Table of Contents Insurance and Financial Responsibility...1 General Information..2 & 3 Pre-Operative Instructions 4 Pre-Operative Visit.5 The Day Before Surgery 6 On the Day of Surgery..7 Pre-Operative Unit.8 Post-Anesthesia Recovery.8 Same Day Surgery..9 Admission to the Acute Care Unit...10 Discharge...11
Insurance and Financial Responsibility Health care benefits are constantly changing. It is important for you to understand your health benefits before surgery. Someone from our scheduling team will contact your insurance company to obtain necessary authorization for surgery and any required hospital stay. Once achieved, a scheduler will call and inform you of what will be covered by insurance and provide an esti mate for copayment or deductible. If you require physical therapy, you will be contacted by our Rehabilitation Services Department to develop a schedule of care. Our physical therapist will inform you of the types of services and number of sessions covered by your insurance plan. You may also contact your insur ance company directly for information about other rehabilitation facilities or Home Health Care. If adaptive equipment is needed, please be aware that Medicare does not pay for most of the recommended equipment. You will need to check with your supplemental insurance provider, if applicable, to determine equipment coverage. Our case manager or physical therapist can provide you with options for purchase or rental. If you need financial assistance, such as establishing a payment plan, please contact Patient Financial Services at 928-684-4365. 1
General Information Thank you for choosing Wickenburg Community Hospital for your surgery. The following Surgery Guide will help assist you through the process and make your experience and recovery as comfortable as possible. Pre-operative testing is often required prior to surgery for medical clearance. If requested, this must be done within 30 days of your surgery date. During the pre-operative visit, your Primary Care Provider (PCP) will review your past medical history and order the necessary tests. Tests may include: Blood Work (CBC, Coags, electrolytes) Urinalysis Electrocardiogram (ECG) Be prepared to give your PCP a complete and current medication list including all herbal supplements and vita mins you take. A small pamphlet will be provided to rec ord your medications and to keep in your purse or wallet at all times. If you have a cardiac history and have not seen your cardiologist for 6 months, you will need a clearance letter from your cardiologist. If needed, you will receive an order for physical therapy. Please make the necessary appointment by calling the Rehabilitation Services Department at 928-684-5529. 2
General Information continues... If your surgeon or anesthetist determines you may need a blood transfusion during surgery, you will be asked to come to the hospital 2 days prior to your surgery to have your blood type confirmed. The following chart shows when you should come to the Laboratory at Wickenburg Community Hospital. If your surgery is on: Monday come to the Lab the Friday before Surgery Tuesday come to the Lab the Monday before Surgery Wednesday come to the Lab the Monday before Surgery Thursday come to the Lab the Tuesday before Surgery Friday come to the Lab the Wednesday before Surgery Please remember: Your surgery will be cancelled if ALL lab work and additional testing is not done. Notify your surgeon of any changes in your condition that have occurred within the week prior to surgery. If you have a cold, cough, or fever call your surgeon s office. Dr. Ripley, Dr. Wagner, or a member of their team may be reached at 928-668-5506. 3
Pre-Operative Instructions Two Weeks before your Surgery: Discontinue ALL over-the-counter herbal medication or dietary supplements. If you have any questions about a medication, please contact your surgeon s office. If you have diabetes, please discuss your medications with your PCP or surgeon. One Week before your Surgery: Discontinue the following medications, unless otherwise advised by your cardiologist, PCP or surgeon: ALL anti-inflammatories: Ibuprofen (Advil, Motrin) Aleve (Naprosyn, Naproxen) ALL blood thinners: Coumadin (Warfarin) Plavix Aspirin Eliquis Any other blood thinners your doctor may have prescribed Lovenox- you may take your last dose 24 hours prior to surgery You may take these medications up until the day Of surgery: Celebrex Tylenol Tramadol Vicodin/Norco/Hydrocodone Percocet/Oxycodone 4
Pre-Operative Visit Come to Wickenburg Community Hospital at least 7-14 days before your surgery. Stop at the Registration Desk just inside the North Entrance on Braillar Road. You will be directed to: 1. Pre-registration for your surgery 2. Laboratory - You will get your blood drawn and provide a urine sample if needed 3. Cardiopulmonary Department - For an ECG, if or dered, and an assessment of your lungs and breathing 4. Radiology Department - For any x-rays or CT scans that may have been ordered 5. Rehabilitation Services Department - You will receive a pre-operative physical therapy assessment and any specific exercise regimes A list of adaptive equipment you may require, and guidance in where to purchase or rent this equipment, will be provided. At some time prior to your surgery, a member of the surgical questionnaire and order any other tests that may be necessary. The Surgical Unit Clerk will call you approximately 2 days prior to your surgery with your arrival time. 5
The Day Before Surgery Stop ALL medications EXCEPT those ordered by your medical provider. You may take your regular heart, blood pressure, thyroid, seizure, anxiety, and GERD medications. You may also use your inhalers. Drink plenty of water. Do not drink any alcohol. Do not eat, drink or smoke anything after midnight prior to your surgery. This includes water, hard candy and gum. Eating or drinking after midnight will cause complications with anesthesia during your surgery and may result in your surgery being cancelled. Shower the night before surgery with the special soap prescribed by your surgeon called Hibiclens. Do not use any perfumes, powers, deodorant or lotions after your shower. Do not shave your surgical area. Confirm that you have a responsible adult to drive you to the hospital and remain in the hospital while you have your procedure. If you are having Same Day Surgery they must be ready to drive you home and stay with you for at least 24 hours after surgery. 6
On the Day of Surgery No smoking, including medical marijuana. No coffee or water except when taking the following regular medications for: blood pressure, heart, thyroid, seizure, GERD, and anxiety medications with a small sip of water. You may also use your prescribed inhalers. Shower the morning of surgery with the special soap prescribed by your surgeon called Hibiclens. Wear loose, comfortable clothing that is easy to get on and off. Leave all valuables at home (jewelry, money, credit cards, cash, etc.). No makeup, nail polish, lotions, perfumes, deodorants or powders. Please arrive at the hospital at least 90 minutes prior to your scheduled surgery time. Your arrival time will be provided to you by the Surgical Unit Clerk. Check-in at Bralliar Registration for completion of admission paperwork. You may be directed to the Laboratory for any additional blood work. A volunteer will then take you to the Surgical Waiting Room where the Pre-Operative nurse will greet you. 7
Pre-Operative Unit The Pre-Operative nurse will greet you and take you to a bed in the Surgical Unit. The nurse will start an Intravenous (IV) line and do a preoperative assessment. You will meet with the anesthesia provider and discuss your course of care. If you are receiving a Nerve Block, the anesthesia provider will start and administer this in the preoperative area. If you are receiving any other anesthesia, it will be started in the Operating Room. Post-Anesthesia Recovery You will be recovered in the Post Anesthetic Recovery Care Unit (PACU) for approximately 1-2 hours. You will either be discharged directly home or admitted to the Acute Care Unit based on the surgeon s instructions. Questions? Please call our Surgical Clinic to speak to a member of your surgeon s team at 928-668-5506. 8
Same Day Surgery If you are here for Same Day Surgery, you must have a responsible adult to drive you to the hospital and remain in the hospital while you have your procedure done. They must be ready to drive you home once you have recovered and be available to stay with you for at least 24 hours after your surgery. Do not drive for 24 hours after your discharge or make any legal decisions. Take your medications as prescribed by your provider. You may resume your regular medications, unless advised not to by your surgeon. Take your pain medication as prescribed by your provider. Treat your pain early; do not wait until it gets out of control. Get up and start moving as soon as you are able. This will help you to recover more quickly. Eat a light diet and avoid alcohol for 24 hours. If it is not scheduled prior to discharge, please call the Surgical Clinic at 928-668-5506 to schedule your follow-up appointment. At home, if you have any issues with redness, swelling, increased pain (not relieved by your pain medication), large amounts of drainage or bleeding at your surgical site, or fever, call your surgeon s office immediately. If it is after clinic hours, go to the Emergency Department. 9
Admission to the Acute Care Unit If you are admitted for observation or inpatient care, you will go to the Acute Care Unit. The staff will complete an assessment and address your pain, the status of your wound and dressings, etc. All your medications and treatments will be ordered either by your surgeon or the hospitalist. Be sure to communicate to the staff any areas of concern such as pain, bleeding, shortness of breath, or chest pain. The expectation in most cases is that you will get up and out of bed, with assistance, on the day of surgery. You will be assisted out of bed and into the chair in your patient room for all meals. You will be assisted to the bathroom. Other departments that you might see during your stay are the Rehabilitation Services Department, Cardiopulmonary, Case Management, Laboratory, Pharmacy, Dietary, Radiology and Environmental Services. The surgeon or hospitalist will determine the length of your stay based on your level of recovery. 10
Discharge On the morning of your discharge you be given instructions that will include: Wound and dressing change instructions Your scheduled outpatient physical therapy plan, which will be discussed with you by the Rehabilitation Services Department A review of your exercise plan, adaptive equipment and any slings or braces you have A list of your post-discharge appointments Prescriptions and instruction on home medications, including any new pain medications Diet and bowel care instructions for home A Case Manager will meet with you during your stay and will confirm with you, your family, or support person that you are able to be safely discharged home. The Case Manager will make sure you are able to care for yourself at home and have the necessary help to recover safely and comfortably. For patients with Diabetes: If your blood glucose is greater than 200 mg/dl twice in 24 hours, call your diabetes-treating physician for further instructions. Thank you for choosing Wickenburg Community Hospital for your surgical needs. We are committed to serving you and our community with excellent care and wish you a speedy recovery. 11