Preparing for Surgery

Depending upon the planned surgical procedure and your medical history, you may be required to undergo Pre-Admission Testing, medical clearance, and/or obtain clearance from a specialist. You may be required to get labs or imaging prior to your surgery – if that is the case, please have these done 1 week before your surgical date.

• If your primary care provider is outside the Scripps network, please have the notes faxed to our office at the number above.
• Cardiologist clearance: required if you have cardiac stents, a pacemaker, history of an arrhythmias, have had any kind of heart surgery, or have had a heart attack.
• Hematology Recommendations: may be requested if you have a personal history of blood clot (DVT or PE) or a strong family history of blood clots.
• Smoking: Smoking is not only harmful to your heart and lungs, but significantly increases the chance that you develop a complication after surgery. Now is the best time to quit. Talk with your primary care physician who may be able to help.

Do NOT take anti-inflammatories (Aspirin, Naprosyn, Aleve, Advil, Motrin, Ibuprofen, etc.) within 7 days of surgery. These medications increase the bleeding risk during/after surgery. Tylenol is OK.

Blood Thinners: If you take a blood thinner (Warfarin, Coumadin, Plavix, Clopidogrel, Aspirin, Heparin, Aggrenox, Lovenox, Enoxaparin, Xarelto, Rivaroxaban, etc.), you MUST have specific instructions from the prescribing physician regarding stopping and restarting of these medications. In general, we recommended these medications be discontinued approximately 7-10 days prior to your planned procedure. Please follow your prescribing doctor’s recommendations.

Birth Control: may increase the risk of developing a blood clot following lower extremity surgery. For your safety, it is recommended that you stop birth control until you are full weight bearing and are walking normally without crutches.

If you are currently on a narcotic (Vicodin, Percocet, Oxycontin, etc), decrease its use now. Your body gets used to taking this medication and it may be difficult to control your pain after surgery.

• Stop taking Aspirin, Anti-inflammatory medicines (NSAIDs, ibuprofen, Aleve, etc), fish oil, or Vitamin E supplements 1 week before surgery. If you are on a blood thinner (Warfarin, Lovenox, Pradaxa), please check with Dr. Cinque and/or your primary care physician when to stop these medications.
• Make arrangements for a friend or family member to take you home (not a Taxi or Uber!!)
• Make arrangements to take time off work as necessary.

You will receive a call from the Surgery Center with the time of your surgery, as well as what time to arrive. Please note that the hospital/surgery center (not our office) determines the surgery schedule each day. As such, changes/delays in your OR time may occur due to unforeseen emergencies.  Please be understanding of the dynamic nature of the OR schedule.

• Take a shower using the chlorhexidine gluconate wipes you received in the office. This is a special type of soap that kills germs on contact and can continue working for up to 24 hours!  Make sure you apply the solution directly on your skin with the sponge, then rinse off afterwards.
• Do not have anything to eat or drink after midnight the night before your surgery!!! This includes gum, candy, mints, water, coffee, or juice. You need to have a completely empty stomach for the safety of anesthesia. If you take medications in the morning, please ask your doctor or anesthesiologist about whether or not to take these on the morning before surgery.

You will meet the Dr. Cinque the morning of surgery to review the planned procedure, answer any remaining questions, and mark the operative site with his initials.

Anesthesia:

You will meet with the anesthesiologist prior to surgery and have the opportunity to ask questions about the type of anesthesia you will be receiving.

• Regional (nerve block) Anesthesia: is a technique where a portion of the patient’s body is rendered insensitive (numb) during surgery, like at the dentist’s office. You will also be given sedation so that you will be sleep throughout the procedure, however you continue to breath on your own.
• General Anesthesia: is when you are completely asleep during the procedure and require a breathing tube.
• Please let Dr. Cinque or the anesthesiologist know if you are allergic or have had a bad reaction to pain medication or anesthesia in the past.

What to Bring:

• Photo ID and Insurance Card
• Glasses if you wear contact lenses
• Telephone numbers of family member or friend
• List of Your Medications
• Small Bag with personal items if you are staying overnight (will be securely stored during surgery)