preparation & recovery



How will I prepare for Surgery?
The decision to proceed with surgery must be made jointly by you and your surgeon. You should understand as much about the procedure as possible. If you have concerns or questions, you should talk to your surgeon. It's important that you understand what procedure (operation) you are having preformed and why this is being done. Educate yourself on your condition and the goals of the surgical procedure.

Once you decide on surgery, you need to take several steps. Your surgeon may suggest a complete physical examination by your regular doctor. This exam helps ensure that you are in the best possible condition to undergo the operation.

Learning that you need spine surgery can be a frightening realization, because all surgery carries risks as well as benefits. You’ve already taken a very important first step in choosing a surgeon and surgical team that you can trust.

Find Doctors and nurses that well respected and well trained. We specialize in spine surgery, and we pledge to use our skills and training to the best of our abilities. We will also educate you about your condition and the surgical plan, including associated risks, possible complications and expected outcomes.

However, even the most successful and technically prepared surgical team cannot compensate for your important role in getting ready for surgery. Your physical and mental preparedness for the operation can have a major impact on surgical success and recovery. Depending on the amount of time you have before your surgery, there are many things that you can do to maximize your chance of a positive experience.

Physical Fitness Physical Fitness

Physical Fitness
It is important that your body be as healthy as possible before undergoing the stress of surgery. We will assess your overall health to identify any concerns in your medical history that could create complications or added surgical risk. We will conduct a thorough physical examination, along with blood tests and urinalysis. Depending on your age and health, we may order additional pre-operative tests such as chest x-rays or an EKG. We may also ask you to improve your health prior to surgery by making nutritional improvements, losing weight, exercising, or stopping smoking.

Nutritional
Eating a healthy and nutritionally balanced diet strengthens your immune system, which helps your wounds to heal faster and may help prevent infection. A balanced diet includes lots of fruits and vegetables, whole grains, and protein from dairy and meat. You should avoid added fat, processed foods, and sugar to maintain the healthiest immune system possible. An IV multi-vitamin supplement may be helpful as well, although it is best to get your vitamins from eating healthy foods rather than supplements. Keep in mind that herbal supplements, although they may be derived from “natural” sources, are still a type of drug and must be discussed with your doctor. Certain supplements can have adverse affects during surgery.

Weight Loss
If you are overweight, you may want to take steps to safely lose weight prior to your surgery through healthy eating and exercise. Excess weight causes additional stress to the spine that can make post-operative healing more difficult and can cause more pain in the recovery process. If you have a lot of weight to lose, be sure to consult your doctor or consider a medically supervised diet. Drastic weight loss or weight loss using unsafe methods (such as some homeopathic diet supplements) can create additional health problems and risks.

Smoke Cessation Smoke Cessation

Smoke Cessation
If you are a smoker, quitting this habit can be the single most important change that you make prior to surgery. Smoking significantly increases your chance of surgical complications. It compromises your immune system, can adversely affect you during the anesthesia process, and can contribute to lung difficulties such as pneumonia during your recovery. In addition, many spine surgeons refuse to perform spine fusions on smokers, because studies show that fusion rates are much less successful among smokers. Stopping smoking three months prior to surgery and during recovery can improve your health and your surgical outcome significantly.

Exercise
Exercise can help you prepare for surgery by building muscle strength and cardiovascular fitness. The more fit you are, the faster your recovery time and your return to an active and healthy life. Exercise also boosts your immune system and contributes to an overall sense of well-being. Almost everyone can safely adopt some form of activity prior to surgery to increase strength and stamina. Depending on your condition and the level of pain you experience, walking, swimming, water aerobics, or light weight-training exercises can be beneficial. A physical therapist or professional trainer may be helpful in designing an activity program that is right for you. However, be sure to consult your doctor as well.

Mental Readiness
In addition to physically preparing for spine surgery, it is important that you are mentally and emotionally prepared for your operation. We want to make sure that you know what to expect in each step of the process. We also want you to be aware of the many practical and logistical details that you may need to take care of before surgery.

Support Persons
A friend, family member, or support person will be needed to drive the patient to and from the hospital for surgery. For the first day or two after surgery a caregiver may be needed to assist the recovering patient with personal care, meals, cleaning, and errands. Depending on the patient's condition, and the type of surgery the patient may need to arrange for professional home care for a longer period of time.

Preparing Your Surrounding Preparing Your Surrounding

Preparing Your Surrounding
It is a good idea to prepare your home for your post-operative recovery needs. You may be temporarily restricted from bending, stooping, or heavy lifting, so place necessary objects such as your telephone, food, toiletries and medicine within easy reach. You may also want to rearrange your furniture so that you don’t need to climb stairs, and remove rugs that might trip you. Depending on your condition, you may need to obtain special equipment for walking and bathing that your doctor, nurse or physical therapist can prescribe.

Recovery Plans
As a patient or caregiver it is important to maintain realistic expectations about post-operative recovery. Our doctors will discuss recovery plans prior to surgery regarding length of hospital stay, temporary or long-term movement and dietary restrictions, and duration of convalescence prior to returning to work or other activities.

Consent Forms
Consent forms showing that you understand the surgical procedure is required to be signed by the patient prior to sugery. Our doctors take care to educate our patients you on your medical history; the type of surgical procedure suggested; the type of anesthesia we will use; the risks, benefits, and potential complications; and the expected plan for your hospitalization, post-operative pain management, rehabilitation and recovery.

Final Pre-Surgery Preparation
In the final days leading up to your surgery, you will receive detailed instructions from us about your medication schedule, blood donations, and how to prepare for your admission to the hospital. These instructions vary depending on your individual circumstances, but in general you may want to consider the following issues.

Blood Donations
Many patients choose to donate their own blood to be stored for their needs during surgery. Other patients obtain blood donations from family and friends with a compatible blood type. If you donate your own blood, you will need to plan your blood donations to begin two to four weeks prior to surgery.

Food and Medication Instructions
We will give you detailed instructions about your medication schedule prior to surgery, and what you may eat and drink. Often patients are not allowed to eat or drink anything after midnight on the night of surgery. Also, we will give you clear directions regarding certain medications such as blood thinners and anti-inflammatories that you might need to stop taking in the days or weeks leading up to surgery.

Hospital Admission
When you go the hospital for your surgery, it is a good idea to wear comfortable, loose-fitting clothes and shoes that are easy to take on and off. If you will be staying overnight in the hospital, bring a small bag with underwear, nightwear, slippers or loafers, and personal toiletries. If you will be wearing a brace after surgery, you will need a cotton t-shirt to wear under the brace. Leave your jewelry and watches at home, and remove your rings.

When you arrive at the hospital, you will be asked to change into a hospital gown. Your visitors will be asked to wait in the waiting area. Medical staff will review your vital signs and start an IV prior to taking you into surgery.

Hospital Discharge Hospital Discharge

While getting discharged from the hospital, the patient would receive a discharge summary that would briefly describe his preoperative condition and the surgical procedure. Most importantly, it would give a detailed description of the medicines that would need to be taken after discharge, along with their dosage schedules. It would be beneficial for the patient to travel by an ambulance from hospital to home at the time of discharge. The surgeon would also give additional instructions as regards the dos and don’ts after discharge. Routine activity restrictions following a spine surgery include avoiding bending forwards, lifting heavy weights, traveling in two-wheelers and auto rickshaws, using Indian style of toilet commode sitting for prolonged times, etc. On reaching home, till the surgical stitches are removed, the wound dressing should not be allowed to get wet.

Follow up visits will be scheduled to make sure your back is healing well. Off-the-schedule meetings can be arranged with the surgeon if the patient has soakage of the wound dressing, fever over 101° F, increase in numbness or weakness in the legs, difficulty to pass urine.

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