Preparing for Inpatient or "Overnight" Surgery
Preparing for surgery (a procedure or operation) can seem overwhelming or scary if you don't know what to expect. You may have some unanswered questions and worries that make you feel this way. Sometimes surgery can be unexpected and you don't have time to prepare for it. Other times surgery can be planned in advance so you have some time to get your questions answered and find out what will happen before, during and after your surgery. Knowing what to expect will help you feel less nervous and more in control. Be sure to get specific questions about your surgery answered by your health care provider.
What is the difference between day surgery and inpatient surgery?
Day surgery is when someone comes to the hospital (usually in the morning) for a minor surgical procedure, and leaves the same day. Inpatient surgery is when you stay in the hospital overnight after your surgery. Sometimes patients who are staying overnight will be admitted to the hospital the day before their surgery. In most cases people who are staying overnight will be admitted the morning of their surgery.
What should I do before my surgery?
This will be different depending on the type of surgical procedure, but usually your health care provider will ask that you not have anything to eat or drink after midnight, the night before your procedure. This means that you can't have anything to eat or drink by mouth—no food or liquids of any kind, not even mints, candy, or chewing gum. An empty stomach decreases the risks of anesthesia. It is very important to follow this rule. You can brush your teeth in the morning, but you can't swallow the water. If you forget and eat or drink before your surgery, be sure to let your nurse or healthcare provider know right away. Your surgery will probably need to be rescheduled.
If you take prescription medicine, ask your health care provider if you should take your medicine with a tiny sip of water. Most of the time you should wait to take your medicine until after your surgery.
What will happen on the day of my procedure?
Depending on the hospital where you are having your surgery, the order of events may be different, and some advice that we list may not apply.
- Time to arrive: Someone from your doctor's office will tell you what time to arrive at the hospital. Usually, this is 1-2 hours before the procedure so you can get settled in. You and your parent(s) or guardian(s) will need to sign a consent form (a document that gives the surgeon/anesthesiologist permission to do the surgery and for anesthesia—"going to sleep"). This sometimes is done before the day of your surgery.
- ID Bracelet: When you check into the hospital, you will be given a hospital bracelet that will have your name and your hospital identification number on it.
- Pre-op Area: After you have checked in with the admissions department, you will probably go to the Pre-op Area, where you will be assigned a nurse who will take your blood pressure and ask you questions (such as if you had anything to eat or drink before arriving at the hospital). He or she will probably meet with you alone and likely ask you some private questions about your habits and lifestyle, such as whether or not there's a chance you may be pregnant, or if you use drugs or alcohol. You should answer these questions truthfully because the healthcare providers, surgeons, and anesthesiologists need to know if there's anything that could complicate your surgery.
- Urine Test: Many hospitals require women/teen girls to have a urine pregnancy test. This routine and mandatory test is done on everyone of childbearing age, even if you are not sexually active. If there is a chance you could be pregnant, it is VERY IMPORTANT to let your doctor know!
- Nail Polish: If you are wearing nail polish and haven't removed it yet, you will be given nail polish remover to take it off. This is done because the healthcare providers/nurses need to be able to see your natural finger nail to check your circulation. Nail polish may also get in the way of the pulse oximeter monitor, which is the small machine that gently clips onto your finger to keep track of how well you are breathing.
- Acrylic nails: Most hospitals require that you remove at least 2 acrylic nails (one on each hand) so that the pulse oximeter can be used.
- Jewelry: All jewelry should be removed and left at home before you go to the hospital. By doing this ahead of time, you won't be worried about losing it. All jewelry will need to be removed, including nose, lip, and belly button rings, before your surgery.
- Makeup: Don’t wear any makeup to the hospital. Small particles of makeup (especially mascara) can get into your eyes during surgery and cause injury. This is because you don’t have a blink reflex while under anesthesia.
- Clothing: Your nurse will ask you to get undressed, and you will be given a hospital gown to wear during the operation and while you are recovering. While you are a patient in the hospital, your clothes will be placed in a bag with your name on it. When you are ready to be discharged from the hospital, you will be able to put on your own clothes.
- Hair: If you have long hair, consider putting it into a braid or a ponytail, or bring an elastic band with you so that you can tie your hair back once you get to the hospital.
- Mouth Appliances: You'll need to remove all dental appliances (such as a retainer or elastic bands from your braces) if you have any.
Why does everyone keep checking my ID bracelet? Don't they know who I am?
Your name, date of birth, and the planned procedure will be reviewed with you and your parent(s)/guardian(s) many times while you are in the pre-op and operating room areas. The staff knows who you are, but these are important safety checks to make sure that your surgeon always performs the right operation on the right person.
What's the "pre-op holding area" and what happens there?
The "pre-op" holding area is where you stay before you go to the operating room. While you are waiting to go into the operating room, an IV nurse will probably start an IV.
What is an IV?
An IV is short for “intravenous”. This is a plastic tube that delivers certain solutions to your body throughout your surgery. It's inserted with a needle but the needle is removed after insertion so that only the plastic tube remains. The IV is usually placed in your hand. You will receive medicine through your IV to make you feel relaxed. If the anesthesiologist gives you a choice of which hand to put the IV in, choose the hand you don't write with.
What happens in the operating room?
When you are taken to the operating room, both your name and the procedure that you are scheduled to have will be reviewed again. Three small, white sticky circles will be placed on your chest. These will be attached to a heart monitor so that your heartbeat can be seen on a small screen. The sticky pads will likely be removed before you wake up. You will be given more medicine through your IV that will make you feel very sleepy. You will drift off to sleep, and you will stay asleep during your surgery. In what seems like a few minutes later, you will wake up in the recovery room, and the surgery will be over.
What is anesthesia?
Anesthesia is the medicine that puts you to sleep and stops you from feeling pain during your surgery. There are two different types of anesthesia, "local" and "general".
Local anesthesia is numbing medicine applied to the area of your body where you are having the procedure. You are awake during the procedure.
General anesthesia is when you are completely asleep during your procedure. Most people wake up feeling sleepy when the surgery is over.
With both types of anesthesia, you won't feel any pain. The anesthesia will take a while to wear off. In the meantime, you will stay in the recovery room where you will be cared for until you are completely awake and alert.
If you have any worries or concerns about the type of anesthesia that you will be receiving, ask your healthcare provider or nurse to answer your questions. Also, it is very important to let your healthcare provider/anesthesiologist know if you or any family members have ever had problems with anesthesia in the past, such as a severe headache, nausea, or a very sleepy feeling that took a long time to wear off. Unless you require emergency surgery, you should know which type of anesthesia you're going to have in advance.
What happens after the surgery?
After your surgery you will be taken to the recovery room. There, the nurse who is assigned to you will check on you often and take your blood pressure, temperature, and pulse and give you any medicine that your healthcare provider orders. It's common to feel cold or chilly after surgery, so don't be shy—ask your nurse for a warm blanket! If you're thirsty, and your healthcare provider has said that it's okay to have something to drink, your nurse will offer you clear liquids (such as ginger ale). In special cases, it's possible that you will have a temporary "catheter" in place. This is a tube that drains your bladder of urine. Your healthcare provider will tell you in advance if he/she expects that you will have a catheter after surgery. After a little while, when you are fully awake and comfortable, your nurse will help you get ready to go to a regular hospital room.
Will I have a scar?
Whether you will have a small, medium, long or no scar at all depends on whether your surgeon needs to make an incision (a cut in your skin). Some surgical procedures can be done without any cuts. Other types of surgeries require your surgeon to cut the skin to remove something. For example, an appendectomy requires a surgeon to make a small size cut on your belly to remove your appendix. Sometimes the cuts and stitches are made inside your body, like during a tonsillectomy (removal of tonsils).
If I have an incision, how long will it take to heal?
Most incisions (where the skin was cut) appear red after the stitches are removed or dissolve (these kind of stitches get absorbed by your body and do not need to be removed) but fade over time. About 4-6 weeks after the surgery the scar from your incision should be much lighter than it was after the operation, but it takes up to a year for it to heal completely. It's very important to keep the area where you had the surgery out of the sun, as direct sunlight may cause scarring. If you can't help being out in the sun, be sure to use a sunscreen with a high (30+) SPF (sun protection factor) on the healed incision area to prevent burning. Most incisions heal well, and the scar will hardly be noticeable. Sometimes, people develop a thicker type of scar that has extra fibrous tissue - this is called a keloid scar.
What can I do to make sure my incision heals well?
The most important thing to remember if you have an incision is to keep it clean. If you have an incision with stitches, you will receive instructions when you are discharged. The instructions will be specific to the type of surgery that you had.
In general, you should call your doctor's office if you have:
- A temperature of 101 or over
- Any blood or drainage from your incision after the first 24 hours
- Redness at the incision area
- A bad odor coming from the incision
- Severe pain in or around the incision
You'lll be given a follow-up appointment with your doctor provider so that he/she can check to see if you're healing well. It's important to keep this appointment even if you feel terrific! Your doctor provider will want to make sure you're okay and healing well.
What can (or should) I bring to the hospital?
You can bring your own pillow, a book/magazine to read, and something to write in, such as a diary or journal, if you wish. Having a personal item from home (such as your pillow or a stuffed animal) can be a huge comfort while you're in the hospital. If you want to bring electrical appliances, such as a blow-dryer or laptop computer, it's important to ask your medical team if this is okay.You may need a special adapter to have your items work. Also, most hospitals require their safety department to check all small appliances before you can use them. Cell phones and pagers may not be allowed in hospital rooms, as they can cause problems with the hospital's communication system.
What if I get bored while I'm in the hospital?
Since you will be staying overnight, there may be times that you might be bored. The good news is that most pediatric and adolescent hospitals have activity rooms with computers, board games, crafts to make, and other things that will make the time go by.
What should I do about the schoolwork I will be missing?
- If your surgery is not an emergency and your surgeon is available, try to schedule your surgery during a school vacation week or during the summer. That way you won't be worried about the schoolwork you will be missing.
- If your surgery needs to be scheduled during school time and you will be staying overnight, you might want to bring some light schoolwork along with you, in case you feel up to doing it later.
- Once your surgery is planned, try to get your school assignments from your eachers in advance. You will be less stressed out if you get as much of your work done as possible before your surgery. Teachers usually will understand your situation if you take the time to explain that you will be in the hospital.
- If your surgery is an emergency, ask a parent or friend to get your work for you. Many teachers will give you some extra time to make up the work. You're in the hospital to get better, not to worry about schoolwork. If a teacher seems too demanding, speak with your guidance counselor or principal when you return to school.
- If you will be in the hospital for a long period of time or if you will be at home recovering from your surgery for longer than a couple of weeks, ask about having a tutor (someone to help with school work).
- Ask your health care provider or someone in their office for a note to excuse your school absences for your surgery and recovery time at home.
What if I have my period while I'm in the hospital?
It's okay if you have your period the day of your surgery or while you're in the hospital. This will not cause your surgery to be moved to another date.
You probably won't be allowed to wear a tampon during your surgery, especially if you are having any type of procedure that requires your surgeon to do a pelvic exam (checking your vagina, cervix and ovaries). You will be given a pad to wear instead. If necessary, the nurse in the operating room will change your pad while you are sleeping. If you'll be staying in the hospital overnight, it may be possible for you to use tampons instead of pads after your surgery.
How will I be able to stay clean?
Depending on whether you have an IV, cast, or you are connected to any other equipment, you may need to take sponge baths (washing up with a bowl of water and soap while you are in bed) until your healthcare provider says it's okay to take a shower. Taking a shower in the hospital is a bit harder than at home, especially because you may not be feeling well. When your healthcare provider gives you permission to shower, your nurse will help you until you can manage on your own. Hospital bathrooms and showers have special lights (similar to the kind by your hospital bed) that you can "turn on" if you need a nurse or help right away.
What if I don't like the hospital food?
You will usually be given a menu that has different food choices for the day. You may be asked to circle the foods you would like for breakfast, lunch, and dinner. This menu will be returned to the dietary department (where they prepare food for patients) and your meal choices will be brought to your room. The dietary department can prepare special meals, for example, if you are a vegetarian, or eat only kosher food. If you are not on a special diet for health reasons and your doctor says that you can eat anything, it may be possible for your parent(s) or guardian(s) to bring food from home, but be sure to ask first! The hospital may have certain rules regarding outside food, and you may have certain food restrictions.
What if I'm still nervous on the day of my surgery?
It's completely normal to feel a bit nervous, especially if it is your first operation, but knowing what to expect will make you feel less afraid. Try not to worry too much. Your medical team is there to answer any questions you have, and they will take good care of you and keep you comfortable while you are in the hospital. If possible, try to talk with another teen who has had the same procedure that you're going to have. This may be a friend, relative, or someone your medical team arranges for you to talk to.
Once you're home recovering from your surgery, it's important to rest, eat healthy foods, and take care of your incision if you have one. Your body is amazing, but everyone needs time to recover from surgery. Ask your doctor exactly what you can or can't do so that your recovery is fast and without complications! Remember to talk with your doctor to learn more about specific instructions for your surgery.
Day surgery is when someone comes to the hospital (usually in the morning) for a minor surgical procedure, and leaves the same day...