INSTRUCTIONS FOR SURGERY AT NHRMC ATLANTIC SURGICENTER

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INSTRUCTIONS FOR SURGERY AT NHRMC ATLANTIC SURGICENTER PATIENT NAME: CHART#: PLEASE READ THE FOLLOWING CAREFULLY Stop taking aspirin/coumadin/plavix/weight loss pills/advil/celebrex/aleve/ibuprofen/nsaid s or any other medications that are blood thinners one week prior to surgery. Please consult with your primary care physician if you have any questions. Do I have a pre-op appointment with my doctor? r I have a pre-operative appointment on at a.m./p.m. in the office with Doctor: Wilson Rhodes Chase Robison Foiles Jones Pierson Novosel r I DO NOT have a pre-operative appointment. I need to pick up my orders from Jennifer on anytime between 8:15 a.m. - 4:00 p.m. Does my surgery require an appointment to learn how to do a self catheterization? r I have an appointment with on at a.m./p.m. r My surgery DOES NOT require self catheterization. ALL surgeries done at NHRMC Atlantic Surgicenter require bloodwork in Glen Meade Building B. Does my surgery require a bowel prep? r I DO NOT need to perform a bowel prep. Nothing to eat or drink after midnight the night before your surgery. r I have to do a bowel prep. Please see the instructions enclosed in this letter. Your surgery is scheduled for: at a.m./p.m. You will have a post operative appointment on at a.m./p.m. Please note this date on your calendar in case you lose these instructions.

INSTRUCTIONS FOR C-SECTIONS PATIENT NAME: CHART#: You have a pre-operative appointment with Dr. at our location on at a.m./p.m. After your appointment, you will have pre-admission testing at the NHRMC Medical Mall on at a.m./p.m. All hospital related questions you may have will be answered. Bloodwork will be done at this time. You can eat and drink as usual no fasting required!! You must shower the night before and the morning of your C-section with hibiclens solution from the neck down. You should get this from the NHRMC Medical Mall. Please no eating or drinking after midnight the night before your surgery. You are scheduled for a Primary/Repeat C-Section on at a.m./p.m. with Dr.. You should go to the NHRMC women s and children s hospital Labor & Delivery area at a.m./p.m. It is very important to keep all appointments. If you have a conflict, please call me immediately.

FREQUENTLY ASKED QUESTIONS (FAQs) FOR NHRMC ATLANTIC SURGICENTER Why do i have to have a pre-operative appointment? Pre-operative appointments are scheduled at the discretion of your doctor. This is a good time to ask any questions (what should I expect from the procedure/how long will the surgery last/ how long is recovery, etc). This appointment is done in our office. Why do i have to learn how to self catheterize? Certain surgical procedures require patients to learn how to do a self catherization. Some doctors request that you do this so you can have the knowledge and equipment to help relieve yourself should you have a hard time urinating after you get home from your surgery. Less than 1 percent of the slings that are done by this office have this problem. If this happens, you will be glad not to have to run to the emergency room in the middle of the night. Why do i have to go to building b for lab work? All surgical procedures done at NHRMC Atlantic Surgicenter require lab work. This is to make sure all your levels are within normal parameters. This is done in our Building B, located at 1810 Glen Meade Road, right across the street from our main building. No appointment is necessary. You just have to sign in when you arrive at Building B. When am i supposed to arrive for my surgery? A nurse from NHRMC Atlantic Surgicenter will contact you 24 to 48 hours prior to your surgery to tell you what time to arrive for your procedure. Why do i have to do a bowel prep? Bowel preps are done for some surgeries to prevent any intestinal issues. When you have a full intestine, it runs the risk of getting in the way of the procedure. Once you start the bowel prep, you will want to be at home with no plans to leave the house. It is advisable that you go to work for a half day or not at all. Do i have to have a driver the day of my surgery? Yes. You will be drowsy due to anesthesia and the NHRMC Atlantic Surgicenter will not let you drive yourself home. If you are staying overnight, you will need a driver for the next day. I have fmla/disability papers. Who fills them out? If you have any FMLA or disability papers that need to be filled out, you will need to get these from your employer. We do not have them in our office as every company is different. Please bring these papers in as soon as possible in order to have them back before your surgery. You may bring these in and give them to a member of the front desk staff, or you may fax them to 910.763.2951. Melanie will call you as soon as they are ready for pickup. Please be aware that these papers are not completed immediately upon request. There will be a fee for filling these out. To reach Melanie, call 910.763.9833 at extension 115. Who checks my insurance and obtains pre-certification? I will take care of checking and/or pre-certifying any and all insurances. Where do i go the day of my surgery? NHRMC Atlantic Surgicenter is located 1.3 miles past Porters Neck Road on the right hand side at 1904 Market St., Wilmington, NC 28411. Should you have any questions regarding directions or need to contact NHRMC Atlantic Surgicenter, their telephone number is 910.686.2840. The website is www.atlanticsurgicenter.com.

Essure & Thermachoice Instructions We have put together a list of information to prepare you for surgery at Glen Meade Center for Women s Health. We want to make sure that you have the very best medical care. It is also our wish to make this experience as painless as possible. Enclosed are several prescriptions designed to make your procedure go smoothly. The only prescriptions you take prior to surgery are the Cytotec and Motrin. Bring the rest of the prescriptions with you to the office. Please **DO NOT TAKE VALIUM, OXYCODONE, & OR PHENERGAN prior to your procedure. YOU WILL BRING THEM TO THE OFFICE TO BE ADMINISTERED by your care provider. **IGNORE THE INSTUCTIONS ON THE BOTTLES until you speak to your physician!** Cytotec: This medicine is given to thin out and open up your cervix. It allows the doctors easier access and makes the procedure go quicker. Hint: Don t wet the tablets directly under the water. They may dissolve. Wet your fingers and then moisten the tablets with your fingers. Break the tablets in half and insert in your vagina eight hours prior to your procedure. (May cause cramping/spotting/diarrhea) Valium: This is given to help you relax. DO NOT TAKE PRIOR TO ARRIVING FOR SURGERY. Oxycodone: This is to help decrease pain. DO NOT TAKE PRIOR TO ARRIVING FOR SURGERY. Motrin: Take this every six hours beginning 24 to 48 hours prior to your procedure to help decrease swelling and limit discomfort and cramping. Phenergan: This is an anti-nausea medication. DO NOT TAKE PRIOR TO ARRIVING FOR SURGERY. PLEASE FILL ALL OF THESE PRESCRIPTIONS PRIOR TO YOUR SURGERY AND BRING THEM WITH YOU ON THE DAY OF YOUR PROCEDURE. Your surgery is scheduled for at a.m./p.m. Please be in Building B at a.m./p.m. You will bring the Valium, Oxycodone and Phenergan with you and take per the nurse s orders when you arrive. This procedure is performed in our BUILDING B, located at 1810 Glen Meade Road across the street from our Main Building. Once you have been taken back to the room for surgery, an injection of Toradol will be given to you as an extra pain precaution. For your relaxation, we will have a portable DVD player with an array of DVDs to pick from. If you have a favorite movie, feel free to bring it with you. YOU WILL BE REQUIRED TO HAVE A DRIVER TO TAKE YOU HOME. DO NOT ATTEMPT TO DRIVE AFTER your PROCEDURE. For your comfort, if you have not taken your Cytotec or forget to bring all your prescriptions, your surgery may have to be rescheduled.

MIRALAX BOWEL PREP 1 CLEAR LIQUIDS ONLY THE DAY BEFORE SURGERY. 2 Purchase MIRALAX POWDER 8.3 oz./238g over the counter. Also purchase over the counter DULCOLAX LAXATIVE tablets (NOT stool softener). 3 Mix the entire 8.3 oz./238g of MIRALAX with either 64 oz. of Crystal Light lemonade, Gatorade or other clear liquids suggested at the bottom of this page. Remember no RED liquids. 4 Chill the Miralax mix. 5 The day before your surgery: A Mix the Miralax and put it in the refrigerator at 7:30 a.m. B Have a light breakfast before 8:00 a.m. C Drink only clear liquids after 8:00 a.m. D At 3:00 p.m. take four Dulcolax tablets. E At 5:00 p.m. start drinking the Miralax (mixed earlier). F Drink 8oz. every 10-15 minutes until finished. DO NOT RUSH. If you need more than 10-15 minutes, please take the time. We would rather you keep it down. NO LIQUIDS AFTER MIDNIGHT. NO DAIRY PRODUCTS SUCH AS MILK OR CREAM. **Liquids that you can have are: Gatorade, Powerade, Propel, soft drinks (light or dark), chicken broth, fruit juices that are strained of all pulp, coffee or tea (without milk or cream), plain Jell-O without fruit or toppings, iced popsicles, Kool-Aid and water (we recommend Smart Water because it has electrolytes). ABSOLUTELY NOTHING COLORED RED OR DEEP PURPLE.

INSTRUCTIONS for SURGERY AT NEW HANOVER REGIONAL MEDICAL CENTER PATIENT NAME: CHART#: PLEASE READ THE FOLLOWING CAREFULLY Stop taking aspirin/coumadin/plavix/weight loss pills/advil/celebrex/aleve/ibuprofen/nsaid s or any other medications that are blood thinners one week prior to surgery. Please consult with your primary care physician if you have any questions. Do I have a pre-operative appointment with my doctor? r I have a pre-operative appointment on at a.m./p.m. in the office with Doctor: Wilson Rhodes Chase Robison Foiles Jones Pierson Novosel r I DO NOT have a pre-operative appointment BUT I need to pick up my orders from Jennifer on anytime between 8:15 a.m - 4:00 p.m. Does my surgery require an appointment to learn how to do a self catheterization? r I have an appointment with on at a.m./p.m. r My surgery DOES NOT require self catheterization. All surgeries done at NHRMC require you to go to the Medical Mall, located on the corner of 17th Street and Glen Meade Rd. This building backs up to our parking lot. Does my surgery require a bowel prep? r I DO NOT need to perform a bowel prep. Nothing to eat or drink after midnight the night before your surgery. r I have to do a bowel prep. Please see the instructions enclosed in this letter. r I have to do a bowel prep. I will get my bowel prep instructions when I go to the Medical Mall. Your surgery is scheduled for: at. PLEASE NOTE THAT SURGICAL TIMES MAY VARY DEPENDING ON EMERGENT CASES OR HOSPITAL DISCRETION. You will have a post operative appointment on at a.m./p.m. If you are unable to keep this appointment, please call 910.763.9833 and press the number for appointments.

FREQUENTLY ASKED QUESTIONS (FAQs) Why do I have to have a pre-operative appointment? Pre-operative appointments are scheduled at the discretion of your doctor. This is a good time to ask any questions (What should I expect from the procedure/how long will the surgery last/how long is recovery, etc). This appointment is done in our office prior to going to the Medical Mall. Why do I have to learn how to self catheterize? Certain surgical procedures require patients to learn how to do a self catheterization. Some doctors request that you do this so you can have the knowledge and equipment to help relieve yourself should you have a hard time urinating after you get home from your surgery. Less than 1 percent of the slings that are done by this office have this problem. If this happens, you will be glad not to have to run to the Emergency Room in the middle of the night. Why do I have to go to the Medical Mall? All surgeries done at New Hanover Regional Medical Center must be proceded by pre-admission testing at the Medical Mall to ensure the best possible outcome for your surgery. The Medical Mall is located on the corner of 17th Street and Glen Mead Road, which it backs up to our main parking lot. Please refer to the following list before your appointment: A You will have to give them your insurance card(s) and a picture I.D. B You will have bloodwork done. You may eat and drink as usual. No fasting is required. C You will meet with a nurse who will go over all of your medical history. Be sure to bring all medications (in the bottles) with you. They will let you know what you can take prior to surgery. D You will be given a map to the Surgical Pavilion. No parking pass will be required. E You will be given information and reminded to call the Call Center the night prior to your procedure. Why do I have to do a bowel prep? Bowel preps are done for some surgeries to prevent any intestinal issues. When you have a full intestine, it runs the risk of getting in the way of the procedure. Once you start the bowel prep, you will want to be at home with no plans to leave the house. It is advisable that you go to work for a half day or not at all. Do I have to have a driver the day of my surgery? Yes. You will be drowsy due to anesthesia, and the hospital will NOT let you drive yourself home. If you are staying overnight, you will need a driver for the next day. I have FMLA/Disability papers. Who fills them out? If you have any FMLA or disability papers that need to be filled out, you will need to get these from your employer. We do NOT have them in our office as every company is different. PLEASE BRING THESE PAPERS IN as soon as possible IN ORDER TO HAVE THEM BACK BEFORE YOUR SURGERY. You may bring these in and give them to a member of the front desk staff or you may fax them to 910.763.2951. Melanie will call you as soon as they are ready for pickup. Please be aware that these papers are not completed immediately upon request. There will be a fee for filling these out. To reach Melanie, call 910.763.9833 at extension 115. Does staying over night in the hospital mean I will be AN inpatient? No. All overnight patients are considered outpatient status unless their admission time or stay exceeds 24 hours. Who checks my insurance and obtains pre-certification? I will take care of checking and/or pre-certifying any and all insurances. Where do I go the day of my surgery? You will go to the Surgical Pavilion which is located right behind the hospital. The Medical Mall will give you a detailed map, or visit www.nhrmc.org/maps and click NHRMC Main Campus/First Floor Map.