Surgical and Post Surgical Instructions
Name: ________________________________________
1. Nothing to eat or drink (NPO) after midnight the night before surgery. You may take your scheduled
2. You may not drive yourself home from surgery. For outpatient surgery, someone should be at your home
with you or immediately available the night of surgery.
3. Pre –Op Medications and Supplements: Please STOP taking any of the following listed medications 5
days prior to surgery, these may lead to bleeding. The medications include: Alka Seltzer, Asprin,
Coumadin (unless directed by your surgeon for this procedure), Excedrin, Heparin, Nuprin, Plavix, Pletal,
Salsalate, Ticlid, Toradol, Vitamin E, Vitamin B, St. John’s Wort, Fish Oil or any other mega dose
vitamins. You may take a multivitamin up to the day of surgery. You may resume your supplements and
medications the day after surgery. DO NOT DISCONTINUE ANY OTHER MEDICATIONS YOU MAY
BE TAKING. If you are taking Heparin, Coumadin, Plavix or Ticlid, please advise your doctor right away.
4. Surgical Medications:
• The week prior to your surgery medications will be phoned into your pharmacy. • _____Coumadin (if instructed) - take 2 of the 5mg tabs the night before your surgery. You will
then be instructed on a dosage following a blood test administered every few days either in the
hospital or by your home care nurse. Coumadin therapy lasts for 14 days following surgery.
• _____ Antibiotics (if instructed) - begin the morning following surgery and take until the pills
• _____Pain medication - is to be taken as needed for pain. Some pain medications, such as
Percocet, cannot be telephoned into a pharmacy. You will be given a written prescription for that
• _____Aspirin (if instructed) –this is purchased over the counter. Buy the coated “adult” dosage
of 325mg. unless instructed otherwise, take one pill nightly for 14 days following surgery.
5. _____ Home Health Care and/or Home Physical Therapy: Home health care is commonly ordered for
patients having reconstructive surgery. They will generally come to your house within 24-48 hours after
surgery. The nurse will check on how you are doing and change the bandage (in most cases). The home
care company (selected by your insurance in most cases) will contact you. They typically will contact you
the day he or she plans to visit, not before. If you do not hear from the home health care nurse by 3pm the
day following surgery, please contact our office at (435) 615-8822 during business hours.
6. _____ CPM (continuous passive motion) device: A CPM is a postoperative treatment method that is
designed to aid recovery of the joint after surgery. It helps restore motion and joint nutrition while helping
to prevent the formation of tight scar. In most cases the CPM vendor is chosen by your insurance company,
and they will deliver the device to your home the day of or the day after your surgery. The company that
provides you with the CPM should review the operation instructions with you.
CPM Settings: (Be sure to take your brace off when using the CPM) Begin 0-70 degrees.
Increase 5 degrees, twice daily if possible. Use the machine approximately 4 to 6 hrs per 24 hour period.
Increase the motion settings as much and as quickly as possible. Unless instructed otherwise you should try
to maximize the motion of the CPM. Once you have reached the maximum setting on the machine for 2 or
3 days, you can then stop using it. At this point you should call the company that provided the machine and
7. Surgery check-in time: This is assigned by the surgical facility or hospital 24-48 hours prior to surgery.
The facility where you are having surgery will call you directly. If you have not heard from them by 2pm
the day prior to your surgery you may call our office or the surgical center/hospital for information.
Generally, they will call you the day before surgery. Please be aware that check-in times are an estimate
8. Wound Care: Keep the surgical dressing and area dry and clean. To shower, you should wrap the surgical
site with plastic. We recommend “Press and Seal”, this is a product available in the grocery store, and is a
sticky version of clear food wrap. Portals (arthroscopic holes) can get soaking wet 3 days after the sutures
are removed. Incisions can typically get soaking wet 2 to 3 weeks postop.
9. Surgical Soap/Adhesive on your skin: The surgical soap used during surgery has an adhesive in it. This
brownish substance may still be on your skin after surgery. It will not come off with soap and water. To
get it off, you need to use a solvent, such as adhesive remover, nail polish remover, or “Goo-Gone”. For
example, you can use a small amount of acetone on a cotton ball or wash cloth and gently rub the area until
clean. Surgical ink (lines and letters) should be removed with an abrasive cleanser or scrubber.
10. _____ Game Ready Device: This is an Ice-Compression device, which in many cases provides excellent
relief from pain and swelling. It is typically used for 1-2 weeks postoperatively, as each patient chooses.
This device is not typically covered by insurance (except Workmen’s Comp, which does provide it).
Please let our office staff know if you want to have the Game Ready unit. You will need to call the vendor,
Mr. Dave Williams to set up this service, his phone is (801)-828-5685. If you elect to have the game ready,
it will be placed on you directly after your surgery and you will go home with the unit. When you are
finished using it, call Mr. Williams and he will come and pick the unit up.
Date of surgery: _________________ Facility: Salt Lake Regional Medical Center Park City Medical Center 1050 South Temple 900 Round Valley Drive Salt Lake City, UT Park City, UT 84060 St. Mark's Outpatient Surgery Center 1250 East 3900 South, Suite 100 Salt Lake City, UT 84124
*The Surgical Facility will call you the day before your surgery to give you a check in time. Home Health Care Agency / Phone: Medications to be phoned in: ______________________________________________________ Medication hand-written prescriptions: ______________________________________________ Pharmacy/Phone #: Your Post Operative appointments are scheduled for: 1st Post-Operative appointment: ________________at _________ in SLC Park City 2nd Post-Operative appointment: ________________at _________ in SLC Park City *If the above information is not filled in, please contact our office before your surgery and make a post- operative appointment for one week after surgery and three weeks after surgery.
Please feel free to call our office with any concerns or questions at (435) 615-8822. v. Mar 2011
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Breakfast and Lunch Ingredient List The information contained in this list is reported by each of the manufacturers. Variations may occur due to the differences in suppliers, ingredient substitutions, recipe revisions, product assembly at the school level, and/or season of the year. This information is effective as of August 2011. Seminole County Public Schools and employees do not a