What to Expect in the Pre-operative Holding Area

What do I expect during the few hours before my surgery?
On the day of surgery, you may be asked to arrive several hours before your procedure is scheduled to begin. This allows the staff to complete any tests that cannot be performed until the day of surgery. You will be taken into an area where you will be asked to remove all of your clothing and jewelry and you will be given a hospital gown. This is sometimes called the Pre-Operative Holding Area. The staff will help secure your belongings, or have you give them to your family for safekeeping.

You may then sit in a recliner or wait on a stretcher. A nurse may have you sign any necessary paperwork. He or she will take vital signs, do a nursing assessment, and review your medications and the time you took them as well as answer any questions you may have. An Intravenous (I.V.) line will be placed in a vein in your hand or arm. The purpose of the I.V. is to provide fluid and medications during the operation. You must remove all hairpins, dentures, contact lens, glasses and bridgework, unless the nursing staff tells you that you can keep these items.

Will I be able to talk to my anesthesiologist before surgery?
Yes. You will meet your anesthesia provider, and other members of the team, before you go into the operating room. The anesthesia provider will examine you, review your medical and anesthesia history and the results of any tests you may have had done. The anesthesiologist will explain to you the type of anesthesia you will get, and will answer any further questions you may have. Depending on your health, the type of surgery and your personal wishes, the anesthesia provider and your surgeon will determine the type of anesthetic that is best for you.

Will I be asleep for my procedure?
There are several types of anesthetic techniques available for your surgery ranging from local to general anesthesia.  

• General anesthesia may begin with medicine injected into your intravenous. You may also be given a mixture of anesthetic gases with oxygen to breathe. You will not be aware of the operation or your surroundings. A breathing tube may be placed into your windpipe to help you breathe during the operation. (This is why some patients may have a slight sore throat on the day after surgery).
• Regional or spinal anesthesia is an injection that produces numbness around nerves in area near the surgical procedure. Epidural or spinal blocks help numb the abdomen and both lower extremities. Other nerve blocks may be done with the nerves in the arms or legs to numb them. With regional anesthesia, you should feel no pain. You may be awake or receive intravenous sedation to your comfort level.
• Local anesthesia involves the use of a numbing medicine injected around the incision site. It produces a lack of feeling, or numbness, in that area only. The rest of the body is not affected. You will be awake but free from pain. The surgeon often administers this type of anesthetic, since only a small part of the body is affected.
• Monitored Anesthesia Care uses both a local anesthetic at the incision site and medicine injected into the vein to relax you. This type of anesthesia does not require the use of a breathing tube. You will be awake after surgery is completed.

Will I get to speak with my surgeon?
Your surgeon will visit you before starting the surgery to ask you if you have any last minute questions and will use a special pen to mark the correct surgery site.

How does the staff keep me safe?
The operating room nurse will verify your identity, allergies, surgeon, correct surgery, and correct site before moving you into the operating room. All team members will be communicating specific information about your clinical status, including your current condition and recent treatments. This communication is designed to ensure a strong link for your patient care and your safety.

After I am checked in, how long do I wait for surgery?
Unavoidable delays may occur when a hospital emergency case is put ahead of yours or apatient before you has surgery that lasts longer than planned. It’s never easy to wait, so try to distract yourself by reading, watching television or using relaxation techniques. If there is a delay, your understanding is greatly appreciated.

Reprinted with permission by the American Society of PeriAnesthesia Nurses (ASPAN). Copyright © 2010.
All rights reserved. ASPAN Patient Information. Available at: www.aspan.org.

Phase II Recovery Room (Day Surgery Recovery)

After you have been discharged from Post-Anaesthesia Care Unit, you will be transferred to the Day Surgery Unit/Phase II Recovery. The goal of this unit is to provide patient comfort in terms of pain and nausea control. The patient and family will be given post operative information verbally and in writing, and will have the opportunity to ask questions.

1. During your stay in Phase II Recovery, you will be monitored by a nurse who will assess your vital signs every 30 minutes which will include:
   • Temperature
   • Blood Pressure
   • Heart Rate
   • Respiratory Rate
   • Oxygen Levels

2. Patient comfort in terms of pain control is a primary goal in Day Surgery/ Phase II Recovery. You will be asked to rate your pain in order to provide the nurse with the necessary information to tend to your needs.The pain scale we commonly use is rated 0 (no pain) to 10 (worst pain imaginable). The nurse will ensure that you are given proper pain medication. (Managing Your Pain pamphlet)
    
3. The nurse will be monitoring your surgical site. You will also be monitored for nausea and medicated accordingly.
    
4. You can expect to be in Phase II Recovery for at least 30 minutes.You may experience dizziness and be unsteady on your feet. Your care provider will need to assist you while walking and/or transferring from a lying /sitting position to a standing position.
    
5. You will be encouraged to drink fluids. You may be expected to urinate prior to discharge depending on the type of surgery you have had.
    
6. Family members or friends will be invited to be at your bedside.
    
7. Your belongings will be returned to you. Please ensure that you have received all the items you had prior to your surgery.
    
8. Post-operative instructions will be discussed with you and your caregiver, and any questions you may have will be answered.  We will also review the booklets and literature that you received in your Pre-Admission Clinic appointment.
    
9. You should have an appropriate caregiver stay with you for 24 hours following your discharge from hospital. Safe and acceptable transportation arrangements must be made. London Health Sciences Centre Discharge Policy
    
10. If you are traveling from out-of-town, you may be asked by your surgeon to find accommodations in London for the first post-operative night.
     
11. With any serious post-operative questions or concerns, call the LHSC switchboard at:

519-685-8500 and ask for the resident on-call for the surgical service
 

12. With any serious concerns, please go to the nearest emergency department

PATIENT DISCHARGE

Your family member or friend will be asked to get the car (or taxi) and pick you up..
 

For University Hospital:

• Patients should be met at the Security Desk near the emergency department doors.
• Bring your car to Zone A, enter the doors by security and ask the security officer to contact Day Surgery on your behalf. A porter will bring the patient.

Map for patient pick-up

For Victoria Hospital:

• Park the car and enter the “C” entrance door located near the Ivey Institute. angle parking is available.
• Turn right and locate the house phone.
• Call Day Surgery using the number listed by the phone.

Map for patient pick-up

First Canadian robot-assisted deep brain stimulation surgery to treat epilepsy at LHSC’s University Hospital

New study using nuclear medicine and rare isotopes in the fight against cancer

Precise, high-dose radiation safe and effective for inoperable kidney cancer, study suggests

Back in the saddle: Grace’s story

Telling a life story: An experience in digital storytelling

Leading the way: 2022-2023 LHSC Annual Report

Hear their stories. Help transform their care.

You Help Create Joyful Moments for Sick Kids

Give a Gift That Makes a Difference

Learning to live. Rehabilitation after surgical operations in Novosibirsk

Any operation is needed to help a person regain health. Today, with the development of technology, postoperative risks are minimized. But every intervention in the body is always a serious burden. After the operation, injuries remain, which, like any others, require special measures for recovery. To do this, the CNMT develops individual rehabilitation programs. The main assistants to patients in most recovery procedures are nurses. Their special knowledge and skills, as well as human support and care, help people from the beginning to the end to go through the rehabilitation program and restore their health.

The article was prepared by Kaiser Oksana Yurievna , Senior Nurse of the Department of Neurology and Rehabilitation and Voinova Irina Mikhailovna, Senior Nurse of the Surgical Department.

Progress in the field of surgery and why rehabilitation is needed

Although rehabilitation therapy programs differ in composition, they pursue the same goals – to relieve pain, accelerate tissue regeneration and wound healing, maintain normal blood circulation and muscle tone in the operated areas, avoid postoperative complications and preserve all body functions in the event that a person is forced to stay in bed for a long time. Psychological support is also of great importance, because it’s scary not only to decide and have an operation, you need to learn how to live after it.

Technological progress in surgery over the past 20 years has made it possible to operate on almost any organ and minimize surgical trauma. Thanks to modern anesthetic aids, absolute contraindications to surgical treatment are becoming less and less. The age of the patient also ceased to be a limitation.

The use of minimally invasive methods that are used in CNMT can greatly reduce the rehabilitation period.

However, surgical treatment, no matter how sparing it may be, is a violation of the integrity and “internal balance” of one or another organ or tissue of the body, therefore, after surgery, each person needs special measures to restore health.

From the moment the patient enters the ward from the operating room, the postoperative period begins, which continues until the patient is fully recovered. At this time, the nurses of the surgical department are especially attentive, their experience and observation are important assistants to the doctor, because the success of the treatment often depends on them.

In the postoperative period, everything should be aimed at restoring the physiological functions of the patient – the normal healing of the surgical wound, the prevention of possible complications. At this stage of recovery, nurses successfully cope: Mishukova Anastasia Alexandrovna (work experience 10 years), Strelenko Irina Alexandrovna (work experience 6 years), Voitsekhovich Inna Viktorovna (work experience 23 years).

How is rehabilitation going

Usually the rehabilitation period after surgery, especially on the musculoskeletal system, takes from 1.5 to 6 months, but it can be delayed for a longer period – it all depends on the nature of the operation, the age and condition of the patient, and also on how professionally the rehabilitation treatment is carried out.

Postoperative rehabilitation is a set of exercises selected by specialists and aimed at restoring body tone and successfully consolidating postoperative results. In the process of recovery, postoperative rehabilitation is considered one of its most important stages.

Very often during the rehabilitation period it becomes necessary to re-teach the patient the simplest things for several weeks, and sometimes even months. At the same time, the main functions of the body will also gradually return to normal.

Joint work of nurses from the surgical department and the department of restorative medicine and rehabilitation, the use of modern equipment, and a personalized approach to each patient, allow for a complete diagnosis, effective treatment and recovery in a short time.

Only an integrated approach ensures the success of postoperative rehabilitation. While treatment is in progress, a person is forced to limit his activity, which contributes to the occurrence of atherosclerosis, muscle atrophy, and joint problems. Hypodynamia negatively affects the psychological state of the patient, especially the elderly. At some point, this can result in depression, which often leads to exacerbation of existing diseases. That is why in reputable clinics, postoperative rehabilitation is a priority. Our Center is no exception.

The Department of Restorative Medicine and Rehabilitation has been functioning since the first days of the opening of the CNMT. In 2002, 2 massage specialists and 2 doctors worked there, and today there are 8 nurses and 9 doctors in the department.

The staff carefully monitors the health and well-being of patients in the postoperative period. An important role in the rehabilitation and restoration of health is assigned to the nursing staff. Nurses, massage specialists are competent and experienced employees, professionals in their field. Their well-coordinated, clear work in a team with doctors is aimed at helping patients to restore their health in a quality and efficient way

Modern methods of postoperative rehabilitation help to fully restore lost functions, if this is facilitated by the general anatomical situation and successful treatment.

Postoperative rehabilitation is essentially hard work, requiring special knowledge and skills from the nursing staff, and perseverance and maximum patience from the patient. Special devices and simulators, author’s methods will help to speed up the rehabilitation process and achieve good results.

Methods of recovery of the body after surgery

Physiotherapy

Physical methods of treatment occupy a prominent place in postoperative rehabilitation. Electrophoresis, magnetotherapy, ultrasound, laser treatment, balneotherapy and other methods are widely used. In addition to the most common methods, there are exclusive ones, such as electrical stimulation on the Esma apparatus, electrovacuum therapy “Body Drain” and variable pneumocompression “Lymphatron”.

Physiotherapeutic procedures can be carried out immediately after the operation, literally the next day. Physical therapy is not only useful in itself – it significantly increases the effectiveness of other methods, reduces the risk of complications and reduces the recovery period. The use of physiotherapy allows you to reduce the dose of painkillers and anti-inflammatory drugs, improve blood circulation and muscle tone, relieve inflammation and swelling.

There are many physiotherapy methods, and at least some of them are included in all postoperative rehabilitation programs. These methods and equipment are fully owned by qualified specialized nurses Levkova Elena Leonidovna, m / s physiotherapy, work experience 30 years, Nechunaeva Tatyana Alekseevna, m / s physiotherapy, work experience 35 years, Zvereva Elena Vasilievna, m / s physiotherapy, experience work 20 years, Borodenko Olga Yurievna, work experience 12 years.

Exercise therapy

Therapeutic physical exercises are indicated after operations on the limbs and the musculoskeletal system. Exercise therapy always consists of three stages: the development of the joints, the restoration and strengthening of muscle strength, and, finally, the return to action.

Mechanotherapy

Mechanotherapy is training on special simulators designed to restore joint mobility. Indications for mechanotherapy are residual effects after injuries and diseases of the musculoskeletal system – weak joint mobility, contractures, cicatricial adhesions of soft tissues, rheumatism, paresis, paralysis. In addition, mechanotherapy is used as the main factor in the rehabilitation of muscle failure and damage to the integrity of the vertebrae.

Massage

Therapeutic massage has practically no contraindications and is actively used in the process of rehabilitation after injuries and surgeries. It stimulates blood flow, improves the functioning of the central nervous system and internal organs, enhances skin nutrition, has a beneficial effect on the muscular and lymphatic systems, accelerates recovery processes, relieves swelling. It is used to eliminate pain syndromes, adhesions, to regenerate injured tissues.

Medicinal ointments and gels can supplement its effect. Therapeutic massage at CNMT is carried out by: Vinogradov Vladimir Konstantinovich, massage specialist, work experience 35 years; Molokoedov Alexey Ivanovich, massage specialist, work experience 9years; Kaiser Oksana Yurievna, massage specialist, 26 years of experience.

Ergotherapy

This is the restoration of motor skills, and this method of rehabilitation focuses not on abstract movements, but on those actions that a person needs in everyday life and self-service. The goal of occupational therapy is to adapt a person to his new limited abilities, to help him gain everyday independence. In our Center, all mid-level specialists of the Department of Neurology and Rehabilitation can perform this therapy.

Diet therapy

During rehabilitation after various types of operations, patients require different nutrition – balanced, rich in vitamins and microelements, sufficient, but not excessively high in calories and, at the same time, improving the functions of the digestive system. It is important that all food is prepared from organic wholesome products. The menu for rehabilitation is developed by nutritionists and is always selected individually.

Psychotherapy

Sudden and dramatic changes in lifestyle, limited opportunities, pain and falling out of the usual social circle have a detrimental effect on the psyche, and a depressed state, in turn, slows down recovery. It turns out a vicious circle, and in order to break out of it, patients need not only the support and attention of loved ones, but also work with a psychotherapist.

Acupuncture is an ancient method, the effectiveness of which has been proven not only by a centuries-old history of application, but also by scientific research. Reflexotherapy is used to correct muscle spasms, treat disorders of the motor and function of the pelvic organs; it normalizes the functioning of the nervous system, relieves neurological pain, improves blood circulation and metabolism, and prevents the development of the inflammatory process.

The specialists of our center fully possess this method: Kovaleva Elena Vasilievna, head of the adult department of neurology and rehabilitation, neurologist, reflexologist, doctor of the highest category, candidate of medical sciences and Yakobi Galina Yuryevna, neurologist of the highest category.

Hirudotherapy is a reliable and safe treatment method with leeches. It is widely used in the postoperative period for gynecological operations, for injuries of the musculoskeletal system, for surgical injuries (hematomas, bruises, fractures). It has an immunostimulating, anti-inflammatory effect, stimulates blood and lymph flow, acts on blood vessels, has an anti-ischemic effect, has a hypotensive and lymphogenic effect.

Ozone therapy. Ozone has a healing effect and is suitable for the recovery of patients after surgery: it destroys pathogens, enhances microcirculation processes, cleanses wounds and accelerates healing, stimulates regenerative processes, anesthetizes, strengthens the immune system, promotes detoxification. This technique is owned by the senior nurse Kaiser Oksana Yuryevna, work experience of 26 years, has a specialization in ozone therapy.

Vacuum Gradient Therapy (VGT) is a method that is based on the use of dosed vacuum exposure to various levels of human body tissues, including deep structures of soft tissues and a very extensive vascular system.

Microcirculation of blood, lymph and interstitial fluid increases, nerve endings are stimulated.

Used to heal postoperative and post-traumatic scars, relieve muscle pain, resolve edema. VGT makes it possible to solve health problems at a fairly serious level. Vacuum-gradient therapy is carried out by Marchuk Oksana Yaroslavovna, massage specialist, 20 years of experience.

There are very few rehabilitation institutions in Novosibirsk, and often people undergo rehabilitation treatment at home, under the supervision of a nurse. There is nothing surprising in the fact that with this approach, rehabilitation drags on for many months, or even years, and often a person fails to return to a normal life.

Now the situation has changed, and people can undergo rehabilitation after surgery at CNMT.

This is exactly the place where you can restore your health, enjoying picturesque views, silence, fresh clean air. We employ highly qualified specialists who practice a multidisciplinary approach, forming a personal program for each patient.

Advice from a nurse:

We recommend that all patients, if possible, keep a diary of recovery, writing down in it the sensations from doing certain exercises, noting progress and all, even the smallest, achievements – so the recovering person can see progress, and this adjusts to positive and empowering.

Wishes

We treat our work with great love and trepidation, as patients trust us with their most important treasure – life. Happiness for each of us when we help to maintain longevity, an active lifestyle for every person, every family, creating your health history!

6 golden rules for quick recovery after surgery – Perfecto-Room Clinic in Kiev

It’s no secret that any surgical intervention is, to one degree or another, stress for our body. In the postoperative period, it is difficult to avoid discomfort: swelling, soreness, fatigue, headache are phenomena that most patients experience. However, all these unpleasant moments can be easily smoothed out and minimized if you remember and follow a few simple rules. It is very important to pay special attention to postoperative rehabilitation, because it is the way to the speedy recovery of strength and return to normal life.

So, what should we take care of in advance when preparing for the operation? We have collected recommendations from experienced nurses and rehabilitators.

1. Rest a lot

All experts unanimously insist that rest and peace after the operation is essential. It is highly desirable to take a week off and postpone all business. Rest is required for all patients without exception. During this period, the body needs to restore strength and energy. It is rest and sleep that can help like nothing else. It is quite natural if a daytime siesta is added to the usual eight-hour night’s sleep.

2. Postpone sports

Depending on the type of surgery to be performed, your surgeon’s recommendations for exercise may vary. However, general advice should be kept in mind during the rehabilitation period. Experts strongly recommend to refrain from any exertion during the first month, focusing on a full and speedy recovery. Each weight you lift or excessive physical stress can not only provoke discomfort, but also slow down the recovery process.

3. Prepare in advance

A positive mental attitude is certainly very important when you are going to have an operation. But do not forget that you will definitely need a rest when you return home. Therefore, we recommend enlisting the support of a person who will help you with household chores in the early stages of rehabilitation. Taking care of children, shopping at the store, cooking, taking care of pets are ordinary things at first glance, but they require a lot of effort on a daily basis. If you delegate some of your household chores to another person for a while, then you are more likely to avoid unwanted discomfort from overwork.

4. Find a reliable helper

You will need a reliable person whom you can trust completely. He will accompany you before the procedure, as well as after it. In addition, he will be able to monitor your condition at night and help you follow the doctor’s orders the next day.

5. Wear compression garments

There are a number of surgical procedures after which experts recommend wearing compression garments to secure the result. Such underwear is designed to create a constant uniform pressure from all sides on a certain area of ​​​​the body. Thus, compression underwear provides tissue support in the desired position, helps to cope with bruises and swelling faster, improves blood circulation and reduces the risk of complications. Some patients do not attach much importance to this recommendation. But experts urge not to ignore this part of rehabilitation. If you are worried that you will be hot and uncomfortable in compression garments, then it would be better to postpone the procedure until the colder season.