Undergoing a surgical procedure can be a stressful experience for many people, we will help guide you through the entire process and answer every question that we expect you to have.
Most probably if you are reading this you already have a procedure scheduled in the near future and we have answered every question you have brought to our attention. You should have a detailed understanding of the procedure and what’s involved. If you do have any more questions or concerns please feel free to contact Dr. Gitlin at the office at 212-372-0991 or 516-791-3338.
Depending on the type of surgery planned you may have to be admitted to the hospital for observation afterward, this is usually in more extensive or complicated cases. Small children are generally kept at least overnight to keep them (and their parents or guardians) comfortable. Otherwise most procedures are ambulatory (also called same day surgery) meaning that you arrive at the hospital 2-3 hours before the scheduled time and are free to go home after a short stay in the recovery area immediately after the procedure. The only requirement is that an escort arrive with the patient and remain to accompany the patient home.
WEEKS before your surgery:
Once we have concluded that surgical intervention is right for you we will-
A. obtain preauthorization for the procedure with you insurance company.
B. Contact the operating room to schedule a date and time for the procedure. We try our best to accommodate all schedules.
C. Obtain pre-operative medical clearance.
Medical clearance ranges from a simple blood test to chest xrays among other necessary tests and a history and physical examination. These are ordered as per the patients medical condition and age. For example if a patient has significant kidney or heart disease they must get separate clearance from their respective specialists. This is ordered on a case by case basis. If you have a regular medical doctor who is familiar with your health you may prefer to be seen by them for clearance. Clearance can also be obtained at the pretesting facility at the the hospital we are scheduled at if necessary.
Although rare if there is a possibility of significant blood loss and we know preoperatively that a transfusion may be necessary we can schedule Autologous blood donation where the patient can donate their own blood before the procedure that is stored at the hospital and used for your particular case. Also there is equipment we can order if necessary to collect lost blood filter it and return in intraoperatively. If there are any religious or any other reason you cannot have a transfusion with donated blood please inform Dr. Gitlin directly.
Certain medications need to be stopped preoperatively such as aspirin and other potent blood thinners. This is done also on a case by case basis and you will be informed of this during your clearance.
Three days before your surgery a hospital nurse will call you directly and give you some instructions as well and answer any questions you may have. Again PLEASE contact Dr. Gitlin if you have any concerns no matter how trivial you think it may be.
The hospital nurse will also call you the day before you scheduled surgery to inform you of the time you need to arrive at the hospital and you will be reminded NOT to eat or drink after midnight the night before. This is a very important precaution to keep the anesthesia safe. Some medications are taken the morning of surgery with a sip of water as necessary. You can eat right after the procedure if you feel up to it, I think you will have a cookie and some juice on the menu!
The MORNING of surgery:
You should arrive at the hospital as instructed by the hospital nurse.
You will be instructed to go to the ambulatory surgery area located adjacent to the main entrance to the hospital. A locker will be provided for your belonging, please do not bring any valuables (leave jewelry at home most times it needs to be removed before surgery)
You will be asked to change into a comfortable hospital gown and assigned a preoperative holding area. There the nursing staff will place an IV line as well as fill out your paperwork as needed.
A podiatry resident will see you to go over the history and physical.
The anesthesiologist will also see you at this time to go over the anesthesia that will be necessary for the procedure. The anesthesia staff at this our hospital is excellent and board certified. Your family or escort can keep you company here if you like.
Dr. Gitlin will then visit with you and answer any questions you may have and again go over the surgery in detail as well as a brief overview of the post operative course once you leave the hospital.
As for the anesthesia, most of our foot and ankle procedures require sedation and a local anesthetic block, occasionally general anesthesia of spinal epidural is necessary depending on the nature of the surgery and patients overall condition. If you have any concerns about this please speak with Dr. Gitlin.
As for the escort or family who accompany you to the hospital they will be with you until we are ready to start the procedure. At that time they will be directed to awaiting area, if they wish they can go to the cafeteria (the food is great) or take a walk in the park outside if they desire. You will be in good hands.
The anesthesiology staff will be with you the entire time until you are resting comfortably in the recovery room. Dr. Gitlin will speak to your family if you wish immediately after the procedure. We will also speak to you to discuss the surgery and any specific instructions will be given.
You will be given prescriptions for pain medications at this time if you have not received them already.
We recommend that you keep the operated limb elevated to prevent swelling at all times. Take the pain medication as prescribed after surgery. Dr. Gitlin is available 24 hours a day 7 days a week for you after surgery. If there are any concerns at all – please call. We will call you at home that evening or the next morning to make sure you are doing well.