Preparing Your Health

Although few of the procedures that most orthopedic surgeons perform are considered to be high risk, there is no such thing as "minor" surgery. In order to best prepare you for your surgery day we want to ensure that your over all health is optimized. Most of the procedures that we perform are considered to be elective. Therefore, we want your body to be prepared for surgery and maximize your chances for a successful outcome.

Medical Clearance

• Most of our patients, including all hip & knee patients, and some shoulder & elbow patients require medical clearance in order to undergo surgery. This is typically performed by your primary care physician.
• At your visit with your primary care physician, you will typically have blood work performed and an EKG to look at your heart function. You may have a chest X-Ray and other tests as well.
• Chronic medical conditions do not necessarily mean that you will not be cleared for surgery. However, we want to make sure your health is optimized. It also helps us to identify any medical conditions that may not have been known to you or your physician before.
• In addition to your visit with your primary care doctor, you will have a phone conversation or visit with a member of the anesthsia team regarding your health.
• Even those patients who do not require formal medical clearance will undergo a phone interview with a healthcare professional to ensure that there is nothing unusual about your health that make your surgery more risky.
• It is important to let your surgeon know about any last minute changes to your health, any new rashes or skin changes, or any new dental problems, illnesses or infections.

Your Medications

In general, you want to continue to take all of the medications your have been prescribed up until your surgery. Exceptions to this are listed below:

• Stop taking any of these medications that can thin your blood at least 5 days prior to your surgery:
  • Aspirin (Excedrin, Anacin)
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve)
  • Mobic
  • Etodolac (Lodine)
  • Ketorolac
• If you take blood thining medications including the following, you should inform your surgeon and consult the prescribing physician to see when they should be stopped before surgery. It may be necessary to "bridge" you with another blood thinner in the days leading up to your surgery.
  • Coumadin (Warfarin)
  • Plavix
  • Xarelto (rivaroxaban)
• If you are taking any prescription pain medications prior to surgery, do your best to wean down from these as your body can build up a tolerance to the medication making post-operative pain control difficult.
• The following herbal supplements should be avoided at least 14 days prior to your surgery:
  • Ginko Biloba (bleeding risk)
  • St. John's wort (sedating effects)
  • Ephedra (Ma Huang) (cardiac risk)
  • Garlic (bleeding risk)
  • Ginseng (bleeding and cardic risk)
  • Fish Oil (bleeding risk)
  • Kava (sedating effects)
  • Valerian Root (sedating effects)

Note: This list is not exhaustive and if you have questions about specific medications or supplements you are taking, you should contact your doctor.

Prehab

For certain conditions, your surgeon may elect to have you start prehab (pre-operative rehabilitation). The goals of prehab are two-fold:

• Strengthen the operative extremity and sometimes improve symptoms enough that surgery can be avoided.
• Condition your body to be prepared for the post-operative recovery. Often times, the post-operative exercises are very similar to the ones that were given to you before surgery.

• Even if a formal prehab program is not prescribed, maintenance of your cardiovascular health is encouraged through light aerobic exercises. This will help with your general endurance and ability to recover quickly from surgery.