Preparing for Surgery – Patient guide

Preparing for Surgery

From the patient’s perspective, the period before surgery can be very stressful and full of unknowns. This is why it is crucial to prepare both mentally and physically for the big day.
Of course, you will need to follow your doctor’s instructions before anything else, but there are a couple of things you can do to prepare yourself on a personal level:

Surgery isn’t a passive event in your life. A highly cooperative patient, disciplined and ready before the surgery will always recover faster and have decreased risks towards complications.

  • Even if the surgery itself probably has the goal to reduce pain, you should try to diminish the number of painkillers you take before surgery; it will be easier to manage the pain after surgery. Please ask your doctor before dropping any kind of medication.
  • You need to make you home post-surgery proof, make sure you prepare your house for the period after the surgery, remove rugs and other objects that may cause you to trip over and fell or harm yourself in any way.
  • If you are a smoker, it would be for the best to quit smoking before surgery as well as after surgery, at least until you are fully recovering. You need to understand that smoking reduces healing by 25%.
  • Don’t take aspirins and anti-inflammatory drugs or other similar meds ten days before surgery because such drugs may have a negative effect and can influence the normal blood coagulation.
  • Keep in mind that there aren’t special meds you can take to recover more quickly; the recovery needs to be natural.
  • Most of the times you need to avoid food as well as liquids for at least 8 hours before surgery.

These were the general notes on preparing for a general surgery, but what do you need to do to prepare yourself for prostate cancer surgery?

  • First of all, you need to make sure this is the decision you want to make. Otherwise, prostate cancer surgery is a relatively simple operation.
  • You need to make sure you flush out any blood thinning medication before the surgery. Bleeding is a risk for any kind of surgery, and this is especially true for prostate cancer surgery, which involves operating around a lot of blood vessels.
  • The day before surgery you will probably need to drink only liquids and drop food intake altogether. Expect a ball-prep with magnesium something similar to an enema but done for the bladder by drinking a special liquid that contains magnesium. Also, expect your doctor not to allow you to drink anything after this prep as well as giving you nothing to eat at least a few hours before your prostate cancer surgery.
  • No matter the surgical technique used (open or robotic) as I said, are relatively simple and painless for most of the patient cases.


Follow these 7 steps to prepare for surgery

Dealing with surgery is a fact of life. Most people go through at least one during their lifetime, be it dental surgery, appendectomies, cardiac surgery or transplants. Supposing it isn’t an emergency intervention, but a planned one, you should take your time to prepare yourself both mentally and physically. This step is important and a key factor in determining the speediness of the recovery, how to handle the pain and how quickly you’ll be able to return to your old life.
We have put together a checklist you need to go through in order to make the entire process as easier and hassle free as possible. Surgery isn’t a walk in the park, but following these steps can make you feel in control and more confident of the outcome.

1. Learn everything about the surgery – Asking your doctor all the questions regarding your intervention, such as dietary plan, risks, healing time and a detailed explanation of the steps involved and staff that will participate, will give you a clean perspective on what to expect and will make you feel less anxious.
Try not to get your information from the internet or other shady sources. Every person’s experience is different and you could be influenced in a negative way. The safest source of information is your doctor.

2. Follow a pre-surgery diet – Surgeries usually require dietary restrictions a few days before. Try to eat as healthy as possible to ensure nutrients, enhance your immune system and shorten the recovery time. You should avoid foods that increase the inflammatory response.
There are a couple of general rules you need to apply to your pre-surgery diet, a few weeks in advance:

  • Drink plenty of fluids that are easily digested by your body: water, black coffee (no added milk or sugar), lemon/lime juice, apple juice. Avoid cola, juice with pulp, milk, dairy beverages. These require lots of time to be processed by your body. In most cases, your anesthesiologist will recommend not drinking anything 8-12h before surgery, not even water.
  • Avoid foods with high-fiber content: meals that contain whole-wheat pasta, whole-grain bread, beans, oatmeal take longer to be digested. Your bowel needs to be clear before surgery, so your doctor will recommend a low-fiber diet.
  • Avoid medication and supplements that could interfere with the surgery: aspirin, vitamin E, vitamin C can increase blood flow.
  • Restrict foods that increase inflammatory response: sugar, white flour, refined carbohydrates, saturated fats, pastries, alcohol. They make your body susceptible to tissue swelling from bacteria and toxins, during the surgery or the hospital stay.

Each type of surgery may have additional restrictions. This is why you have to consult with your doctor and anesthesiologist at least a week before the intervention.

3. Strengthen your body – Being fit, flexible and strong is generally a good thing. You might consider getting in shape a few weeks before (if you have the notice of your surgery), which will help your body heal faster and you get around easier while in recovery.

4. Learn what to expect after surgery – You need to be aware of several aspects you’ll be facing after the surgery: how long after it will you be able to go home, how much pain will you be in, what pain-medication will the doctor recommend, will you need a rehabilitation program or somebody to stay with you. Make arrangements for someone to pick you up from the hospital and drive you home.

care after surgery

5. Find out the care you’ll need after surgery – The more complicated your intervention will be, the more days you’ll need to stay submitted. Information such as what machines you’ll be connected to when you wake up, what intravenous treatments you’ll receive, what assistants you can call on when you need something, what are the visiting hours, or the food you’ll receive, will help everything go smoothly.

6. Make arrangements in your home – When you’ll get home from the hospital, it’s likely you won’t be able to put on new sheets, arrange your pillows, or start cooking a light meal. Prepare everything beforehand and arrange with someone to cook for you or bring you some food. Make yourself a cozy spot, stack up on relaxing music, some movies, books and get a lot of rest.

7. Pack your bag – If you’re going to be submitted in the hospital for a few days, you will want to bring some items. A pajama, robe, slippers, your toiletries, your telephone and charger, books, even your favorite pillow and blanket. Pack anything that will make your stay more comfortable.

Nobody goes to surgery with a full smile on their face. As simple as it might be, you will likely feel a bit scared, intimidated and confused. Preparing for the intervention will reduce a big part of these feelings, especially if you know you are in the hands of an experienced doctor and his/her staff. The most important thing to anticipate is having supportive people around you, family and friends that will be with you throughout the entire process.


The Surgical Team: Meet the 5 superheroes of the OR

Being a part of a surgical team is much like being in the army: it requires preparation, discipline and cooperation.

Surgical team operating room

We all see surgeons as rock stars – VIPs of medical care, all-knowing gods that walk among us and see over our well-being. Doctors usually have this effect over us: you often feel intimidated around them, because disease makes you vulnerable. But this shouldn’t be the case and you should consider surgeons more like frontmen of their bands, not solo artists. They may be the ones that do the talking, diagnose and prescribe treatment, but they also have a team of professionals that tend to the patient’s every need and make sure the surgery goes smoothly.

As with any other professional lineup, the surgical team also relies on the technical competence and preparation of each member. The level of stress can be much higher than that of other jobs out there. This is why it’s important that each member cooperates, knows their role and behaves appropriately. Leadership is of high-value and the chief surgeon is regarded as a pillar of moral and ethical grounds. His or her behaviour and interpersonal relations have a high influence on the overall environment, performance and cooperation between each member of the team.

This is the surgical team structure:

1. The surgeon

Surgeons are medical school graduates that complete surgery residency and receive all certifications required for practicing general or specialised surgery. They often specialise in a particular area of study such as trauma surgery, colorectal surgery, breast, vascular, endocrine, transplant, oncology. Key requirements are the full knowledge of the instruments required, on-going training in new procedures, the ability to make close call decisions to save a patient’s life and the overall management of the OR.

2. Anaesthesiologist

Similar to surgeons, anaesthesiologists complete 4 years of medical school and 4 years of anaesthesia residency. There are certain areas of anaesthesia that require special certification and training, such as cardiac anaesthesia. They are present before, during and after the surgery. It’s necessary that they’re informed about the entire medical condition and history of the patient before the procedure, in order for them to choose the best anaesthetic option. During the surgery, he/she will monitor the critical life functions – breathing, heart rate, blood pressure – and take any necessary precautions.

3. Certified registered nurse anaesthetist (CRNA)

The nurse anaesthetist is an advanced practice registered nurse (APRN). In order to become one, he/she has to complete one year of full-time nursing experience in a medical or surgical intensive care unit, followed by a master’s degree in anaesthesia and/or nursing, with a post-masters certification in anaesthesia. Nurse anaesthetists work under the supervision of a licensed physician, dentist or podiatrist and assist in anaesthesia care before, during and after surgery, labour and delivery.

4. Operating room nurse

The OR nurses have various responsibilities in making sure everything is well organised and the surgery can be performed under the highest operating standards.
• Scrub nurses ensure that all instruments are sterilised and layered out for the operation. They provide care for the patient before and during the surgery, attach equipment and monitors and pass instruments to the surgeon.
• Circulating nurses take care of all the documents required before the surgery and handle the procurement of instruments and surgical supplies.
• Registered nurse first assistants play a higher role in assisting the surgeons during the operation: they administer medication, control the bleeding, suture incisions, monitor vital signs, perform CPR.

5. Surgical technologist

The surgeon needs to concentrate on the patient, not on finding instruments. This is where the surgical techs chime in: they’re trained in hundreds of types of surgery and are able to anticipate next steps in the procedure, in order to provide the surgeon with the required instruments and equipment. In the US, they are graduates of surgical technology programs and can specialise in a vast array of surgeries.


6 sites that help you choose the best hospital

Finding the best hospital for any disease can be difficult, even in our times.

According to the most recent statistics, the United States is currently home of approximately 5,600 hospitals. This figure has been constantly decreasing over the past decades, contrary to the steady enlargement of the number of employees in the U.S. healthcare system.
For an accurate depiction of the situation, the graph below reveals the ratio for hospital beds per 1000 people. The data contains treatment spaces available in public, private, general, and specialized hospitals and rehabilitation centers.

hospital beds statistics


In 1975, the number of hospital beds in the US was exactly 1,465,828. This has decreased to approximately 924,000 until 2011. In 2015, the number fell to a historical level below 900,000, while the U.S. population has seen a steady increase. A comparison between countries and hospital beds per 1000 people places the US in the 80th position worldwide.

Although statistics show a narrower palette of options compared to the ’70s or ’80s, this does not mean that deciding upon a hospital in which to have surgery or to be submitted for long-lasting treatment has gotten any easier for you. There still are a lot of options to choose from and the plethora of information available can make the entire process quite overwhelming. The increase in mobility makes it easier to travel to remote locations to find the perfect hospital, with enhanced facilities, renowned surgeons and good patient reviews.


Factors to consider when choosing a hospital

Surgery room

When conducting research for the best hospital for your disease, there are several factors to consider:

  1. Does the hospital have a special unit or floor for your type of surgery or treatment?
  2. Do they have a team of doctors that are specialized and renowned in treating your type of disease?
  3. Are the operating rooms fitted with special equipment required for your type of surgery?
  4. Are they invested in offering you every information you need in order to prepare for the surgery (by printing and giving you pamflets, writing a special section on their website)?
  5. How many patients have they operated on with the same condition as yours?
  6. How many auxiliary personnel such as nurses are allocated to that unit?
  7. What is the rate of success they report for this specific surgery? If possible, talk to other patients or check the testimonials on their website.
  8. Verify if there are reported cases of post operatory infections. A 2015 study at John Hopkins, on patients undergoing colon and rectal surgery, showed that hospitals that focus on quality-improvement solutions (such as getting patients to take antibiotics, encouraging them to drink fluids, cleansing their skin with antiseptics before surgery) report less lengthy recoveries and lower rates of surgical site infection by more than a half, as well as shortened hospital stays.
  9. Search for photos online of their private rooms, waiting areas, cafeteria, bathrooms, as you and your family will spend at least a few days in there;
  10. Has integrated an Electronic Health Records System (EHRS) that can track results of lab tests, diagnostics tests or patient referrals.
  11. Check to see if they have sufficient on-call assistants on holidays, especially if your surgery is planned during that period.


Sites that help you find the best hospitals


Gathering all this information on your own can prove to be overwhelming. Luckily, there are scoring systems put in place that help you quickly analyse one hospital over the other:

  1.  – the US government provides information and reports on hospitals and doctors, as well as a list of all hospitals in your area (based on ZIP code, city or state). The site also facilitates comparison of 3 hospitals at a time, based on quality measures, distance from the city centre, emergency services, EHRS integration and a safe surgery checklist.
  2. The Joint Commission Quality Check – is an independent, non-profit organisation that accredits and certifies nearly 21,000 healthcare institutions and programs in the US. Their platform allows you to check if a certain hospital adheres to its performance standards, committing to deliver safe and effective care of the highest quality and value.
  3. The Leap Frog Group – is also a non-profit organisation that aims to protect patients and their families from errors, injuries, accidents and infections. It reports data on more than 1800 hospitals in the U.S., having programs that regularly survey and grade hospitals for their quality care and procedures.
  4. Consumer Reports – this site rates each hospital based on their patient safety score, as well as on measures relating to patient experience, outcomes and certain hospital practices.
  5. Health Grades – Provides statistics on clinical quality for each specialty (incidence of mortality during and after surgery) and patient experience (in terms of overall feedback, cleanliness, staff, doctors, facilities).
  6. Why Not The Best – tracks performance on various measures of health care quality. Their tool permits comparison of process-of-care measures, patient satisfaction, readmission rates, average reimbursement rates and mortality rates. It also includes data on the incidence of central line-associated bloodstream infections (from over 1500 hospitals), the adoption of electronic medical records, as well as population health, utilization and costs.

Another offline resource you could turn to is your health insurance company. Many insurers have ratings on how hospitals perform the type of surgery you’re having. Ask them if they have a ranking system for trustworthy healthcare providers and, if so, use the information provided to find the best option for your surgery.


Good Physician-Patient Communication – Why is this crucial?

Excellent communication is learned and developed over time and it plays a vital role in understanding the patient’s suffering, establishing the correct diagnosis and prescribing the right treatment which will essentially cure the patient’s illness.

rgetgrYou may be inclined to think communication between two people is something natural and you don’t need specialized training for doing it well. But still, a lot of physicians are struggling with proper communication between them and their patients. Focused on their work with a high attention to details not to miss anything, doctors may overlook the explanation part of their jobs and give the patient an incomplete talk about their condition.

First consultation

The quality of the information obtained by the doctor during the first consultation is closely related to the ability to ask questions and create a relationship with the patient.
Studies show that between 60% and 80% of the information needed to establish the primary diagnosis are obtained during the interview with the patient.

Physician-Patient Communication

Why proper communication is crucial:

  • information exchange;
  • mutually accepted decisions;
  • better understanding;
  • building trust.

The physician is obligated too:

  • concentrate this whole attention on the patient;
  • creating an environment that protects the dignity of the patient;
  • confidentiality (non-disclosure of intimate patient information to others);
  • permanent concern for the well-being of the patient;
  • respecting the rights of the patient or his / her family.

Patient Obligations:

  • establishing a list of specific questions he/she wants to ask the doctor;
  • if necessary, designate a family member or other trusted person to represent him/her in discussion with the doctor;
  • open dialogue with the doctor;
  • presenting as objectively as possible the symptoms he/she experiences;
  • be utterly truthful in everything the patient is information the doctor off.

When all of the above obligations aren’t respected by either of the parties involved and the overall physician-patient relationship is deficient so of the consequences may include: frustration, anger, accusations, an increased number of tests or even getting a different opinion from another doctor.
And not only the patient can experience feelings of frustration or anger, but also the doctor who fails to achieve the patient’s healing.

Online communication and information

The Physician-Patient talks shouldn’t stop only with the traditional face-to-face discussions at the clinic. It can also include e-mail exchanges, phone talks, but also direct online chats via messager apps.
Doctors may also suggest different online resources where the patient can read more about specific conditions and even join special forums and online support groups where people with the same illness can help and support each other.

Until recently, during the consultations, the doctor was solely responsible for holding the scientific information. Now, with the ease with which such information can be obtained, patients can play an active role in the decision-making.

Of course, there is enormous concern over the certain accuracy content found online may have from a medical perspective. But this is why your doctor needs to play an essential role in all of this right from the start, guiding you into the right direction and helping you with approved online information.
Leaving everything in the hands of the patient regarding medical information can have disastrous consequences like scaring the patient or even giving the patient false hope.

Communicating the diagnosis

Disclosing the diagnosis to the patient, especially when it comes to incurable illnesses, is one of the problematic aspects of communication between the doctor and the patient.
Many doctors still believe that being faced with a grueling diagnosis, many patients may stop fighting the disease, getting depressed and overall losing the battle with the illness.
So, in the end, it is all about the doctor’s ability to sensitively attenuated the mental collision such a diagnosis can have on the patient while staying truthful.

Before communicating the diagnosis, it is good for the doctor to know as much as possible about his patient, about his life, his values, his abilities and his mental strength. Thus, when dealing with a terrible diagnosis, the news should come encouragingly, emphasizing what the patient could do to improve his condition.

For most doctors, it is all the more difficult to talk openly about when the diagnosis and the prognosis are reserved, and the patient is very young. Of course, the doctor can call on a psychologist to help with a communication strategy.

Lack of information creates confusion

One of the most significant issues with all Patient-Physician relationships is the lack of communication and how this void of knowledge creates confusion for both parties, but it can be especially bad for the patient.

When the patient does not receive the desired information, different reactions can be expected. The patient may be unhappy and then call another doctor. There is a category of patients who are “shopping” for doctors, gathering multiple investigations and a massive file of different treatments and test results.

The ambiguity of a discussion with a doctor can scare a patient. The patient may get a false impression that it’s something serious, maybe incurable, and the doctor hides it. The patient may start he can start looking for evidence to support his hypothesis and will interpret every symptom, every condition, and implement a self-diagnostic. All of this can be extremely dangerous. This is why physicians need to be very clear and leave no room for ambiguity when talking to the patient.