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The most important thing in preparing for an operation is to STOP or REDUCE SMOKING!

Smoking not only affects a person's lungs, which increases the risk of pneumonia after being on a ventilator (even for a short operation), but it also affects blood pressure and the function of the heart. The nicotine in cigarettes constrict small and large blood vessels, changing blood pressure and narrowing the conduits through which blood flows, including those of the heart.

Good blood flow is important to the heart as well as to healing tissues. Stopping smoking at least one week before an operation lessens the risk of heart attacks peri-operatively as well as having benefits for the recovery and healing process.

"Blood thinners" or, in reality, anti-coagulants, should often be stopped before an operation. However, some people need special care in stopping their anti-coagulation, and this should be arranged with your surgeon and/or primary doctor. These agents include aspirin, clopidogrel (Plavix), dipyridamole (Persantine), ticlodipine (Ticlid), heparin, low molecular weight heparin (Lovenox), anisindione (Miradon), warfarin (Coumadin), dicumarol, and many herbal supplements, including gingko biloba, ginseng, licorice, and many others. Please discuss all medicines and herbs with your doctor before an operation.

Diabetics require special care before an operation. During even a short stay in either the hospital or an outpatient setting, dietary and sugar intake can be dramatically changed. Therefore, careful attention to insulin or oral anti-hyperglycemic regimens is recommended. Often, some juice can be accomodated several hours before the operation. Most operations require an empty stomach for at least 8 hours, although six hours is often acceptable if only liquids have been consumed. There is usually no need for longer periods of abstinence and if your operation is later in the day or delayed, this should be discussed with your surgeon.

Learn to breathe deeply and practice this for the day or two before your operation. This helps clear your lungs and can be continued after the operation. Of all patient efforts, this is the most significant aid to faster recovery!

Learn to exercise your calf muscles. Deep vein clots can happen after long operations or long stays in the hospital, often unrecognized. Constant calf muscle motion diminsihes this risk, as the veins beneath the calf muscles are the site for the majority of deep vein blood clots in the leg. Your physician may ask for compression stockings or a pneumatic compression device to aid in calf muscle compressions. If you have your own compression stockings, wear them to your operation!

Take a shower or bath, if able, with an antibacterial soap the night before going to the hospital. This can cut down on infections.

Pack a small game, book, magazine to take with you. There is frequently small delays that can be tolerated more easily with a little light entertainment.

Bring a toothbrush. Although most hospitals supply them for inpatients, this small thing can make all the difference to your feeling of well-being.

Lastly, make sure you understand thoroughly what your operation is going to be. It is never too late to ask questions!

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Vincent Mazzarella, MD
General and Vascular Surgery