Prior to Surgery: What to Expect?

How Do I Schedule My Surgery?

You may schedule or follow-up on your upcoming surgery by contacting our office at (724)933-3300. Note that if Dr. Bowman has spoken to you about surgery during your first visit (and has fully explained and reviewed the surgery, the postoperative regimen, and its risks and benefits) our office staff will also start the process of scheduling your surgery. This includes obtaining medical clearance, obtaining the necessary preoperative tests, coordinating care with your other physicians, and obtaining any necessary surgical equipment. Following this prep work, our office staff will then be able to give you a date for your surgery.

What Do I Need to Do Prior to Surgery?

You will need to have a preoperative History and Physical (H&P) completed by your family physician/PCP prior to surgery. Please allow plenty of time to get an appointment with your PCP, and for them to complete your H&P and submit it to our offices.

In certain cases, we may be able to have a H&P done the morning of surgery. Our staff will advise you about your specific needs during your visit to our office.

For certain medical conditions, such as severe heart disease, diabetes or bleeding disorders, you may need additional medical clearance from one or more physicians before your surgery can be scheduled. Note that we will not be able to administer your anesthesia without your medical clearance/H&P, and your surgery may have to be rescheduled!

What Laboratory Studies or Tests do I Need Prior to My Surgery? 

Depending on your age and general health status, you will be required to undergo certain standard preoperative tests, particularly to clear you for anesthesia. Our staff will always give you a written list of the required tests needed prior to your surgery. These can include:

  • a CBC (complete blood count)
  • EKG
  • chest x-ray
  • other blood work

Dr. Bowman may also request imaging studies such as a CT scan or MRI prior to the surgery. 

Our office will assist you in arranging all of these studies. However, you are ultimately responsible for getting the studies completed, having the results sent to our office 3 days prior to surgery, and bringing in the imaging studies with you to the surgery. Failure to receive all of the required information prior to surgery may result in having to reschedule your surgery.

When can I Eat Prior to Surgery?

In order to avoid complications from anesthesia (such as aspiration), most patients are instructed to consume n.p.o. (nothing by mouth) after midnight on the night prior to surgery. This generally means:

  • Refraining from eating or drinking any fluids
  • No gum or candy
  • If you brush your teeth in the morning, do not swallow any of the fluid

Any allowable modifications in these instructions will be given directly to you by the hospital or surgery center.

Never drink alcohol or smoke for 24 hours before surgery.

Failure to follow these instructions may result in canceling and rescheduling your surgery by anesthesia.

Should I Stop Taking My Medications Prior to Surgery? 

The short answer is: it depends.

The full answer is: it is very important that you give us a complete list of all your medications and doses prior to surgery, including the prescriptions, vitamins, over-the-counter medicines, or herbal supplements you take. We can then guide you on your medication needs and restrictions.

Some general guidelines on what to expect include the following:

  • Some medicines - such as blood thinners (like Coumadin, Plavix, Lovenox) – and some supplements (like vitamin E and Fish oil) may cause increased bleeding after surgery. These will need to be stopped 7 to 10 days prior to surgery (or modified in cooperation with your other physicians).
  • Other medicines (such as prednisone, methotrexate or Embrel) inhibit wound healing and need to be stopped prior to surgery if possible. 
  • Anti-inflammatories such as Ibuprofen, Aspirin, Aleve, Celebrex, and Chondroitin sulfate may cause increased bleeding during and after surgery. They can also inhibit bone formation after surgery and result in decreased healing of fractures or fusion surgeries. These will be discontinued prior to surgery. 
  • Some medications will need to be given on the morning prior to surgery and may be taken with a small sip of water. Our staff or your anesthesia team will review these with you. 
  • You may also take plain Tylenol prior to surgery in approved doses up to midnight prior to surgery.

Notify our staff if you are taking any medications or supplements prior to surgery.

What Do I Need to Bring With Me to Surgery?

Please bring:

  • comfortable loose fitting clothing
  • your insurance card for the hospital
  • any imaging studies (such as CT scan, MRIs or x-rays) requested by Dr. Bowman
  • if you have been given a boot for foot surgery, please bring it along with crutches, a walker or a wheelchair

Additionally, if you are having any type of anesthesia other than straight local anesthesia, another individual will need to drive you home about your procedure. They can arrive with you prior to surgery, or arrangements can be made for them to pick you up.

Where Will My Surgery Be?

Dr. Bowman operates at the Western PA Surgery Center in Wexford, UPMC Cranberry Surgery Center and Alle-Kiski Medical Center in Natrona Heights.

In most cases, outpatient surgeries may be scheduled at any of the above sites.

Surgeries requiring an overnight stay are scheduled at either UPMC Cranberry or Alle- Kiski. However, for your convenience, your choice of site may be accommodated if one is preferred to the other. 

Occasionally there are restrictions imposed by your insurance plan, special required surgical equipment, your desired timeframe, or urgency dictated by your medical problems. In these cases, our team will review the options with you.

When Will My Surgery Take Place and When Will I Need to be There? 

The hospital or surgery center will call you the business day before your surgery with your surgery time, preoperative instructions and what time you are to arrive at the hospital or surgery center.

At Surgery: What to Expect?

Upon arrival, the OR staff will:

  • check you in
  • review your health records, medications, and allergies
  • review if you have been n.p.o. compliant after midnight
  • ask you several times to confirm your surgical site (i.e. right or left, arm or leg).

You will then change into OR clothing and they will take your vital signs. An Intravenous line (IV) will be started and you may be given some preoperative medicines. In most cases, you will receive preoperative antibiotics. You will also be asked to sign the consent for your surgery.

The anesthesiologist and certified registered nurse anesthetist will speak to you and review the anesthesia options for your surgery. They will discuss the risks and benefits of each method with you. You will then be asked to sign your consent for anesthesia. After the choice is made, you may be given a block in order to numb the surgical area.

Dr. Bowman or Lindsey will sign your consent form, autograph the surgical site and review any last minute questions. After all preparations are completed, you will then be taken to the operating room. You may not remember this because of the effects of the anesthesia medicine.

After Surgery: What to Expect?  

What Will Happen After My Surgery?  

After your surgery, you will be taken to a recovery room. There, recovery room personnel will take excellent care of you. Your vital signs will be monitored to make sure that you are responding well to surgery. The arm or leg that was operated on will be elevated. You will be given pain medicine if there is any postoperative pain as well as medication for any nausea. This is minimized with the use of modern anesthesia. 

After the effects of the anesthesia have worn off, you will be discharged with a list of postoperative instructions and appropriate prescriptions. These will usually include a prescription for pain medicine and antibiotics. There may be a prescription for physical therapy or occupational therapy.

If you have not done so prior to surgery, please call the office at 724-933-3300 to schedule your postoperative appointment. This is usually at two weeks post-op. At that time, we will remove any sutures if the wound is appropriately healed.

In most cases, the key to remaining comfortable after surgery is elevation, elevation, and elevation! Keep your hand elevated with your fingers towards the ceiling or keep your leg elevated with the foot higher than the knee. This will reduce swelling and really help diminish discomfort. Take your pain medication as needed and as prescribed. Take your postoperative antibiotics in order to reduce the possibility of infection.

Note that we will discuss prior to surgery (and afterwards) when you can resume taking certain medications (such as anti-inflammatories or blood thinners) after surgery. Restrictions of hand or foot usage will also be discussed both prior and after surgery. The need for immediate postop occupational therapy or physical therapy may be decided at surgery. You will be instructed afterward.

You should call the office at 724-933-3300 if you are having a problem post-op. This includes things such as severe pain, excessive or unusual bleeding, fever or chills, or severe discoloration of your hand or foot.