What You Must Know Before Having Surgery

Each year, more than 80 million Americans H undergo some type of surgery. Over the U last 35 years, I have advised thousands of surgical patients on the information they should give their doctors and the questions that must be asked to ensure the best possible odds for a successful operation and recovery. Here are the areas that are most often overlooked or cause confusion among patients…

• Medications and/or supplements before surgery. If you take a blood thinner, such as warfarin (Coumadin), you will likely need to stop taking it three or more days before any major surgery, such as a coronary bypass or a hysterectomy, to prevent excessive bleeding. You will probably need to modify your medication schedule even for less invasive surgery, such as knee surgery or removal of a growth.
  

Caution: Do not assume that your surgeon knows the drugs and/or supplements you are taking. In fact, he/she probably doesn't. Give him a list of all your prescription and nonprescription drugs, such as aspirin or antacids, as well as all vitamins and other supplements that you take.

Self-defense: When your surgery is scheduled, ask your surgeon to write down the specific drugs and/or supplements you should stop taking before surgery and exactly how many days prior to the operation you should discontinue them. Also, be sure to mention any chronic conditions you have, such as diabetes, heart disease or allergies, which may affect the outcome of your surgery.

• New drugs before surgery. It's not uncommon that the surgeon will ask you to take an antibiotic (to prevent infection) or an anticoagulant drug to prevent blood clots) several days before surgery.
  

Self-defense: Don't wait for the surgeon to tell you this. As soon as your operation is planned, ask about pre-surgery medications. Get this in writing as well.

• Fasting. Many types of surgeries require that you fast or go on a liquid-only diet the day prior to the procedure. Among other reasons, fasting is necessary to prevent the patient from vomiting and possibly choking. You also may need to take a laxative to empty your bowels before the operation.
  

Self-defense: When surgery is scheduled, ask your surgeon for a written schedule of when you should stop eating solid foods...when you should take a laxative (if necessary).. and when you must stop ingesting anything, including liquids.

• Medical tests. Pre-surgical tests may be required a few days before the operation to rule out any reasons to delay, alter or cancel the surgery. However, often, those same tests were performed only a week or two earlier to diagnose your condition.
  

Self-defense: Ask the surgeon or his staff to check whether you need to repeat a recently performed test. You have enough to do prior to surgery without going for unnecessary tests.

• Conflicting instructions. Your surgeon may tell you that it's okay to take a certain drug prior to surgery while one of your other doctors says to stop it.
  

Self-defense: When your surgeon gives you instructions that differ from what one of your other doctors has told you, ask that the doctors speak with each other and give you their joint recommendation.