Lenox Health Greenwich Village: 200 West 13th Street, 6th Floor, New York, NY 10011
646.665.6784
 

Before Your Surgery Instructions

PRE-OPERATIVE INFORMATION

Learn More About Your Surgery:

Visit Dr. McCann’s website to learn more about your procedure.

https://shouldersurgerynyc.com 

One Month before Surgery:

New York State law requires that a Comprehensive Medical Evaluation be performed within 30 days of your scheduled surgery. This exam may be done by Dr. McCann if you are in good health and take no medications or by your medical doctor if you have a medical condition or take any prescription medications.

Alternatively, your pre-operative evaluation may be performed by the medical team at the hospital testing facility. Dr. McCann’s Office Manager will review these options with you.

The following routine lab tests are required:

Males under 40 years: None

Females 12 years and older: CBC, Pregnancy test (child bearing age)

Patients 40 years and older: pending type of surgery and medical condition

If your pre-operative evaluation is performed by your medical doctor, this report must be faxed to our office within one (1) week of your scheduled surgery.  FAILURE TO RECEIVE THIS INFORMATION MAY RESULT IN CANCELLATION OF YOUR SURGERY.

For those patients requiring hospitalization, Lenox Hill Hospital offers private rooms and deluxe suites for an additional fee. If you request such accommodations, please discuss with Dr. McCann’s office manager when you schedule your surgery. However, the regular semi-private rooms routinely offered will provide for all of your post-surgical medical needs.

Two weeks before Surgery:

Herbal Supplements:

While some patients find herbal supplements beneficial, many of them interact with anesthesia medications or can cause other issues during surgery.  The Anesthesia Society of America recommends discontinuing all herbal supplements 2 weeks before surgery.  Below is a list that Dr. McCann considers especially important to stop with an absolute time cutoff and the reasoning:

  • Arnica (1 week)- causes wound healing problems and may increase bleeding
  • Black Cohosh (2 weeks)- increases bleeding risk, may cause unsafe drops in blood pressure
  • Echinacea (2 weeks)- used regularly, may increase risk of infection and wound healing problems
  • Ephedra (24 hrs)- with may cause abnormal heart rhythms, blood flow, or blood pressure
  • Kava (24 hrs)- may dangerously increase depth and length of sedation with anesthesia
  • Garlic (7 days)- increases bleeding risk, may resume 24 hrs after surgery
  • Ginger (2 weeks)- increases bleeding risk, especially with spinal or epidural anesthesia;  can be useful staring 12-24 hrs after surgery to decrease nausea and help prevent blood clots
  • Ginkgo (36 hours)- increases risk of bleeding problems
  • Ginseng (7 days)- increased bleeding risk, can cause low blood sugar when fasting preop
  • St. John’s Wort (5 days)- under anesthesia can cause brain hyperactivity, decrease the efficacy of anti-clotting treatments, and decrease the efficacy and duration of anesthetics and pain pills
  • Tumeric (2 weeks)- can increase bleeding problems
  • Valerian (taper off over 2 weeks beginning 1 month before surgery)- may unpredictably increase the strength and duration of sedatives, prolonging immediate recovery from surgery
  • Reference:  Wong A and Townley SA  Br J Anaesth 2010.

 One Week before Surgery:

Stop taking any anti-inflammatory medicines (Aspirin, Advil, Mobic, Aleve, etc.) as these medications can increase bleeding.  Substitute with Tylenol if you require pain medication during this time.

Stop taking any blood thinners (Plavix, Coumadin, Xarelto, and Eliquis) 5 days prior to your surgery date.

Day before Surgery:

The hospital will call you the evening before surgery to tell you what time to arrive at the hospital, typically 90 minutes prior to the schedule start of your surgery.  TAKE NO FOOD OR WATER AFTER MIDNIGHT.

Dr. McCann will E-prescribe pain medications to your pharmacy the day before your surgery.

Day of Surgery:

Take your usual blood pressure or heart medications first thing in the morning with a sip of water.  DO NOT take diuretics (water pill) or diabetic medications.

  • Leave all valuables at home.
  • Do not wear contact lenses or body jewelry.
  • Bring eyeglasses, hearing aids or dentures as needed.
  • Bring any x-rays or MRI’s you may have.
  • Bring a list of your current medications, times taken, dosages, as well as a list of allergies to medications, foods, or other substances.
  • Bring reading materials: delays are not uncommon on the operating room, we appreciate your patience. If you wish, bring your cell phone which will be placed in a locked cabinet with your personal belongings during surgery.
  • Wear casual, loose fitting clothes so that it will be easy to dress when you return home.

Dr. McCann, the Anesthesiologist, and the Operating Room Nurse will meet with you in the holding area before surgery where you will sign various consents for surgery and anesthesia.

Going Home: Ambulatory Surgery

If you are having ambulatory surgery and going home the same day of the procedure, you must designate an adult escort to bring you home. Your escort may wait in the waiting room or can stay at home/work and wait for Dr. McCann’s call after surgery informing your escort that surgery went well and that you will be able to leave the ambulatory center in 60-90 minutes, depending on your condition. Your escort should be within one hour comminuting distance from the ambulatory center.

You will be given Ambulatory Discharge Instructions upon leaving, and Dr. McCann will call you the following morning to check on your condition. At that time, you will make a follow up appointment in 10-14 days. If you have any problems during the night, you should call Dr. McCann’s office, 646-665-6784, and he will return your call promptly.

Discharge from Hospital: In-Patient

You will be evaluated by the Orthopedic Resident the night of surgery and Dr. McCann will evaluate you early the following morning. The majority of patients are ready to go home the day following surgery. Discharge time is 11 AM. You will be given detailed Discharge Instructions by your nurse upon leaving the hospital.

Dr. McCann’s office manager will call you on the afternoon of discharge or the following morning to check on your condition and schedule a post-operative visit in 10 – 14 days. If you have any problems at home, you should call Dr. McCann’s office, 646-665-6784, and he will return your call promptly.

Return to Work, Driving:

Generally speaking, ambulatory patients may return to office work and drive a car when narcotic pain medications are no longer required, usually 2-5 days after surgery.

Patients who have required hospitalization generally have more extensive operations and may require narcotics for a longer period of time, but rarely beyond 10 – 14 days. Driving and return to office work should not be considered prior to the first post-operative visit. 

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