Preparing for an Operation
	What preparation should a patient do before an operation? When the hospital asks a patient to come in for an operation, they usually send a set of instructions explaining how to prepare oneself, a list of the things patients should bring with them and information about what is going to happen.  Everyone who is going to have a scheduled operation needs to see a specialist surgeon beforehand. The surgeon will explain to the kind of operation the patient will require. There is a difference between an outpatient operation (day-case procedure) where the patient can go home the same day, and an operation that requires several days in hospital (in-patient procedure) The hospital will send the patient details of their admission and a medication history and allergy enquiry form which will need to be completed and signed by their GP  What happens before an out-patient operation? If the operation is going to be performed under a local anaesthetic there is usually no need to make special preparations  If it is a minor operation that requires a general anaesthetic, the doctor will ask the patient about their health in general and if they are allergic to anything, such as penicillin or sticking plaster. They will also be asked about any medication they are taking, whether or not they smoke and how much alcohol they drink. The doctor will listen to their heart and lungs and check their blood pressure.  This information will be given to the anaesthetist who will make sure that the patient won't have any problems with the general anaesthetic, such as an allergy. On the day of the operation, the patient must not eat or drink anything for six hours before having a general anaesthetic.  What happens before an operation requiring a hospital stay? If the operation involves staying in the hospital, the patient will be asked to come in a day or two beforehand for a few investigations. These will include a blood sample, possibly an electrocardiogram and maybe an X-ray of their heart and lungs. Some people will need additional investigations before their operation.  If the patient will need to stay in hospital for a few days, a nurse will explain exactly what to expect during their stay.  The day before the operation the patient will be visited by the anaesthetist. He or she will plan what kind of anaesthetic will be used, and how it is going to be given. In some cases the patient will be offered a sedative on the day of the operation itself.  A patient can't eat, drink or smoke in the six hours before an operation, but they will be allowed to take any morning medicine, which the nurse will give them.  Before the operation they will be asked to sign a consent form, indicating that they understand the nature of the operation and giving their consent for it to be carried out.  What to take to hospital Medication history and allergy form, signed by the patient's GP Any daily medication Necessary items such as glasses, hearing aid or personal wheelchair Toilet requisites, slippers, bathrobe or tracksuit Names, addresses and phone numbers of the patient's closest relatives A good book  What about medicine? If patients are taking any blood thinning medicine (e.g. Warfarin), they may need to stop taking this for a couple of days prior to the operation. If unsure, they should contact the ward before going to hospital Patients should continue taking any other daily medication as usual unless told otherwise  What does the doctor need to know? If the patient has recently had, or currently has, a fever If the patient has smoke damaged lungs (chronic bronchitis) If the patient has asthma, and takes medication for asthma or adrenal cortex hormones If the patient has breathing difficulties If the patient has uncontrolled high blood pressure If the patient's sometimes get chest pain (angina), especially if this happens while resting If the patient's pulse is sometimes irregular If the patient has recently suffered from a coronary thrombosis or a stroke If the patient has a tendency to get deep phlebitis (inflammation of the vein walls) If the patient is allergic to certain kinds of medicine, such as penicillin If the patient has previously had bad experiences under anaesthetic, or know that there have been problems of this type in their family If the patient is unwilling to receive a blood transfusion, should this become necessary  What are the risks? There is always a certain risk involved when an operation is performed, but it is usually quite minor, depending on the type of operation  The patient's heart, lungs, and kidneys will be strained to some extent, and if any of these organs are weak, the risk of complications increases If the patient is overweight the risk is greater  If the patient has an infection, it should be treated before the operation