Preparing well makes your surgery safer and your recovery smoother — and most of it is simple. Follow the steps below on the timeline shown. If anything is unclear, call our office. I would rather you call ten times for nothing than guess once on something that matters.
Two to Four Weeks Before Surgery
- Let's get to know each other. A great result is a team effort — and teams do best when they know and trust each other. Watch my videos at darinallredmd.com, and follow along on YouTube, Instagram, and TikTok. You'll understand how I think about surgery and your health.
- Learn about your surgery. Find details on this website's Protocols pages, or search for your surgery online. The more you know, the calmer surgery day feels.
- Arrange a ride home after surgery, and have someone stay with you the first night. If no one is available, we may have to postpone.
- Schedule a history and physical (H&P) exam with your primary care provider. You must have this before we can give you anesthesia.
- If you take blood thinners (Coumadin, Warfarin, Eliquis, Pradaxa, etc.), ask your primary provider whether — and when — to stop and restart them.
- Lower your risk: stop smoking, eat well, keep your diabetes well controlled, and do the CHG (chlorhexidine) washes described below.
- Eat plenty of protein: 120 g per day for women, 150 g per day for men. (A chicken breast or steak has about 25 g each.) Keep this up for 6 weeks after surgery — healing is hungry work.
- Start daily vitamins: Vitamin C 1000 mg, Magnesium glycinate 400 mg, and Vitamin D 5000 IU. Take these for 2 weeks before and 6 weeks after surgery.
One Week Before Surgery
- Stop all aspirin and anti-inflammatory medicines (Naprosyn, Feldene, Motrin, ibuprofen, etc.). Tylenol is OK.
- Stop all herbal products, supplements, and homeopathic medicines — even natural products can cause problems such as bleeding. Keep taking your Vitamin D and Magnesium.
- Rheumatoid arthritis patients: contact your rheumatologist about which medicines to stop and when.
- Buy CHG (chlorhexidine) soap and start the pre-op washes 3 days before surgery (see below).
Skin Washing with CHG
Getting your skin clean before surgery is one of the most important things you personally do to prevent infection — a few minutes a day, and some of the cheapest insurance you will ever buy. You'll wash with CHG (chlorhexidine) soap, such as Hibiclens. Buy 4% Hibiclens at any pharmacy or online. For each wash, use clean, freshly laundered washcloths, towels, and clothes. (If you have a cast, you won't be able to do this.) Use the CHG soap for the 3 days before surgery and the morning of surgery. Stop if you have an allergic reaction.
- Wash and rinse your hair, face, and body with your usual shampoo and soap.
- Rinse off completely, then turn off the shower or step out of the bath.
- Put a quarter-sized amount of CHG/Hibiclens on a wet, clean washcloth and apply it to your whole body from the neck down.
- Do NOT use it on your face, hair, or genitals.
- Rub the soapy washcloth over your whole body for 3 minutes, adding more soap as needed (use about a quarter of the bottle each time — 4 washes total).
- Don't scrub too hard.
- Rinse all the soap off with warm water. Do NOT use regular soap after the Hibiclens.
- Pat dry with a clean, freshly laundered towel.
- Put on freshly laundered clothes.
- The night before surgery (after your 3rd day of washing), sleep on clean sheets.
- Do NOT use any lotion, deodorant, powder, or perfume.
- Do NOT shave your legs or remove any body hair below the neck the night before or day of surgery. Facial shaving is OK.
One Day Before Surgery
- Remove nail polish.
- Do NOT eat or drink anything after midnight — including coffee, water, gum, and mints. This is for your safety.
- Eat about 100 g of healthy carbs the night before surgery (about 5 slices of whole-wheat bread). Diabetic patients: skip this if it will raise your blood sugar.
Day of Surgery
- Don't bring valuables.
- Wear loose clothes that fit over a brace or splint (such as a knee brace or wrist splint).
- Remove all jewelry, including piercings.
- Take your routine medicines with a small sip of water. Diabetic patients: do not take your diabetes medicine, but bring it with you.
- If you have crutches or a brace, bring them. Otherwise, we'll give you any supplies you need — including crutches or a walker — when you're discharged.
- Sign in at your scheduled time.
In the Surgical Admission Area
You'll change into a surgical gown and meet your team — a registered nurse, the anesthesiologist, and an operating room nurse. A physical therapist will give you exercise and crutch or walker training if needed. And you'll see me — I'll answer any last questions before we head back.
After Surgery
- After surgery, you'll be in the recovery room for about an hour. Outpatients then go to the observation area and are discharged once you can get out of bed, eat, drink, and use the bathroom.
- Do not drink alcohol while taking prescription pain pills.
Questions before surgery? Call the clinic where your surgery is scheduled — it is always better to ask than to guess. The better we know each other, the better you'll do.