Your Surgery At Cottage Hospital

Thank you for choosing Galesburg Cottage Hospital for your scheduled surgery. The staff at Cottage will work with your physician to make your stay as comfortable as possible.

This booklet will give you some general information regarding your upcoming surgery. Please take time to read this booklet and share it with the adult who will come with you the day of your surgery.

Please ask your doctor or a member of the Cottage staff any questions you have regarding your surgery. We are here to work with you to make this surgical experience as pleasant as possible. As you read through this booklet, please jot down your questions so you will not forget them when you talk with your doctor or the hospital staff.

Before Your Surgery

Prior to your scheduled surgery, please check with your employer and insurance company for authorization, second opinion and precertification requirements. Not notifying your insurance company as required may result in a penalty and reduction in their payment of your bill. This will increase the amount you will be required to pay.

Advanced Directives

An Advance Directive is a prepared, written, witnessed, statement about how you want your medical decisions to be made if you are unable to make them for yourself. A Living Will and a Healthcare Power of Attorney are two types of advance directives. If you have advance directives and the hospital does not have a copy, please bring a copy to be placed on your hospital record. It will then always be on your record for any future need. If you do not have an advance directive, but would like information about it, you may request information from the hospital by calling, or when you come in to pre-register.

PreAdmission Testing/PreRegistration

All surgical patients should go to the hospital Patent Registration Department to pre-register before the day of the procedure.

Before many procedures, your physician will order some testing such as blood tests, urine tests, EKG, or x-rays. If any of these things are ordered, they need to be completed within 7 days of your procedure or as instructed by your physician.

The advantages of having your testing done before the day of surgery are that it will save time the morning of surgery and that the written reports of your tests will be reviewed by your Doctor and caregivers ahead of time. You may also be able to bypass Patient Registration/Admitting the day of your procedure.

To have your testing done prior to the day of surgery, you will first need to be registered. Please park in the Visitors’ Parking Lot, which is located across from the main entrance of the hospital. Enter the hospital through the main entrance at 695 N. Kellogg Street, and go to the Patient Registration Department (Admitting). Your Doctor’s office may have given you written orders to bring with you for the testing or they may send them to the hospital. To assist the registration process, please bring all insurance or medical cards with you.  After registering, you will be directed to the appropriate testing department.

Pre Surgical Interview

When you pre-register, a nurse may visit with you to obtain a medical history and review specific instructions. Please bring a list of all medications, herbs, or vitamins.

If the nurse is not available to speak with you at this time, she will attempt to call you 1 to 3 days before your surgery. If you will not be home, please call the hospital before the day of your procedure to speak to the nurse. Please call (309) 345-4542 from 7am to 3pm Monday through Friday.

The Night Before Surgery

Do not eat or drink anything, including water, after midnight the night before your surgery. This helps to prevent you from vomiting and breathing stomach contents into your lungs during surgery. If your surgery is later in the day, ask your doctor or nurse if this time may be adjusted. If you do eat or drink after the time instructed, please call the Cottage Surgery Pre-Op Department after 6:00 a.m. at (309) 345-4325 as soon as possible. If you are an inpatient, please tell your nurse. Your surgery may need to be postponed.

You should not smoke the morning of surgery.

Medications

Morning medications should be taken as usual with a small amount of water. You should not take any “water or fluid pills” or diabetic medication. If you are unsure about which medicine to take, contact your medical doctor. If you are on any “blood thinners” such as Heparin, Coumadin, Plavix, Aspirin or others, please notify the doctor or nurse. You may need to stop these for several days before your procedure. If you use inhalers, bring them to the hospital with you.

Bring a LIST of ALL medications, including vitamins, herbs or over the counter medicines that you are taking. A form is provided at the back of this booklet.

The Day of Surgery

• If you are an inpatient, you will be taken to the Pre-Op Holding area approximately 2 hours before your expected surgery time.
• If you are an outpatient, please come to the hospital at your designated time. If you are unable to be at Cottage at your scheduled time, please call the Outpatient Surgery Department at (309) 345-4325 as soon as possible.

You must check in with the Patient Registration Department the day of your surgery if you did not come in for pre-registration. Here you will be registered and then directed to the surgical area.

Please try to be pre-registered with all necessary testing completed before the day of surgery.

Reminders:

• Wear comfortable, loose clothing, keeping in mind what bandages or dressings you might have after surgery.  Low-heeled shoe are also preferred.
• Jewelry, earrings, make-up, fingernail polish, and contact lenses must not be worn the day of surgery.
• All body piercings must be removed.
• A small locker is available to you for your personal belongings.
• Please leave valuables at home.
• Bring your list of medications.

Only two visitors can be with you in the patient preparation area. A comfortable waiting room is also down the hall for their convenience. Please do not bring small children.

Once you arrive at the patient preparation area, a nurse will briefly review your medical history and answer any questions you may have regarding your surgery. Your blood pressure, pulse and respiration will also be recorded. You will be asked to put on a hospital gown, and an IV (intravenous-fluid given through a vein) will be stared in your arm. Local anesthesia will be used before the IV is started.

Patients who are Children/Minors:

• MUST be accompanied by a PARENT or LEGAL GUARDIAN

Surgical Consents

You will be asked to sign an operative and anesthesia permit. Signing the consent form means that you understand you physician’s explanation of the surgical procedure. The operative site will be marked to indicate the correct site. (Example: right leg, left arm).

About Anesthesia

An anesthesiologist (a physician who specializes in administering anesthesia) or a nurse anesthetist (a nurse who specializes in administering anesthesia) will visit with you in the patient preparation area. They will ask questions about your health, your family’s health history, medicines you are taking and whether you have had surgery previously. The answers you give will help them to administer the most appropriate anesthesia for you.
You may be given medication just prior to going into surgery to help you relax.  This medication will be given through your IV line.

Types of Anesthesia

Anesthesia is medicine to make you comfortable during surgery or a procedure. There are several types of anesthesia. The anesthesia medicine may be given in your IV, through a face mask, or through a tube in your nose or throat. It can also be given as a shot in your back or as a shot in the area where you will have surgery. The type of anesthesia you may have depends on the type of surgery or procedure you are having. You and your caregiver will decide which type of anesthesia is best for you. Following are some of the types of anesthesia.

• General anesthesia means the entire body is “asleep” for surgery. General anesthesia can be used for most procedures or surgeries. The medicine may be given as a liquid in your IV. It may also be given as a gas through a face mask, endotracheal tube, or a laryngeal mask airway.
• Regional Anesthesia numbs certain areas of the body so that you do not feel pain. Common types of regional anesthesia are epidural, spinal, and caudal anesthesia, as well as peripheral nerve blocks such as IV blocks. With regional anesthesia, you may be awake and aware, or you may receive medication that will make your drowsy or keep you in a light sleep.
• Local Anesthesia is injected by the surgeon. With a local, you may be awake and aware throughout the surgery.  You may also receive medication that will make you drowsy or keep you in a light sleep. An anesthesiologist may be in attendance or a Registered Nurse will monitor your vital signs and provide sedation and pain relievers as needed.

Drains, Catheters, Pain Pumps, Epidurals

These may be inserted in Pre-Op or in surgery. Catheters are usually inserted after patient is asleep in surgery.   Drains are placed at the end of surgery before the patient awakes.

The Surgical Suite (Operating Room)

Trained professionals staff the surgical suite. The surgical suite provides a safe and sterile surgical environment. The health care team in the surgical suite includes your surgeon, nurses, surgical technicians and anesthesia personnel. The team watches over you constantly, and monitors your progress and well-being through out the surgical procedure.

You will be escorted to the surgical suite by a member of the health care team.

When you are in the surgical suite:

• Warm blankets will be provided if the surgical suite feels cold.
• A blood pressure cuff will be place on your arm to monitor your blood pressure.
• EKG pads will be place on your chest to monitor your heart.
• A soft padded clip will be placed on your finger to measure the oxygen level in your blood.
• Oxygen may be administered by a mask or tubing under the nose.
• You will be given medicine to relax you or have you go all the way to sleep.

Information for Your Family

When you leave for surgery, your family will be directed to the surgical waiting area, which is located next to the patient preparation area. A volunteer is usually in the waiting area to assist the family. If your family needs to leave the hospital, they must notify the nurse or the volunteer, where they can be reached. If you are an outpatient we must be able to contact your escort when you are ready to go home. We encourage family members to be with you during the later stage of recovery. Your family/escort may be with you in the outpatient area after recovery. To promote a restful environment for all patients we recommend limiting young children to brief visits.

It is difficult to give an accurate time on how long you will be in surgery and recovery. On the average, your stay will be at least 3-4 hours from the time the surgery actually starts. This does not include the 1-2 hours needed for your surgical preparations.  The nurses will give their best estimate of time after your arrival.

After Surgery

After surgery, you will be taken to the recovery room (Post Anesthesia Care Unit). While you are in the recovery room, your physician will usually meet with your family to let them know how you are doing and answer any questions they may have.

In the recovery room, the nurse will frequently take your blood pressure, pulse, respiration and check your dressings. You will have an IV and may have other tubes or catheters for drainage.  You may experience blurring vision, dry mouth and chills as you wake up from the anesthesia. The area of your surgery may burn and hurt. Please do not hesitate to ask the nurse for pain medication.  It is important for you to try to move around in bed and take good deep breaths. This will help you wake up and speed your recovery.

Outpatients:After 30 minutes to one hour, you will be taken from the recovery room to the outpatient surgery area to continue to recover and be discharged. There are certain criteria that must be met prior to discharge. The nurses determine when you may be discharged by this criteria. The medication and/or anesthesia you received will make it unsafe for you to drive a motor vehicle or operate power tools for at least 24 hours. Your will also not be able to walk home. Upon leaving you must be accompanied by a responsible adult. We recommend that an adult stay with you the first night to assist you during your recovery at home.

Inpatients:After your recovery time, you will be taken to your hospital room. The nurse will stop by the family waiting area to inform your family that you are going to your room.

Recovering

Always follow the directions given by your doctor.

Activity:Walking and movement helps to wake up the entire body system. It speeds healing, improves circulation, helps prevent blood clots, prevents pooling of secretions in the lungs (pneumonia) and aids peristalsis (gets the bowels moving!) Please make sure you have appropriate help the first few times you get up in order to avoid any unexpected falls. If on bed rest post-op, you should be turned from side to side or repositioned every 2 hours. Do leg and foot exercises (pump feet, do ankle circles, flex and straighten knees) several times a day unless against orders or contraindicated.

Deep Breathing and Coughing: These exercises boost circulation, clear the lungs, and lower risk of pneumonia. Should be done several times a day (every 2 hours), for 1-2 days for minor surgery, and until pain in the incision is gone after major surgery. Splint or support the incision with a pillow or both hands to assist in coughing and provide comfort. Coughing may not be recommended with some surgeries. In that case just take deep breaths and expand the lungs fully.

Wound Care:

• Always follow your health care provider’s instructions.
• Keep the wound area clean and dry.
• Wash your hands before and after caring for your wound or dressings.
• Watch for signs of infection:
  Fever
  Increased redness or swelling
  An odorous discharge

Post-Op Pain Can be Controlled:

• Communicate your pain. Don’t try to tell yourself you should “put up with it.” Describe your pain to your healthcare provider using the1-10 scale.  Zero means “no pain” and ten is the “worst pain.” Tell if it is sharp, throbbing, etc.
• Take pain medication promptly. Once pain takes hold it is harder to relieve. Talk to your health-care provider about available pain medications.  When medication is taken as directed, addiction is rare.
• Always follow your healthcare provider’s instructions.
• Use a system for keeping track of medications.
• Report any side effects.
• Try drug-free techniques such as deep breathing, relaxation exercises, or cool packs.

Please feel free to call the Cottage Surgery Department with any questions, concerns or problems. The surgical area is open Monday through Friday from 6am to 6pm, and their phone number is (309) 345-4325.

If the surgical area is closed, then call either your doctor or the Cottage Emergency Department at (309) 345-4223.

Follow Up Call

We are interested in how you are doing at home. Nurses from the Surgery Department will try to call you a day or two after your surgery to ask how you are doing and answer any questions you may have.

More Questions or Concerns?

We understand that surgery can be frightening and confusing with so many special instructions. If you would like to have a tour of the Surgery Department or a chance to talk with a nurse abut your upcoming surgery, please feel free to call (309) 345-4542. The tour and visit can be extremely helpful for children or first-time surgical experiences. Family members are also welcome.

Wishing you a speedy recovery!