Pre Operative/Before The Operation
A consultation and physical examination by Dr. Iswanto Sucandy take place in the office with help of surgical fellows, physician assistants, and or nurse practitioners. Once a surgical treatment is determined, our surgical coordinator will solidify your surgery date. We routinely obtained a preoperative cardiac clearance from a cardiologist for all patients above age 50. Our staff will go over with you our standard preoperative preparation (nothing to eat/drink before midnight, do not take blood thinner within 3 days of surgery, and light bowel cleansing prior to the operation).
One of our medical assistants will explain to you our ERAS (Enhanced Recovery After Surgery) protocol. In summary, this modern protocol entails taking high protein diet starting 5 days before the operation, injection of intrathecal Duramorph in the morning of surgery by an anesthesiologist to reduce pain, and minimizing use of narcotic/opiods after the operation.
Next, you will be scheduled to have a preanesthesia testing (PAT) appointment in the hospital, approximately 1 week prior to your operation. You will need one of our nurse practitioners or anesthesia providers to make sure everything is completed and ready to go for surgery.
If you take Coumadin blood thinner, you will have to stop it 5 days prior to the operation. You may need a Lovenox/Heparin brigde depending on the indication of your anticoagulation. If you take Xeralto, Elliquis, or other similar class of blood thinner, you will have to stop them 3 days prior to the operation. You may continue taking your baby aspirin.
If you are a smoker, this is a great opportunity to stop smoking. If you are a drinker, this is a great opportunity to stop drinking.