Surgery Associates  

Surgery Information Packet

For a pdf version of the imformation presented here click here.

Dear Patient:

You and your doctor have decided that you will have a surgical procedure. We understand this can be a stressful time for you and your family. We will do our best to make the process as worry-free as possible and will work hard to ensure that your procedure moves forward in a timely manner.

This packet of information has been developed to help you understand the processes necessary to schedule and prepare for the procedure, as well as general post-operative information. Please read all of this information carefully so you will know and understand what our office will be doing and what you need to do.

Please follow all of the instructions outlined in this packet completely. If at any time you have any questions about what to do, please do not hesitate to call our office and talk with one of our Clinical Specialists.

Sincerely,

The Surgeons and Staff
Virginia Surgery Associates, P.C.

Before Surgery/Scheduling

What Virginia Surgery Associates, PC (VSA) will do:

  1. VSA’s surgical scheduler will contact the facility to schedule your surgery. She will coordinate your physician’s and the hospital’s availability and your indication of availability on the form you completed before you left our office today. The scheduler will contact you with the date, time, and location of your surgery. The scheduling process takes several days. Once you hear from the Scheduler please write down the information.

    Please understand, rescheduling surgery is very difficult and any changes can delay your procedure for several weeks!

  2. The Scheduler will set up your post operative visit when she calls you about your surgery time. Our physicians would like to discuss your pathology results with you in person during your post operative appointment. To ensure your complete understanding of results, staff may not give you your pathology results over the telephone. Please write down the information when the Scheduler calls you.

    Please Read the Following Carefully

    The surgery scheduling process involves coordinating your schedule and your surgeon’s schedule with the surgical facility’s availability. This process can best be facilitated if you inform us of the dates you are not available to have your surgery performed. The more flexibility you have in your scheduling preferences, the more timely we can schedule your surgery.

    Additionally, every effort is made to accommodate your preferences regarding the facility where your surgery is performed. However, we can generally schedule your surgery in a timelier manner with your increased flexibility. Please indicate your preference to the scheduler which facility you would like to have your surgery performed in:

    • Fairfax Facilities
    • Fair Oaks Facilities
    • Loudoun Facilities
    • First Available

    Please be aware that our surgeons rotate to different facilities and not all surgeons perform surgery at all locations.

    Please be aware that first available can mean within the next several days, if a cancellation occurs.

Before Surgery/Preparing

What YOU need to do AS SOON AS YOU HAVE YOUR SURGERY DATE:

  1. 1. Once the Scheduler has notified you of your surgery date, time and facility, you must contact the INOVA Teleservices Department at the appropriate hospital to make an appointment to review your medical history, medications, and other necessary information. Please call one of the following:

    INOVA Fairfax Hospital: (703) 208-2525
    INOVA Fair Oaks Hospital: (703) 391-3500
    INOVA Loudoun Hospital: (703) 858-6768
    Loudoun Ambulatory Surgery Center: (571) 209-6441
     

  2. If your surgeon has ordered any pre-operative testing (lab, x-rays, EKGs, etc.) you must schedule them to be done. Please call the hospital where you are going to have your surgery to schedule these tests. If you have your pre-operative testing done somewhere else, you must ensure that the test results are Faxed to the hospital where you are going to have your surgery at least 14 days prior to your surgery date.

    INOVA Fairfax Hospital Pre-Surgical Testing: (703) 970-3100
    Fax: (703) 970-3136
     
    INOVA Fair Oaks Hospital Central Testing: (703) 391-3610
    Fax: (703) 391-3992
     
    INOVA Loudoun Hospital (703) 858-6768
    Fax: (703) 858-6425
     
    Loudoun Ambulatory Surgery Center (571) 209-6465
    Fax: (571)209-6477

    Please Note: The hospital may require Mammograms/Sonograms for some surgical procedures. YOU WILL BE NOTIFIED IF YOUR FILMS ARE NEEDED. It is YOUR responsibility to take those films to the Department of Radiology at the designated hospital 10 to 14 days prior to surgery. When you drop them off with the Department of Radiology please make it clear to them that your films are needed for your upcoming surgery!

    What YOU need to do AS SOON AS YOU HAVE YOUR SURGERY DATE:

  3. If you are currently taking prescription medications, you must contact the prescribing physician regarding possible changes that may be necessary prior to your surgery. (Specifically, Coumadin or Lovenox)

    DO NOT TAKE ANY BLOOD THINING PRODUCTS SUCH AS ASPIRIN - 10 DAYS PRIOR TO SURGERY

    Aspirin products include Advil, Motrin, Ibuprofen, Aleve, Naprosyn, Celebrex, Orudis, Plavix and Lodeine.

  4. If you were given Bowel Prep instructions, please follow them EXACTLY.

The Day of Your Surgery

For your safety:

  1. DO NOT EAT OR DRINK ANYTHING, OR SMOKE AFTER MIDNIGHT THE NIGHT BEFORE SURGERY. No gum, cough drops, or hard candy.
  2. Please arrange for transportation home from the hospital. Taxis will NOT be able to pick you up. Hospital safety regulations prohibit you from driving yourself home.
  3. Please leave your jewelry and valuables at home.

Before you leave home for the hospital:

  1. Please be sure you have: your photo ID, Insurance card(s), co-payments (check or credit card), Advanced Directive, Living Will or Durable Power of Attorney. Bring cases for dentures, glasses or contact lenses.

At the hospital:

  1. Check in at the hospital at the time given to you by our office.
  2. When you arrive, you will be registered and then directed to the surgical preparation area.
  3. Any last minute questions you may have can be directed to the surgeon and anesthesiologist at this time. A family member or friend may wait with you in this area.
  4. After surgery, while you are in the recovery area, your family or friend will be notified of your condition.
  5. You may then remain in the hospital to recover or be discharged to recuperate at home.

Please Note:

At times, due to unavoidable circumstances, it may be necessary to change the time of your surgery because of cancellations and/or emergencies. This is infrequent, but may happen. If a change in your surgery time is necessary you will be notified.

Maps and/or brochures for the hospitals are included in the Surgical Information Packet given to you. Please reference the materials for the hospital to which you will be going.

After Your Surgery

General post operative instructions are included in this packet. Please read them prior to your surgery and refer to them after surgery.

A prescription for post operative medication(s) may be given to you at the time of your discharge.

Pathology results will be made available and reviewed with you at the time of your post operative visit in our office. Our physicians wish to discuss these directly with you to ensure your complete understanding of results. As such, Staff may not give pathology results over the phone.

During your post operative visit with your physician, please discuss your activity and return to work or school plan. If you need a return to work or school slip or written documentation regarding activity level, please ask the Clinical Assistant before you leave the office.

If your employer requires a statement of disability on their form (including FMLA) there is a $30.00 fee payable in advance for completing each form. You may bring or send requests to:

Virginia Surgery Associates, P.C.
Attention: Disability Department
4001 Fair Ridge Drive, Suite 304
Fairfax, VA 22033

Checks for payment should be made payable to:
Virginia Surgery Associates, P.C.

Please be sure to specify where the form(s) are to be sent. Please allow 10-15 business days for the forms to be completed.

If at any time you have questions or concerns, please do not hesitate to contact the office at (703) 359-8640 between the hours of:

Monday - Thursday: 9:00 AM - Noon and 1:00 PM - 4:00 PM
Friday: 9:00 AM - Noon

Surgery is a stressful event for everyone. We will do our best to make the process as worry-free as possible for our patients. While operations are routine for our surgeons, we understand they are not routine for our patients!

Some basic information that may be helpful for all surgical patients:

FEVER

Low grade temperatures (99-100.5 degrees) are common in the first 2-3 days after surgery, especially if you have had general anesthesia. The best treatment is coughing, deep breathing, and use of the incentive spirometer from the hospital (if you were given one). Higher or persistent temperatures warrant notification of our office.

BOWEL MOVEMENTS

Bowel movements are commonly altered after surgery. If you received even one dose of antibiotics, you may develop several days of diarrhea after surgery. If so, eating yogurt may help this condition. If the diarrhea is foul-smelling, very frequent, or associated with fever, please notify our office. More often, the combination of anesthesia and pain medication (especially after bowel surgery) can cause severe constipation for up to a week. This may be treated with Metamucil each day, plus Milk of Magnesia if needed. Stubborn cases may benefit from Citrate of Magnesia or Fleets enemas. If you have had intestinal surgery, do not use an enema without clearance from your surgeon. Call the office if you have exhausted all of these methods.

PAIN

Surgery hurts! The bigger the operation, the more it hurts. One of the reasons for the hospital stay in larger operations is for pain control with IV medications. In smaller operations, or after several days in the hospital, the pain can usually be well controlled with oral medications. Narcotics such as Percocet, Vicodin, and Tylenol #3 are fairly powerful medications that usually control pain very effectively. However, they have frequent side effects such as dizziness, nausea, and constipation. We recommend treating your postoperative pain initially with Ibuprofen (such as Motrin, Advil, or generic) 600-800 mg with food 3 times a day. Take this medication until your pain subsides to the point that you don’t need medication any more.

In addition to the Ibuprofen, take your prescription medication as directed for the first few days if needed. Do not take Ibuprofen if you are allergic to that family of drugs, if you take blood thinners, or if you have had stomach ulcers or gastric surgery. Do not drive if you are taking narcotics. Do not mix alcohol with narcotics.

WOUNDS

Surgical incisions usually require little care. Inpatient surgical incisions are often closed with staples or external sutures. These are usually removed after 5-10 days, often in the office. You will be told in the hospital when you can get the incision wet. Typically showers are allowed after 3 days and tub baths after the sutures are removed. Outpatient or overnight-stay surgical incisions are often closed with dissolving sutures. Steri-strips are then applied to the skin. These may be exposed to the shower the next day, but tub bathing and scrubbing should be avoided for a week. Pinkish or clear discharge is common for 2-3 days after surgery. Thick yellow or foul-smelling discharge, or frank bleeding, should prompt a call to the office. Dissolving sutures typically take 3 weeks to disappear. If they protrude from the skin they may itch, and you may call the office for an appointment to have them trimmed. In a few cases, a blood collection in the wound (hematoma) or a wound infection may cause the edges of the wound to separate. This is usually a simple problem to deal with in the office; call for an appointment if this happens. In some situations wounds are not completely closed. These will be managed by dressing changes several times a day (visiting nurses may be arranged in complex cases), often for several weeks.

BANDAGES

Band aids may be applied to small incisions. They should be removed the next day or changed as desired. If there are small white tapes on the incision under the band aids (steri-strips or "butterfly" bandages), these should be left on until they begin to fall off in 7-10 days. They may get wet 24 hours after surgery. Larger incisions may have gauze taped over them. This can usually be removed 48 hours after surgery. All wounds may be covered with clean bandages (changed daily) if they are tender or chafed by clothes.

FOLLOW UP

You will be seen in our office 7 to 10 days after your surgery and again in several weeks. Prior to surgery, you should have made an appointment for your first post-operative visit. If for some reason that appointment was not scheduled, please call our office at (703) 359-8640 as soon as your return home to schedule your appointment.

IF DIFFICULTIES ARISE

You may have trouble belching or vomiting for several weeks after surgery. This will subside as your body adjusts to the operation. Please call our office immediately if you develop any of the following; chest pain, excessive drainage, fever over 100°F, persistent nausea or vomiting, or difficulty with urination. Please call us if other problems or questions arise. We can be reached any time, including evenings and weekends, by calling our office number (703) 359-8640.

PRE-OPERATIVE BOWEL PREP INSTRUCTIONS FOR PATIENTS UNDERGOING COLON SURGERY

Cleansing the bowel prior to colon surgery is crucial for a successful operation. This requires "Flushing Out" the intestine with a large amount of fluid and taking antibiotic pills to kill the bacteria which normally reside in the large intestine. Please follow this instruction carefully. If you experience difficulty with the preparation at any time call our office at 703-359-8640 and ask to speak with a member of our Clinical Team.

On the day prior to your surgery:

  1. Eat a clear liquid diet only without any milk products. This includes clear soups, broth, jell-O, Kool-aid, Italian ices, coffee, tea, carbonated beverages and clear fruit juices without pulp. Remember to keep yourself well hydrated.

    You will not be allowed to have anything to eat or drink after midnight the night before your surgery.

  2. Beginning at 10:00 am the day before your surgery, drink 30 cc’s (1 ounce) of the Phosphosoda (available at any drug store) combined in 1 cup of water. Follow with 3 more cups of water.

  3. Repeat again at 8:00 pm.

  4. Take Neomycin and Flagyl pills as directed on the bottle at 7:00 pm, 9:00 pm and 11:00 pm

    The prescriptions are attached to the surgery information instructions you will receive from your doctor.

  5. Do not take ASPIRIN, Motrin, Advil or any other medications that contain aspirin for 10 days prior to surgery unless instructed by your doctor.
 
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