Scott Webb (Host): Having surgery can be stressful, but my guest today is here to answer many of the questions folks have leading up to surgery. I'm joined today by Heidi Mueller, she's a Registered Nurse and Clinical Nurse Specialist Intern with Summa Health.

 This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb.

Heidi, it's so nice to have you here today. We're going to talk about what folks can expect on the day of surgery. And you and I were just sort of joking a little bit that you probably get these questions a lot. You probably answer these questions a lot. So hopefully now that it's in the form of a podcast, folks can, you know, click play, get the answers they need.

So let's start here. How can patients be as healthy as possible leading up to a scheduled surgery?

Heidi Mueller, RN: A couple of things that we recommend prior to coming in for your day of surgery, obviously we would recommend quitting smoking, if you're a current smoker, but if that's not in your plans for right now, reducing or at the very least not smoking on your day of surgery is one of our biggest recommendations. It can help your body really perform at its highest level, especially your lungs, during your procedure. If you are pursuing quitting smoking, please reach out to any of your healthcare professionals. We would be happy to assist you on your journey.

Good blood sugar control if you are someone who manages their blood sugar on a regular basis, really good blood sugar control on the day of surgery, will also assist your body in performing at its best. Getting a really nice healthy diet leading up to your surgery, low processed foods, nice, healthy, whole fruits and vegetables, lean proteins, things like that can give your body the energy it needs to take on the big day.

If you're not currently getting any routine physical activity, starting a very slow exercise program can help build up some strength. Again, to take on your big day, and then take all of your medications as you're prescribed, keeping in mind that that, may change, that your typical medication regimen may change, as you're leading up to or following the procedure, but taking good notes on your medication plan and taking all medications as prescribed.

Host: Yeah, that's perfect. It does seem that, you know, surgery, I mean, certainly there are traumatic events and last minute surgeries and things, but it does seem like usually folks have time, right, they have time to prepare a little bit and, as you say, cut back on smoking and sugar and, you know, maybe get a little exercise, right? Like, it's usually not oh, by the way, we're having surgery tomorrow. They usually have some time, right?

Heidi Mueller, RN: Absolutely. Yeah. Sometimes those events do come up where we need to expedite the process a little more, hurry it along. But most of the time, you have plenty of time to plan to make some lifestyle adjustments if needed. It's always a good time to, maybe prompt some lifestyle changes, when things like these come up.

Host: So what are some of the steps then that patients can take prior to scheduled surgery, just to be as prepared as possible?

Heidi Mueller, RN: Most of the times, I would say a majority of the patients will qualify for a pre admission testing appointment that's done at one of our Summa locations, either Akron or Barberton. We have an excellent pre admission testing department that will review your general health, perform a physical exam.

So we want to, make sure that you're attending those, because they are very important for assessing your readiness for your procedure. Coordinate a ride to and from the hospital, after your surgery. It will not be safe for you to drive home. So having a ride to get you on home, scheduled ahead of time, will be very important.

 Prepare your home for return. So having a nice, quiet, comfortable, safe space to return to that will promote your healing. Having things in reach and ready to go will ahead of time will I think save a lot of stress after your return. We'll have you shower on the morning of surgery using a special medicated soap if it is ordered.

Not all procedures order it, but in general, everyone should shower the morning of their procedure. And then we would advise against the use of deodorant, perfumes, lotions, things like that on the morning of your procedure. And then plan your medication schedule. So if there are going to be any changes to your medication regimen, having that planned out, if there's any special medications you need to take or add, leading up to your procedure, having that planned out, I think will help you be prepared when you're going into a scheduled procedure.

Host: Yeah, no, I've never had any surgeries, knock on a fake Ikea wood, I guess. Uh, but I've known my wife and other family members. And this always seems, this next question always seems to be the one you know, that comes up the most is what do I bring with me to the hospital? What's okay to bring with me? What am I going to need, you know, on the day of surgery?

Heidi Mueller, RN: Absolutely, yeah. I usually go with less is more. Keep all of your valuables, jewelry, remove all jewelry if possible. All of your valuables, go ahead and leave at home so that someone doesn't have to keep track of that on your behalf. And it doesn't have to be a stress for you on your day of your procedure, but I would recommend bringing a photo ID and a copy of your insurance card if applicable and then a living will or power of attorney paperwork if that applies to you as well.

If, if we already have a copy, it should be in your records or if anything has changed or you haven't brought that in yet, go ahead and bring that for us on the day of surgery. Other than that, a list of your current medications is always helpful, when you took them last, how you typically take them, any changes that may have come up recently. We recommend you wearing loose fitting clothing, something nice and comfortable on the day of the procedure. Slip on shoes are typically very helpful for people, as long as it's safe for you to walk, to and from the car, but slip on shoes are usually pretty easy and comfortable for coming to and from the hospital.

And then I would work with your medical team if you should bring, say for example, a CPAP machine, any supplies for any implanted medical devices you may have, any implant cards for any devices. See if those would be needed or would be utilized during your procedure day.

Host: Yeah. Yeah. Always good to just, you know, and if people are in doubt, they can always ask, right? They can ask you and others, uh, what do I need? What can bring? But this is a great sort of to do list here today. And as you say, you know, avoid the laces if you can. Use slip on shoes.

So what can patients expect on the day of surgery?

Heidi Mueller, RN: The hospital is going to call you with an arrival time ahead of time. So, make sure you're not blocking any unknown numbers, or if you see one that may be from the hospital, make sure you're taking those calls as we will give you an arrival time. Typically, depending on the location of your procedure, that'll be about two hours before your scheduled start time.

 You'll arrive about two hours ahead of time. Make sure you have a ride kind of scheduled and ready for you. Once, it's time to begin in the preparation, you'll be escorted back to a private room. Any family members, friends that you have with you, can accompany you as well.

 There'll be an assessment by a nurse, by your anesthesia team and by other surgical team members, in addition to your primary operating surgeon. They're going to ask you a lot of questions, lots and lots of questions. A lot of them may be repetitive. It's not because we're not communicating with each other. It's not because we haven't documented them appropriately. It's because we want to make sure that we're all on the same page and we hear that information directly from you. So, again, a lot of questions, some of them may be repeating, but we do repeat them for a reason for your safety to make sure we're all confirming the information we all have.

 You'll have an IV placed so that we can administer medications, the anesthesia, and, any IV fluids that you may need. And during that preoperative time, there may be some preoperative medications that you'll be given as well, we may give those to you as well.

So, after you're all set to go, you will be escorted back to the procedure area by your anesthesia team or members of your surgical team. You'll get to meet everyone that'll be in the room ahead of time and we will take great care of you while you're undergoing your procedure.

Host: Yeah, that was my experience with the others who have had surgery, like my son and wife and everyone else I know, is, there's lots of questions and there's lots of repeating, but it's not because folks aren't listening. It's because everyone just wants to make sure that they're on the same page, especially about medications and things like that, right?

Heidi Mueller, RN: Exactly. Yeah, we're not doing it to be difficult or because we're not communicating with each other. We want to confirm that we are all on the same page for the patient's safety.

Scott Webb: Yeah, that's perfect. It's been really helpful today. I just want to finish up and find out, you touched on this a little bit, but when folks come home and planning for that return home, what do they need to do?

Heidi Mueller, RN: Yeah, I find that's one thing that we worry so much about leading up to the procedure or the day of surgery that we tend to overlook what's going to happen afterwards. So, having a ride home arranged is going to be very important. We want to have that information.

 If it's going to be someone that's going to be picking you up, having that contact information, or if they're going to be there with you, we'll keep them updated throughout your day. But having a ride home arranged, like I said, it will not be safe for patients after having a procedure done to drive home themselves.

 If you do need public transportation, a cab, a ride share, anything like that, we will require that another adult who has not had surgery that day to be present for your trip home. Make sure you get home nice and safe. You may be going home with some prescriptions, some medications, and our meds to beds program can, typically deliver those to you prior to going home so you don't have to make a stop.

We would just have you plan if your insurance company requires any co pays for any of those medications. Typically they're symptom management medications. Such as for pain or nausea, we would recommend that you work with your insurance company to figure out if there are co pays ahead of time and then kind of have some cash or a card on hand if you would like to utilize our meds to beds program prior to even leaving the hospital that day.

 When you return home, I recommend having a nice place to rest and recover all set to go. Keep in mind that you may have some activity restrictions or lifting restrictions, so maybe getting the laundry done or vacuuming done ahead of time will help minimize the strain placed on you after surgery.

Having those things done and out of the way so you can focus on your rest and recovery. Having all of your necessities within reach, maybe a landing spot where you're going to be taking that first really nice nap after returning home with all of your necessities within reach for you. And then if there are no contraindications to having some over the counter pain medications, typically we would recommend to most patients, unless there's a reason not to take them, to have some ibuprofen or acetaminophen on hand at home, that can be used for pain management after surgery and your surgical team and the post operative nurses would go over all of those with you prior to ever leaving the procedure area that day. So those are kind of some of the things that I would do prior to the day of surgery to make sure that I have a good spot to return home.

Host: Yeah, and maybe just have Netflix, you know, queued up right on Bridgerton.

Heidi Mueller, RN: Queued up, all logged in.

Host: Just, just, yeah,

Heidi Mueller, RN: try to think of your password.

Host: Just go ahead and hit play. Uh, this has been really great today. Really helpful. You know, there's these sort of common questions that folks have, and they don't always have the opportunity to host a podcast like I do.

So, great to ask you these questions. Great that you have the answers. Thanks so much.

Heidi Mueller, RN: Thank you very much. I appreciate it.

Host: And for more information, go to summahealth.org/surgeryprep.

 And if you enjoyed this episode of Healthy Vitals, we'd love it if you'd leave us a review. Your review helps others find our educational content. I'm Scott Webb. Thanks for listening, and we'll talk again next time.