Before surgery, your surgeon may ask you to see your primary care provider for an examination and possibly tests. A surgeon may request this to make sure that surgery is not too hard on you. Your primary care provider may order certain tests such as blood tests, urine tests, and blood clotting tests to help determine your overall health. You also may be scheduled for other tests, such as, X-rays or an electrocardiogram (EKG).
You will also have an appointment with your surgeon before your surgery. For this appointment, take along a list of surgery questions to help you understand your treatment. Your surgeon will explain why your surgery is needed, what it will involve, what the risks are and the expected outcome. The expected length of recovery will also be discussed. You may want to discuss other treatments that are available other than surgery.
Get as healthy as you can before surgery
- Talk to your family doctor or surgeon about things that you can do to improve your health before surgery.
- As a general rule, the healthier you are before surgery, the faster you’ll be to recover and get back to normal.
- If you smoke or drink heavily or use street drugs tell your family doctor or surgeon. These habits raise your risk of serious problems during and after surgery, and will make it harder for you to recover.
Stopping smoking before surgery
- Reduces the risk of complications
- Lowers the change of surgical site infections
- Shortens hospital stay
Get your free nicotine patches or nicotine gum through the BC Smoking Cessation program by visiting HealthLinkBC or calling 811.
Visit Quitnow.ca to learn more, and access resources about stopping smoking before surgery.
What is optimization and why does it matter to me?
We want patients to be as healthy as possible before surgery. Improving both your mental and physical health before surgery can lead to better surgical outcomes. While you are waiting for surgery, a nurse may call you to discuss getting healthy before your surgery.
Prehabilitation or "prehab" (also known as optimization), is using the time before your surgery to improve your health and wellbeing and strengthen your functionality. Optimization helps you better prepare for surgery, improve your recovery, and lower your risk of surgical complications.
BC surgical patient prehabilitation overview - YouTube video
What can I improve to help make me healthier before surgery?
You are the most important person in your own care and little changes can go a long way! Below are some areas that are important to optimizing your health before and after surgery.
- Anemia (low red blood cells): Anemia means you have a low amount of red blood cells, which carry oxygen from your lungs to the rest of your body. This can make you feel tired or weak.
- BC surgical patient prehabilitation - Anemia - YouTube video
- Anemia - HealthLink BC
- Cardiac: Ensuring good cardiac health before surgery can significantly improve outcomes and reduce the risk of complications. Poor heart health can lead to unwanted surgical complications and requires close monitoring.
- BC surgical patient prehabilitation - Cardiac - YouTube video
- Heart health - HealthLink BC
- Delirium: A change in your mental state. You can feel confused, disoriented, and not able to remember or think clearly. Knowing what to look for can prevent these symptoms after surgery.
- Delirium (acute confusional state) - HealthLink BC
- Delirium prevention and care with older adults (PDF) - Canadian Coalition for Seniors' Mental Health (CCSMH)
- Frailty: Refers to a holistic whole-body approach, where there has been a decline that makes you more vulnerable. It can make it harder to recover after surgery.
- BC surgical patient prehabilitation - Frailty - YouTube video
- Frailty in older adults - HealthLink BC
- Healthy aging - HealthLink BC
- Canadian Red Cross Northern BC list (PDF)
- Glycemic control (blood sugar levels): Good glucose control will help reduce your risk of infection, improve wound healing, and decrease other problems after surgery.
- BC surgical patient prehabilitation – Glucose control - YouTube video
- Diabetes - HealthLink BC
- Goals of care: You and your team work together to decide what is best for you. This means considering your own values and what truly matters to you, along with any medical treatments that may be required during your surgery care.
- Advance care planning - Northern Health
- Advance care planning - HealthLink BC
- Advance care planning - Government of BC
- Mental wellbeing: Your mental health is as important as your physical health. Learning some stress management strategies or relaxation and mindfulness techniques are great ways to take care of your mental health before surgery.
- BC surgical patient prehabilitation – Anxiety - YouTube video
- Mental health - HealthLink BC
- Nutrition: Eating a healthy, balanced diet is vital to healing and gaining strength after surgery. Healthy eating can also reduce your risk of infection, help control your blood sugars and help you heal faster.
- BC surgical patient prehabilitation - Nutrition - YouTube video
- Healthy eating - HealthLink BC
- Healthy eating and physical activity - HealthLink BC
- Obesity: Excess weight can lead to surgery related complications but also puts you at risk for other factors such as sleep apnea, poor nutrition, unstable blood sugars, and reduced physical activity.
- BC surgical patient prehabilitation – Weight loss - YouTube video
- Healthy eating and physical activity – HealthLink BC
- Healthy weights – HealthLink BC
- Pain management: If your pain is not well controlled before surgery, you'll be less likely to take part in post-surgery exercises, and it can take longer to recover and get back to your usual activities.
- BC surgical patient prehabilitation – Pain - YouTube video
- Pain management – HealthLink BC
- Physical activity: Getting active before surgery can help strengthen your heart, lungs, and muscles, and help to better manage conditions like heart disease, high blood pressure and diabetes.
- BC surgical patient prehabilitation – Physical activity - YouTube video
- Canadian Red Cross Northern BC list (PDF)
- Healthy eating and physical activity – HealthLink BC
- Sleep apnea: Obstructive Sleep Apnea (OSA) is a disorder where your breathing is partly or completely blocked during sleep. It can lead to complications after surgery.
- BC surgical patient prehabilitation – Sleep apnea - YouTube video
- Fatigue and sleep apnea – HealthLink BC
- Smoking cessation: Quitting or reducing smoking before surgery can significantly improve your overall health and lower your risk of surgical complications.
- BC surgical patient prehabilitation – Smoking cessation - YouTube video
- Quitting smoking – HealthLink BC
- QuitNow.ca
- Social supports (support after surgery): Having a support system can make a big difference in your surgical experience and recovery. It is important to communicate your needs and accept help from those around you.
- BC surgical patient prehabilitation – Social supports - YouTube video
- Social connections – HealthLink BC
- Substance use: Sharing information about any recreational substance use with your health care team before surgery helps keep you safe during surgery. Some substances can affect your anesthesia as well as your pain management, making it harder to control pain after surgery.
- BC surgical patient prehabilitation – Substance use - YouTube video
- Mental health and substance use – HealthLink BC
How can I be involved in optimizing my own health?
Research has shown that when you become an active partner in your care, you are more likely to engage in changes leading to better outcomes. You will also experience increased satisfaction with the surgical process and feel more informed.
- Ask me 3 (PDF) - IHI
- Diary of symptoms (PDF) - HealthLink BC
- My personal action plan (PDF) - HealthLink BC
- Patient passport for surgical optimization (PDF) - Specialist Services Committee BC
Who can I contact if I have any questions?
Please contact your local health care provider for more information.
- Shower the morning of surgery, but do not use perfumes, colognes, or body lotion.
- You may be asked to do further skin preparation by your surgeon or the hospital. Be sure to follow those instructions.
- Remove all nail polish and body jewelry, such as piercings.
- Do not wear make up.
- Brush your teeth. Do not swallow.
Fasting restrictions
Restricting food and fluid (fasting) before surgery helps to keep the stomach empty during surgery.
Be sure to follow the instructions that are provided by your surgeon or preadmission clinic as to when you are to stop eating and drinking. Your surgery will be postponed if you do not follow the fasting instructions.
- Fasting before surgery: Adults (PDF) - Northern Health
- Fasting before surgery: Children/infants (PDF) - Northern Health
Stopping medications
Do not take any medications, prescription or non-prescription, on the day of your surgery without your physician’s specific permission. If you take heart or blood pressure medications, you will be instructed which medications to take with a sip of water on the morning of surgery.
What to bring to the hospital
Please be aware that you will be responsible for the care and safety of your personal property while you are at the hospital.
Documentation:
- Bring your BC Care card or proof of substitute Medical Insurance Plan.
- Identification showing your name, address and date of birth.
- Extended health care information.
Personal:
- Glasses or contact lenses, hearing aids, and dentures with storage cases labeled with your name.
- Bring your CPAP, Bi-level machines or dental appliance if you use one for sleep apnea.
- Any crutches, cane, braces or walker that you have been told by your surgeon to that you will need, labeled with your name, and brought in by family/friend after your surgery.
- If you are staying overnight or longer, pack a small bag with a few personal hygiene items such as toothpaste/toothbrush, lip moisturizer, brush/comb, shampoo, sanitary products, shaving kit.
- You will also bring any prescription medications, respiratory inhalers, eye drops, topical medicated creams, estrogen patches, or birth control pills (all other medications and supplements should be left at home). Most other medications are supplied by the hospital.
- Slippers with non-slip soles. Socks and comfortable shoes with rubber, non-skid, soles ( such as running shoes).
- Cell phone.
- A small amount of cash ($20- $40) to cover the cost of the TV rental, newspapers, coffee shop, etc.
- A novel or puzzle book.
Please do NOT bring
- All jewelry or body piercing items. (These items cannot be worn in the operating room because they increase your risk of infection and injury to the body)
- Laptops, DVD players, electronic games.
- Hair dryers.
Perioperative area
Once you have checked in and it is time for you to prepare for surgery, your nurse will:
- Check your name, your birth date and your signed consent for surgery. Your nurse will also check the correct body area for your surgery.
- Measure your vital signs (temperature, blood pressure, heart rate and respiratory rate and oxygen level).
- Measure your height and weight.
- Make sure you have not had anything to eat or drink for the length of time your surgeon or anesthesiologist told you.
- Ask you to change into a hospital gown.
- May give you some medicines ordered by your anesthesiologist.
- May start an intravenous (IV) in your arm or hand, if ordered by the surgeon or anesthesiologist, for fluids and medicines before, during and after your surgery.
- Give you antibiotics, if ordered by your surgeon.
- Ask your support person for a phone number where they can be reached when you are ready to go home or moved to a hospital room. If they wish to wait, they will be directed to a waiting area. Make sure this person can be contacted by phone at any time during the day of your surgery.
- If you do not arrange a person to escort you home or someone to stay with you for 24 hours after surgery, your surgery may be postponed until you can make these arrangements.
One family member or friend can stay with you until you are taken to the operating room.
Before going into the operating room, you will be asked to:
- Empty your bladder.
- Remove your any dental work, dentures or plates, hearing aids, contact lenses, glasses and body piercings.
You may be moved to the operating room “holding area.” You will be asked questions you may have already answered. This is to double check all of your information. Your surgeon or anesthesiologist may visit you there.
When you are taken to the operating room, a nurse will greet you and check your hospital identification bracelet. You will be asked again about allergies and the type of surgery you are scheduled for. The nurse will stay with you to explain what is happening, answer any questions and offer support.
All of the staff members in the operating room wear special clothing, caps and masks. The operating room has bright lights and is quite cool. The special equipment, supplies and instruments have already been prepared by the surgery staff members.
The length of surgery depends on the type of surgery.
During surgery, your vital signs will be watched closely. Patches containing leads for monitoring your heart will be placed on your chest. A small clip (pulse oximeter) is placed on your finger to monitor your pulse and the amount of oxygen in your blood.
The surgical team uses a safety checklist to keep you safe. Below are some of the activities you can expect.
Re-confirm the correct patient
Before you are given an anesthetic, the surgical team will again confirm that you are the right patient. You will be asked your name and other identifying information possibly many times. Someone will make sure that you have a wrist band on that has your name, any allergies you may have, and other important information about you. This information will be checked before you go for your surgery.
Re-confirm the correct surgical location
Before your surgery, your surgeon will verify with you the location on your body where the operation will occur and will use a marker to initial the spot. If you are having a regional block before your surgery, the site where the block will be done will be marked by the anesthetist before the procedure.
A "time out" and a "briefing session" inside the operating room
The surgical team will again confirm that you are the right patient. The side of your body and site of your surgery will be talked about out loud and everyone will agree that this is correct. All important information about you will be reviewed by the team out loud. This is to make sure that the operating room team understands and agrees with what is going to happen. The team will discuss the important steps in your surgery, your medications, allergies or any special needs you may have during your surgery.
Debrief after surgery
Before you leave the operating room, the team will talk about what happened during your surgery and will confirm where you are to go to recover.
Your surgery may take more or less time than your physician estimated. If your surgery takes longer, it does not mean that anything is wrong. Your family will be told how you are doing. Once your surgery is over, the physician will come to the waiting room to talk to your family.
Monitoring your recovery
Right after surgery, you will be taken to a recovery area where nurses will care for and observe you. A nurse will check your vital signs and bandages. You may still have tubes and monitors connected to you. You will be awake, but you may feel very sleepy or like you are in a dream. You may have a sore throat, headache or muscle pain. The nurse will ask about your pain level. The length of time you are in the recovery room will depend on the type of surgery and how much you respond to the anesthetic. It is common to not remember much of your time in the recovery room. You will then be moved to a hospital room or you will go home.
Managing your pain
Your nurse will help to take care of any discomfort you may have. Pain can be managed in several ways. These include pills, injections, patient controlled analgesia (PC) pumps and epidural injections. Your surgeon and/or anesthesiologist will decide which the best method is for you depending on the type of surgery you have. Pain medications work best when taken at regular intervals and before the pain gets too bad. Do not hesitate to tell your nurse when you are getting uncomfortable. It is important to be honest about how much pain you have – not to minimize it or exaggerate it. You should be comfortable enough to turn, move your arms and legs in bed and to do deep breathing and coughing exercises.
Going home
Whether you go home a few hours or several days after your surgery the nurse will:
- Help you get dressed if required.
- Give you any discharge instructions on how to take care of yourself when you go home.
- Review which medications you are to take and when, including medicines you take regularly.
- Review your care instructions with you. (Wound care)
It is particularly important for you to ask the surgeon or nurse what signs or symptoms you might expect, what is normal, what is cause for concern, and what you should do if you are concerned.
Please remember that the effects of the anesthesia medications go away very slowly. Do not plan on doing anything important the day of or day after surgery. You will feel drowsy for hours after the surgery. For these reasons, you MUST NOT drive a car, work with machinery or sign any important papers for at least 24 hours.
Ensure that you have all of your belongings and any medications or valuables with you before you leave the hospital.
On returning home
- Follow the instructions given to you.
- Fill any prescribed medications and take as directed.
- Make/keep appointments for follow-up care with your doctor.
- Contact your doctor, a walk-in clinic, HealthLink BC at 811, or the Emergency department for any problems.