Preparing for Outpatient or "Day" Surgery
You are planning to have a procedure/operation. Preparing for surgery can feel 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 might not have time to prepare for it. Other times surgery can be planned in advance, and you will have some time to get your questions answered, and find out what will happen before, during, and after your procedure. Knowing what to expect will help you feel less nervous. The following guide addresses the most commonly asked questions by teens about surgery. You should ask your health care provider (HCP) for more specific information about the surgery you will be having.
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 isomeone stays in the hospital overnight after his/her surgery. Sometimes people 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?
What you should do before your surgery will be different depending on the type of surgical procedure you'll be having, but your HCP will usually 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. Having an empty stomach before surgery decreases the risks of anesthesia, so it's very important to follow this rule. You can brush your teeth in the morning, but you can't swallow water after rinsing your mouth. If you forget and eat or drink before your surgery, be sure to let the nurse or doctor know right away. Mostly likely, your surgery will need to be rescheduled.
If you take prescription medicine, ask your HCP 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.
I'm having day 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. The following information is general and is meant to help you get an idea of what might happen on the day of your surgery.
- Time to arrive—Your health care provider or someone from your HCP's office will tell you what time to arrive at the hospital. Usually this is 1-2 hours before the procedure, so you have time to get settled in. Both you and your parent(s) or guardian(s) will need to sign a consent form (a document that gives the doctor permission to do the surgery and for anesthesia). Sometimes the consent forms are done before the day of your surgery.
- ID Bracelet—When you check-in to the hospital, you will be given a bracelet that will have your name and your hospital identification number printed on it.
- Day Surgery Area—After you have checked in with the admissions department, you will go to the Day Surgery 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 ask you some private questions about your 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 doctors, surgeons, and anesthesiologists need to know if there's anything they should look out for that may complicate your surgery.
- Urine Test—Many hospitals require teen girls/women 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 doctors/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 monitor, which is a small machine that gently clips onto your finger to keep track of your pulse.
- Acrylic nails—Most hospitals require that you remove at least 2 acrylic nails (one on each hand) so that your finger pulse can be checked.
- 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, especially 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 can cause damage because you don't have a blink reflex while under anaesthesia.
- Clothing—Your nurse will ask you to get undressed. While you are a patient in the hospital, your clothes will be placed in a bag with your name on it. You will be given a hospital gown to wear during the operation and while you are recovering. When you are ready to be discharged from the hospital, you will be able to change into your own clothes.
Why does everyone keep on checking my name and ID bracelet? Don't they know who I am?
You 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 day surgery area. The medical staff knows who you are, but these are 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 anesthesiologist or nurse anesthetist will probably start an IV. This is a plastic tube that delivers certain medicine to your body throughout your surgery. It is inserted with a needle, but then the needle is removed 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 if I'm afraid of needles?
If the thought of having an IV is causing you a great deal of anxiety, please let your nurse know as soon as possible. You may be able to have a numbing cream places on your hand which will numb your skin and lower the feeling of pain, so you will have very little (if any) discomfort with the IV. The numbing cream takes time to work, so it's important to ask for it as soon as possible. When your anesthesiologist or nurse anesthetist comes to start your IV, try to stay as relaxed as possible. You can do this by taking slow, deep breaths, concentrating on something pleasant, or having your parent(s) or guardian(s) distract you with conversation.
Remember, once the IV is started, the needle comes out and all that remains is a tiny plastic tube. When your surgeon feels you are taking fluids well after your surgery (and you are ready to go home), the plastic tube will be removed.
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. A heart monitor will be put on your chest so that your heartbeat can be seen on a small screen. It is attached by 4-6 small, white circular patches that stick to a few areas on your chest. These white sticky patches are usually removed before you wake up. You will be given more medicine through your IV that will make you very sleepy. You will drift off to sleep and you will stay asleep during your surgery. After what seems like a few minutes, you will wake up in the recovery room, and the surgery will be over.
What exactly is anesthesia?
Anesthesia is the medicine that puts you to sleep and makes you feel no pain during your surgery. There are two different types of anesthesia; "local" and "general".
Local anesthesia is special numbing medicine that is applied only to the area of your body where you are having a procedure. If you have local anaesthesia, you stay awake during the procedure.
General anesthesia puts you 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. It will take a while to wear off, and 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 surgeon or nurse to answer your questions. Also, it is very important to let your surgeon/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 surgery?
After your surgery you will be taken to the recovery room. There, your nurse will check on you often, and take your blood pressure, temperature, and pulse, and give you any medicine that your HCP orders. It is common to feel cold or chilly after surgery. Don't be shy—ask your nurse for a warm blanket. If you're thirsty and your HCP has said that it's okay to have something to drink, your nurse will offer you a clear liquid such as ginger ale. Before you can go home, you will need to pass urine (pee). Your nurse will offer you a bedpan or take you to the bathroom. After a little while, when you are fully awake and comfortable, your nurse will help you get ready to go home. You will probably have your IV removed at this time.
Will I have a scar?
Whether you will have a small, medium, long, or no scar at all depends on whether your doctor 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 small size cut on your belly to remove your appendix. Sometimes, the cuts and stitches are made inside. One example of this is 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. Dissolving 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, because direct sunlight may burn the area and cause a more noticeable scar over time. 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 though, 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've had.
In general, you should call your doctor 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 will most likely be scheduled for a follow-up appointment with your surgeon so that he/she can check to see if you are healing well. It is important to keep this appointment even if you feel terrific.
What can or should I bring to the hospital with me?
Since you are having day surgery, you really don't need to bring very much with you. Most people wear the same clothes home that they wore to the hospital.
What if I get bored while I'm in the hospital?
You probably will be on your way home before you know it—in less than 4 hours, but if you think you might get bored while you are waiting, you can bring music to listen to just in case.
What should I do about the school work I'll miss?
- If your surgery isn't an emergency and your surgeon is available, it might be possible to schedule your procedure during a school vacation week, or during the summer. That way you won't be worried about missing any school.
- If your surgery is scheduled during school time, try to get as much of your work done before your surgery without getting too stressed out. Teachers will usually understand your situation if you take the time to explain that you will be having surgery and you may be home for a few days recovering.
- If your surgery is an emergency, ask a parent/guardian or friend to get your school work for you. Many teachers will give you some extra time to make up your assignments. You shouldn't have to worry. If a teacher seems too demanding, speak with your guidance counselor or principal when you return to school.
- Ask your HCP or someone in their office for a note that excuses your school absences because of your surgery and recovery time at home.
What if I have my period while I'm in the hospital?
Don't worry - It's okay if you have your period the day of your surgery or while you are in the hospital! This will not cause your surgery to be moved to another date.
Most likely you won't be allowed to wear a tampon while in surgery. Instead, you will be given pads to wear. The nurse in the operating room will change your pad while you are sleeping if necessary.
What if I'm still nervous on the day of my surgery?
It is completely normal to feel a bit nervous, but knowing what to expect will make you feel less afraid. Try not to worry too much. Your health care providers and nurses are there to answer any questions you have. They will take good care of you and keep you comfortable while you are in the hospital. If possible, try to talk with someone else who has had the same procedure that you're going to have. This may be a friend, relative, or someone your HCP or nurse arranges for you to talk to.
Once you are home recovering from your surgery, it's important to rest, eat healthy foods, and of course take care of your incision (if you have one). Our bodies are amazing, but everyone needs time to recover from surgery. Ask your HCP exactly what you can or can't do so that your recovery is fast and without complications. Remember to talk with your HCP to learn more about specific instructions for your surgery.
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...