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Your appointments before surgery

You must attend these appointments:

Who

Where

Surgeon

Outpatient Department
at Tauranga Hospital

Clinical Nurse Specialist

Outpatient Department
at Tauranga Hospital

Preassessment nurse and/or Anaesthetist

Preassessment unit on the first floor at Tauranga Hospital

Admission for surgery

Surgical Admission Unit on the first floor at Tauranga Hospital


Referral-cycle

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Pre-assessment clinic/Anaesthetic


The pre-assessment nurse or anaesthetist will ask you about your general health, medical history, previous anaesthetic, and if there were any problems.

It is important that you are assessed prior to your operation to minimise the risks associated with your surgery. This appointment usually takes place soon after you have seen the surgeon in the clinic.

The anaesthetist will discuss your general health, the types of anaesthetic and pain relief that can be used and the risks and benefits. Consent for your general anaesthetic will be obtained at this time.

A record will be made of any family history of anaesthetic problems. Medicines, pills, inhalers or alternative medications that you use  will be noted and recorded. The following will also be noted; allergies, smoking, alcohol use, and whether you have any loose, capped or crowned teeth. You may have investigations such as blood tests, a heart trace (ECG), urine tests and X-rays. This helps your anaesthetist consider any medical problems which may either affect the risks to yourself, or the likelihood of complications from the anaesthetic or surgery.

The operation will not go ahead until you understand and agree with what has been planned for you. You have the right to refuse if you do not want the treatment suggested or if you want more information or more time to decide.

The pre-assessment nurse will give you time to ask questions about any possible problems and give advice and education on your hospital stay and activities following your surgery.

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Consent

You will need to sign a consent form that says you agree to the operation and the collection of specimens and technical data. A full explanation of the surgery and risks should be given to you before you sign the consent form.

You will usually meet your anaesthetist on the day of surgery, prior to your surgery. They will answer any further questions you may have.

General anaesthesia produces a state of controlled unconsciousness during which you feel nothing. You will receive anaesthetic drugs, strong pain relieving drugs, oxygen to breathe and sometimes a drug to relax your muscles. You will need a breathing tube in your throat once you are unconscious, and will be put on a breathing machine (ventilator) during your operation. When the operation is finished the anaesthetic is stopped and you regain consciousness.

Advantages

  • You will be unconscious during your operation.

Risks

  • Common side-effects (<1 in 100) include headache, sore throat, feeling sick or vomiting, dizziness, bladder problems, damage to the lips or tongue, temporary confusion or memory loss, aches and pains and bruising/soreness.
  • Uncommon side-effects (<1 in 1000) include chest infection, muscle pains, damage to teeth, becoming conscious during your operation, slow breathing and existing medical conditions getting worse.
  • Rare side effects (less than 1 in 10,000+) include damage to the eyes, serious drug allergy, nerve damage, equipment failure, heart attack, stroke or death.

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Blood products

There is a small risk that you may need to have a blood transfusion. A transfusion of blood or blood products is only given when the benefits outweigh the risks.

You have the right to decide whether you want to have the treatment or not. You can ask as many questions as you need, to ensure you are making the right choice.

You will be asked to sign a consent form to show that the benefits, risks and alternatives for your treatment, including transfusion of blood products, have been explained to you. The consent form will confirm that you have been able to ask any questions and that you agree to receive the treatment.

If you refuse to have the transfusion when needed, the risks to your health are likely to increase.

Further information about blood transfusions can be found at: www.nzblood.co.nz

The contact for the Tauranga Hospital Liaison Committee for Jehovah Witnesses is Clarence Ririnui and he can be contacted on 07 572 3462 or 027 776 4898.

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Bowel Preparation

You may require some form of bowel preparation prior to your surgery. You will be advised at the Pre-admission Clinic, if this is applicable to you, and given instructions from the nurse.

Limited bowel preparation

  • You will be given one or two enemas on arrival to hospital on the day of surgery
  • You will be able to eat a normal diet up to 6 hours before anaesthesia

Full bowel preparation

  • Three days before your surgery you will commence the low fibre diet that is shaded in the table below. Do not have any red or purple jelly or juices as this may stain your bowel.

Food-table

  • On the day before to your surgery you will need to drink clear fluids only. Do not have milk in your tea or coffee, or fruit juice with pulp in it. Please ensure no food is eaten.
  • On the day before to your surgery you will have two oral Fleet drinks.

First bottle of Fleet:

Start

Start + 10 mins

Start + 20 mins

Mix 15mls (1/3) of the bottle of Fleet with one full glass (approx. 250mls) of clear liquid. Stir and drink the whole glass,

Mix 15mls (1/3) of the bottle of Fleet with one full glass (approx. 250mls) of clear liquid. Stir and drink the whole glass,

 

Mix 15mls (1/3) of the bottle of Fleet with one full glass (approx. 250mls) of clear liquid. Stir and drink the whole glass.

Between the first and second bottles of Fleet:

Take at least an additional 3 glasses (approx. 250ml each) of clear liquid. More can be taken as desired to replace water lost from your body and to ensure a clean bowel.

WaterX3

Second bottle of Fleet:

Start

Start + 10 mins

Start + 20 mins

Mix 15mls (1/3) of the bottle of Fleet with one full glass (approx. 250mls) of clear liquid. Stir and drink the whole glass,

Mix 15mls (1/3) of the bottle of Fleet with one full glass (approx. 250mls) of clear liquid. Stir and drink the whole glass,

Mix 15mls (1/3) of the bottle of Fleet with one full glass (approx. 250mls) of clear liquid. Stir and drink the whole glass.

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Clear liquid options

These should not include solid materials, milk or milk products, or be coloured red or purple.

Hot options: (No milk or creamer. No solid materials)

  • Black or herbal tea
  • Black coffee
  • Marmite or Vegemite drinks
  • Clear soup

Cold options: (No red or purple colouring)

  • Water - still or sparklingLiquid-options
  • Coke, lemonade, ginger beer, tonic etc
  • Pulp free fruit juice
  • Sports drinks (low sodium)
  • Cordial
  • Jelly (no fruit)
  • Clear ice blocks

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Eating and Drinking Instructions

You may eat (unless you have been instructed otherwise) up until six hours before your operation. Do NOT chew chewing gum, suck lozenges or lollies in the 6 hours prior to surgery.

Keep a note of the time and date you stopped eating and drinking.

You may continue to drink up to 400mls of clear fluids up to 2 hours before the time of your operation, or your 2 cartons of Nutricia PreOp®.

Morning (am) surgery admit 7am:

  1. Nutricia PreOp® drink at 5.30am
  2. Nutricia PreOp® drink at 5.45am
  3. Finished by 6.00am

Afternoon (pm) surgery admit 12pm (midday):

  1. Nutricia PreOp® drink at 10.30am
  2. Nutricia PreOp® drink at 10.45am
  3. Finished by 11.00am

Clear fluids are any liquids that you can see through, this includes water and fruit juice without pulp. You should avoid carbonated (fizzy) drinks and drinks containing milk or caffeine (including tea and coffee).

Nutricia PreOp® is a clear lemon-flavoured carbohydrate (sugar) drink designed to prepare your body for your operation.

  • Best served chilled
  • Shake well before use
  • Drink 2 cartons of the PreOp® as instructed by the nurse.
  • Drink both cartons of PreOp® within 15 minutes

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What do I need to do to prepare myself for surgery?

It is important that you maintain your current level of fitness. Staying fit will help your goal of having a smooth recovery from surgery. You should also continue your normal eating pattern. There is no need to eat either more or less than what is normal for you. Good nutrition prior to surgery will help reduce the risk of complications and decrease your length of stay in hospital. A healthy diet and a healthy weight are beneficial for your recovery.

To help prevent a wound infection after your operation, we ask thatShower you use Chlorhexidine 4% skin wash (provided). The tube is intended for two washes before your operation. We ask that you shower or bath the night before and the day of your surgery. (If you have a shower we would prefer that you shower rather than bath).

When you shower or bath, wet your body all over and then turn the shower off or stand up on the bath. Using half the tube of Chlorhexidine soap lather your body and hair with foam and remember to wash any skin folds and inside you tummy button. Be careful to avoid contact with your eyes. Leave the foam on the skin for at least two minutes and then rinse off and dry your body thoroughly using a clean towel.

Redress in clean clothes.

Phone-icon

You will be phoned in the day or two prior to your Admission day by a nurse to check that you understand your pre-admission instructions, and are fully prepared for surgery.

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Preparing for your hospital stay

Smoking and your lungs

We strongly advise that you try to avoid getting chest infections (stay away from people with coughs and colds) and give up smoking. Continuing to smoke doubles your risk of complications.  It also compromises wound healing and can add to the risk of leaks developing from the bowel staple line.

If you need help to quit smoking, please contact resources such as your Doctor (GP) or Quitline (0800 778 778) www.quit.org.nz or www.health.govt.nz\tobacco

Bay of Plenty District Health Board has a "No Smoking" policy onsite and throughout hospital grounds.

Alcohol and drugs (such as Cannabis and P)

We encourage you to minimise your drug/alcohol consumption prior to, and after your surgery. Drug/alcohol consumption significantly increases the risk of complications and compromises healing. It can also affect your anaesthetic and pain relief requirements.

Exercise

It is advisable to remain as active as possible leading up to your surgery, to strengthen your muscles and speed up recovery.

What to do if you become unwell

It is important we know if you have any of the following:

  • A cold or cough.
  • Skin infections - such as a sore, graze, pimple or eczema, especially around your operation site.
  • Burning pain or passing urine more often than usual.
  • You are generally unwell - such as diarrhoea, vomiting or high temperature.

For your safety it is important that we know about any of the above prior to your operation. You will receive a phone call from the Surgical Admission Unit two days before your operation day to check whether you are well.

If you do not receive a call and you are unwell please phone the hospital where you are having your operation and ask to speak to someone in the Surgical Admission Unit, Tauranga 07 579 8000.

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What do I bring to hospital?

  • Medications - Bring in all medications, including over the counter and herbal medications. Don't stop any medications unless told to do so by your anaesthetist or surgeon.
  • You should leave valuables at home (eg; jewellery, bank or credit cards etc.) The Bay of Plenty District Health Board does NOT take responsibility for stolen items.
  • You may bring something to read.
  • Night clothes, easy to wear day clothes, shoes or slippers,toiletries.
  • You may also bring your own pillow which will make your hospital stay more comfortable. Please make sure your pillowcase is not blue or white (these are hospital colours).
  • Please name your personal belongings.
  • Mobile phones may be used on the ward, but please be considerate of other patients

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Preparing for your discharge home from hospital

It is important to consider how you will manage your care in your home once you are discharged from hospital. It is essential to start planning now.

Before you come to hospital, organise your daily living needs in preparation for your return home. As an example, you can prepare meals and freeze them.

Please make plans for someone to drive you home. This list will help you prepare for your return home:

  • Arrange for someone to take me to hospital.
  • Arrange for someone to take me home on the day I am discharged.
  • Arrange for someone to stay with me for a few days after discharge (if I live alone).
  • Tell family, friends and/or neighbours about my operation.
  • Organise family/friends who are willing to help with chores/housework.
  • Cook extra meals and freeze them.
  • Buy extra groceries and/or arrange for someone to do my grocery shopping.
  • Organise someone to look after my pets.
  • Pack ALL my medications/herbal products/alternative medications.

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Last updated: October 16, 2017