Pre operation Guidance:
In the clinic you will be asked about your health and medication.
Past Medical History:
All medical problems you may have or have suffered previously including; Asthma, Diabetes, High blood pressure, Heart problems, Heart attacks, Strokes and Epilepsy.
Medication:
All drugs or medication you are taking especially; Warfarin (or other blood thinning tablets), Aspirin or anti-platelet medication, Hormone containing tablets including (HRT (Hormone Replacement Therapy), The Pill (Oral Contraceptive Pill etc.) and heart or water tablets (Diuretics).
Allergies:
Any allergies you may have, especially those to: Antibiotics, Iodine, Elastoplast and Aspirin.
Smoking:
Smoking increases the risks of the operation including those related to the anaesthetic and the surgery itself. It is advisable to stop at least 2 weeks before the date of your operation. It is preferable that you are off nicotine replacement, such as patches, as well before the operation. If you feel you can give up but need more time, it may be advisable to postpone the surgery to give you a chance to do so. Please discuss this with your General Practitioner and Surgeon.
Rings and Jewellery:
Any rings on the arm to be operated on will need to be removed prior to surgery. If you are unable to remove these rings yourself it is advisable to ask a Jeweler to remove them for you in advance of the operation. Rings that have not been removed before surgery will need to be cut off and this may cause damage to precious items.
What to bring:
You should bring a dressing gown and slippers. You may wish to bring a book, magazine or other entertainment. Even if you are anticipating going home the same day, it is advisable to bring items to allow a comfortable overnight stay such as toiletries.
Additional preparation:
Please also see the post operative guidance which contains further advice for making life easier in the post-operative period but may require some preparation.
The Morning of the Operation:
In almost all cases you will be asleep (under General Anaesthesia) for the operation. Because of this, you should not eat or drink within 6 hours of proposed surgery. You may be allowed to have clear drinks (water or black tea) up to 2 hours before the proposed surgery. Any non clear fluids such as milk or tea/coffee with milk and fruit juice etc. count as food and should be avoided for at least 6 hours before surgery.
As you are likely to require a General Anaesthetic you will not be able to drive home after the operation and need to have made arrangements for a responsible adult to be with you for 24 hours after the surgery. You should not make any important decisions (sign legal papers etc.) or operate machinery for at least 24 hours after surgery.
The Day of the Operation:
Medication:
On the morning of the operation you should take your usual medications eg; antihypertensive tablets on the morning of surgery with small sip of water or clear fluids (see above).
Rings and Jewellery:
Any rings or jewellery from your hand or arm will need to be removed before coming to hospital (see above). If the ring has been there for a long time and cannot be removed manually, then it must be cut off. During or after the operation the arm and hand may swell. If there are tight rings present, then the blood flow to the fingers may be impaired and the finger can be put at risk.
The Surgeon:
Before the operation your surgeon should see you and go over the operation again, confirming your consent for the operation. The side of the arm (left or right) will be checked with you and with the consent form and then marked in pen. This is another chance to ask any remaining questions you may have.
The Anaesthetist:
The anaesthetist will usually see you and discuss the anaesthetic and any blocks or injections that may be necessary. Pre-anaesthetic medication (Pre-Med) may be prescribed and given.
Transfer to Theatre:
When it is time for your operation you will be taken to the Theatre Suite. You may be wheeled down in your bed or choose to walk. You will be taken to the Anaesthetic Room next to the Theatre. You will usually be put to sleep in this room and be taken thorough to the theatre once you are asleep.
After the Operation:
You will wake up in the Recovery Room where a nurse will check on you until you are fully awake. You may eat and drink when you feel able. Once you are awake and comfortable you will be taken back to the ward.
Your surgeon will explain the operation and results to you. However, although you will be awake in enough to hold a conversation and acknowledge the explanation, many people find they do not remember this. Do not worry as you should be given clear rehabilitation guidelines by the physiotherapists on the ward and arrangements will be made for you to be seen in the clinic.
In the clinic, the explanation of the operation and findings can then be repeated and any questions answered. There are often intra-operative images or photos, particularly if you have had key-hole (arthroscopic) surgery and these will normally be explained to you.
Going Home or Staying in Overnight:
Once you are awake, comfortable, had something to eat and drink and the Nursing Staff are happy with your condition you may go home. Most people can go home the same day even if their operation is in the afternoon. However, some people will choose or need to stay in over night. If so you can go home the next morning as soon as the Nursing Staff are satisfied with your condition.
If you have had an anaesthetic block or injection your arm may still have a numb, tingly or floppy arm. This will recover but may take 24 to 48 hours to do so. The prolonged block may be irritating but does mean that the arm is more comfortable after the operation.
You will usually be given pain-killers and anti-inflammatories to take home with instructions when to take these. Do not exceed the recommended doses.
You should contact the ward if you have any concerns (Spire
0117...........
