Preparing for Surgery/Procedure

Once you and your Doctor decide that surgery will help you, you’ll need to learn what to expect from the surgery and create a treatment plan for the best results afterward. Preparing mentally and physically for surgery is an important step toward a successful result. Understanding the process and your role in it will help you recover more quickly and have fewer problems.

If you are currently taking a GLP-I medication such as Ozempic, Wegovy, Trulicity,

Bydureon, Byetta, Saxenda, Victoza, Adlyxin, or Rybelsus, please follow the instructions below.

• NO solid foods after NOON the day prior to surgery
• NO liquids after midnight
• Hold 48 hours prior to procedure for daily dosing patients
• Hold 7 days prior for once weekly dosing patients
• For diabetic patients, check blood sugars the night before surgery

If you are currently taking an SGLT2 Inhibitor medication such as Invokana, Farxiga,

Jardiance, Steglatro, Xigduo, Brenzazawy, or Sunjardy, please follow the instructions below.

Patients scheduled for surgical procedures should stop SGLT2 inhibitors THREE days prior to surgery. These medications should be stopped for cardiac and/or diabetic indications. Failure to comply will result in the postponement or cancellation of the procedure.

For example: If your surgery is scheduled on a Thursday, your last dose should be on Sunday.

Guidelines for patients 1 - 12 years old

For your child's safety, it is very important to follow instructions about eating or drinking before surgery.

Your child may eat solid foods until 8 hours before their scheduled arrival time at the hospital or surgery center.

Your child may drink milk, formula, or breast milk until 6 hours before their scheduled arrival time at the hospital or surgery center.

Encourage your child to drink clear liquids - NOT milk or dairy products - until 2 hours before their scheduled arrival time at the hospital or surgery center.

Clear, see-through liquids that are good for your child include:

• Water
• Apple juice
• Pedialyte

Certain procedures may require special preoperative fasting instructions. If you receive separate instructions from your child's surgeon or the physician performing the procedure, those should be followed carefully.

Below is a table to further explain the timing of when your child should stop eating and drinking. Look for your child's scheduled arrival time, and when to stop giving solid food and dairy products. Please offer your child clear liquids before surgery as desired until 2 hours before their scheduled arrival time at the hospital or surgery center.

Guidelines for Adults and Teenagers

Adults and teenagers over the age of 12 may have solid foods until 8 hours before their scheduled arrival time at the hospital or surgery center.

• Clear liquids are encouraged until 2 hours before the time the patient is scheduled to arrive at the hospital or surgery center.

*Clear liquids do NOT include milk or dairy products*

• Examples of clear liquids include: o Water o Clear fruit juices such as apple juice and white cranberry juice o Plain tea or black coffee (NO milk or creamer) o Clear, electrolyte-replenishing drinks such as Pedialyte, Gatorade, or

Powerade (NOT yogurt or pulp-containing "smoothies") o Ensure Clear or Boost Breeze (NOT the milkshake varieties)

Certain procedures may require special preoperative fasting instructions. If you receive separate instructions from the surgeon or the physician performing the procedure, those should  be followed carefully.

Below is a table to further explain the timing of when to start fasting. Please look for the scheduled arrival time, and when to stop eating solid food. We encourage you to continue to drink clear liquids until 2 hours before arriving at the hospital or surgery center.

PRE-ADMISSION TESTING

Please report to:

HUNTERDON MEDICAL CENTER

Admitting Office (1st floor), then proceed to

Ambulatory Testing Center

(Located on the 1st floor, to the left of the information desk & down the first hallway)

You will NOT receive an appointment reminder for this.

 SURGERY DATE

HUNTERDON MEDICAL CENTER

Same Day Surgery Second Floor

2100 Wescott Drive

Flemington, NJ 08822

(The office will call you ONE DAY BEFORE the surgery to let you know what time to arrive at the facility)

ON YOUR SURGERY DAY

Please report to the Same Day Center on the 2^nd floor of the Hunterdon Medical Center

Working with Your Doctor

• Before surgery, you are likely to be referred to an investigation clinic at the hospital where you’ll undergo routine tests, such as blood tests and x-rays, together with a physical examination, and at that time you’ll be provided with more detailed information regarding your in-patient stay, and your joint replacement generally.
• Discuss any medications you are taking with your doctor and your family physician to see which ones you should stop taking before surgery.
• If you are overweight, losing weight before surgery will help decrease the stress you place on your new joint. However, you should not diet during the month before your surgery.
• If you are taking aspirin or anti-inflammatory medications, you will need to stop taking them one week before surgery to minimize bleeding.
• If you smoke, you should stop or cut down to reduce your surgery risks and improve your recovery.
• Have any tooth, gum, bladder or bowel problems treated before surgery to reduce the risk of infection later.
• Eat a well-balanced diet, supplemented by a daily multivitamin with iron.
• Report any infections to your surgeon. Surgery cannot be performed until all infections have cleared up.

Home Planning

• Arrange for someone to help out with everyday tasks like cooking, shopping and laundry.
• Put items that you use often within easy reach before surgery so you won’t have to reach and bend as often.
• Remove all loose carpets and tape down electrical cords to avoid falls.
• Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.

Preparing for Procedure

If You are Having Day Surgery, Remember the Following:

• Have someone available to take you home, you will not be able to drive for at least 24 hours.
• Do not drink or eat anything in the car on the trip home.
• The combination of anesthesia, food, and car motion can quite often cause nausea or vomiting. After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours.
• If you had surgery on an extremity (leg, knee, hand or elbow), keep that extremity elevated and use ice as directed. This will help decrease swelling and pain.
• Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty controlling the pain.

If you need to find out more, please do not hesitate to call us during office hours.