.
• Special equipment will be used to record and monitor your blood pressure, pulse, breathing and other body functions.
• If you have received medication to help you relax, you will feel sleepy; but, you may still be able to hear noises as everyone does their work.

After Surgery
After your surgery is over, you will be moved to a recovery area. You may have a mask with oxygen and a mist. This will help your body get rid of the anesthesia. You may also have a tube in your mouth to help you breathe. The IV may still be in your arm, so nurses can give you medications, if needed. In special cases, if your surgery is performed in the hospital, you may be wearing compression stockings on your lower legs. These stockings help maintain good circulation. You will feel them gently squeeze your legs to help the blood return to your heart.

Your throat may be sore and you may feel a little woozy, tired and may be nauseated. These are side effects of the anesthetic which will gradually wear off. Unless you are told not to, you should try to cough and breathe deeply to rid your body of the anesthesia.

The nurses will be near your bed to check on you and to see that you are awakening. They will check your blood pressure and see if you have any swelling or drainage around the surgery area. Since anesthesia wears off differently with each individual, the length of stay in the recovery room varies with each patient. However, you will be in the recovery room at least one hour. If you are having any pain, let the nurse know. A nurse will be able to help you control your pain with medication.

Your family and visitors will be informed when your surgery is over and you have been taken to the recovery room. If they have not learned about your condition by phone after the surgery, they may call the recovery room directly.

Your Recovery

Outpatient Recovery
If you are going home the same day as surgery, you will be moved to another area to recover. Here you will be allowed to sit up and drink fluids such as tea, soda or broth. Sluggish digestion, gas pains or other discomfort after surgery are normal. Do not be alarmed. You will be able to leave when you can take fluids, walk a few steps and go to the bathroom. Your family or friends should be with you when the nurse gives you special instructions. Someone will be required to drive you home and to stay with you for the next 24 hours.

Inpatient Recovery
If your recovery requires an over-night stay, you will be moved to a Hospital or Recovery Center room once you are ready. The nursing staff will continue to care for you. How often they check your blood pressure, heart rate, breathing and temperature will depend on the level of care you need, the type of surgery you have had and your surgeon's orders. Your activity and diet will be increased gradually based on your progress.

Going Home from the Hospital

When your doctor decides you are ready to leave the Hospital, a discharge order will be written. Your nurse will need to do some final preparations before you are actually ready to go home. Please speak with your nurse about the exact time you will be ready for discharge. You will want to arrange for a family member or friend to help you when it’s time to go home. If this is not possible, please tell your nurse. Your nurse will contact your case coordinator who can discuss post-discharge care options with you.

Please remember to stop by the Hospital Registration Center before you leave to make sure your paperwork is completed.

Checkout Time
On most units, checkout time is 11 a.m. If you cannot leave by this time, please notify your nurse so other arrangements can be made. You will be billed for extra time in your room if the wait is not medically necessary. This charge is not covered by most insurance plans.

Discharge Instructions
Your doctor and your nurse will give you instructions about post-hospital care. Your nurse will go over written instructions regarding your discharge with you. He or she will also review any special instructions about activity and diet and help you determine if you will need any medical equipment at home. While your doctor is discussing discharge with you, take the opportunity to discuss medications. Now would also be a great time to discuss any refills of prescriptions that you may need. You may have your prescriptions filled at your own pharmacy or they can be filled at the RxExpress pharmacy located in the Main Lobby, so you can pick them up before you leave the Hospital. (For more information about RxExpress, please see page 27 in the Additional Care and Treatment section.) Please let your doctor know where you would like your prescriptions sent.

A case coordinator is also available to assist you. Whether you need home care, medical equipment or placement in a continuing care facility, he or she will help you make all the needed arrangements. Your case coordinator can also assist you with any insurance questions you may have regarding these services.

Remember, if you have questions about any of your discharge instructions, feel free to ask your doctor or nurse. We want to ensure that before you leave the Hospital you feel comfortable with your treatment and all of your questions are answered.

Personal Belongings
Collect all of your belongings and double-check closets and drawers. The day before you are discharged is a good time to have a friend or family member take home flowers, balloons or gifts you have received while in the Hospital.

Escort Service
Patients who are able to leave on their own may do so with a family member or friend. A Hospital staff escort may not be necessary, but is available if you desire. If you need a wheelchair or assistance, we’ll be happy to help. Carle Auxiliary members also provide patient escorts.