Preparing for Your Procedure or Surgery

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Preparing for Your Procedure or Surgery Early planning is the key for a successful surgery and to meet your needs at home. We urge you to start planning today by following the information in this booklet. * * Your doctor may adjust these instructions to meet your needs. Central Washington Hospital & Clinics Wenatchee Valley Hospital & Clinics

TABLE OF CONTENTS 3 3 4 5 5 6 6 7 8 9 10 10 10 11 12 12 13 13 13 14 14 14 15 16 16 18 Before Your Procedure or Surgery Days / weeks before procedure or surgery Evening before procedure or surgery Day of: Before Your Procedure or Surgery Between midnight and your check-in time Before you leave home What to bring Questions about pre-admit Instructions Once you arrive at the facility After your procedure or surgery Day of: After Your Procedure or Surgery Pain control Hospital care for overnight patients Activity Treatments and medications You are ready to leave the hospital when... At Home Diet Activity Pain medicine Upset stomach/constipation Wound care When to call your doctor Directions Central Washington Hospital & Clinics Wenatchee Valley Hospital & Clinics

BEFORE YOUR PROCEDURE OR SURGERY The Days / Weeks Before Call your insurance company right away to tell them that you are having surgery. Our staff will also be happy to assist you with this. Plan for a ride home. You must have a responsible adult drive you home due to the medications given for your procedure or surgery. If traveling home by taxi or public bus; please arrange for a responsible adult to accompany you. Someone should stay with you or check on you for at least 24 hours after going home. Follow your physicians instructions in regards to antiinflammatory medications such as: Aspirin, Celecoxib, Diclofenac Sodium, Ibuprofen, Indomethacin, Meloxicam, Nabumetone, Naproxen, Piroxicam. Discontinue herbal supplements as soon as you know you are having surgery; ideally, 7 days prior to your surgery. If taking any blood thinners; follow your physician s instructions on whether to continue to take or to hold this medicine.

4 The Evening Before A nurse will call you between 12:00 p.m. and 6:00 p.m. the day before your procedure/surgery to confirm your appointment time, where to check-in, and answer any questions you may have. Follow bowel preparation instructions, if ordered by your physician. Take a shower or bath on the day of your surgery. DO NOT shave surgery site. The hospital has special clippers to remove hair if needed. If you become ill or have any rashes, cuts or scrapes on or near your surgery site, please call your physician.

DAY OF: BEFORE YOUR PROCEDURE OR SURGERY Between Midnight and Your Check-in Time For your safety, your stomach must be empty for your surgery. If you eat or drink before your procedure, it may have to be postponed or rescheduled. Dietary Restrictions: Fasting Guidelines for 3 years of age to Adult: May Have Time prior to Check-In Clear Liquids 2 hours Milk 6 hours Crackers or dry toast 6 hours Fasting Guidelines for children under 3 years of age: May Have Time prior to Check-In Clear Liquids 2 hours Breast Milk 4 hours Infant Formula 6 hours Regular Milk 6 hours Crackers or dry toast 6 hours Clear Liquids Include: water, 7-Up, apple juice, Gatorade, tea or black coffee (sugar is OK, but NO creamer or milk) No gum, mints, hard candy or chewing tobacco Laboring women may have water or Gatorade every 4 hours; follow adult guidelines if a C-Section is likely

6 Before You Leave Home Remember not to eat or drink as instructed. You can take your medications with a sip of water. DIABETIC Patients: Your insulin or other blood sugar medication dosages may be adjusted before your procedure or surgery because you will not be eating your usual diet. Please follow your physician s instructions closely. Your blood sugar level will be checked and monitored when you arrive. Wear loose, comfortable clothes, slip-on or easy to get on shoes and little or no makeup. Leave all jewelry and valuables at home. Do not apply dental adhesives. What to Bring Copy of Advance Directive, Living Will or Durable Power of Attorney, if you have one. Write down the name and phone number of someone we may call while you are in the hospital to help with any unexpected needs. A list of all your medicines, including doses and time when medication was last taken. CPAP or BiPAP machine, if you use one. Toys, books or videos for child. Case and solution for glasses or contact lenses. Hearing aides. If staying overnight, you may bring a robe and personal items. Bring slippers with non-skid soles or comfortable walking shoes. Health insurance/prescription cards/co-pay.

7 Questions? If you have questions or concerns about pre-admit instructions, please call: Central Washington Hospital & Clinics Pre-Admit 509.662.1511 x: 6246 Wenatchee Valley Hospital & Clinics Pre-Admit 509.663.8711 x: 5584

8 Once You Arrive at the Facility Central Washington Hospital & Clinics 1201 S. Miller St. 509.662.1511 For a map and directions see page 16. Wenatchee Valley Hospital & Clinics 820 N. Chelan Ave. 509.663.8711 For a map and directions see page 18. Check-in at the reception desk. The nursing staff will review your health history with you and prepare you for your procedure or surgery. Your surgical site may be cleaned and hair clipped by staff. The physician will review your procedure or surgery with you and mark the surgical site if indicated. The anesthesiologist will also review your health history and discuss anesthetic options and medications with you.

9 Medications may be ordered to treat anxiety, infection, pain and nausea. Children must be accompanied by a parent or legal guardian. Parents or legal guardian of children under age 18 must remain at the hospital until the child is discharged to home. One or two family members may sit with you while you are waiting for surgery. After Your Procedure or Surgery Your physician will talk to family/friends (if present) in the waiting room. Please ask them to be available in person or by telephone. You may be able to eat and drink after surgery, depending on the type of surgery you had done. Vital signs and surgical site are checked. You may be asked to cough and breathe deeply. Simple foot-leg exercises help your blood flow. Compression stockings or foot pulsers may be used. You may have a urinary catheter to help you urinate.

DAY OF: AFTER YOUR PROCEDURE OR SURGERY Pain Control Good pain control won t take away 100% of your pain, but it will control your pain enough so you can cough, take deep breaths, and get in and out of bed. Tell your nurse if you feel pain, or have an upset stomach. There are many medicines available to help you feel better. Your nurses will help with other ways to make you feel comfortable. Pain is personal. The amount or type of pain you feel may not be the same as others feel. You can help the doctors and nurses measure your pain by using a 0 10 Pain Rating Scale. Imagine zero is no pain and 10 is the worst pain you can think of or use a description of the pain you are having such as slight, moderate or severe. Children or older people may find the Faces Pain Scale helpful. Hospital Care for Overnight Patients Fewer and fewer people are admitted to hospitals today. Modern medicine makes it possible for people to return home faster than ever before.

11 If you are staying in the hospital, it is because your surgery requires special needs that cannot be met at home. Your hospital staff will work hard to get you home. Nursing staff, Physical Occupational Therapy, and Social Services are available to discuss any discharge and home care needs that you might have. If you need more help after surgery than your family/friends can provide, contact: Central Washington Hospital & Clinics Care Management Department 509.662.1511 x: 2344 Wenatchee Valley Hospital & Clinics Social Services Department 509.663.8711 x: 5983 Activity After your surgery it is important to begin normal activities as soon as possible to improve your recovery. Coughing and deep breathing, and moving your legs are activities you can do while in bed. You may notice that moving around can be uncomfortable. It is normal to have some discomfort at rest and with activity. You and your nurse will work out a pain control plan. The nursing staff will assist you with walking.

12 Treatments & Medications Vital signs will be checked throughout your stay. Your nurse will teach you about wound care, including when it is OK to bathe or shower. Diet as recommended by your physician. IV (intravenous catheter) will be removed when you are able to eat and drink. Urinary catheter may be removed. The nurses will check to see if you can urinate without the catheter. You may go home with the urinary catheter in place. Pain pills or shots are given as needed. You may have a PCA (Patient Controlled Analgesia) IV Pump for pain medicine. It is important that only you, the patient, control the medication, not your family. This will prevent you from receiving more medication than you need. Ask your physician or nurse about when to resume taking your usual medicines, hormones, and/or supplements. You Are Ready to Leave the Hospital When: You are able to drink some fluids to the level approved by your physician. Pain medicine keeps your pain under control. You are able to walk. Discharge Instructions have been reviewed with you and another responsible adult.

AT HOME Diet Continue with clear fluids such as water, 7-Up, apple juice, Gatorade and tea. Progress your diet gradually to light foods and slowly return to your normal diet. Drink 8 glasses of fluids a day. Activity Move around more each day. Do not drive if you are taking prescription pain medicine. Follow your physician s instructions on when it is OK to resume strenuous activity and driving. Pain Medicines You may notice that moving around can be uncomfortable. It is normal to have some discomfort at rest and with activity. You and your nurse will work out a pain control plan. Add prescription pain pills when ibuprofen or acetaminophen is not enough to control pain as directed by your doctor. Continue to ice and elevate to help with comfort, if appropriate.

14 Upset Stomach / Constipation Prescription pain pills may cause constipation, nausea, and vomiting. If this occurs, consider taking overthe-counter pain medication pills and limit the use of prescription medications. You may use an over-the-counter laxative or a stool softener, unless told otherwise. Eat high fiber foods, like bran and fruits / vegetables. If nausea / vomiting continue, please contact your physician. Wound Care Leave tape / tape strips on until they fall off. If tape strips are still there after two weeks, you can remove them. Please follow your surgeon s instructions regarding showering.

15 Call Your Doctor If You Have: Nausea, vomiting or pain that won t go away Chills and/or a fever over 101 Wound is red, swollen, draining, open, or more painful Itching, or break out in rash or hives Inability to urinate Chest pain or shortness of breath - Please Call 911

16 DIRECTIONS TO: CENTRAL WASHINGTON HOSPITAL & CLINICS From the South: Cross the George P. Sellar Bridge. Turn left on Mission at traffic signal. Go approximately 3 blocks. Turn right on Crawford St. Go approximately 10 blocks. Turn right on Fuller St., then left into hospital entrance drive. Drive around the far side of the hospital (west side). There is a designated parking area for patients entering Surgery & Procedures Entrance. Enter the green wall entrance and report to Admitting desk. From the North: Travel south on Wenatchee Ave. until the two right-hand lanes angle right at Miller Street (near ShopKo and Denny s Restaurant). Angle right on Miller St. (in front of the Valley North Mall). Continue south on Miller St., approximately 2.2 miles, past Wenatchee High School and 4 way stop intersection. Turn left into parking lot at Central Washington Hospital. There is designated parking area for patients entering Surgery & Procedures Entrance. Enter the green wall entrance and report to Admitting desk.

17 9th Street 1 Emerson Ave. 2 Central Washington Hospital & Clinics 1201 S. Miller St. N. Mission St. Red Apple Rd. 5th Street H 28 N. Chelan Ave. N. Wenatchee Ave. Miller St. J I Miller St. Orondo Ave. H I J Professional Building 509.663.8711 Central Washington Hospital 509.662.1511 Family Physicians Building 509.665.6087 285 Cherry St. S. Mission St. erdale Ave. Wenatchee High School Miller St. Russell St. Ferry St. Geor Sell Brid Red Apple Rd. 2 Fuller St. Crawford Ave.

18 DIRECTIONS TO: WENATCHEE VALLEY HOSPITAL & CLINICS From the South: Cross the George P. Sellar Bridge Turn right on Mission. Travel north on Mission to Ninth Street (approximately 2 miles). Turn left on Ninth Street. Turn left on Chelan (next street) and move into right lane. Turn right into Wenatchee Valley Hospital & Clinics parking lot just past intersection of Ninth and Chelan Ave. Use the Wenatchee Valley Hospital entrance. Take the elevator to the 2nd floor and the reception area. From the North: Travel south on Wenatchee Ave. until the two right-hand lanes angle right at Miller Street (near ShopKo and Denny s Restaurant). Angle right on Miller St. and get in the left lane. At the second light stay in the middle lane and turn left on Chelan Ave. Get in the right lane. After you cross Ninth St. turn right into the Wenatchee Valley Clinic parking lot. Use the Wenatchee Valley Hospital entrance. Take the elevator to the 2nd floor and the reception area.

19 9th Street 1 Emerson Ave. N. Mission St. 1 Wenatchee Valley Hospital & Clinics 820 N. Chelan Ave. A B C 5th Street N. Chelan Ave. N. Wenatchee Ave. N. Miller St. 9 th Street D N. Emerson Ave. N. Chelan Ave. N. Mission St. 28 E Miller St. F G Orondo Ave. A B C Physical Therapy & Spine Clinic 509.663.8711 Sleep Center 509.663.8711 Pediatrics Building 509.665.5851 285 Cherry St. illerdale Ave. Wenatchee High School Miller St. Russell St. D E F G Mares Building 509.663.8711 Smith Building 509.663.8711 Haug Building 509.663.8711 S. Mission St. Behavioral Ferry St. Health Building 509.667.3650 Ge Se Br Red Apple Rd. 2 Fuller St. Crawford Ave.

Patient Name: Date of Procedure: Location: Central Washington Hospital & Clinics (Hospital, Surgery & Procedures Entrance) Wenatchee Valley Hospital & Clinics (Mares Building, Hospital/Surgery Entrance, 2nd Floor, take elevator by Bistro) Surgeon: Staff to call with questions: We are dedicated to improving our patients health by providing safe, high-quality care in a compassionate and cost-effective manner.