Northern Westchester Hospital

New York Presyterian Health Care System
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Preparing for Your Procedure

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A Guide to Help You Prepare for Your Procedure

To download and print the "Prepare for My Procedure" guide, click here >
Please contact your physician to review in detail or answer any questions.

Preparing for Surgery

One of the most important factors for successful surgery is gaining an understanding of your entire surgical process. We encourage you to ask your doctors and nurses questions about: the surgery; your diet prior to surgery; the process of being admitted to the hospital (if applicable); the type of anesthesia you may need; your medical history; your home medication regimen; insurance coverage; and legal arrangements.

Here are some tips that may help you:

  • Contact your insurance carrier to find out what coverage they provide.
  • Ask your insurance carrier if they provide any wellness benefits that may entitle you to discounted nutritional care and other rehabilitation services after discharge.
  • Advise your surgeon of any medical conditions you have, and if you are taking any medications at home on a regular basis. Some medications may need to be temporarily stopped in advance. Please mention all herbal supplements and over-the-counter medications, as they may impact your surgery as well.
  • Talk with your surgeon about anesthesia.  Visit our anesthesiolgy group, Northern Westchester Anesthesia Services, at WestchesterAnesthesia.com
  • Talk to your surgeon about the potential benefits of donating blood in advance for your own surgery. If your surgeon decides that you are a suitable candidate for blood donation, please call the Hudson Valley Blood Bank at 914.784.4600 for an appointment.
  • If your surgeon determines it necessary, you will need to be medically assessed for surgery by your primary care physician or a NWH Hospitalist physician (whichever is more convenient for you), and may need to complete several types of tests, including blood tests, an ECG, a chest x-ray, and/or pulmonary function tests depending on your physician’s orders. Please confirm with your surgeon whether this is required.  If this assessment is necessary, please contact your surgeon’s or your primary care physician’s office to schedule a time that is convenient for you.
  • Eat foods rich in iron to help boost your circulatory system and blood counts prior to surgery (green leafy vegetables, lean red meats, etc.)
  • If you are overweight, your doctor may recommend a pre-operative weight loss program or you may wish to consult with one of our nutritionalists to establish your dietary needs. Please dial 877.677.1077 to learn more.
  • If you smoke, ask how we can help you quit. Smoking changes blood flow patterns, delays healing, and slows recovery.
  • If you regularly consume alcohol, please discuss this with your surgeon and your medical doctor. They may have specific recommendations for you to follow.
  • If you use any controlled substances or narcotic pain medications, please discuss this with your surgeon and your medical doctor. Regular use of narcotics (and other drugs) can impact your surgery and post-operative pain control. Knowing this information in advance will help us provide appropriate pain relief for you.
  • Ask your surgeon if he/she recommends any preferred pre-surgical exercises.
  • Should you require it, many employers have specific disability paperwork that needs to be filled out. Please contact your employer and allow your surgeon’s office adequate time (at least one week) to complete these forms.

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Questions to Ask Your Surgeon

Potential Medical and Surgical Complications
While we attempt to fully explain the nature and purpose of surgery, including its benefits, possible alternative methods of treatment, the risks involved, the possibility of complications, the possible consequences of surgery and the possible results of non-surgical treatment, we cannot guarantee or assure that complete restoration of function will be achieved as a result of your specific procedure. Your surgeon is always willing to discuss with you in greater detail the benefits and risks of surgery as it relates to your specific medical history.

Questions you may want to ask your surgeon before surgery:

  • What are the major and/or most frequent complications of surgery?
  • If I do not have surgery, what is the risk?
  • How much pain can I expect and how will it be managed after I go home?
  • How long will I be in the hospital?
  • How often will you check on me?
  • Who can I contact after the surgery if I have questions or problems?
  • Do you recommend that I go home or to a rehab facility following surgery?
  • Following rehab, where should I go for my ongoing physical therapy?
  • How long after surgery will it be before I can become completely active again?
  • What specific activities need to be avoided immediately following surgery (for 6 weeks), over the short-term (6 weeks-9 months), and for the remainder of my life?
  • How may this surgery improve my quality of life?

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Medications

For those who take medications at home on a regular basis, please clarify with your surgeon or primary physician if you are allowed to take any medications on the day of surgery and, if so, at what time. You may be allowed to take medications on the morning of the surgery with a small sip of water.

Please do not take any of your own medications in the hospital yourself without staff supervision. This will help to avoid medication error. Your surgeon (and if applicable, your medical doctor) will decide which medications are needed during your hospital stay. Your nurse will administer them to you as scheduled by your surgeon. Please ask your nurse if you have any questions or concerns regarding your medication regimen.

Nausea Medications:
Some people experience nausea, or even vomiting, after surgery. It is typically caused by anesthesia and usually goes away during the first day. If your nausea is severe, your surgeon can prescribe medication to help you manage this condition.

Antibiotics:
Antibiotics may be prescribed to help prevent surgery-related infection. Your surgeon will determine if you require antibiotics, when you will begin taking them, and for how long.

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Preventing Surgical Site Infections (SSIs)

A surgical site infection can occur after surgery in the part of the body where the surgery took place. Most patients who have surgery do not develop an infection. Some of the common symptoms of a surgical site infection are:

  • Redness and pain around the area where you had surgery;
  • Drainage of cloudy fluid from your surgical wound;
  • Fever.

If you experience any of these symptoms, call your surgeon immediately.

What are doctors, nurses, and other healthcare providers doing to prevent SSIs?

  • Providing patients with antibiotics prior to surgery (when deemed appropriate);
  • Shaving and cleaning the skin at the site of the surgery;
  • Cleaning their hands and arms with an antiseptic agent just before the surgery;
  • Wearing sterile, protective clothing during surgery to keep the surgical area clean;
  • And, cleaning their hands before and after caring for each patient.

What can I do to help prevent SSIs?

  • Be sure to inform your health-care team about any health problems you may have.
  • Quit smoking. Ask your health-care team how we can help.
  • Do not shave the area where you are having surgery unless asked to do so.
  • If you do not see your providers clean their hands, please ask them to do so.
  • Visitors must clean their hands before and after visiting you. If you do not see them clean their hands, ask them to do so.
  • Ask how to take care of your wound at home before leaving the hospital.
  • Always clean your hands before and after caring for your wound.
  • Ask who to contact if you have questions or problems after you get home.

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Three Weeks Prior to Surgery

To register for your procedure, approximately 2 to 3 weeks prior to your surgery, you will receive a telephone call from NWH’s Registration Department, and the following information will be requested:

  • Insurance information; if your insurance company requires that you pay a "co-pay,” the hospital requests this amount be paid at the time of registration. If for some reason you are unable to provide co-payment at the time of registration, Northern Westchester Hospital will request this payment be made on the day of your surgery.
  • Validation of your address, date of birth, etc.
  • Possibly some additional, health-related questions for verification purposes.

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Two Weeks Prior to Surgery

Shortly after you are registered, you will receive a telephone call from one of our Pre-Admission Testing Nurses to help you prepare for surgery. He/she will ask you many questions, so we ask that you review the Pre-Admission Testing Questionnaire form which can be found at the end of this packet. Please make every attempt to have the information available ahead of time so you are prepared for this call.

Please note: minimally invasive (arthroscopic) and some spinal procedures may be scheduled by you and your surgeon with shorter lead times (i.e., one to two weeks prior to surgery). Therefore, the preceding actions may take place closer to your date of surgery.

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Twenty-Four Hours Prior to Surgery

Please confirm the time of your surgery the day before it is scheduled by calling the Pre-Admission Testing Unit at (914) 666-1560 after 2:00pm. You will need to arrive at NWH about two hours prior to the procedure; there is a lot that needs to be done before you go into the operating room and it takes approximately two hours to complete the preparation.

Here is what you should bring to the hospital on your day of surgery:

  • Insurance card, advanced medical directives, a listing of your medication allergies, and your home medication list. Your medication list should include all prescription and non-prescription medications, as well as any vitamins and herbal supplements that you may be taking;
  • A pair of comfortable, sturdy non-skid slippers and your favorite knee-length robe;
  • Your favorite personal care items (denture case, hearing aid, contact lenses, eye glass case, tooth brush);
  • Something to read;
  • A loose-fitting sweat suit;
  • Personal entertainment, such as an MP3 player, laptop, or personal gaming system. We are in the process of setting up our Wi-Fi network to accommodate guests and visitors, and anticipate this being ready in January of 2011.

Preparing for Your Surgery:

  • Take a shower or bath the night before the surgery. This will help reduce the risk of infection. Do not shave the area of the surgery—your care team will do this if needed.
  • Do not wear any make-up, lipstick, or nail polish (Vaseline for dry lips is okay).
  • Do not eat or drink anything after midnight the night before surgery. This will help to lessen the risk of choking and nausea from the anesthesia.
  • Please do not bring cash, credit cards, or jewelry to the hospital.
  • Do something fun to relax!

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The Day of Your Surgery

Parking:
Arrive at Northern Westchester Hospital according to your scheduled time of arrival. When entering the hospital driveway, bear right and park in the North Building parking lot (or take advantage of our valet parking service). The parking lot is gated and you will need to push the button and take a ticket. There is a fee for parking.

Registration:
All surgical patients check-in at the Ambulatory Surgery Center, even if you are staying overnight. Enter the North Building, turn left and proceed down the hallway. Turn right at the first hall you come upon and take elevator #5 or #6 to floor 2R (ASC). When the doors open, you will be in the Ambulatory Surgery Center. Please sign in at the front desk.

Procedural Preparation:
After you register, a nurse will perform an assessment and review your medical history with you to be sure that all necessary paperwork is in your procedure chart. You will be given an identification bracelet with a barcode that enables us to create an electronic record of your stay at the hospital and helps us to ensure that you receive the correct medications at the appropriate times.

You will again be asked by the nurse about your medication allergies and to review your home medication list. Different people will ask you several times to verify your name and date of birth, any allergies you may have, the procedure you are having and the side you are having it on. While this may seem redundant, it is vitally important. We ask for your patience with these repeat questions.

In anticipation of your surgery, the nurse will ask you to remove your clothing (including underwear and socks) and to wear a hospital gown. In addition, you should remove any contact lenses, dentures, wigs, hairpins, jewelry, etc. These items should be given to your family members to hold during your surgery.

In addition, the following steps will be taken:

  • An intravenous line will be inserted so you can receive intravenous fluids and hydration.
  • The anesthesiologist will review with you, in detail, the anesthesia you will be receiving.
  • Your surgical site may be shaved and your surgeon may initial the surgical site.
  • Your surgeon will visit you in our surgical center and discuss your surgery with you. After this, you will be asked to sign a consent form for the surgery.
  • You may also be asked to sign an “Observer Consent”. This form indicates your permission for the operative presence of a clinical representative from one of the various vendors which supply our surgical implants. Their presence is necessary as they support the surgeon in his/her use of their products.

An escort will transport you to the Operating Room on a stretcher. Your anesthesiologist may administer medicine through your IV that will sedate you as you are being transported to the operating room. He or she will let you know if they are going to do this. Once you are there, you will see many people, some of whom you have already met, including nurses, anesthesiology personnel, physician assistants and your surgeon. Nurses will confirm your identity and the surgical procedure. You will then be moved from the stretcher to the OR table, and the nurse or anesthesiologist will place ECG stickers on your chest that will be connected to wires running to a machine that monitors your heart. You will also have a device placed on your finger that monitors your oxygen levels.

After Surgery:

After surgery, you will either be transferred back to a patient room in the Ambulatory Surgery Center or into the Post-Anesthesia Care Unit (PACU) or “recovery room” to recover from the anesthesia. Once you are stable and all immediate orders from your surgeon or anesthesiologist are carried out (such as blood work, x-rays, etc.), the PACU nurse will call your family in the waiting room and invite them to visit you. Family members/acquaintances are asked to limit visitors to two at a time. The PACU staff also asks that neither you nor your guests enter the area with cell phones, flowers, food/beverages, or balloons.

In PACU, the nurse will frequently monitor your vital signs (heart rate, blood pressure, temperature and respiratory rate), and check your dressing, as well as the circulation and movement in your toes and legs.

Once you have recovered from the anesthesia, you will be taken to a patient room in the Ambulatory Surgery Center, where your family can visit you. Prior to surgery, please ask family members to stay in the waiting room area until they have spoken with the doctor.

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Visitors

Visitors may come with you on the morning of your surgery (try to limit visitors to one or two people). The nurse will direct them to the Surgical Family Waiting Area where they can wait during your surgery. Your surgeon will call there after surgery to talk with them. Your family should take your personal belongings with them to the Surgical Family Waiting Area and then bring them to you in your assigned room.

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Discharge from the Hospital

If you are to undergo ‘same day surgery’, you will require a responsible adult to drive you home. If you are being admitted to the hospital, you may require a responsible adult to drive you home or to a rehabilitation facility upon discharge; if medically appropriate and based on insurance coverage, transportation may be arranged for you.

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Preparing for Your Homecoming

  • What are your plans? Do you live alone? Do you have stairs? Is there someone to help you with everyday needs?
  • Make food in advance and freeze batches.
  • Remove throw rugs or any unsecured electrical wires. You may need an elevated toilet seat, a walker, or crutches. Your insurance may cover these and additional items, and we can help you to get them. You may also want to consider buying a long-handled shoehorn, a long-handled sponge, a grabbing tool or reacher, and a footstool. Please discuss this with your surgeon.
  • Setup an area at home where you would have everything you generally use within reach, such as water bottles, remote control, telephone, books, medications, and a whip to boss everybody around!
  • Speak with your surgeon about applying for a temporary handicap sticker prior to your surgery. If you qualify, you should obtain an application at your local Town Hall and ask your surgeon to complete the form. Please do not feel badly about parking in those coveted spots, as you will appreciate the convenience after your surgery.

Items you may need when you arrive home from the hospital:

  • Raised toilet seat or 3-in-1 commode
  • A reacher, sock aide, long-handled shoehorn, long-handled sponge, dressing stick, elastic shoelaces
  • Hand-held shower head
  • Shower seat
  • Chair cushion
  • Walker and/ or cane

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Hand Hygiene

Proper hand hygiene is the #1 way to prevent the spread of infections. The following steps will guide you through proper hand hygiene techniques.

  • Clean your hands very often, especially after touching objects or surfaces in the hospital room, before eating, and after using the restroom. Your healthcare providers should practice hand hygiene every time they enter your room.
  • It only takes 15 seconds of using soap and water or an alcohol-based hand rub to kill the germs that cause infections.
  • You can take action by practicing hand hygiene regularly and by asking those around you, including your loved ones and your healthcare providers, to practice it as well.

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Smoke-Free Campus

To protect the safety, health, and comfort of all NWH patients, visitors, staff, volunteers, and students, smoking is prohibited on the grounds of the Hospital, including all Hospital buildings, common areas, parking lots, and inside vehicles parked on campus.

To make your stay as comfortable as possible, NWH offers nicotine-replacement therapy including nicotine gum 24 hours a day, seven days a week, to help patients, visitors, and staff control their cravings while on-site at NWH. Additionally, NWH, in conjunction with Mount Kisco Medical Group, offers a free smoking cessation program providing educational and emotional support to people of all ages interested in quitting smoking.
For more information on the program, call (914) 666-1182.

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Integrative Medicine

Northern Westchester Hospital is proud to offer Integrative Medicine Services to our patients. This program is staffed with holistic health nurses who are focused on creating an environment of health and wellness for our patients. Services focus on incorporating healing of the mind, body, and spirit into the daily care of our patients. Integrative medicine services complement conventional western medicine with techniques that support the body’s natural ability to heal and include: Clinical Aromatherapy, Energy Healing, Therapeutic Suggestion/Guided Imagery, and Massage Therapy. Please speak with your nurse or the Orthopedic and Spine Institute Nurse Practitioner to learn more about these services.

Northern Westchester Hospital has developed complimentary patient and family support services to assist you and your family during your stay. These include:

  • The Ken Hamilton Caregivers’ Center:
    An oasis for your family within NWH where family members can meet with a social worker, take time to meditate, and receive support and advice to help them prepare for their role as caregivers.
  • Pet Therapy:
    At times, everyone needs a companion that will simply listen and provide comfort to help ease stress relating to a surgical procedure. To help with this, NWH has established a pet therapy program. Please ask your nurse for additional information.
  • The Art Cart Program:
    Do you want to add a custom-touch to your room during your stay? NWH volunteers can help with this by providing you with a selection of artwork and photography (prints only) to choose from. This is a very popular program, so please ask your nurse for more information.

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The Role of Hospitalists and Other Physicians

Prior to surgery, your surgeon may determine it necessary for you to see your primary care physician or NWH Hospitalist for a pre-operative medical evaluation. These evaluations are sometimes necessary to help better coordinate the medical care around the time of your surgery, and often include home medication review and consideration of any additional tests or treatments. Instructions on how to schedule this assessment with a NWH Hospitalist physician are printed in the “Welcome Letter” enclosed in the packet of information you received at the physician’s office. If you have questions, please contact NWH at (914) 666-1480.

The anesthesiologists at NWH review every scheduled surgical case in advance, and will discuss any potential concerns with the surgeons. On the day of surgery, the anesthesiologist will meet with you pre-operatively to review your medical history and explain in detail the anesthesia plans for your surgery and post-operative period.

Depending upon your medical condition, if you require an overnight stay in the hospital, your surgeon may request the assistance of a Hospitalist. The Adult Hospitalists at Northern Westchester Hospital are board-certified Internists whose practices are limited to taking care of hospitalized inpatients. The Hospitalist would be in communication not only with your surgeon but also with your primary care physician, so that all of your medical care is coordinated. In addition to the Hospitalists, your surgeon may deem it necessary to have you seen and cared for by one or more of the other medical specialists during your hospital stay.

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Pre-Admission Testing Questionnaire

Download here.

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Important Appointments and Contact Information

Download here.

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