This is a general guide as to what you need to know prior to surgery. If you are not sure about anything contact me via my rooms.
10 days before surgery
For major surgery, medications which can increase your risk of bleeding should be stopped where possible. That includes tablets like Aspirin and some arthritis medications. This includes herbal and naturopathic medications which have an aspirin like effect.
Attention to your bowel habit prior to surgery
EnsuEnsure you are having regular bowel movements prior to major surgery. Many pain relief medications can cause constipation. Surgery in the pelvic area is made more difficult by a loaded bowel so it is helpful to sort this out before your operation. If you don’t go regularly try something like Metamucil, Coloxyl or a combination if necessary. As it may take a few days to get the desired result start early. If you are having difficulties with this ask for some advice.
What to bring to hospital?
- Toothbrush / paste / toiletries (staying overnight)
- Nightgown (staying overnight)
- Underwear
- Sanitary pads
- All usual medications
- All Xrays and scans
On The Day of Surgery
If you take regular medication, it is important that you mention this prior to surgery so that you can be advised which medications should be stopped or continued prior to your operation. You will be advised to stop eating and drinking 6 hours before your scheduled surgery. If you need to take medication for example blood pressure medication it is okay to take this with a mouthful of water.
On arrival at the hospital there is paperwork to be completed at the reception desk. You will then get changed and sometimes have additional tests the anaesthetist may have requested for example an ECG. The anaesthetist will talk with you about your general health and previous anaesthetics you have had. You will have your list of medications and allergies rechecked several times which is part of the safety culture of the hospital not because they have lost your records!
Getting to theatre is a bit of a process but all designed to make the procedure as safe for everyone as possible. If you have questions along the way ask.
Immediate Post-Operation
When you wake up in recovery you will have several pieces of equipment monitoring your heart rate, blood pressure, breathing and if you have had long surgery you often have additional warming equipment and compression stockings to prevent blood clots in your legs. This is all normal.
Gradually they will be removed as you transition back to a normal state. Depending upon what your surgery was, some of this may stay on in the post-operative ward overnight.
Part of the role of the recovery team is to ensure you have your pain adequately controlled before you leave and so additional pain management systems are sometimes set up at this time some of which you can control. Recovery staff use a pain scale to monitor your level of pain and will ask you about this.
I will usually check on you in recovery after surgery and if you are awake enough have a chat about what was done, what I found and so on. Often though, you are too sleepy to get into much detail at this time and I will generally have arranged a follow-up time to discuss things in more detail. If you are admitted to stay in the ward I will generally see you daily until you go home.
After your stay in recovery
Day surgery
you had day surgery and the plan is for you to go home that day, you will be transferred to the step down recovery area, where little by little you are prepared for discharge home. Usually this will be about 4 hours after surgery. You will still need to take things easy after discharge even though it is called day surgery. You will need anywhere from the next day up to a week to recover from the surgery and the anaesthetic depending upon what surgery you had. You are advised not to drive for 24 hours after an anaesthetic.
Ward admission
I will review you post operatively on the day of surgery. This may be on the ward or in recovery if your surgery happened late in the day. Generally speaking I won’t get into in depth conversations with you then as you will be too sleepy to take anything much in, so if you are asleep and everything looks okay I will not wake you up. The next day when I visit, I will go through things in more detail and check you are doing okay.
After discharge
Try to keep on top of pain relief requirements as instructed by the anaesthetist or myself as it is more effective than always trying to catch up if the pain returns. Keep your wounds dry – if they have dressings you can shower but pat those areas dry afterwards. If I have advised you about medications for bowels I would advise you to keep this up for the first two weeks or at least until you have stopped pain relief medications.
Symptoms to report are:
- Fever or feeling unwell
- Offensive vaginal discharge or heavy bleeding
- Wound becomes hot, painful or discharges
- Intractable nausea or vomiting
- Inability to empty your bladder or bowels
- Severe pain
You will have my cell phone number and can use it for advise if you observe any of the above. On occasion I may not be able to see you straight away and you can always attend the Mater Private Hospital Emergency Department at any time if something cannot wait.
Mater Private Hospital Brisbane
301 Vulture St, South Brisbane QLD 4101
Phone: (07) 3163-1000
Follow-up
The follow-up I recommend after your surgery will depend on what type of surgery you had and why. For minor surgery where we were just trying to check out an abnormal symptom, I will often phone you a week later to see how you are going and talk about any results I have received. After that I may leave you in the care of your GP if nothing further is needed at that time.
If we performed some sort of treatment then I usually will recommend seeing you. I still will phone you at 1 week to check on progress and tell you any test results, but generally the timing of when to see you is determined a bit by what we did.
There are two situations where GP follow-up seems to be appropriate:
- Women undergoing hysteroscopy to investigate bleeding where nothing abnormal is found and no treatment required
- Women for whom I perform a D&C for a miscarriage with no other issues
Other than those two examples, my recommended timing for post-operative follow-up is:
| Procedure | First visit | Subsequent visit |
|---|---|---|
| Diagnostic laparoscopy | 1-2 weeks to review wounds, and discuss findings in detail | If treatment provided in 3 months |
| Operative laparoscopy (ovarian cyst, endometriosis, oophorectomy) | 1-2 weeks | 3 months |
| Operative laparoscopy – ectopic | 1-2 weeks | |
| Mirena insertion or ablation | 3 months | |
| Hysterectomy | 6 weeks | If HRT required 3 months |
| Prolapse surgery | 6 weeks | |
| Continence surgery | 6 weeks | |
| Sterilisation procedure | 6 weeks | |
| LLETZ or Cone biopsy | Colposcopy 6 months |