What tests may be done prior to surgery?
Your surgeon may order blood tests, an electrocardiogram and/or a chest x-ray in the days or weeks prior to your surgery. In addition, your doctor or nurse practitioner/physicians assistant will perform a physical examination to check your baseline health. You may meet with the anesthesiologist. This is a good time to ask any questions relating to your surgery.
Can I eat or drink?
You should not eat or drink anything after midnight the night before your surgery. If you eat or drink anything after midnight your surgery may be cancelled.
What medications can I take?
You should inform your doctor of any medications you are taking. You may be told to discontinue them before surgery. All aspirin-like drugs should be discontinued for ten days prior to surgery. High doses of vitamin E, C and gingko Biloba should also be avoided. All of these can interfere with blood clotting during surgery.
When Should I Arrive at the Hospital?
You will receive a telephone call from the hospital the day before your surgery (if surgery is scheduled for Monday you will receive your call on Friday). You will be asked to arrive two hours prior to your scheduled surgery.
What Should I Bring With Me to the Hospital?
- Hearing aides
- Contact lens storing case
- Loose shirt that buttons in the front to wear home
- Do not bring: jewelry, money, valuables
What should I do before coming to the hospital?
- Shower, shampoo and brush your teeth as usual. Rinse, but do not swallow the water.
- Remove all jewelry.
- Remove red or frosted nail polish (clear or neutral colors are allowed).
- Remove contact lenses (wear your glasses. You will be asked to remove them before surgery).
- Do not eat or drink anything unless otherwise instructed by your doctor or nurse.
- Do not smoke.
- Bring all medications with you. Write down all their names and how often you take them.
- Make sure to arrive on time.
Day of Surgery
What is the Check-In procedure?
When you arrive you will report to the area as directed during your pre-operative phone call. You will be escorted to the waiting area where we will provide a locker for your clothes. You will be given a hospital gown, bathrobe and slippers to change in to. You can relax in this comfortable room with one or two family members.
A nurse will take some preliminary measurements; your temperature, heart rate and blood pressure. (S)he will review the surgical plan and ask you to verify the procedure and confirm the correct side. The surgery site will be marked as needed. You will also speak briefly with the surgeon and the anesthesiologist. An intravenous (IV) line will be started in a vein in your arm. This allows the medical staff to deliver fluid and medication directly into your bloodstream. The IV will remain during surgery and for a while after surgery.
In the OR
When you are called into the operating room you will be asked to remove any dentures, eyeglasses and wigs. Your family will move to the family waiting area at this time. You will be escorted to the OR and meet the surgical team. You will be connected to a heart monitor, your blood pressure will be taken, and a small clip will be placed on your finger to measure your blood oxygen level.
The type of anesthesia you receive will depend on the type of surgery you are having and your personal preferences.
- Local Anesthesia: the operative area is numbed so that you will not feel pain. This is commonly used for lumpectomy, wide excision, segmental resection. Local anesthesia is often accompanied by a sedative to reduce anxiety.
- General Anesthesia: you will sleep deeply during the surgery and there may be a breathing tube placed in your throat.
You will be monitored by an anesthesiologist at all times.
Where Will I wake up?
After surgery you will be taken to the recovery room where you will be observed while you recover from the anesthesia. Your family members will be notified that the surgery is over. If you are going home on the day of surgery you will be transferred to the Ambulatory Recovery Room. Family members can visit you there and discharge instructions will be given to you before you are sent home. All Ambulatory Patients are required to have an adult escort to take them home. If you are staying overnight you will be taken to one of the hospital units. Your family can visit you in your hospital room.
What if I have pain?
Pain medication will be prescribed by your doctor. You will be assessed for pain by the nursing staff. You will be asked to describe your pain on a scale of 1-10. However, there are several different pain medications and you will receive a medication and regimen that works for you.
What is Patient-Controlled Analgesia (PCA)?
This is a pump used to administer pain medication. When you feel pain, you press a button on the pump and pain medication is delivered to you through an IV line. The PCA pump is set so that you cannot give yourself too much pain medication.
When Will I Be Able to Eat?
When the effects of anesthesia have worn off you will be given clear liquids to drink. You will be able to eat your regular diet soon after you are able to tolerate clear liquids.
Post Operative Care
When Will I see my Surgeon After the Operation?
You will be given an appointment to see your surgeon about one week after surgery. Sutures and/or drains may be removed at this time.
When will the Pathology Report Be Ready?
Your pathology report will generally be ready in about one week from the date of your surgery. Your surgeon will discuss the results with you in detail, usually at the post-operative visit.
When Can I Shower?
Your surgeon will let you know when you may shower or bathe. If you have drains in place you may shower after they are removed, or according to your doctor’s instructions. Ask your surgeon about using deodorant and shaving under your arm.
Should I Avoid Any Activities?
It is normal for you to tire easily while your body is healing. Be sure to include frequent rest periods each day during the first few weeks. Eat a well-balanced diet and drink plenty of fluids. Short walks are encouraged to stimulate circulation and relieve stress.
Use your affected arm as normally as possible in your daily activities without causing discomfort. DO NOT do heavy lifting or strenuous activity for two weeks or longer, depending on the type of surgery. Avoid activities that involve reaching or stretching with your affected arm (for example vacuuming or scrubbing) for several weeks until your incisions have fully healed.
Be kind to yourself! Do things that give you satisfaction and let go of activities that are physically and emotionally draining. Resume your social, household and work activities gradually. You will soon be feeling better and stronger.
When Can I Drive?
How soon you can start driving depends on the type of breast surgery your reconstruction performed. Ask your surgeon when it is okay to drive.
When Can I Return To Work?
You may return to work as soon as you feel strong enough. At first working fewer hours in a day or fewer days in a week may help you to ease back into a full-time schedule.
When Can I Resume Sexual Relations?
Resume sexual relations as soon as you feel physically and emotionally ready.
Family members and guests can play a vital role in the healing process of our patients. AP Breast Centre visiting hours and guidelines help in ensuring that patients have enough time to rest and heal; and that all visitors can be adequately accommodated.
At AP breast Centre, visits by relatives and friends to see the patients are encouraged to make their stay more enjoyable. With the doctor’s permission, patient may also see visitors in the patient rooms or the visitors’ waiting area (if provided). However, visiting hours and rules vary from department to department. For patient’s attendant, a Visitor’s Card will be provided, which must be produced whenever required.
For patient’s comfort and care, visitors are asked to observe the following rules:
- Visiting hours are from 7A.M. to 8 A.M. or 5 P.M. to 7 P.M unless you are notified by our staff (nurse), of additional restrictions
- Visitors must meet patients only during visiting hours and must not exceed the time limit specified. This is to ensure the well being of the patients.
- Only two visitors per patient are allowed at a time.
- Smoking by patients, visitors and staff is strictly prohibited.
- Visitors are asked to check with a nurse before bringing food or beverages to a patient.
- Visitors are requested to keep visits brief and to speak softly.
Intensive Care Unit (ICU)
Owing to the intensity of care given in this area, visits at the ICUs are generally restricted to immediate family members only. However, visitors can visit the patient after consulting and with the permission of the treating.
Patient safety is a healthcare discipline that emphasizes on the reporting, analysis, and prevention of medical error, physician error, medication error, pharmacy error, nursing error, medical equipment failure, root cause analysis, and failure due to human factors. Negligence in patient safety often leads to adverse healthcare events.
The whole team of AP Breast Centre actively participates in patient safety as partners to the patients. At AP Breast Centre, we improve patient safety through our infection control practices, prevention programs, patient awareness programs and other safety procedures. AP breast Centre practices patient safety by
- Using good hospital design principles
- Limiting shift durations for medical residents and other hospital staff
- Preventing central line-related blood stream infections
- Educating patients about using blood thinners safely
- Building rapid response systems and better teams
- Re-engineering hospital discharges thus reducing potentially preventable readmissions by assigning a staff member to work closely with patients and other staff to settle medications and schedule necessary follow-up medical appointments.
- Preventing venous thromboembolism by eliminating hospital-acquired VTE (venous thromboembolism), the most common cause of preventable hospital deaths.
Some safety tips for patients to make sure that the care is as safe as possible.
- Keep the latest list of the following with you at all times:
- Your immunizations, prior hospitalizations and medical problems
- The name and phone number of your pharmacy and physician
- Any allergies you have to medicine, food or anything else
- Learn about your illness and how to stay healthy.
- Ask a family member or friend to go with you to the doctor to help you ask questions or get further information.
- Cooperate with your doctor by answering the questions about your illness in order to understand and plan for your care.
- Let your physician know if you are not feeling well or if you experience any change in your condition.
- While in the hospital:
- Wash your hands with soap and water, especially after using the restroom and before eating
- Ask everyone who comes in contact with you, visitors or staff, to wash their hands. This will reduce your exposure to germs
Use Medications Safely
- Keep the latest list of drugs you are taking including prescriptions, herbals, vitamins, or any other medicines.
- Bring your list of prescriptions with you every time you go to the hospital or visit your doctor.
- Make sure you know the names of all your medicines and why you were prescribed to take them.
- Ask questions about any instructions or information given that are confusing or unclear.
- When a doctor suggests you a new medicine, ask him/her if the new medicine will interfere with or substitute for what you are already taking.
- If you are concerned with any safety issues, please speak with our doctor or with our front desk.
- Immediately contact your doctor, nurse or attender if you do not feel well after taking a medicine.