About Your Surgery Experience Getting ready for your surgery at University of Washington Medical Center

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1 From Everett Exit I Exit 168B Roosevelt Way N.E. From Downtown Seattle University Way N.E. 15th Avenue N.E. UWMC University of Washington N.E. Pacific Street Montlake Blvd. Exit Montlake Blvd. N.E. 24th Avenue E. Stadium 25th Avenue N.E. Montlake Bridge Evergreen Point Bridge N.E. 45th Street Lake Washington W N S E 520 From Bellevue Patient Education About Your Surgery Experience Getting ready for your surgery at University of Washington Medical Center Map to University of Washington Medical Center If you have an extra-large vehicle, you cannot park in the Triangle Garage. Please go to lot S1 behind the hospital. If you need to arrive before 6 a.m. the morning of your surgery, please talk to the staff about where to park NE Pacific St. Box Seattle, WA University of Washington Medical Center Rev. 04/2002 UH 1761

2 Important Phone Numbers You may find the following telephone numbers helpful. If you're in the medical center, dial only the last five digits of numbers with a 598- prefix. Administration Admitting Bills Financial counseling Doctor fees (UW Physicians) UWMC billing Emergency Medicine Service (ER) Information Lost and Found Medical Director Parking Information Social Work Department TTY Web site... Driving Directions UWMC is located at 1959 NE Pacific St., at the south end of the University of Washington campus. From Interstate 5: Take Exit 168B (Bellevue, State Route 520) heading east. Then take the Montlake Boulevard exit and follow the signs to University of Washington Medical Center. From Interstate 405: Take Exit 14 (Seattle via Evergreen Point Bridge, State Route 520) heading west. Then take the Montlake Boulevard exit and follow the signs to University of Washington Medical Center. The underground Triangle Parking Garage across NE Pacific Street from the medical center's main entrance is for UWMC patients and visitors. It is located on the north side of NE Pacific Street in the triangle formed by Montlake Boulevard NE, NE Pacific Street, and NE Pacific Place. The entrance is on the northwest side of the triangle. A pedestrian tunnel leads from the garage to UWMC. If you have a mobility impairment, disability parking is available in the Triangle Garage across the street from the medical center. Parking validation is provided for UWMC patients and visitors in the Triangle Garage. The maximum parking fee is $4 per day for validated tickets for patients and their visitors. For more information on parking, call Driving directions to locations on the UW campus, including UWMC, are available on the following Web site:

3 Patient Education About Your Surgery Experience Getting ready for your surgery at University of Washington Medical Center This booklet and your visit to the Pre-Surgery Clinic will help you get ready for surgery and understand what will happen and why. Your visit provides us with important information about your health. We are committed to working with you for a comfortable stay and quick recovery.

4 Page 2 Name Date of surgery Time to arrive (You will be called between 1p.m. and 4 p.m. from the the afternoon before your surgery.) Surgeon Clinic nurse Patient care coordinator Telephone number NOTE University of Washington Medical Center has interpreters to assist you before and after surgery. Please tell the patient care coordinator or if you would like an interpreter, or call Interpreter Services at the number on the last page of this booklet.

5 Page 3 Your Visit We need information about your health before your surgery. You will be asked to complete a health survey before coming to the. At the Pre- Surgery Clinic, your medical history will be reviewed and, if necessary, blood tests, an electro-cardiogram (EKG), and a chest X-ray will be done. Other tests may also be needed because of your particular surgery. Before your visit in the, you will meet with your surgeon in a UWMC specialty clinic. When you meet with your surgeon, he or she will discuss your medical history, give you a physical exam, talk with you about the surgery, and have you sign consent forms. These forms document your agreement to medical care and direct the hospital in case of a medical emergency. You should also meet your patient care coordinator at the specialty clinic visit. He or she may suggest special procedures before your surgery, such as a blood donation from yourself. When you come to the Pre- Surgery Clinic, be sure to bring two things with you: 1. A list of all the medicines you take; 2. The results of tests you have had at any other hospital or clinic. When you come to the, be sure to bring two things with you: 1. A list of all the medicines and doses you take; 2. The results of tests you have had at any other hospital or clinic, particularly heart or lung diagnostic testing, i.e. EKG, stress test, pulmonary function tests, etc. This information is important so your doctors know about everything that may affect your care and recovery. Some medicines you are taking may not mix with ones you will be given in the hospital. The visit is a good time for you to ask questions about the day of surgery.

6 Page 4 Your Surgical Experience This flow chart shows some of the steps you will go through before, during and after surgery.

7 Page 5 Medicines Before Surgery It is very important to talk with the staff about the medicines you are taking. You may not be able to take some of them the days before your surgery, such as: Oral diabetic medicines, insulin Coumadin Aspirin Certain diet medicines Non-steroidal anti-inflammatory drugs (NSAIDS) Herbal preparations/supplements Anesthesia An anesthesia care provider will talk with you about the types of anesthesia possible for your surgery. The nurses in the have been specially trained to evaluate your anesthetic needs. A nurse will tell you which of your medicines you can take the morning of surgery. Please be sure to ask questions and talk about any concerns you may have. An anesthesiology team will be with you in the operating room to manage your comfort, breathing, heart rate, blood pressure, and any medical issues that might arise. The three main types of anesthesia that may be discussed are: General you are unconscious and have no awareness of the surgery. Regional a numbing medicine injected into a cluster of nerves, so you do not have sensation in a large area of your body. You may also be given medicine to relax you or help you sleep. Local a numbing medicine injected into the skin and tissues near the area for surgery. This numbs only the area for surgery, similar to the local anesthetic given for dental work. If you are diabetic and take insulin or an oral diabetic medication, be sure to receive instructions from the Pre- Surgery Clinic about your dose of these medications the day before and morning of your surgery. Additional information regarding anesthesia is available. Please tell your nurse if you would like to discuss special concerns with an anesthesiologist during your visit.

8 Page 6 Remember: No cellular phones in certain patient care areas. Unless told otherwise, do not eat or drink anything after midnight the night before your surgery or in the morning, not even water, candy or gum. All jewelry must be removed. This includes body piercings of all types. Day Before and Morning of Surgery A nurse from Surgical Services or will call you the afternoon before your surgery day to tell you what time to come to the hospital. If your surgery is on Monday, this call will be on the Friday afternoon before. If you are not called by 5 p.m., call the at the number on the last page. Please make sure the Pre- Surgery Clinic has the telephone number for where you will be the day before surgery. The day and evening before surgery, you can eat normally and take your usual medicines. Unless told otherwise, do not eat or drink anything after midnight the night before your surgery or in the morning, not even water, candy or gum. This is very important during surgery, to reduce the chance of vomiting and inhaling it into your lungs. Swallow the pills you are to take the morning of surgery with only a sip of water. Brush your teeth without swallowing any water. You may be asked to bathe with an anti-germ soap the night before surgery and again in the morning. Use approximately one ounce of the anti-germ soap (30ml) each time you bathe the area to be operated on. Do not use this soap for your hair or face. Use your regular shampoo and soap for your hair and the rest of your body. If you are going home on the same day you have surgery, you must arrange for someone to take you home. You may be cancelled if you arrive without someone (friend/family) available to drive you home. This must be a responsible adult who will get you into your home and make sure you are comfortable. Due to limited space in Surgery Center Recovery your ride must be available within 30 minutes of your discharge to drive you home. It cannot be a taxi driver. You also need to arrange for a responsible adult to stay with you for at least 24 hours after surgery. Please be sure to call the or your patient care coordinator if for any reason you cannot keep your appointment for surgery. If you have a problem the morning of your surgery, call the Surgery Center or 4 South after 5:30 a.m. at the numbers on the last page.

9 Page 7 Arriving at the Hospital Parking Valet parking is available at the front of the medical center. Additional parking is available in the Triangle Garage on NE Pacific Street, across from the main hospital entrance. Parking is validated by the hospital at a fixed daily cost of $4.00, and is subject to change. Please see page 12 for a map to the hospital entrances and the back cover for a map to parking, and special reasons to park in lot S1. A.M. Admission - 4 South If you are to stay in the hospital one night or more, report to 4 South on the day of your surgery. To reach 4 South, enter the medical center through the main entrance on NE Pacific Street. In the main lobby, turn right and go to the Pacific elevators. Go to the 4th floor. Turn right as you leave the elevator then turn right again. Check in at the reception desk. Same-Day Surgery - Surgery Center Recovery If you are having same-day surgery in the Surgery Center, you have two choices: From the Triangle Garage, walk through the tunnel, take the elevator to level 2. Enter the Emergency Room entrance, go left to the Surgery Center reception desk and waiting area. Come in the main hospital entrance on NE Pacific Street, turn left, and go down the hall to the Cascade elevators. Take the elevators down to the second floor. Turn left and follow signs to the Surgery Center. Check in at the reception desk. The reception area is also the waiting area for same-day surgery patients' families and friends. Please keep in mind that there are no accommodations for children. Children under the age of 13 are not allowed in the Surgery Center Recovery area unless they themselves are the patients. 4 South Your family and friends can accompany you to 4 South. Due to the limited space in the check-in area, they may be asked to wait in the general waiting area. Surgery Center Recovery Due to our limited phsical space in the outpatient surgical area, we may need to limit the presence of family/friends to one at a time. Check with your nurse in Surgery Center Recovery.

10 Page 8 Please do not bring jewelry (including rings), money, credit cards or other valuables with you. Bring a list of your medicines, but do not bring the medicines unless you have been told to by the Pre-Surgery Clinic nurse. Bring your cases to store glasses and contact lenses while you're having surgery. Generally we ask you to come in two hours before your surgery. This allows time for us to prepare you for your surgery. During this time you will: meet your anesthesiology team have your IV started Bring a book or project you are working on to help this time pass more quickly. We will do our best to let you and your family members know of any changes about your start time. When you come to UWMC, wear clothes that are easy to take off and are loose and comfortable to wear home. Please do not bring jewelry (including rings), money, credit cards or other valuables with you. Bring a list of your medicines, but do not bring the medicines unless you have been told to by the nurse. Please remember to bring your hospital card (U-Card), as well as insurance pharmacy card and applicable co-payment for discharge medication. We will ask you to remove all your clothing, including undergarments, and to put on a hospital gown. You will need to remove glasses, contact lenses, hearing aids, and hairpins. Please bring cases to store these items, if you have them. In the Pre-Operating Area and Operating Room The pre-operating area has many patients who are being prepared for surgery. We regret that your family and friends cannot go with you to the pre-operating area or the operating room. The nurses and anesthesiology team who will care for you during surgery will introduce themselves to you. You will have a chance to ask questions about your care and what is happening. After a numbing solution is applied, an IV a small intravenous needle and tube will be put into the back of your hand. Liquid and medicines can be given to you quickly and easily through the IV, and it will be in place for some time after surgery. Usually you will be given medicine through this IV to make you relax, or even sleep, before going to the operating room.

11 Page 9 In the Recovery Room You will be in the Recovery Room for about an hour after your surgery. It is a busy area with many patients being cared for after their surgery. Your family and/or friends will not be able to see you in the Recovery Room. If you are having same-day surgery, one visitor will be able to join you in Surgery Center Recovery. There are no children allowed in Surgery Center Recovery. If you are staying overnight, your family will be able to join you once you get to your hospital room. While you slowly wake up from the anesthetic, you may feel cold and nauseated. Your mouth may be dry, and your throat may be sore if a breathing tube was used during surgery. If you have had a regional anesthetic, that part of your body may be numb until the anesthetic wears off. It is important that you are comfortable be sure to ask the nurse for pain relief before the pain gets too severe. A nurse will check your breathing, heart rate and blood pressure often. He or she will help you with any nausea and/or pain you may feel. It is important that you are comfortable be sure to ask the nurse for pain relief before the pain gets too severe. Pain relief may be: A pill, if you can eat and drink after surgery Medicine put into the IV tube in your hand Medicine injected into your arm or buttock Medicine given through a small tube in your back Patient-controlled analgesia (PCA) by a special machine that puts a dose of pain medicine into your IV tube when you push a button. Your doctors decide the correct amount for your needs. You do not have to wait for a nurse you are in control of your pain relief. You will not become drug addicted if you are in pain and use the machine as prescribed.

12 Page 10 Ask your surgeon how you might be limited after surgery. Think carefully about what you will need to help you at home and make arrangements before surgery. Going Home Your surgeon will decide whether you are to go home the same day as your surgery or stay in the hospital. Please discuss this with him or her during your Specialty Clinic visit. If your ride does not stay with you at the hospital, please assure they can be available within 30 minutes. You will need someone to take you home after surgery who can get you into your home and make sure you are comfortable. For your safety, you will also need a responsible adult to stay with you for at least 24 hours after surgery. For patients going home the same day you can expect some nausea and pain. You may also be sleepy for the rest of the day. Please do not do any of the following for 24 hours after anesthesia or sleeping medicine: Drive Drink alcoholic beverages Travel alone Operate machinery Sign any legal papers Be responsible for another person, such as a child Ask your surgeon how you might be limited after surgery and how long these limitations will last. Think carefully about what you will need to help you at home and make arrangements before your surgery. Work out things like how you will get to the bathroom, up and down stairs, have your meals, and care for yourself. If you need temporary local housing, ask at the or call the Social Work Housing Services number on the last page. Before you leave the hospital, you will be given information about your care at home, and a return visit for follow-up care will be scheduled for you.

13 Page 11 Do you understand everything? Medical history, blood tests, X-rays, EKG done in (page 3) Consent forms (page 3) Medicines that should not be taken before surgery (page 5) Anesthesia choices (page 5) Telephone number where we can reach you the afternoon/night before surgery (page 6) No food or liquids after midnight the night before surgery (page 6) Night and morning bathing before surgery (page 6) Where to come the day of surgery (page 7) What to bring and what to leave at home (page 8) Pre-operating area, starting your IV (page 8) Recovery room: how you will feel, pain relief (page 9) Going home, have someone with you for 24 hours (page 10) Help you will need at home (page 10) Safety after anesthesia (page 10) Helpful Contacts Surgery Center (outpatient) South (a.m./limited stay) Interpreter Services Social Work Housing Services Hours 7:30 a.m.-6:00 p.m. Mon-Fri 5:30 a.m.-8:00 p.m. Mon-Fri 24 hours Mon-Sat 24 hours Mon-Sun 8:00 a.m.-5:00 p.m. Mon-Fri

14 Page 12 To 4 South To Surgery Center/ Parking Attendent Metro Bus Stop Questions? : Surgery Center: South: Interpreter Services: Social Work Housing Services: Other:

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