Surgery can be a viable option on your road to wellness. We offer state-of-the-art surgery services at HCM, and we systematically review every detail prior to your surgery to foster a successful outcome for you or your loved one.
How to Prepare for Surgery
Our team of health care professionals is here to guide you before, during and after your procedure. Please read the following instructions to prepare for your stay and recovery at home. If you have questions, please contact a preadmission nurse at (830) 990-6117 or (830) 990-6129.
You are important to us, and we will do everything we can to enable you to have the result you want and need. Please ask us any questions as we work together toward your recovery.
Inpatients are usually admitted the day of surgery and remain in the hospital for a few additional days. Occasionally, you may be admitted the day before surgery.
Outpatients are admitted the day of the surgical procedure and go home the same day to recuperate. Occasionally, a medical or surgical need may require an overnight stay in the hospital. If this occurs, your physician will discuss the situation with you.
The preoperative screening nurse will be calling you to review your medical history and provide you with any pertinent information prior to your procedure date. Please have available a list of medications you are taking including any over-the-counter nonprescription drugs, vitamins and herbal supplements. We will need to know the dosages for all and how often you take them. Also, please have information available about any allergies, past surgical procedures and other non-surgical hospitalizations you have had.
The screening nurse will give you preoperative instructions after considering your medications and medical history. This phone call is your opportunity to ask any questions or voice any concerns, including any anticipated needs during or after your surgical experience.
Your physician may want to complete preadmission testing such as laboratory, electrocardiogram and/or chest x-rays. All of these results, along with the screening nurse’s information, provides your medical team with optimal tools to better care for you during your surgical procedure. Preregistration can be done through the admissions office.
Preparing for surgery
Since you will likely come to the hospital on the same day as your surgery, you may need to do some preparation while at home. It is extremely important to follow the instructions given to you prior to surgery regarding when to stop eating and drinking. You should not take medications unless instructed to do so by your nurse or physician.
Unless otherwise instructed by your physician or the pre-admission nurse, do not eat or drink anything after midnight the night before your procedure. This requirement includes chewing gum, candy, dipping snuff or tobacco.
Your physician may ask you not to take some of your regular medications. If your physician instructs you to take your medications, please do so with only a small sip of water. If you use an inhaler or eye drops, please bring them with you on the day of your procedure. If you’re using a CPAP/ BIPAP machine, please bring it to the hospital.
Surgery Dos and Don’ts
DO be on time.
DO bring personal items such as a comb, brush, chapstick, books or other items you may like to have. If you are being admitted, please leave personal items in your car until your room assignment is made.
DO arrange for transportation to and from the hospital and for someone to accompany you home. You will not be allowed to drive.
DO wear loose-fitting, comfortable clothing. You may want to bring a pair of warm socks to wear during your procedure. If you are having leg surgery, please bring crutches (if you have them) or walker and wear shorts or pants with loose legs. If you’re having arm surgery, bring a sling (if you have one) and wear a shirt that opens down the front and/or has loose sleeves. A pair of rubber sole shoes or slippers will provide safety during ambulation.
DO bring copies of lab reports, EKGs and x-rays that were not done at Hill Country Memorial Hospital, or tell us where you had them done.
DO bring a copy of any Advance Directive you may have (Durable Power of Attorney for Health Care or a Living Will).
DO let your surgeon know if you have a sensitivity to latex or rubber.
DO take a shower or bath with Hibiclens soap the evening before and the morning of your surgery. Hibiclens soap can be bought over the counter at most drug stores.
DO bring your contact lenses in the case, along with solution, because contacts may NOT be worn during surgery.
DO keep the lines of communication open. If you have not received a call from us or have not been interviewed by a nurse by 3 p.m. on the day before your procedure, please call 830-990-1826.
DO NOT take any medications unless instructed to do so by your physician.
DO NOT wear jewelry, makeup or nail polish. Please leave all valuables at home.
DO NOT shave face, underarms or legs for 24 hours before surgery.
DO NOT drink any alcoholic beverages 24 hours before surgery.
DO NOT smoke 24 to 48 hours before surgery. Quit smoking or at least cut down a week before surgery. Hill Country Memorial is a tobacco-free environment. If you use tobacco, talk with your physician or a nurse about options.
Notify your physician or the day surgery department at 830-990-1836 no later than the day before the scheduled procedure if any of the following conditions have occurred: If you develop a persistent cough, cold symptoms, fever, or if you get a cut, scratch or bite in the area where you’re having surgery, or if an emergency arises that may require canceling your surgery.
On the Day of Surgery
When you arrive at the hospital, please come in the admissions entrance and check in at the front desk. Our admissions staff will complete your registration and direct you to the surgery area located on the second floor.
A nurse will provide a gown and complete the preparation for your procedure. Your surgeon and anesthesiologist will visit you in the surgery holding room. An intravenous line (IV) may be started to give you fluids and medications during your procedure.
Your surgeon will explain the surgery and ask you to sign a surgical consent form giving permission to perform the procedure. This form will serve as an acknowledgement that the surgeon has discussed the procedure with you. You will be actively involved in identifying the surgical site with your physician or nurse before the procedure is performed. The surgeon may use a skin marker to mark the site. This added safety measure will ensure that everyone is clear on what the surgery is and where it is to be done. If you have any questions regarding the procedure or the consent form, please be sure to discuss these concerns with your surgeon.
An anesthesiologist or a Certified Registered Nurse Anesthetist (CRNA), the person responsible for putting you to sleep or giving medication to block pain, will visit with you before your surgical procedure and obtain a brief medical evaluation of your overall health status. At the end of the pre-anesthesia evaluation, you will be told what anesthesia you will receive.
The holding area is where the surgical team makes final preparations for surgery. For your safety, you will be taken to this area on a stretcher or in a wheelchair. The surgical team will check your chart and ask you some questions. For your safety, you will be taken to this area on a stretcher or in a wheelchair. The surgical team will check your chart and ask you some questions.
In the Operating Room
Our surgical team is made up of the surgeon who is responsible for your overall care, the anesthesiologist and/or nurse anesthetist who administers the anesthesia, the scrub nurse who sets up the sterile instruments, and the circulating nurse who oversees your nursing care. When you get to the operating room, you may notice that the lights are brighter and the temperature is cooler. The staff will be wearing scrub suits and masks, and you may also notice that the operating room bed is narrow with a safety belt that will be placed over your legs to prevent you from falling. These steps are taken to make sure your procedure will be performed in a safe environment.
Depending on the type of surgery you had, you will be taken to one of three places to recover: Post Anesthesia Care Unit (PACU), the inpatient nursing unit or the day surgery department. After the surgery, your physician will meet with your family to discuss your condition and answer their questions.
The nurse will use monitoring equipment to check your progress. To measure your vital signs, the nurse will use a blood pressure cuff, a cardiac monitor (pads on the chest), and a pulse oximeter (placed on your finger to measure oxygen in your blood). You will spend approximately one to two hours recovering, depending on the surgery you had and the anesthesia used.
The PACU does not have visiting privileges (except for parents of pediatric patients when authorized), but family members may check with the nurses for status reports.
Family Waiting Room
The surgical waiting room is located on 2 South across from Elevator 3. The waiting room telephone extension is 1363 (from outside, dial 830-997-4353 and ask for ext. 1363). The surgeon will visit your family after the surgery is completed. If surgery takes a particularly long time, the surgeon or a surgery staff member will give the waiting family members a report.
Vending machines are located in the snack bar on the first floor. The cafeteria is on the first floor and serves breakfast, lunch and dinner. The hospital chapel is loated on the first floor. A chaplain is available by calling 830-990-6125. The hospital gift shop is located in the main lobby. Restrooms are located outside the surgery doors to the right.
Visitors after Surgery
Visiting patients in the intensive care unit (ICU) is more restrictive because of the extent of the patient’s illness and the amount of care and rest the patient needs to recover.
■Ten-minute visits can be made every two hours from 8 a.m. to 8 p.m.
■Two visitors at a time are allowed at the bedside.
■No children under the age of 12 are allowed to visit in the ICU.
■Visiting hours in the other nursing units are from 11 a.m. to 9 p.m.
■Immediate family members may visit a patient before surgery. In order to do so, you must arrive at least an hour before the scheduled time of surgery.
■Children under the age of 12 are discouraged from visiting the hospital because of their inquisitive nature and their tendency to want to touch and investigate things that could harm them or spread bacteria to other patients.
■Please check with the patient’s nurse to make arrangements for special visitation needs.
Some patients (inpatients) will stay in the hospital after surgery so the physician and nurses can monitor their recovery. Other hospital staff members, including occupational therapists, physical therapists, social workers, dietitians and clergy are available as needed. All other patients (outpatients) will be discharged the same day as their surgery so they may heal and regain strength and activity levels at home. Remember that activity helps circulation.
Breathing and Coughing
Deep breathing and coughing are important for all patients following surgery. Deep breathing expands the lungs, aids circulation and helps prevent pneumonia. Your doctors and nurses will tell you what activities you can safely do during the first few days after surgery. If you are recovering in the hospital, you may be asked to use a special breathing device called an incentive spirometer to expand your lungs. The first time you are asked to cough will be the hardest. If you have had abdominal surgery, sometimes holding a pillow over the incision will provide support and decrease the pain.
Your digestive system may be slow after surgery. If you are an inpatient, you may be fed with an IV tube following your surgery. Your diet will then gradually progress from liquids to solid food. If you are an outpatient recovering at home, be sure to follow your physician’s orders.
Walking wakes up your entire system. It helps pump blood and oxygen to your cells, and that will assist your body functions in returning to normal. For your safety, be sure to have someone assist you the first time you get out of bed. First begin by sitting on the edge of the bed, and then slowly stand up. If you feel unsteady, sit down.
When you are ready for discharge, your nurse will review all post-operative instructions with you and your family. It is important that you follow all instructions. You may feel weak and drowsy; therefore, you should not drive or make important decisions until at least one day following surgery or longer. It is essential that a responsible adult be present for your post-operative instructions, to drive you home and to care for you after surgery. You will not be allowed to drive or travel by yourself, because you may still be feeling the effects of the anesthetic which will result in slower reaction time and judgment.
At Home after Surgery
The success of your recovery depends on how well you follow your surgeon’s instructions during the first few weeks after the procedure. If you have any problems or concerns that you believe warrant a physician’s care, please call your surgeon. Listed below are guidelines that will assist you in your care at home, as well as a list of symptoms or conditions that warrant evaluation by a doctor:
■Ask your doctor for written instructions on how to dress and care for your incision.
■Do not remove stitches yourself. Your doctor will do this at your follow-up appointment.
■Wear clean clothes daily, especially those that cover your surgery site.
■Take it easy and get plenty of rest.
■You are not expected to stay in bed. You should return to your normal activities gradually–according to your physician’s guidelines.
■Eat a good diet of nutritious foods.
■Continue to cough and deep breathe to avoid lung congestion.
■You should expect some pain or discomfort after surgery. Your doctor will order medication to make you as comfortable as possible.
■Take medications as instructed by your physician.
■Wash your hands before touching your incision. Your incision should be kept clean and dry.
■Follow your prescribed exercise plan.
■Return for your scheduled follow-up appointment.
When to Call your Physician
■If the skin around your incision becomes red, swollen, with pus-like drainage, or if your incision site feels more sore as the days go by
■If you have a fever (above 100 degrees) or if you develop chills
■If you have excessive bleeding
■If you are unable to move a joint below the incision
■If you have persistent nausea and vomiting
■If you have persistent pain that is not helped by medicine or rest
■If you have numbness at the joint below the incision
■If you have any unusual problems or concerns