Pre Op Preparation

Pre-op Preparation: What you need to know and prepare

If you feel weight loss surgery is right for you, the whole process begins with an initial consultation with Dr Craig Taylor. You will need a referral from your GP. If you’re still not sure that you’re ready, that’s perfectly OK. Why not come along to a free patient consultation and find out more about Gastric Banding, Gastric Sleeve and our Total Care program.

Initial stages

Following your initial appointment, a date for your surgery can be scheduled in as little as two weeks. During this time, you will be asked to:
Pre-surgery: During this time, you will be asked to:

  • Sign a patient admission form
  • Make an initial dietary appointment
  • Get blood tests done at Douglas Hanly Moir collection centre – Surgery may not be performed if blood tests have not been done
    Sign Oclinic consent forms
  • Make initial psychology appointment
  • Ensure post-operative appointments have been booked by reception staff

2 Weeks prior to surgery: During this time, you will be asked to:

  • Start Optifast – http://oclinic.ypodemos.com/wp-content/themes/oclinic/pdf/OClinic-preSurgery-optifast.pdf
  • Make payment for program fee
  • Refer to medications list to check when to stop taking specific medications

1 Working day prior to surgery:
A nurse from either the SAN or Mater will call you between 4 & 9 pm to inform you what time to arrive at hospital and what time you will need to start fasting.
2 Weeks after surgery:

  • Attend post-operative appointment with doctor & dietician
  • Book follow up appointment/s at reception

Following surgery, patients may experience the following symptoms:

Common Symptoms

Medication Required

  • Pain

  • Digesic or Endone (prescription)

  • Shoulder tip pain

  • Heat pack or tiger balm

  • Nausea

  • Zofran Wafers or tablets (prescription)

  • Stemetil suppository (prescription)

  • Reflux

  • Somac or Nexium (prescription)

  • Constipation

  • Movicol (no prescription required)

  • Redness & inflammation at sites of incision (possible local infection)

  • Contact clinic for advice

Warning Symptoms

Treatment

  • High temperature

  • Fever

  • Whole body sweating

  • Marked facial flushing

  • Contact clinic during or between the hours of 9 am to 5 pm, or if after hours present to Concord Hospital emergency department

  • Sudden onset of severe abdominal pain which appears to be worsening by the hour and is not relieved by medication

If you are feeling generally unwell, please contact the clinic for advice. If outside of clinic hours, present to Concord Hospital emergency department to be seen by one of Dr Taylor’s registrars.

Patient’s Rights and Responsibilities

YOUR RIGHTS

YOUR RESPONSIBILITY

RESPECT

You have the right to be shown respect, dignity and consideration.

RESPECT

Consider the privacy and comfort of other patients.

TO BE WELL INFORMED

You have the right to be informed clearly about services, treatment, option, and costs.

COMMUNICATION

Provide accurate information regarding your medical history and ask questions.

PARTICIPATION

You have a right to be included in decisions and choices about your care.

COMMITMENT

Commit to attend all appointments that have been arranged for you including dietary and psychology consultations.

PRIVACY

You have a right to privacy & confidentiality of your personal information.

PAYMENT OF FEES

You should pay your account in full within the requested time.

ASK QUESTIONS

You have a right to comment on your care & contact the clinic for advice or clarification of instructions pre and post operatively.

PROVIDE SUFFICIENT NOTICE

Provide our clinic at least 24 hours’ notice when rescheduling or cancelling appointments.

VOICE ANY CONCERNS OR COMPLAINTS

You should direct any complaints to the practice manager so that immediate action can be taken to resolve your concern.

SUPERVISE YOUR CHILDREN

Parents are to control their children at all times whilst attending the clinic for the comfort of other patients.

MEDICATIONS AND YOUR SURGERY

Some medications, including natural therapies (especially Chinese Herbs), must be stopped prior to a procedure as they may cause thinning of the blood, which can lead to bleeding. We have listed examples of medications we would like you to stop prior to your procedure with us. If you are unsure about your medications, please contact us on 8197 9595. Please take your regular medications as usual with a sip of water only.

Platelet inhibitors and Anti-coagulants – check with Dr Taylor when to cease these medications

  • Coumadin (Warfarin)
  • Persantin
  • Marevan (Warfarin)
  • Plavix
  • Iscover

Aspirin and Aspirin-containing Medications – SHOULD BE STOPPED 2 WEEKS BEFORE SURGERY

  • Action Cold & Flu
  • Dispirin Forte
  • Aspro
  • Astrix 100
  • Bex Powder and tablets
  • Dispirin
  • Cartia
  • Aspro Clear
  • Bayer Aspirin
  • Vincent’s powder
  • Cardiprin 100
  • Aspaigin
  • Soiprin
  • Codral Forte

Anti-inflammatory drugs – SHOULD BE STOPPED 3 DAYS BEFORE SURGERY

  • Aclin (sulindac)
  • Nurofen (ibuprofen)
  • Orudis (ketoprofen)
  • Orudis SR (ketoprofen)
  • Ibuprofen
  • Prioxicam
  • Bugesic
  • Mobilis (piroxicam)
  • Voltaren (diciofenac)
  • Naprosyn SR 750 (naproxen)
  • ACT-3 (ibuprofen)
  • Actiprofen (ibuprofen)
  • Advil
  • Ponstan (mefenamic acid)
  • Brufen (ibuprofen)
  • Suldac (sulindac)
  • Naprogesic (naproxen)
  • ACT-3C (ibuprofen and codeine)
  • Feldene (piroxicam)
  • Fenac (diciofenac)
  • Anaprox (naproxen)
  • Indocid (indomethacin)
  • Mobic
  • Naproxyn SR (naproxen)

Herbal Remedies with aspirin-like effects – SHOULD BE STOPPED 24 HOURS BEFORE SURGERY

  • Ginko Biloba
  • Ephedra/Ma Huang
  • Kava

Herbal Remedies with aspirin-like effects – SHOULD BE STOPPED 1 WEEK BEFORE

  • Evening Primrose Oil
  • Garlic tablets
  • Omega-3
  • St Johns Wort
  • Willow Bark
  • Ginger tablets
  • Bromelain
  • Valerian
  • Ginseng
  • Feverfew

Herbal Remedies with aspirin-like effects – SHOULD BE STOPPED 2-3 WEEKS BEFORE

  • Saw Palmetto
  • Omega-3 EFA
  • Vitamin E
  • Dong Quai
  • Flax & Fish Oil
  • Chondroitin & Glucosamine
  • Licorice
  • Goldenseal

ANAESTHESIA and YOU

There is no safer place in the world to have an anaesthetic than in Australia. Please read the following information carefully – we want you to be well-informed, and we will be happy to answer any questions you have about the anaesthetic before your operation.
You’re in good hands.
In the first place, we want to reassure you about the ability and the qualifications of the anaesthetist who will manage you during surgery. Anaesthetists in Australia are among the world’s most highly trained doctors, having spent several years undergoing specialized training in anaesthesia, pain control, and resuscitation and managing medical emergencies.

The role of anaesthetist

People often think of anaesthesia as being put to sleep. However, that’s not strictly true. Rather, the anaesthetist puts you into a state of carefully controlled unconsciousness. This is done so that surgery will be painless.
No chance is taken during the period. All your bodily functions are carefully and constantly monitored by your anaesthetist.
Afterwards, we want you to experience as little pain and discomfort as possible and there again, the anaesthetist will help.

Your Role

  1. There are some things you can do which will make your anaesthetic safer.
  2. Get a little fitter – even a regular walk will do wonders.
  3. Don’t smoke – ideally, stop six weeks before surgery.
  4. Drink less alcohol.
  5. Continue to take any drugs, which have been prescribed but remember to let your anaesthetist and surgeon know.
  6. If you are taking aspirin, consult your surgeon or anaesthetist about whether you should stop taking it two weeks prior to surgery.
  7. If you have any kind of health problem tell your anaesthetist and surgeon so they are fully informed.
  8. If you are anxious and have questions, make an appointment to see your anaesthetist before admission to hospital and the answers you need.
  9. For children, many hospitals can arrange a pre-operative visit.
  10. Stop taking herbal products at least 3 weeks prior to surgery.
  11. Inform your anaesthetist of you use recreational drugs as these may interact with the anaesthetic.
  12. Inform your surgeon/anaesthetist if you object to blood transfusions.

What should I tell the anaesthetist?

Your anaesthetist will meet you before your operation, to discuss the risks and to perform a relevant examination. Depending on the type of operation, hospital or facility this may not occur until immediately beforehand. The anaesthetist will want to know:

  • How healthy you are, if you have had any recent illnesses also about any previous operations.
  • Abnormal reactions to any drugs or whether you have any allergies.
  • Any history of asthma, bronchitis, heart problems or any other medical conditions
  • Whether you are taking any drugs at present – including cigarettes and alcohol – and for women, whether they are on the pill. If you are taking prescribed tablets, bring them along.
  • If you have any loose teeth, wear dentures, caps or plates.

You will probably be given questionnaires or be asked questions by nurses, before seeing your anaesthetist.

Is fasting really necessary?

We know the pangs of hunger can be severe but no food or drink before the operation is a must. Not even water. Food or fluid in the stomach may be vomited and enter your lungs while you are unconscious. If you don’t allow this rule of fasting, the operation may be postponed in the interests of your safety.

General, regional, local or sedation?

This question relates to the type of anaesthetic you will receive. This will depend on the nature and duration of the surgery. Regional or local anaesthesia may often be used in association with general anaesthesia.

General anaesthesia – You are put into a state of unconsciousness for the duration of the operation. This is achieved and maintained by injecting drugs through a needle placed in the vein combined with mixture of gases, which you will breathe. While you remain unaware of what is happening around you, the anaesthetist monitors your condition closely and constantly adjusts the level of anaesthesia.

Regional anaesthesia – A nerve block numbs the part of the body where the surgeon operates and this avoids a general anaesthetic. You may be awake and free of pain, sedated (see below). Examples of regional anaesthetics include epidurals for labour and eye blocks for cataracts.

Local anaesthesia – A local anaesthetic is injected at the site of the surgery to cause numbness. You will be awake, but comfortable and feel no pain. An obvious example of a local anaesthetic is numbing an area of skin before having a cut stitched.

Sedation – To make things more pleasant, the anaesthetist might administer drugs to make you relaxed and drowsy. Sometimes called twilight sleep or neurolept, and often used for endoscopy and colonoscopy.

After the operation

Your anaesthetist will continue to monitor your condition carefully, well after surgery is finished, to ensure your recovery is as smooth and trouble-free as possible.
Once awake, you will feel drowsy. You may have a sore throat, feel sick or have a headache. These are temporary and will soon pass.
To help the recovery process, you will be given oxygen to breath, encouraged to take deep breaths and to cough. Only when you’re fully awake and comfortable will you be transferred either back to your room, ward or waiting area before returning home.
Don’t worry if there is some dizziness, blurred vision or short-term memory loss. It usually passes quite quickly.
If you experience any worrying after effects, you should contact your anaesthetist.

Infections

Needles, syringes and intravenous lines are all used only once. They are new in the packet before your surgery commences and they are disposed off immediately afterwards. Cross infection from one patient to another is thus eliminated.

Blood transfusion

This is kept in minimum but you are likely to need blood, you may be able to donate your own blood well in advance of surgery. This can be stored and used when, and if needed.
All blood collected today from donors is carefully screened and tested, but a very small risk of cross infection still remains. Hence, unless absolutely necessary, blood transfusions are not given.