You must stop smoking and/or using tobacco products of any kind for at least four weeks prior to your surgery. It is best to stop smoking at your initial consultation and never resume smoking and/or using tobacco products of any kind. Your surgery will be cancelled if you have smoked and/or used tobacco products of any kind during the four week period prior to your surgery date. Smoking may adversely affect your healing process and the successful outcome of your surgery. It may also increase your pulmonary complications. Once you have stopped smoking and/or using tobacco products it is recommended that you do not start using them again.
Do not use aspirin, blood thinners or NSAIDS (Ibuprofen, Aleve, Motrin…) for 1 week prior to surgery. If there is a special need for the use of these medications please discuss them with your prescribing physician and Dr. Felts. If you are on blood thinners please discuss this with Dr. Felts and your prescribing physician.
PMC (PERIOPERATIVE MEDICAL CLINIC)
Once you have completed all your insurance and clinical requirements your case will be submitted to your insurance company for coverage approval of your surgery.
When your Insurance Company has given us an approval for your surgery our office will call you to schedule your surgery date, your education and your PMC (Perioperative Medical Clinic) appointment. The PMC may do a pre-operative assessment of you by phone or they may require you to schedule an appointment with them to come to the hospital for a pre-operative assessment. They will ask about prior surgeries, medications, allergies, use of herb and food supplements, any over-the-counter medications and any current medical conditions you may have. Please make sure you have a current list of your past surgeries, allergies, herbs, over the counter and medications or bring your medication bottles for accurate information. The PMC team will give you your arrival time for surgery.
To better prepare you for your surgery, we have partnered with EMMI Solutions, an interactive tutorial. Dr. Felts requires that you walk through the procedure with EMMI as it takes you step-by-step from pre-surgery to post surgery, including risks and benefits. You will be given a web site and an access code to go on line and take the EMMI education for your procedure. The video is short but very educational. This is required in order to have your surgery. Please make sure you have completed the online video prior to your education class. If you do not have a computer at home or if you need help with this process please contact the office and we will assist you through the process.
About 2 weeks prior to your procedure you will need to attend an education class. The classes are on Monday afternoon and Wednesday morning. The class takes about 1 to 1 ½ hours. You have been given a personalized process and education booklet. During your class we discuss your procedure, your activities, your diet, medications, regurgitation, support groups and the signs and symptoms to call Dr. Felts. You must attend this class prior to having your procedure. Adult family members are welcome but please make arrangements for small children.
YOUR SURGICAL CLEARANCE
You will need to see your Primary Care Physician for a surgical clearance prior to surgery. This should be done 3-4 weeks prior to your surgery date. Your surgical clearance is valid for a 30 day period. The office will provide you with a letter to give your physician if you need it or they may just write us a letter stating you are medically cleared for your surgery. If you have a history of heart, lung or other conditions you may be required to see your cardiologist/pulmonologist/ hematologist for surgical clearance as well.
You will be placed on a high protein, very low calorie pre-op diet 2-3 weeks prior to your surgery. The diet reduces the fat in and around your liver improving the ease and safety of your surgery.
PRE OP DIET INSRUCTIONS
SURGERY DATE: _______________________________________
PRE-OP APPOINTMENT WITH DR. FELTS: ____________________
START YOUR PRE-OP DIET TODAY__________________________________
During the pre-operative diet, you will need to limit your daily calorie intake to 800 calories/day.
ELIMINATE FROM YOUR DIET:
- All fats, butter, fatty meats, fried foods, whole milk products
- High sugar foods
- Carbonated drinks
- Bananas – they are high in sugar
- Mix as per directions on package
- Powder can be mixed with water or skim milk
- You may use ¼ cup of the following: fresh berries, frozen berries, fat free/sugar free Jell-O or pudding to add flavor. You may also try extracts and spices
- You may have coffee, tea, or Crystal Lite and may use any of the artificial sweeteners, though we recommend stevia.
- You may have 1 healthy meal, to include 4-5 oz. of lean meat (chicken, turkey, fish and beef).
- Green vegetables ONLY.
- You may also have 1 cup of fruit after your meal if you have not added this fruit to your protein drink.
REMEMBER TO BRING IN A “BEFORE PHOTO” FOR OUR SUCCESS ALBUM
THE DAY BEFORE YOUR SURGERY
The day before surgery you will begin a clear liquid diet.
When you get up the day before your surgery you will begin your clear liquid diet. This will help make your intestines and stomach easier to handle during your operation.
Liquids that you can see through at room temperature are considered clear liquids. This includes clear juices, broths, ices and gelatins. The list below will help you with your choices. (Choose sugar free or light drinks)
- Sugar Free Kool- Aid
- Crystal Light, Mio, Vitamin Zero
- Sugar Free Gelatin
- Sugar Free Popsicles (made from clear juices)
AT NOON THAT SAME DAY you will need to drink a 10 Ounce Bottle of Magnesium Citrate followed with 8 ounces of water. This is a strong laxative needed to clean out your intestines before your surgery. If you drink this by noon know that it will begin to work in 4-6 hours. MAGNESIUM CITRATE is available in all drug stores and most grocery stores over the counter. If you do not find it ask someone at the pharmacy or store where to find it.
Take a shower with Hibiclens (get at your drug store) the night before surgery and Nothing to eat or drink after midnight. See Hibiclens instruction sheet:
Preoperative Hibiclens Bathing Instructions
Before surgery, you can play an important role in your own health. Because skin is not sterile, we need to be sure that your skin is as free of germs as possible before surgery. You can reduce the number of germs on your skin by carefully washing before surgery. Following these instructions will help you be sure that your skin is clean before surgery.
IMPORTANT: You will need to shower with a special soap called chlorhexidine gluconate (CHG)*. A common brand name for this soap is Hibiclens, but any brand is acceptable to use. The soap may come in a liquid form or in a scrub brush applicator. Either form is acceptable to use.
- Not to be used by people allergic to chlorhexidine.
- Shower or bathe with CHG the night before your surgery and the morning of your surgery. Do not shave the area of your body where your surgery will be performed.
- With each shower or bath, wash your hair as usual with your normal shampoo.
- Rinse your hair and body thoroughly after you shampoo your hair to remove the shampoo residue.
- Then apply the CHG soap to your entire body ONLY FROM THE NECK DOWN. Do not use CHG near your eyes or ears to avoid permanent injury to those areas. Wash thoroughly, paying special attention to the area where your surgery will be performed.
- Turn water off to prevent rinsing the soap off too soon. Wash your body gently for five (5) minutes. Do not scrub your skin too hard. Do not wash with your regular soap after CHG is used.
- Turn the water back on and rinse your body thoroughly.
- Pat yourself dry with a clean, soft towel.
PHARMACIES STOCKING CHG (HIBICLENS) ANTIBACTERIAL SOAP
CHG soap can be purchased at most large pharmacies, including CVS, Rite Aid, Stop & Shop, and Arrow. Please call your pharmacy to be sure that they have CHG soap in stock.
You were given a consent form for your procedure in your Education booklet. Please take the time to read over it prior to surgery so we may address any and all question.