Preparing For Surgery - A Guide

Surgery. For many of us with rheumatoid arthritis and other chronic illnesses, surgery is as much a part of life as fatigue or blood tests or having to make a sock-put-er-on-er out of 2 back scratchers, an old fork, and some duct tape. No on that last one? Just me?

Well, still, it holds true. I am about to embark on my 3rd surgery on my right ankle to hopefully, once and for all, fix the problem and give me a flat foot that actually fits in a shoe instead of the dumpster-fire-shaped blob that, as of now, comprises the termination of my right leg.

Undergoing surgery... again

Now, I know what you’re saying. Getting another surgery to fix previous surgeries sounds a lot like a hat on a hat… on another hat… on a tiara… on a hoodie… on top of a toupee. I’d have to say yes, in some ways, that’s correct. How many times can I surgerize, err… surgerificize? Hmmm, surgicalize! Yeah, that’ll do. Ahem, anyway, the point is, it’s a natural question.

How many times can I get the same problem fixed before I just accept that it can’t be fixed? To that I say- however many times a surgeon says he will fix it until it gets to a point where I can live with it. Whatever the outcome, it will be better than literally walking on the side of my foot, which is what I’m doing now. So, I either get it fixed or join a circus sideshow as the amazing sideways foot-having boy.. err, man? Person? That got away from me, but you get the idea.

My how-to guide for RA surgeries

So in honor of my upcoming surgery, I figured I’d put together a little guide of what you should do to prepare for your surgery and hospital stay. I'll also talk about what to do afterward, using the things I’ve learned over the past 30 years of hospital visits and ER trips. It will be divided into 2 parts because it’s a lot. Some of it will be obvious to you, but there are other things you might not have thought of, so I hope it helps. Let’s start with what to do the days before the actual procedure.

Preparing for the procedure

First, you may or may not receive an enema kit to prepare. Yes, it’s uncomfortable, yes, it’s gross, and yes, it’s a pain in the butt. Literally. Ha! That worked out perfectly, didn’t it? Still, even if you don’t have to take that drastic step, you will likely be instructed not to eat solid food or cloudy liquids up to 12 hours before. This is because general anesthesia shuts down your bowel, more or less, and they don’t want food in there, stuck, rotting away.

In addition, if the surgery is on your legs, you likely won’t be able to get to a bathroom for at least 24 hours, if not longer. So, the less you have inside you, the better. I wouldn’t stuff myself with a 7-course meal that ends exactly 12 hours before surgery, either. Trust me, I’ve learned from experience. Awful, smelly, awkward experience.

What to know the day of

You’ll want to schedule the surgery as early as possible, and this is for several reasons. First, you want your doctor to be as bright-eyed and bushy-tailed as possible. You don’t want to be their last surgery of the day when they are late to a Knicks game and rushing to get that hip ripped out and the metal one shoved in so they don’t miss the tip-off. Yes, professional ethics and the Hippocratic oath and all that, but doctors are also humans – do you really want to take the chance?

Next, the earlier you start, the earlier you finish, and the longer you can spend recovering in the actual hospital. Insurance these days doesn’t like to pay for inpatient care unless they have to, and if you finish your procedure at 11 pm, they will count that as a day in the hospital. You want to be in your room, recovering for as long as possible before they boot you.

Finally, the earlier the procedure happens, the greater the chance you will get to eat dinner or lunch in the hospital! I know, not exactly gourmet, but still, you will be hungry, and once they give you the green light, you will want to chow down! Getting food in a hospital after dinner is exceptionally difficult without help, which segues nicely into the next section: what to bring with you.

Things to bring with you

Things to bring to the hospital: snacks, cell phone chargers, portable game units, laptops – all pretty standard stuff.

Here are some of the things you might not think of: extension cords, power strips, a decent pillow, extra blankets, moisturizer, socks (they may or may not provide), a gift card for the nursing staff (it helps to grease the wheels in your favor), glasses are better if you wear contacts, salt, pepper, and ketchup packets if you use them, pen and pad (you never know), some cash just in case, and finally, make sure to bring a small number of your medicines and pills. You never know what the hospital may or may not have, and, frankly, sometimes you may not be able to get pain meds or other things in time. It’s always good to have an emergency supply.

That’s it for this half, but there’s much more to discuss. Don't worry, I will prepare you fully for whatever kind of procedure you have coming up. In part 2, we’ll talk about preparing physically and mentally before heading into the OR and recovery. Talk soon!