What to Expect for Outpatient Surgery?

What to Expect for Outpatient Surgery?

Fabio Pencle, MBBS; Kingsley Chin, MD

The Consult Visit

When you are diagnosed by your primary care provider with a condition that requires surgery, they should send you to the surgical specialist for further investigation. Surgery is a treatment option for injuries or disorders of the body by incision or manipulation, especially with instruments.

During a consult visit, your surgeon will perform an examination and ask more questions. They will explain their findings and recommendations to you. They may recommend outpatient surgery, often a procedure that lets you go home at the end of the day.

Surgical Education

Our surgical team consist of a surgeon who makes the recommendation and advises the patient about the procedure. Most patients still have questions and we provide a dedicated education class to allow discussion and questions from the patient to be answered. Our trained surgical concierge educator and team provides additional support to the patients and help to coordinate preoperative and postoperative follow up.

Clearance & Preoperative Visits

Once your procedure has been scheduled, you will receive further instructions on clearance and a pre-operative visit will be needed. The Anesthesiologist is a medical specialist responsible for sedation, 'putting you to sleep', and pain control after surgery he will see you prior to surgery.

The Week Before Surgery

In the days before surgery your doctors will recommend that some medications be avoided as they might interfere with healing or anesthesia. Some examples are aspirin and anti-inflammatory drugs such as Motrin, Advil, Excedrin and ibuprofen. Also reduce or stop smoking in the week before surgery.

Night Before Surgery

Eat a light dinner in the late afternoon. Avoid alcohol 24 hours before surgery. Ask your provider if you should take your regular medications. The use of illicit drugs will prevent surgery from being performed.

After midnight, do NOT eat any food including gum, candy, breath mints, or cough drops. Also do NOT drink anything - water, coffee, juice, etc. Do NOT swallow any of the water that is used to brush your teeth.

If you accidentally consume food or water tell your provider as doing so could be dangerous and the surgery may have to be postponed. For your safety, surgery must be done on an empty stomach. Also, if you begin to feel sick or develop a fever call your provider.

These are very general instructions, so ask your MD, as instructions vary with treatment.

Day of surgery

For outpatient procedures, patients should be at the facility at least one hour before their surgery's scheduled time. A staff member will check you in and take you to the waiting area before your surgery. There you will change into a hospital gown.

If you wear glasses, contacts, and/or hearing aids they will need to be removed.

A staff member will come to check your blood pressure, pulse and temperature. Your anesthesiologist will come to talk to you about how you will be sedated, 'put to sleep', and cared for after surgery.

Shortly thereafter, you will be sedated and brought into the operating room for your procedure. If you have any questions feel free to ask them at any time. Our medical staff want to know about your concerns.

Remember to bring with you:

·       Someone to take you home

·       Your insurance card

·       A change of comfortable clothes

·       A case or holder for glasses, contacts, dentures or hearing aids (if you wear them)

·       Sometimes there might be some waiting involved so you might want to bring a book

 Do not Bring:

 ·       Do not bring valuables - jewelry, credit cards or more money than necessary to fill any prescriptions

·       Do not wear make-up and make sure nail polish is removed

·       Do not use lotions, creams, or aftershave, and do not wear perfume.

·       Do not use hairspray, mousse, or gels.

·       Do not shave or use deodorants near the site of surgery

·       Take off all body piercings

During Surgery for Friends and Family

We know that your surgery can be an anxious time for your friends and family who accompany you to your procedure. Our staff will keep them informed as to your progress while they wait in the waiting room.

After Outpatient Surgery

After your surgery you will be taken to the recovery room. You will be monitored and given time to recover. The length of time will depend upon the type of surgery you had. When it is time to leave, a staff member will go over instructions on how to take care of yourself at home. You may also be given prescriptions that you will need to have filled. If you need some extra help a staff member can help you to your car.

You should take it easy the next few days after surgery. Do not drive or operate machinery the day after surgery. If you have questions, please ask your provider.

You may be tired and feel discomfort after surgery. This is to be expected. Your provider will give you something to ease the pain or discomfort. If you are in pain, have a fever, or drainage and/or pus from where you had surgery, call your provider right away. If you have any acute concerns, call 911 or have someone drive you to the closest emergency room.

Be sure to keep all post-surgery appointments that you have with your surgeon. Call your provider's office for any questions that you might have.

The LESS Institute uses a new philosophy of Less Exposure Surgery (LES), utilizing the least invasive techniques and technologies to achieve the best and most efficient outcomes so patients can return immediately to an active lifestyle. As LESS Institute Founder, Dr. Kingsley Chin, board certified spine surgeon, pursues endeavors of medical entrepreneurship, tourism & mentorship throughout Florida, New Jersey, New York, Arizona & Jamaica, treating thousands of patients globally each year. For more information or to get in touch with our team visit www.thelessinstitute.com or call 855-411-LESS.

What should I know before a Surgical evaluation: Goals, Expectations and Concerns

Written by Fabio Pencle

Overview

Surgery is a branch of medicine that deals with the treatment, management, and assessment of a wide range of medical conditions. It is the treatment of injuries or disorders of the body by incision or manipulation, especially with instruments.

A surgery consultation is the first step towards understanding your diagnosis and asking relevant questions you may have. It is an essential part for both your surgeon and you. During the consultation a clinical assessment involves the surgeon asking about your complaint (History) and performing an examination (Physical) to determine your diagnosis. Based on this diagnosis a surgical recommendation is made by the surgeon and any further questions can be answered about the procedure, benefits and risks. At this time if the you agree to surgery, you may be consented to have a record of the type of procedure and a tentative date scheduled.

Our practice offers further follow up with a concierge service. Further education classes and logistics for surgery schedule is coordinated for you.

According to the data of Centers for Disease Control and Prevention (CDC), approximately 22.5 million surgeries are performed in ambulatory surgery centers every year.

Goals of Surgery

• Ensure the patient is not subjected to unnecessary pain, discomfort, and recovery process

• Suggest the most suitable surgical technique or procedure to treat the disease, reduce the symptoms, or manage the condition

• Make the patient fully understand the potential risks or complications of the procedure

• Outline an individualized surgical plan that can be followed through

• Keep track of the patient’s progress and recovery, especially during the first 24 to 48 hours after the surgical procedure

Expectations and Fears

Patients go through surgery consultation when they are referred by their primary care provider (PCP) or other specialists

Are meant for surgery? If the surgeons determine the patients are likely candidates for surgery, they conduct more consultations wherein they perform or interpret test results, plan the surgical procedure (including the date of the surgery), recovery program, etc.

What occurs when surgery is complete? Consultations are also carried out as soon as the surgery has been completed. At this point, the surgeon’s concern is to ensure that the patient responded well to the procedure and to verify whether there are complications.

What happens if there is a complication? Not all surgical complications occur quickly. In some cases, it takes days or even years for them to be discovered. Patients who develop such are encouraged to set an appointment with their surgeon, so the complications are addressed as soon as possible, preventing them from getting worse.

The expected results of the surgery depend on the goal of the consultation. The patients may:

• Learn whether they are fit for surgery or, if not, understand the reasons why and determine other possible treatment options

• Identify the risks and possible results of the surgery so they can decide for themselves whether to proceed with it or not. In the case of minors (pediatrics), the decision rests with the adult, who is either a parent or a guardian.

• Obtain a better picture and prognosis of the disease based on the additional tests

• Ensure patients are prepared physically, mentally, and even spiritually for the surgery

• Determine the best steps to take during the post-operative care

How Does the Procedure Work?

Most of the surgical consultations are planned. This means the patient has been referred by a doctor or a specialist following the results of initial tests. Patients then set appointments with the recommended or their chosen surgeon.

During the initial pre-operative consultation, the surgeon asks a series of questions to know the main concern of the patient, from the disease to the fears or discomfort about surgeries. The surgeon then reviews the results of the exams, which should have been forwarded before the consultation. If the tests are not enough to decide, the surgeon may request for more tests, which will then be evaluated and discussed during the next consultation.

Possible Risks and Complications

A surgery consultation doesn’t in any way guarantee the elimination of risks and complications. However, one of the primary objectives of the consultation is to reduce and/or mitigate these risks, which can include bleeding, infection, and organ failure. Patients and surgeons should work hand in hand to ensure the patient’s safety all throughout the surgical process.

Building from the ground up, we strive to be a global outpatient Academic Orthopedic and Neurosurgery-Spine Specialty & Research Institute of Excellence. We aim to lead in Less Exposure Surgery techniques. For questions and scheduling call 855-411-LESS.

You Won’t Believe the Most Common Question after Back Surgery

By Admin

As a healthcare professional in an orthopedic spine clinic, I field questions all day long from patients about their recovery.

The most common question after back injury or surgery is: “Doc, when can I have sex?”

Our LESS Institute Founder Dr. Kingsley R. Chin advises, “Remember -all our bodies are different, and your medical history, as well as the complexity of the injury or procedure ultimately determine how much time your body needs to heal.”

So although we can’t give an exact answer, there is a guideline that can help you answer that all-important question -just in time for Valentine’s Day.

Consult Your Surgeon

Before you attempt to engage in sexual activity, consult your surgeon to make sure your back is well enough.   You want to make sure that you don’t aggravate your pain or worsen your condition.

Learn

Learn more about your back condition.  Why is this happening? What can or can’t you do for now?  What precautions do you need to take?

Speak

Sit down and speak with your partner about what is happening. Tell them how you feel.  Communication is key as back pain can affect intimacy in the bedroom, as well as relationships in general.

Plan

Yes -that’s right: Plan your positions together.  Research how you can safely position your body to support your back and reduce your pain.  Also speak with your physical therapist for proper body mechanics or positions that will be safe during intercourse.

Explore

Be creative; be imaginative.  Surrender and approach new ideas together.  Try a little more sensuality versus sexuality by pleasuring your partner’s senses with some essential oils or music.

If you are experiencing back pain, don’t hesitate to contact us at the LESS Institute. We understand how challenging living with back pain can be and we’re here to help you.

About the LESS Institute

The LESS Institute uses a new philosophy of Less Exposure Surgery (LES), utilizing the least invasive techniques and technologies to achieve the best and most efficient outcomes so patients can return immediately to an active lifestyle. As LESS Institute Founder, Dr. Kingsley Chin, board certified spine surgeon, pursues endeavors of medical entrepreneurship, tourism & mentorship throughout Florida, New Jersey, New York, Arizona & Jamaica, treating thousands of patients globally each year. For more information or to get in touch with our team visit www.thelessinstitute.com or call 855-411-LESS.

---

The LESS Institute Fosters Adolescent Scoliosis Care With the Best in LES

Written by Fabio Pencle & Garianne Bowen

Compiled & edited by Esther Rodriguez

Adolescent idiopathic scoliosis (AIS) is the most common form of pediatric scoliosis in individuals between the ages of 10 and 18,1 found in as many as 4 in 100 adolescents.2 By definition, idiopathic scoliosis implies the cause is unknown or not related to a specific syndromic, congenital or neuromuscular condition. Treatment options include conservative management, bracing or operative intervention.

Marketing Intern Garianne Bowen is no stranger to a life with adolescent scoliosis, although she may not have known it at first.

“Looking back, though I had the signs of scoliosis growing up, my family wasn’t aware of the potential for this diagnosis. We all thought nothing could be done of it – and though I tried to accept it, I somehow could not,” she said. Bowen spent years settling for a life that held so much more potential, in the physical and emotional space. In a world where lives are hyper visual with social media exposure, “I always felt uncomfortable in my own body. It sometimes felt like I didn’t know how to walk correctly, and that eyes were always on me. My breasts were two different sizes, my stride wasn’t straight, clothes fit awkwardly and I experienced occasional annoying back pain. My shoulder was damaged by birth and my parents attributed that to me being ‘different,'” said Bowen.

Eventually Bowen’s parents discovered an article on scoliosis – and as they read, realized she fit the mold so entirely. Because of this, they scheduled an X-ray to be read by an orthopedic surgeon, witnessing first hand their daughter’s 40 degree spinal curvature.

A proper adolescent scoliosis evaluation includes X-ray imaging from various angles.  Generally speaking, those with curves of 10 to 25 degrees are monitored for surveillance with serial X-rays. This is usually at three, six or 12 month intervals. Those with curves greater than 25 degrees but less than 40 to 45 degrees are candidates for bracing. And those with curves of over 40 to 45 degrees who are skeletally immature are considered operative candidates.3

Bowen’s 40 degree spinal curvature seen through X-ray

During her preliminary orthopedic visit, her doctor at the time being highly encouraged Bowen to undergo a spinal fusion from the neck down, a more major procedure for an adolescent scoliosis case that would limit Bowen’s flexibility and motion. But Bowen was not so on board. She became determined not to undergo surgery, adapting to a life of covering her curvature and accepting pain as the norm.

Three years post scoliosis discovery, Bowen’s mother met Orthopedic Surgeon Dr. Kingsley R. Chin at a conference. Impressed by his profile as a successful Jamaican-born, Harvard-trained spinal surgeon, she brought her daughter to him straightaway to determine a second opinion regarding treatment options. Dr. Chin assured Bowen he would not be completing a full spinal fusion, introducing a Less Exposure Surgery procedure in its place – and clarifying her every concern regarding maintaining motion post-procedure.

Dr. Chin pioneered this LES procedure, a short segment scoliosis surgery with a focus on the apical curve, gearing treatment to the levels above and below – limiting fusion levels.

“As he reassured me, my perceptions of the procedure were altered for the positive,” she said, and after further personal research and consideration, she ultimately trusted Dr. Chin to perform the surgery. “I am so grateful to have gotten to that place,” attests Bowen.

We know it’s vital to prioritize our health, but we must also expose ourselves to our options that lie ahead. Explore your varying avenues of recovery and choose the most appropriate healing method for you.

“I can personally vouch for Dr. Chin as a top orthopedic surgeon, as I begin enjoying my young years to my utmost potential – confident and free of pain.”

— Garianne Bowen

And just like that, from curvature to confidence, Bowen leads a life of health, happiness and pain-free motion.

The Less Exposure Surgery Advantage

In advancing Less Exposure Surgery, The LESS Institute aims to reduce operative time, minimize blood loss and decrease instrumentation, while improving overall outcomes. For more on adolescent scoliosis cases with The LESS Institute, see the Jamaica Gleaner article and our post titled 15-Year-Old Jamaican Girl Appreciates Life Changing Scoliosis Surgery in Jamaica by Dr. Kingsley R. Chin.

About Dr. Kingsley R. Chin

Dr. Kingsley R. Chin is a board certified Harvard-trained orthopedic spine surgeon and professor with copious business and information technology exposure. He sees a niche opportunity where medicine, business and info. tech meet – and is uniquely educated at the intersection of these three professions. He has experience as Professor of Clinical Biomedical Sciences & Admissions Committee Member at the Charles E. Schmidt College of Medicine at Florida Atlantic University, Professor of Clinical Orthopedic Surgery at the Herbert Wertheim College of Medicine at Florida International University, Assistant Professor of Orthopaedics at the University of Pennsylvania Medical School, Visiting Spine Surgeon & Professor at the University of the West Indies, Mona, and Adjunct Professor of Clinical Biomedical Studies at the University of Technology, Jamaica.

1. , 3. https://www.ncbi.nlm.nih.gov/pubmed/29763083

2. https://www.srs.org/patients-and-families/conditions-and-treatments/parents/scoliosis/adolescent-idiopathic-scoliosis 

---