Instructions for Your Surgery
- Most surgical procedures require pre-operative clearance. Your surgical scheduler will discuss this with you when your surgery is being scheduled.
- Pre-operative clearance entails a physical examination by your primary care physician, and depending upon your age, you may also require blood work, an EKG, and a chest x-ray.
Your Day at the Hospital
- Most of the orthopedic surgeries performed today are done on an outpatient basis. Total joint replacement surgery and certain fracture care procedures require a stay in the hospital for one to several days.
- You will be asked to arrive at the hospital two hours prior to your scheduled surgical time.
- After arrival, you will be evaluated by nurses and a member of the anesthesia team.
- Post surgery, you will be transported to the recovery room or the ambulatory surgery care unit.
- Most patients undergoing ambulatory surgery will be ready to go home within one to two hours after surgery is completed. Please make arrangements for someone to accompany you home after your surgery. This is required by state law. If you are undergoing straight local anesthesia, such as minor hand surgery procedures, you may be able to go home yourself. Please ask your surgical scheduler or surgeon if you have any questions in this regard.
- Please be certain to give your surgical scheduler in our office a working phone number (such as a cell phone) to reach you on the day before and of your surgery, in case we need to contact you regarding a change in the scheduled surgical time.
Where to go the Day of Surgery
We perform surgery at both Mount Sinai Hospital in Manhattan and Mount Sinai Hospital of Queens.
- Location: Mount Sinai Medical Center, 1468 Madison Avenue (Madison Avenue & 100th Street)
- Go To: The Guggenheim Pavillion, 2nd floor, Check-in Surgery
- Telephone: 212-241-7778
- Check in time: Arrive 2 hours prior to surgery
Queens- Main Hospital Operating Rooms
- Location: Mount Sinai Hospital of Queens
- 25-10 30th Avenue, Long Island City (Corner of Crescent Street & 30th Avenue)
- Go To: 5th floor, Check-in Surgery
- Telephone: 718-267-4214
- Check in time: Arrive 2 hours prior to surgery
Queens – Ambulatory Annex Operating Rooms
- Location: Mount Sinai Hospital of Queens Ambulatory Surgery Center 25-25 30th Road (Between Crescent Street & 30th Road)
- Go To: Main floor, Check-in Surgery
- Telephone: 718-267-4251
- Check in time: Arrive 2 hours prior to surgery
Preparing for Surgery
- Do not eat or drink anything after midnight the night before your surgery.
- If you take daily medications (i.e. heart, blood pressure, diabetes medications), you may need to take them the day of surgery with a sip of water. Please consult your prescribing physician or call the office for specific questions.
- Do not take any aspirin, aspirin-containing medications, or nonsteroidal antiinflammatory (NSAID) medications (such as Advil, Aleve, Motrin, Ecotrin, Naprosyn, etc.) for 10 days prior to your surgery. These medications may cause increased surgical bleeding. You may continue to take Tylenol (Acetominophen) up until your surgery.
- If you take anticoagulation medications such as Coumadin or Plavix, you will need to discontinue these medications 7-10 days prior to your surgery. Please discuss this with your surgeon and your prescribing physician.
- If you take Glucophage for diabetes, you will likely need to discontinue this medication 1-2 days prior to your surgery, as it can interact with the anesthesia. Please discuss this with your surgeon and your prescribing physician.
- Please tell your surgeon and anesthesiologist if you take herbal supplements.
- Please do not drink alcoholic beverages 24 hours prior to surgery.
- Please do not smoke at least 24 hours prior to surgery. It is best to stop at least one week before your surgery. Smoking also adversely affects wound and bone healing – so quitting is best.
- If you develop a cold, fever, or chest congestion prior to surgery, please call the office immediately, as we may need to reschedule your surgery.
- Please bring a list of all your medications with you to the hospital, so that they can be reviewed by the nursing staff and your anesthesiologist.
- Please be certain to have your pain medication prescriptions filled before your surgery, so that you can take them as soon as you get home.
- If you are having ambulatory surgery, please make arrangements for someone to accompany you home from the hospital after your surgery. You will not be permitted to leave the hospital without someone in attendance. This is required by law. If you cannot arrange for someone to accompany you home, arrangements can be made by your surgical scheduler or the hospital. If you are undergoing straight local anesthesia, such as minor hand surgery procedures, you may be able to go home yourself. Please ask your surgical scheduler or surgeon if you have any questions in this regard.
- If you have any further questions regarding these matters, please do not hesitate to call the office to speak to your surgical scheduler or your surgeon.
Practical things to know…
- If applicable, remember to bring your cane or crutches with you to the hospital. If you did not receive crutches before surgery, they can be fitted for you at the hospital after your surgery, but this may delay your discharge.
- Please do not bring jewelry or other valuables with you to the hospital.
- Please try not wear contact lenses to the hospital, as they cannot be worn into the operating room. Wear your eye glasses and bring along an eye glass case.
- If you wear dentures, please bring along a container to keep them protected while you are in the operating room.
- Please wear clothing that is loose, comfortable and easy to remove. You will receive specific hospital clothing (such as robe, gown, slippers, etc.) from your preoperative nurse.
- Please remove all make-up, nail polish, hair spray, and body jewelry prior to leaving your home.
- If you are under 18 years of age, a parent or legal guardian must accompany you to the hospital.
- Get a good night’s rest before surgery.
Surgery can be performed under local, regional, or general anesthesia. The anesthesiologist will help you determine which kind of anesthesia will be best suited for you.
- Local anesthesia numbs a specific area, such as a finger or joint (knee).
- Regional anesthesia numbs your entire extremity (such as an arm or a leg).
- General anesthesia puts you completely to sleep.
When You Get Home After Surgery
Post-operative Arthroscopy Instructions
- Appointment: Please schedule your follow up appointment for 1 week after your surgery.
- Dressing Care: You will leave the hospital with a dressing covering your wound. If there is blood that appears on the dressing DO NOT PANIC. This is normal. It will usually stop within a few hours. If the spot continues to enlarge, put a sterile gauze and ace wrap over the area and call the office at 212-289-0700. Otherwise, if the dressing gets dirty or begins to fall off, you can replace it with sterile gauze and an ace wrap.
- Removing Bandage: You may remove the dressing 3 days after surgery and place Band-Aids on the wounds. The surgeon will instruct you in the recovery room if a formal incision was made. In that case, do not remove the dressing. This will be done at your first follow up visit.
- Showering: After you remove the bandage on day 3, you may shower and allow the wounds to get wet. Do not soak in a tub. Keep your wounds clean and dry. The surgeon will instruct you in the recovery room if a formal incision was made. In that case, do not allow the wound to get wet for 1 week.
- Sutures: These usually will be removed at the first post operative visit.
- Ice: Apply ice intermittently to the surgical area for 20 minutes, every 1-2 hours, as needed.
- Medication: The anesthesia may last for several hours following surgery. As it begins to wear off, please take the pain medicine that was prescribed for you. Pain can last for several days. These medications may make you drowsy, so please curtail your activity and do not operate heavy machinery or drive a motor vehicle.
- Emergency: If there is any problem at all, please do not hesitate to call the office at 212-289-0700.
- Home Exercise: Please start the home exercise program during your first post operative week (an exercise sheet will be provided). In certain cases, the surgeon may instruct you to delay starting exercises until after your first post-operative visit.
- Pillow: Do not place a pillow under your knee for prolonged periods of time, as this may lead to a knee flexion contracture. You may place a pillow under your foot and ankle to help elevate your leg.
Post-operative Knee Arthroscopy Instructions
- Swelling: Keep your leg elevated as much as possible for the first few days after surgery.
- Bearing Weight: After most arthroscopic surgeries, you are allowed to walk and put all of your weight on this leg. We advise you to use crutches, a cane, or a walker for a period of time after surgery to help you. Please take it slow and avoid long periods on your feet for the first week. In some cases (such as non-weightbearing) the surgeon may instruct you otherwise .
Post-operative Shoulder Arthroscopy Instructions
- Sling: After surgery, a sling will be placed on the operative shoulder. Your surgeon may tell you to remove the sling several times a day during your exercises and when showering. Sleep with your sling on.
- Exercises: NO lifting objects or raising your arm under its own power. Depending on the type of shoulder surgery performed, your surgeon will indicate which activities/exercises are permissible during the post-operative period.
Post-operative Upper Extremity Surgery Instructions
- Elevate your arm above the level of your heart for at least 48 hours after surgery. Avoid dangling your hand by your side. When wearing a sling, adjust it to keep your hand near your opposite shoulder, with your elbow flexed at a 90 degree angle. When sitting, prop your arm up next to you on several pillows, with your fingers pointed towards the sky. When sleeping, elevate your arm on a pillow or across your chest. If you feel that your dressing is too tight, you may either loosen the outer ace bandage, or call the office for instructions
- Keep the dressing in place and clean and dry until your first post-operative visit, unless otherwise instructed. When showering, cover the dressing with a plastic bag and secure it with tape and/or a rubber band above the dressing. If your dressing gets wet, please call the office immediately. Commercial dressing/cast protectors for showering can be purchased at a surgical supply store.
- If your fingers are not enclosed in the dressing, you should gently flex and extend the digits approximately every hour while awake, unless otherwise instructed by your surgeon.
- Observe your fingers for warmth, color and sensation. Call the office if you notice any concerning changes.
- You will be given a prescription for post-operative pain medicine before your surgery. Most upper extremity surgery is performed under a regional block, which will usually last for a number of hours after you get home from your procedure. When you get home, have something light to eat and then take the pain medicine that was prescribed for you. DO NOT wait until you feel the pain. Pain usually lasts for several days, so do not be concerned. The pain medications prescribed may make you drowsy, so please curtail your activity and do not operate heavy machinery or drive a motor vehicle.
- Unless otherwise instructed by your surgeon, you should avoid any aspirin, aspirin-containing medications, or nonsteroidal antiinflammatory (NSAID) medications (such as Advil, Aleve, Motrin, Ecotrin, Naprosyn, etc.) for 3-4 days after your surgery, as these may increase bleeding at the surgical site. You may take Tylenol (Acetominophen) without risk.