Before Surgery
Overview
Before you have your surgery, you will be asked to complete a pre-surgical screen. This screen will ask about your heath history and current medications and will helps us to take great care of you.
There are two ways to complete your pre-surgical screening:
- MyChart: This is the preferred and fastest method for us to get in contact with you. The screening form will be sent to you electronically for completion if you have a MyChart account. Once completed our screening nurses will review it and contact you with any questions.
- Telephone screening call: You will receive a phone call by one of our screening nurses over the phone to complete the screen. Answering this phone call will be helpful in reducing your time in the clinic.
Pre-Surgical Screening In-Person Visits
You may need to meet with an anesthesia provider before your surgery. If you need to be seen, our scheduler will give you a call and arrange a convenient time to meet with a member of the anesthesiology team. If you are scheduled to come to the clinic, we encourage you to bring:
- A list of your medications
- A support person (friend, family, significant other)
UR Medicine's Approach
The purpose of our perioperative service is to keep you safe before, during, and after surgery; we work towards this goal by providing these screenings and reducing your risks.
We will work in a multidisciplinary manner to help keep you safe; our work is made possible by our team of anesthesiologists and advanced practice providers coordinating with your surgical team, your subspecialists, and your primary care provider.
What to Expect
Pre-Surgical Screening On-site Evaluations
History Review: Including a review of surgical and medical history, any history of problems in anesthesia, allergies to medications and anesthetic agents, and current medications.
Cardiac Evaluation: May include imaging and assessing risk for cardiac problems during surgery.
Pulmonary: May assess lung function including chest X-rays.
Anesthesia Risk and Perioperative Planning: We will look at how you move your neck and open your mouth to help plan for your anesthesia care.
Anemia: We provide point of care testing to assess anemia, and we have an in-clinic iron infusion site if you are found to be needing iron supplementation.
Smoking: We advise you to quit smoking prior to surgery so that your body can recover quickly from surgery. If you need help with smoking cessation, we will provide resources.
Special concerns: We will be here to address any of your concerns regarding surgery.
Screenings and Services
Collaborative Assessment Risk and Evaluation (CARE) Pathway
CARE is a multidisciplinary screening program that we provide for patients so that you safety is prioritized before, during, and after surgery. These screenings help provide a risk assessment for:
- Malnutrition
- Frailty
- Cognitive dysfunction
- Depression
- Anemia
This program also evaluates and plans for these aspects of your well-being:
- Medication Reconciliation (we review the medications you are taking)
- Mobility (how do you get around to doing daily activities?)
- What Matters to You
- Advanced Care Planning (MOLST form, Health Care Proxy)
- What do hope to get out of undergoing surgery?
- What are your long term goals for after surgery?
Pediatric Perioperative Wellness Program
Whether you are a patient or someone who is supporting a patient during their perioperative journey, you know that having a surgical procedure can sometimes cause stress. By participating in the PPWP, you will have a chance to learn several mind-body techniques that have been shown to decrease the effects of stress on the body and can potentially make the process of having a procedure or surgery less difficult.
Some of the techniques included in this program:
- Self-Administered Auricular Acupressure
- Coherence Breathing using a HeartMath Inner Balance Biosensor
- Mindfulness and Guided Body Scans
- Aromatherapy
This program is open to patients 10-20 years old who are scheduled to have an invasive procedure or surgery and are interested in learning ways to improve their experience. The program includes:
- Participate in a live, small group session, where you will learn about how the body’s stress response system works and how you can control it. At this session, you will be introduced to, and be able to practice, several specific techniques that will teach your body to associate certain activities and actions with relaxation and calm.
- Practice any or all of the techniques at home as you approach the date of your procedure or surgery. We provide you with all of the materials you might need and a workbook to remind you exactly how to practice.
- Come for your procedure, where we will encourage you to use the techniques you have been working on at home during your time with us.
- Follow up with your surgeon or proceduralist and bring back any borrowed equipment. We will check in with you and get feedback about your experience with the program.
Additional Programs
- Anticoagulation program
- Anemia program
- Smoking cessation
- Complex spine
- Maternal Anesthesia Optimization Program
- Cardiopulmonary optimization
- Hospital Medicine Co-Management
What Sets Us Apart?
As part of a world-class medical center and academic institution, the UR Medicine Department of Surgery is dedicated to advancing excellence in health care. In a continued effort to provide our patients and their families with the highest level of care and service, we also have an unwavering commitment to education and research. Our surgeons are more than highly skilled doctors. They are dedicated to delivering an exemplary patient experience across the full care continuum.
Our Center for Perioperative Medicine has received national recognition for our work in caring for older adult patients. We received the Age-Friendly Health System — Committed to Care Excellence award, the highest designation bestowed by the Institute for Healthcare Improvement (IHI) in partnership with the John A. Hartford Foundation, the American Hospital Association and the Catholic Health Association of the United States.
Our clinic went through a rigorous screening and selection process to receive this award, and we believe this to be a testament to the quality of service we provide and the commitment of our staff to provide excellent healthcare to Rochester’s community. With the growing older adult population in the United States, our work in providing excellent screening programs and risk reduction for older adult patients will continue to be of paramount important. Thank you for entrusting us with your care.
Patient Education & Support
Day Of Surgery Arrival Time
Strong Memorial Hospital Main Operating Room: Call (585) 275-8256 between 2:30pm and 7:00pm the business day prior to surgery for arrival time.
Strong Memorial Hospital Second Floor Operating Room (example: ophthalmology): Call (585) 273-4361 between 2:30pm and 4:30pm the business day prior to surgery for arrival time.
Sawgrass Surgery Center: You will be contacted with your arrival time between 2:00pm and 5:00pm on the business day prior to your procedure. You do not need to call yourself, however, if you have questions, please call (585) 242-1410.
Strong West Surgical Center: You will be contacted with your arrival time between 3:00pm and 4:00pm on the business day prior to your procedure. You do not need to call yourself, however, if you have questions, please call (585) 758-8700.
Highland Hospital: You will be called between 1:30pm and 4:00pm to verify your arrival time. If your surgery is on Monday, you will be called the Friday before your surgery. If your surgery is the day after a holiday, you will be called the last business day prior to your surgery. However, if you have questions, the surgical center phone number is (585) 341-6707.
Additional Instructions
If you’re feeling sick before your surgery, call the pre-surgical center or contact your surgeon's office.
Your family will be directed to a waiting area when you are taken to surgery. We ask that only one or two family members accompany you on the day of your procedure. Additional visitor restrictions are possible. Your family will be notified when your surgery is completed, and you have arrived on the patient care unit.
You will not be allowed to drive yourself home from the surgical center or hospital. You will not be allowed to use a city cab, Uber, Lyft, or bus unless accompanied by an adult (age at least 18) who is responsible for you. It is also strongly recommended you have a responsible adult available to assist you for the first 24 hours after discharge. If you are unable to find transportation, please call our office (585) 262-9150 to see what options may be available to you.
Preparing For Your Procedure
What Should I Bring To Surgery?
Only bring items that you will need before or after the procedure. Be prepared to leave items in your car or with your family/friend as there is no place to store items during the operation.
Bring the following the day of the procedure:
- Photo ID and insurance information.
- Eye glasses and/or hearing aids: These may be removed prior to surgery so be prepared to leave them with a trusted family member.
- Extra batteries for your hearing aids.
- Advance directives (if you have one)
- Court-issued guardianship document (for legal guardians)
- CPAP mask and machine (if you have sleep apnea).
- Support equipment if you have it (sling, knee brace, cane and walker)
- Crutches can be left in the car if only needed for after surgery.
- Loose-fitting clothing
- Dentures, hearing aids, glasses and other necessities
Do not bring the following:
- Before coming to the hospital, remove all makeup (including mascara), jewelry (including wedding band and watch), hair accessories and nail polish from toes and fingers.
- Do not bring any valuables (money, wallet, purse, jewelry, or contact lenses).
Should I Still Take My Medications Before Surgery?
Most medications are ok to continue without problem however there are some medications you may be asked to stop prior to surgery. On the morning of surgery, take only the medications you are instructed to take. Contact your surgeon or the pre-surgical center with any questions.
- It is recommended that any herbal supplement, vitamin E or fish oil be stopped 7-10 days prior to surgery.
- Blood thinning medications can require specific instructions: please don’t decide by yourself - talk to us or your surgeon for assistance.
- Certain weight loss medications: please don’t decide by yourself - talk to us or your surgeon for assistance.
- Diabetes medications can require specific instructions; please don’t decide by yourself - talk to us or your surgeon for assistance.
Being Your Best For Surgery
If you smoke - QUIT. Quitting smoking is one of the best things you can do to help yourself. Quitting 6-8 weeks before surgery is the best time to quit. But don’t worry if you don’t have that much time - QUIT NOW. Ask your healthcare provider for help or call the Healthy Living Center at (585) 530-2050.
Follow your health care provider’s advice. Follow the medication recommendations and diet instructions prior to surgery to help us keep you safe.
Call if you have a fever or feel sick before surgery. Getting sick before surgery might mean your surgery should be delayed until you are better. Call your surgeon or the pre-surgery center if you have a fever, productive cough or chest congestion.
Take care of your health. Poorly controlled medical problems can cause longer stays in the hospital, infections and other problems. Talk to your primary care doctor if your blood pressure, blood sugar or other medical problems are not controlled.
Eat healthy. You need energy to heal. Good nutrition around the time of surgery will help you to heal well and have energy. Ask your health care provider if you need help with this.
Get adequate rest and exercise (unless your doctor has limited your activity).
Plan for your recovery. You may need a family member/ friend to help you at home with things like rides, meals, or cleaning. The amount of support you need can vary depending on your health and the type of surgery you are having. Ask your surgeon about any limitations you might have after surgery. Most people will be tired and need extra rest. We recommend you have an adult stay with you the first 24 hours after discharge if possible.
Get a Primary care doctor if you don’t already have one. View UR Medicine providers accepting new patients.
Pre-Surgical Eating and Drinking Guidelines
Follow these instructions below unless otherwise instructed by your surgeon or by the anesthesiology team. Failure to follow these instructions, could lead to a delay or cancellation of your procedure.
Adults: For Non-Bariatric Surgery
- No solid food after midnight the night before surgery. No candy, gum, mints or chewing tobacco.
- Stop all clear liquids 4 hours before surgery.
- Clear liquids include water, apple juice, clear sports drinks (Gatorade), clear carbonated beverages.
Adults: For Bariatric Surgery
Bariatric Surgery patients may not eat solid foods for 48 hours prior to surgery. Only clear liquids are permitted.
Children
- No solid food after midnight the night before surgery. No candy, gum, or mints.
- ONLY Clear liquids are ok up until 3 hours before surgery. Clear liquids include: Pedialyte, water or apple juice (without pulp) up to 3 hours before arrival.
Infants
- No infant cereal or other solid food after midnight prior to your child's procedure.
- Breast fed infants may have breast milk up to 4 hours before arrival.
- Formula fed infants can have formula up to 6 hours before arrival.
- Clear fluids are allowed up to three (3) hours prior to your child's procedure. This includes water, apple juice (without pulp), glucose water and Pedialyte. These are the only allowable fluids.