Gyne Surgery

When we meet in the office, I review different management options that are possible for your condition. I go through the medical and surgical options as well as special methods that may be applicable to your condition. If we agree on surgery, I hope you will find this useful.

How do we arrange surgery
Day of Surgery
In the OR
In the Hospital
How do we arrange surgery

We had our discussion in the office, and you chose the surgical option. We had our discussion about the other options as well as possible side effects and complications. We then filled in the hospital documents for surgery.

Our receptionist will then book a date for your surgery. About the week prior to your date, the hospital will call you for a pre-operative appointment. This is done either in the hospital or over the phone. A nurse will go through the questionnaire that you were given in the office. It has questions regarding your past medical history.

Depending on your age and the type of surgery you are booked for, you may have some investigations done. These may include only the questionnaire and the interview with the nurse, or may include blood work, EKG, etc.

Sometimes, and especially if you have medical conditions that make you a high risk surgical candidate, an anesthesia consult will be arranged for you. 
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Day of Surgery

You are expected to be in the hospital 2 hours before the time of your surgery. In general you should have nothing to eat or drink after midnight the night before surgery. If your surgery is later in the day, you should have nothing to eat or drink 8 hours before surgery. Avoid fat in any food you eat before surgery. In general clear fluids, juices, jello, teas, etc are fine.

If you take daily medications, generally you should take them on the morning of surgery, with a small amount of water. If you are diabetic, or on a blood thinner, especially Warfarin, make sure you communicate this with us or with the nurse in the pre operative screening visit. You may need special arrangements. You do not take your diabetes medication the day of surgery. Blood thinners need to be stopped a few days before surgery.

You will then go to the pre surgical suite, and will be asked to change into a hospital gown. There are some surgeries where you will be advised to put on elastic stockings that were prescribed to you in the office.

Your surgery may be delayed. There are many factors that can affect surgery, and surgeries may take more time than planned. Again, babies come at all times, and we may be delayed for an emergency C Section.
In rare occasions, and for unseen cirmucstances, your surgery may be cancelled on that day. This usually happens for matters out of our control. If this happens, we try to book as soon as we can.
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In the OR

A nurse will come and greet you in the holding area, and then walk you to the OR. We usually work in rooms 9 or 14. In the OR I usually meet you before you sleep, and ask you "who are you" and " what are you doing here today?" We ask everyone this question, once before you sleep, and once again after you sleep. We actually have to review your name and your surgical procedure booked against the documentation that we have in the consent form and on the hospital paperwork both before and after we put you to sleep.

You will then meet the OR nurses, the surgical assistant and the anesthetist. Everyone will be in greens, and with head cover and mask. And the room will be cold. If you feel too cold, ask a nurse and she will bring you a warm blanket.

It is also normal to feel anxious. You do not go to ORs every day, and you are having surgery soon. This is normal. Talk to any of us if you think you want to discuss these feelings.

You will then have an IV started, and then saline fluid to test it. You will then get the medications that put you to sleep. This sometimes burns or stings, and you may feel drowsy before you actually go to sleep.
Sometimes you may not go to sleep. Depending on the type of procedure and the anesthetist on that day, they may give you a spinal anaesthetic. This is a very safe and effective way of prevent pain, and allows us to do surgery. You will typically not feel any pain, and many times, they give you something that makes you relax. This might make you dose off.

You will wake up after surgery in the OR, but you will start to really feel alert in the recovery room. We wait until you are fully awake before we give you something for pain. If you are able to communicate to the nurse in recovery that you are in pain, the nurse will give you a pain killer.

I will talk to you after the surgery is over, and will let you know what we did and how things went. I make sure that your nurse also knows. You may want to ask again about what we did, and he or she will communicate this to you again.
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In the Hospital

After surgery you will usually be taken to the Med/Surg floors. These are routinely the sixth floor (6F). Rarely, when beds are limited, you may be taken to other floors (examples are 7G or 3F).

You usually will stay in the hospital 1-2 days depending on the tyoe of surgery done .Rarely you may need to stay longer. The day of surgery you will be given pain medications and may feel drowsy. You will have an IV running with fluids all day long. To help you evacuate your bladder, a catheter will drain your urine on the that day.

On the first day after your surgery we take the catheter out, and encourage you to walk out of bed. The first one or two times out of bed, a nurse will help you as you may feel a bit dizzy. You will be encouraged to move around the floor and breathe deeply as well as move your feet around, and up and down. This will help your recovery, and prevent possible clots in the legs. I routinely use blood thinner shots after major surgeries for the duration of the hospital stay, to prevent clots. This increases the risk of bruising on your tummy, but this is minor compared to having a clot after surgery.

On the day following your surgery you will feel much better. You will start eating and drinking and passing gas, and may even have a bowel movement. If you feel strong enough, you may go home on that day.

I usually give a prescription for a pain killer and a stool softener, and will see you in the office 1-6 weeks later. In the rare event that we use staples for your skin, I will see you within 7-10 days to have them removed.

In case you feel unwell in any way, you need to go to the Emergency department in the hospital,  especially if it is after hours.

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Gyne Surgeries

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