Have realistic expectations
Surgery can be stressful, but if you plan ahead, you can make your experience smoother and more comfortable. You can help make your surgery a success by ensuring you are prepared for it mentally, physically and financially. Talk to Dr. Maxwell about how much time you’ll need to be away from work. Make sure family or friends can help you with errands and household chores for a few weeks after surgery. This preparation below includes planning ahead for your surgery and having realistic expectations about what surgery can and cannot do for you.
Being financially prepared
Many patients want to know exactly what they will need to pay out-of-pocket for a surgery. You will need to factor in the anesthesiologist’s fees, the Hospital / facility’s fees, lab tests, MRIs and other diagnostic tests which are all billed separately by the physicians providing these services. Dr. Maxwell’s professional fees for your surgery will include all postoperative visits for 90 days after the date of surgery.
There are many variables that will influence the amount that you will have to pay for services that you receive. The design of your health insurance plan is the first and foremost deciding factor that will influence your out-of-pocket costs. For example, you may need to pay an annual deductible before your insurer will begin reimbursing you for care that you receive. Your insurer may also reimburse your out-of-network expenses according to a formula that is different from what is anticipated. It is important to understand that your actual final costs may vary based upon factors specific to your plan. Arctic Spine cannot determine what is a “reasonable and customary” or UCR charge. That determination is made by your health plan.
If you require more information on your health policy, you can ask your employer’s benefits group to provide the coverage type and percentile you will be responsible for. Or alternatively, contact member services from your insurance company. Most healthcare insurers have member areas on their websites, online question forms and in some cases live chats with customer service representatives. You can also call the phone number listed on the back of your insurance card.
Being physically prepared
Do not eat or drink after midnight before your surgery. The anesthesiologist will not put you to sleep if you have anything in your stomach and your surgery will be cancelled. However, it is okay to have a sip of water with your necessary medications the morning of surgery. Just note the time so that you can tell your anesthesiologist. Examples of necessary medications include decadron, medications for seizures, high blood pressure, thyroid or heart disease. Please bring your medications list, with the dosages and instructions to your pre-op appointment with Arctic Spine.
Blood thinning medications need to be stopped 10 days prior to surgery. These include but are not limited to Coumadin, Aspirin, Plavix, Ticlid, Lovenox, Dipyridamole, Dicoumarol. Make sure Dr. Maxwell knows that you are taking these and notify the prescribing physician that you are having surgery. Please contact their office for instructions regarding stopping these medications.
Non-steroidal medications need to be stopped as soon as possible before your surgery. These include as Aspirin, Advil, Ibuprofen, Motrin, Voltaren, Aleve, Naproxen, Excedrin etc will need to be stopped 5 days prior to your pre-operative testing.
You must commence your 10 day course of Keflex antibiotics 3 days before your surgery date. These will be prescribed to you by our office.
Any vitamins and herb medicines such as arnica, fish oil, vitamin E, gingko biloba, ginseng, garlic and green tea will need to be stopped 5 days prior to your pre-operative testing. These increase your risk of bleeding. Grapefruit seed and and Grapefruit interacts with many medications such as blood pressure and cholesterol medications.
If you feel you are developing cold symptoms or you are actively being treated for an infection prior to surgery, please notify our office as soon as possible.
Dental procedures are to be avoided 3 weeks prior to surgery and for 6 weeks following your surgical procedure. Patients with spinal instrumentation will need to have antibiotic coverage prior to dental procedures for 2 months after surgery.
You must tell our office of all the medications you take. This includes herbs, supplements, and over-the-counter medications such as ibuprofen or other NSAIDs (non-steroidal anti-inflammatory drug). You may be told to stop certain medications before surgery. Smoking may slow bone healing. If you smoke, your surgeon may talk to you about stopping before surgery. Do not eat or drink anything for 8 hours before surgery. This includes water, gum, and mints.
Day of your surgery
You should arrive before your allotted surgical time at the facility and sign in at the reception desk. One of the staff will meet you in the lobby and escort you to the preoperative area. Your caregiver should accompany you on the morning of surgery. However, your caregiver will not be allowed to accompany you into the preoperative area without prior approval from the director of nursing.
Once you have been escorted to the preoperative area, you will change into a gown. You will be assessed by an anesthesiologist, Dr. Maxwell and a registered nurse. The surgical procedure will be reviewed, and you will be asked to sign consent forms. The medical staff will start an IV and prepare you for surgery. Typically you will spend one to two hours in the preoperative area. When you are in the operating room, you will be under sedation during the procedure. The goal of the anesthesia, in addition to local anesthetic, is to keep you comfortable. A typical surgery will last anywhere from one to three hours.
Risks and complications of surgery
All surgical procedures carry risk and the possibility of complications. These include but are not limited to:
• Swallowing problems
• Persistent hoarseness
• Recurrent laryngeal nerve palsy
• Side effects from anesthesia
• Failure of the graft to fuse
• Damage to nearby tissues
• Bone graft shifting or displacement
• Bleeding and possible need for transfusion
• Spinal cord or nerve damage including paralysis