Preparing for Surgery

Always Be Prepared
It's normal to feel anxious and to have questions when you are facing any kind of surgery. A little preparation can go a long way towards helping your surgery and recovery go as smoothly as possible.

1. Jot down a list of questions in advance to discuss with your surgeon and nurse. Don't be shy: there are no "stupid questions." If it is important to you, it is important to your doctor.
   
   Many people find it helpful to have a family member or friend attend the meeting with the doctor before surgery. When you are feeling anxious, it is natural to forget what the doctor tells you. By writing down his or her response to your questions or by having a friend with you, you can be sure to remember everything.



2. Be sure to carefully follow the instructions your surgeon gives you.



3. Inform your surgeon of any special needs you may have -- from diet to medications.

Below are other tips that can help you as you prepare for surgery.

Medicines
Discuss with both your doctor and anesthesiologist (the physician who will be putting you under for the operation) any prescription, over-the-counter medicines, vitamins, and herbal supplements that you take.

Note: Aspirin and some other over-the-counter drugs can interfere with blood clotting and cause increased bleeding during surgery. This is also true of some herbal supplements, (i.e., St. John's Wort, Ginkgo biloba, and others).

You may want to simply write out a complete list of medicines and supplements with the dosages. Make a few copies: one for the surgeon, one for the anesthesiologist, one for the nurse, and an extra that you should keep on hand. Or, if it is easier for you, bring all your medications, over-the-counter medicines, vitamins, and herbal supplements when you visit the surgeon prior to your surgery.

If you are taking medications, check with your surgeon or anesthesiologist to see if you must take the medication or if you can skip it the day of surgery. For instance,

• If you are taking blood pressure medicine, your doctor may tell you to take it on the morning of your surgery with a small sip of water.



• If you have diabetes, be sure to check with your doctor about taking your medication -- whether it be insulin or pills. Your doctor will tell you how to adjust your dosage for surgery.



• If you have been on prednisone, you will need more doses of this medicine before surgery and for a short time after surgery. Never stop taking prednisone abruptly -- stopping too quickly without slowly decreasing the dose can be dangerous.
  
  If you are taking prednisone or have taken it within the six months before surgery, you will usually be given an intravenous dose of a similar steroid medicine before and after surgery.

Be sure to tell the anesthesiologist if you have ever had a bad reaction to any kind of anesthesia.

Let your doctor know what pain medication has worked for you in the past and which pain medicines have not.

Allergies/Adverse Drug Reactions
Tell both your doctor and anesthesiologist if you have drug allergies or other allergies. Be sure to relate any bad reactions to certain medicines you have experienced in the past. For instance, some people cannot take codeine because it makes them nauseous. Other people are allergic to penicillin.

You may want to write up a list of allergies and give copies of the list to the surgeon, anesthesiologist and the nurse.

Remember: Be sure to mention any allergies to tape or latex.

Exercises
Your surgeon may prescribe special exercises to help strengthen your anal muscle before your operation.

Blood Transfusions
Although blood is screened very carefully, there are still risks associated with blood transfusion and many people are concerned about receiving blood transfusions. Ask your surgeon if you can donate your own blood prior to surgery.

Diet
The day before your surgery, you will be on a clear liquid diet for the whole day or part of the day.

You will also be given a bowel preparation and may receive an antibiotic. Be sure to follow the instructions.

Remember: Have nothing to eat or drink after midnight before your surgery -- unless your doctors have told you to take specific medicines. This includes chewing gum, mints, and hard candies.

Hospital Stay
In most instances, you will come to the hospital the day of your surgery.

In some cases, the enterostomal therapist (ET) or ostomy nurse will see you that morning and mark the location of the temporary ostomy in case one is needed. In some cases, the surgeon will mark this site.

Your ostomy nurse will discuss the operation and answer any questions you may have. After your surgery, he/she will instruct you on the care of your stoma.

A temporary ostomy may not be necessary if you are not on steroids or other immune suppressing medicine. If there is no tension on the area where the ileal J-pouch is connected, this operation can be safely done without a temporary ileostomy. Your surgeon will discuss whether you are a candidate for this.

You may want to have someone stay with you during the first night after your surgery. Ask your doctor or nurse if this is possible.

Plan on a minimum three (3) to five (5) day hospital stay.

Home health nursing will be arranged while you are in the hospital. We strongly recommend home health care to ensure that you know how to care for your temporary ostomy in the postoperative period after you go home.

When it comes to your medical needs, you are your own best advocate. Be open and honest with your physician. Share your feelings about the operation.

It may be reassuring to know that satisfaction with this procedure has been high. The absence of a permanent ostomy has eliminated the concern of many people about their body image.

Finally, remember to enlist the aid and support of family, friends, and qualified members of your personal healthcare team. Together, you can help to ensure the best surgical outcome.

Remember: For any questions about your surgery, it is always best to contact your physician.

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