Preparing for Surgery

Will I need medical clearance from my primary care doctor?

Based on your medical history and your responses to the standard NYU pre-surgical questionnaire, you may be required to see a medical doctor to prepare for surgery. Additionally, based on the type of surgery that you will be having, you may also be required to visit the NYU Langone Orthopedic Hospital Pre-Admission Testing (PAT) department (*You will be informed if this is necessary).

What if I need medical clearance and I do not have a regular medical doctor?

My office would be more than happy to refer you to an excellent Internist who would be able to assess your medical risk for the surgery and optimize your condition.

When will I find out my surgical time?

The appropriate surgical facility will give you a call the day before surgery to notify you of your arrival time/surgical time. If you have not heard from us by 6:00 p.m. the night before your surgery, you can call the surgery information line:

• NYU Langone Orthopedic Hospital: 301 East 17th Street, NY, NY 10003 Telephone: 212-598-6577
• NYU Langone Outpatient Surgery Center: 339 East 38th Street, NY, NY 10016 Telephone: 212-263-1515

**If you have any questions about timing, please email me at Kirk.Campbell@nyumc.org**

Before Your Surgery

Pre-Surgical Wash

Prior to your surgery, you are going to need to purchase Hibiclens, a pre-surgical soap, from your local pharmacy.

The night before surgery, the hospital staff will contact you and let you know what time to check in for surgery, and remind you to clean your surgical site the night before with the Hibiclens soap.

What should I do to prepare for my surgery?

1. Do NOT eat or drink anything after mid-night prior to your surgical date.
2. Arrange for a family member or friend to accompany you to the hospital the day of your surgery.
3. Plan ahead for transportation home the day of your planned discharge.
4. If having shoulder surgery, you may want to adjust your wardrobe to provide a front closure shirt/blouse or sweater, which are easiest to wear after shoulder surgery.
   1. If you are having a shoulder replacement you will be staying at the hospital for 1 to 2 days. If you are having an arthroscopic procedure, you will go home the same day as your surgery.
5. If having shoulder surgery, you may be in a sling for up to 6 weeks. During that time you will not be able to use that arm, which includes NO DRIVING. If you have questions about how long you will be in your sling please contact my office.
6. Remember to adjust your work/social schedule accordingly during your anticipated recovery time.
7. While taking narcotic pain medication, you will not be permitted to drive. You may need to arrange for transportation to your initial follow-up visit.
8. Be sure to wash the surgical site with the Hibiclens soap the night prior to surgery.
9. If you have pets, you may want to arrange for someone to assist in caring for them for a few days after you return home.
10. Unless told otherwise, you will need to have a follow-up visit with me 7-14 days after surgery for suture removal.

What should I bring with me the day of surgery?

• Photo ID
• Insurance Card
• Friend or family member who will be available the entire time and take you home after surgery
• Wear comfortable, loose fitting clothing
  • Shoulder/elbow surgery: zip-up or button down shirt
  • Knee/ankle/hip surgery: loose fitting pants or shorts

**Please leave jewelry, money and valuables at home.

Medications to Stop Before Surgery

14 days before surgery, you need to stop:

Any Narcotic (example: Vicodin, Norco, Darvocet, Percocet or Oxycontin)

• Advil and aspirin like products should also be stopped 14 days before surgery

7 – 10 days before, you need to stop:

Any medications that can lead to increased bleeding (example: Plavix, Coumadin, Warfarin, prescribed Aspirin). **** Please consult with the prescribing physician prior to stopping prior surgery***

You can continue to take:

• Tylenol
• Celebrex
• Glucosamine Chondroitin Sulfate
• Daily Vitamins
• Ultracet

You may eat normally on the day before your surgery, but do not drink alcohol. DO NOT EAT OR DRINK ANYTHING OR CHEW GUM AFTER 12:00 a.m. (MIDNIGHT), unless specifically told otherwise. This is important when having anesthesia. The only exception is if your doctor specifically tells you to take medication with a sip of water.

On the morning of surgery:

• Take only medications that are for your heart (hypertension, arrhythmias, etc.)
• If you use an inhaler, please bring it with you
• If you are taking diabetic medications, you should check with your internist to determine if you should take these medications on the morning of surgery

If you are taking any other medications that are not listed, please consult with your internist prior to surgery to determine if you should continue taking the medication or to see when you should stop and resume the medication.

Anesthesia

General

General anesthesia is used for many types of major surgery. During general anesthesia the entire body, including the brain is anesthetized. The patient has no awareness, feels nothing and remembers nothing of the surgical experience afterward. General anesthesia is administered by injecting a liquid anesthetic into a vein, or by breathing a gas anesthetic flowing from an anesthesia machine to the patient through a mask or tube. A plastic endotracheal tube or a mask placed over the airway is frequently used to administer gas anesthetics. With the tube in place, the airway is protected from aspiration of stomach fluids into the lungs. It is normal to have a slight sore throat after your surgery.

Regional

Injection of anesthetic into the neck region for shoulder and elbow surgery blocks pain impulses before they reach the brain. With this anesthetic, mental alertness is unaffected. Sedation, or even sleep may be offered to make you comfortable throughout the surgical experience. To receive the injection, you lie down while the anesthetic is injected into the neck or shoulder region. To make placement of the needle almost painless, your skin is first numbed with local anesthetic. This anesthetic may last for 8 to 10 hours and sometimes longer. It is important to start taking your postoperative pain medicine as soon as you begin to feel the onset of discomfort or when the numbness begins to wear off.

** Your anesthesiologist will speak with you directly prior to surgery to review your choice of anesthesia.

Medication Refill Policies

• Refill requests should be made during regular business hours and will be processed within 24 hours of request.
• Narcotics will be administered post-operatively by Dr. Campbell only, unless patient is receiving care from a pain management physician.
• Patient must indicate if receiving narcotics from any other physician. A treatment plan for refills should be discussed with Dr. Campbell.
• Only in very special circumstances will a patient receive narcotics for longer than 2-3 weeks after surgery.