A Patient’s Guide to Same Day Surgery – “The Greater Phoenix Way”:

At SurgCenter of Greater Phoenix we believe that patient and family education is a critical component of providing excellent patient care. We designed this online pamphlet to guide you and your family through your ambulatory surgery journey from beginning to end.

Our objectives are the following:

  1. To help prepare you for your Ambulatory surgical experience and recovery.
  2. To prepare you for initiating and maximizing your recovery at home following your procedure.

You play an important role in achieving an optimal recovery from your surgery by being an active part of the care team before and after surgery.  Continue these principles throughout your recovery.

Preparation for Ambulatory Surgery

Your Ambulatory surgery will occur in an ambulatory surgery center (ASC) located at 7231 E. Princess Blvd. Suite 100, in Scottsdale, AZ.  You will be returning back home on the very same day.  The total time spent at our facility on your surgery day is typically 3-6 hours.

Some patients require a Pre-Surgical Screening.  This is arranged by your surgeons office.

Adhering to the instructions on this checklist will ensure an optimum outcome.

Pre-Surgical screening:

Diagnostic testing may be recommended for some patients prior to your surgical procedure.  These tests are ordered by your surgeon. This may include routine tests such as blood tests, urinalysis, chest x-ray and EKG. This pre-surgical testing is completed prior to surgery.

SurgCenter of Greater Phoenix receives notification of your procedure and performs an over the phone pre-operative health assessment.

10 days prior surgery stop taking blood thinning medications including aspirin, most anti-inflammatory medications (ibuprofen,  naproxen), plavix, coumadin as well as nutritional supplements, such as Vitamin E, Ginseng, GinkoBiloba, Garlic and Ginger.  Celebrex and Meloxicam may be continued.  In some cases plavix may be continued.   Contact your Surgeon’s office for specific instructions.

Pre-Surgical phone call:

A Registered Nurse from SurgCenterGreaterPHX will phone the day before your scheduled surgery (or on Friday, if scheduled for Monday) to advise you on arrival time, to discuss your specific preparations for surgery, and to answer your questions.

Fasting:

Please follow fasting instructions provided by our RN during your telephone conversation. If your surgery is scheduled before 2 pm, please DO NOT eat or drink anything after 12 midnight. If you are on medications for other medical problems, you will be advised what to take on the morning of surgery with an ounce of water. Diabetics, only take day of surgery diabetic medications as instructed by your prescribing medical physician.

Showering or bathing prior to surgery:

Please shower/bathe the night before or morning of surgery.  Chlorhexidine antibacterial soap is available without prescription and is recommended.  Use only non fragrant antipersirants and lotions.

Brushing your teeth morning of surgery:

Just brush and rinse. DO NOT swallow.

Planning for help at home before surgery:

Arrange for someone to stay with you at home or to be available for the first 48 hours at home to assist you with activities of daily living.

Physical therapy planning before surgery:

Some surgical procedures you require physical therapy as part of your recovery. Discuss this with your surgeon before your scheduled surgery. It is easier to learn about outpatient rehabilitation facilities, their locations, hours and accepted insurance plans before your surgery.

MANDATORY:

Prearrange for your escort and transportation home after your surgery. Surgical patients are not allowed to drive themselvesshome after Ambulatory surgery. This arrangement must be clearly established when you arrive at SurgCenter of Greater Phoenix for your procedure.

What to Wear to the ASC for Your Surgery Day:

Please wear loose comfortable casual clothing and athletic comfortable footwear. If you are having upper extremity surgery such as shoulder, elbow or hand surgery, a loose button down shirt is recommended. If you are having lower extremity surgery such as knee, ankle or foot, loose fitting sweat pants with a zipper or shorts are recommended. You will be provided with a hospital gown and you are allowed to wear cotton underwear during your procedure.

What to Bring on the day of surgery:

  • Personal Identification card
  • Health care insurance card
  • Prescription medication card
  • One credit card
  • Diagnostic testing results: X-rays, Labwork, MRI’s
  • Any pre-op assistive device that hasbeen prescribed and provided to you:such as cane, crutches, braces, splints,and/or immobilizers.
  • You may bring a book, magazines or musicfor relaxation. A locker is provided foryour belongings.

Pre-Surgery:

You and your family will remain in the waiting area until you are called to the pre-op area. After you are called, your family may stay in the nearby waiting room.

  1. In the pre-surgical unit you will be greeted by the nursing staff and physician assistant. You will be asked to change to a hospital gown. Your clothes and personal possessions will be placed in a personal locker.
  2. Next, the nursing staff will take your temperature, pulse, respiratory rate and blood pressure (all your vital signs) and review your chart. Your surgical areas may be shaved and washed with antiseptic soap, if necessary. If you have not had a full physical exam in the last 30 days, your surgeon or the anesthesiologist will review your medical history and perform a physical exam.
  3. Mandatory Pregnancy Test: All female patients who are in their childbearing years will have a pregnancy test performed on admission prior to your surgical procedure.
  4. When you are ready for surgery, your surgical team will introduce themselves to you. These include the nurse, surgical assistant, anesthesiologist, and any assisting physicians. Each member of this group will have already reviewed your medical record in light of their own role in your surgery. They will discuss key aspects of your health as they relate to your surgery and explain the procedures. This is an excellent time for you to ask any last minute questions about your surgery that you may have thought of since your last contact with your surgeon.
  5. “Sign your site.” Your surgeon or an assisting physician will initial the surgical site to be operated on. Two other team members will also confirm the site before surgery. Verification of your surgical site will be documented on your OR & Anesthesia Consent for Surgery.

Recovery Phase

In the recovery room: the nursing staff will provide the necessary care for you and will monitor your return to full awareness. In order to be discharged from the recovery room to home you must be able to:

  • Stand up and walk without feeling dizzy or lightheaded
  • Urinate without difficulty
  • Tolerate food and fluid

Pain Management

As your anesthetic wears off you can anticipate some pain in your surgical site. The staff will ask you to rate your pain on a scale from 0 – 10 pain scale. O = no pain and 10 the worst ever. The nurse will assess your pain and administer your first dose of pain medication prior to going home. You will be provided with a prescription for pain medication which should get filled as soon as possible.

Pharmacies close to SurgCenter of Greater Phoenix:

Safeway Pharmacy (inside Safeway)
6501 E Greenway Pkwy #400
Scottsdale, AZ 85254

Bashas’ Pharmacy
20745 N Scottsdale Rd
Scottsdale, AZ 85255

Walmart Pharmacy (inside Walmart)
4617 E Bell Rd
Phoenix, AZ 85032

Walmart Pharmacy (inside Walmart)
15355 N Northsight Blvd
Scottsdale, AZ 85260

The Use of Cold Therapy to Reduce Pain and Promote Healing:

You may already know the value of applying “cold” to injuries. It can help decrease pain, swelling and inflammation. It may be implemented in the form of ice wrapped in bags or towels, commercial cold packs or compression cuffs. You will receive instructions on cold therapy treatment. Begin using it as soon as possible after you arrive home. A common misconception about cold therapy is that it is used only during the initial post-operative phase. Actually, it will benefit you throughout your recovery and rehabilitation. (Do not apply heat directly to your surgical site as it may increase swelling and inflammation.)

While in the Recovery Room, you may, if ordered by your surgeon, be visited by a physical therapist to begin your Rehabilitation Program.

At Home after Ambulatory Surgery

(Please follow the detailed instructions provided to you from the nurse upon discharge.)
Many of the functional limitations that you are experiencing now, you will likely experience post-operatively. If you live alone, you may want to make arrangements for someone to help during your initial recovery.

Some helpful hints: Organize your daily routine so items are easily accessible, like cookware.

Dressing: Put your operative extremity in the clothes first when you get dressed. When getting undressed, take your operative extremity out last.

Food Preparation: Make arrangements before your surgery if possible.

How long your recovery will take depends on your personal goals, your general physical condition, and the nature of your surgery. The most critical period is the first few days and weeks, as you move toward achieving your goals. You will be guided by your surgeon and your healthcare team. On your first follow-up visit, you may receive new and/or additional instructions.

Pain Management:

DO NOT drink alcoholic beverages or use street drugs when taking pain medication.

  • Avoid taking medication on an empty stomach. Have something to eat first.
  • You may get lightheaded after taking pain medication. Move slowly, as when getting up from lying to standing position.
  • Take your pain medication 30-45 minutes before doing your prescribed exercises.
  • Drink a lot of water (at least eight – 8oz. glasses per day) to keep yourself well hydrated after surgery.
  • When possible keep your surgical site elevated (higher than your heart). This will help to decrease pain and swelling.

Surgical Site Care

  • Keep surgical site area clean and dry at all times. Do not put tight clothing over it.
  • Keep the surgical site dressing on, follow your specific instructions provided by the nursing staff on your discharge instruction form.
  • Your sutures and remaining steri-strips will be removed during your first post-operative visit with your surgeon 7-14 days after surgery.
  • Discuss with your surgeon when you may shower.

Common Post-Operative Reactions

As you might expect, your body will react to surgery in one or more ways:

  • Low grade fever (<102°F) for a week.
  • Small amount of blood or fluid leaking from the surgical site.
  • Bruising of surgical extremity.
  • Swelling of the surgical site and surrounding area.

Call your surgeon if any of the items below occur:

  • Fever of 102°F .
  • Severe, unexpected pain.
  • Excessive bleeding or fluid coming from surgical site.
  • Persistent nausea and vomiting.
  • Calf or thigh pain that is constant and does not go away with elevation/rest.
  • Trouble/pain with breathing or chest pain/shortness of breath-best to phone 911.

If you experience these warning signs and are unable to reach your physician proceed  to the nearest hospital emergency department.  The emergency room physician will contact your surgeon.

*Adapted from: Hospital for Special Surgery, Your pathway to recovery: A patient’s guide to ambulatory surgery, 2005.