Before you are admitted to hospital for a surgery, there are things to do to ensure you are ready for your operation.
A month before your surgery
Dr Teh’s staff will have arranged for your admission to hospital and will let you know your admission date.
Preoperative consult
When you see Dr Teh before your surgery, it is an opportunity for you to ask any questions you may have about your surgery. We suggest you write down your questions so you don’t miss out on any important details. For more complex or cosmetic cases, Dr Teh will normally arrange for you to be seen again just prior to surgery to complete the consent process and to have preoperative photographs taken.
We will organise any relevant investigations you may require prior to surgery, such as blood and other diagnostic tests(ie. xrays/CT scans) .
Dr Teh will go through the hospital consent for the procedure with you. He will then give you the signed form to keep and you should bring it with you to the hospital on the day on the surgery.
Blood Thinners
If it is safe to do so, most procedures are best undertaken after adequate cessation of antiplatelet (ie aspirin, clopidogrel, prasugrel or ticagrelor) and/or anticoagulants (ie clexane, warfarin, dabigitran, apixaban, rivoraxaban and edoxaban). Antiplatelet agents are best stopped 7-10 days prior to surgery and anticoagulants 2-3 days prior.
Do check with your GP or specialist before stopping these medications. They can usually be restarted the day after surgery provided there hasn’t been any significant postoperative bleeding.
Please contact Dr Tehs rooms if you are unable to stop your prescription blood thinners.
There are some natural medicines that thin blood and these should be stopped (turmeric, cayenne peppers, ginger, garlic, vitamin E, chinese cassia cinnamon, gingko biloba, ginseng, St Johns wort, bromerlain and grape seed extract).
Other relevant medications
GLP-1 agonists (for weight loss and diabetes) like Ozempic, Mounjaro, Wegovy, Saxenda, Zepbound, Trulicity and Rybelsus will need to be stopped 4 weeks before surgery if you are having a general anaesthetic or a twilight procedure.
Other medications which will impact on your surgery and recovery include oral steroids (prednisolone), diabetic medications including insulin, immunosuppressants, chemotherapeutic and immune modulating agents. Please inform Dr Teh of these medications.
Hospital Preadmission
You will need to complete the pre-admission form provided and send it to the hospital at least seven days prior to your admission date.
If a pre-admission hospital appointment is needed a pre-admission nurse will complete a pre-operative check which may include blood tests or other scans. You will also be assessed to see if you may need any further help after discharge.
Be aware that for safety reasons, hospitals have varying BMI weight limits and your admission may be cancelled should you exceed this limit.
Anaesthetist
If you are having a general anaesthetic or sedation(twilight), you may be contacted by your designated anaesthetist about your anaethetic fees, or if further tests are required. This is usually done over the phone.
Important note for people who smoke
If you smoke, now is the time to give up or at least reduce the amount of cigarettes you smoke. Smoking can increase your risk of complications during and after surgery. Furthermore, if you don’t stop smoking before your surgery you are more likely to have:
- Wound related problems such as wound breakdown or tissue necrosis, infection and swelling (seroma) – all leading to delayed healing
- Lung related issues like lung collapse(atelactasis), poor oxygenation(hypoxia) and pneumonia
- As a consequence of the above, you will have a longer stay in hospital
To reverse the effects of smoking, you should ideally stop smoking 6 weeks prior to surgery where possible. Dr Teh will usually not undertake complex elective or cosmetic surgery if you continue to smoke due to the higher risk of a suboptimal outcome.
One week before your surgery
You may be required to see Dr Teh during this time to complete your presurgical checks. You may be required to have some blood tests and do follow any special instructions, in particular if you need to stop any medication such as blood thinners.
Some of the painkillers you will get after your surgery will cause constipation. It is a good idea to ensure that your bowels are regular prior to your surgery to avoid problems during your stay in hospital.
If you have had problems with ‘Staph’ (staphylococcus) skin infections in the past, do inform Dr Teh of this and he may consider a decolonising treatment for your skin a week prior to your surgery.
If you have symptoms of a cold/flu, perform a rapid antigen test for COVID, influenza and RSV. Contact the rooms if any of these are positive and you will need to reschedule your surgery. If the tests are negative and the surgery is urgent, then we suggest that you see your GP to assess your suitability to have your surgery that week. If in doubt, it is generally best to postpone your surgery till you have recovered.
One day before your surgery
A hospital caregiver will contact you in the afternoon of the business day before your surgery with information about your admission and fasting times and pre-surgery instructions. You will need to fast if you are booked for a general anaesthesia or twilight/sedation procedure. You do not need to fast for a local anaesthetic operation.
If you are having major surgery or if you have had a history of blood clots, you may be required to self administer an injection of a blood thinner the night prior to surgery to reduce the risk of blood clots following your surgery. Dr Teh will write you a script for this injection if you are required to have the injection. Avoid injecting the blood thinner anywhere near the site where you will be having the surgery.
It is not recommended that you drive home after surgery, so have your travel arrangements finalised at this time. This could mean a quick call or SMS to your family member or friend to confirm that they can drop you off or pick you up.
If you are undergoing a day procedure, you must arrange for a responsible adult to drive you home and stay with you overnight.
The day of surgery
Your approximate surgical time will be confirmed by a hospital caregiver during your pre-admission phone call the day prior. For general anaesthesia and sedation/twilight patients, you should fast for 6 hours prior to that time. Please note that lollies and chewing gum are considered food. It is safe to have small sips of clear fluids up to 2 hours prior to your surgery. Clear fluids pass through the stomach faster than food. A clear fluid is a fluid you can see through. It must not contain food, fibre or fat. Milk or formula is not a clear fluid. An example of a clear fluid is water, clear apple juice or other clear fruit drinks, black tea, lemonade and cordial.
Unless otherwise instructed, continue to take your prescribed medications.
Shower at home and do not apply any powders, deodorants or other cosmetics. We recommend that you shower using a presurgical antiseptic body/hairwash either the morning of or night before surgery.
Shave around the area of the surgery. This will help with applying dressings to the wound after the surgery. If you are having an abdominoplasty or DIEP flap procedure, you will need to shave your pubic area.
Ensure any gel, acrylic nails and nail polish is removed from your fingers and toes. Any piercings should be removed if possible if they are in the vicinity of the surgical sites. For surgery on the hands, all rings must be removed.
What to bring
Read your hospital’s admissions information to find out all the details about what to bring to hospital. Importantly, we strongly recommend you leave valuables such as electronic items, jewellery (wedding rings can be taped) and large amounts of cash at home. Keep only small amounts of cash for newspapers or other items.
If you have any questions about your upcoming surgery contact Dr Teh’s office or phone the hospital pre-admission department.
