Use this three-part guide to help ensure a smooth experience and recovery from your foot or ankle surgery. Collaborating with Dr. Kamel for preparation and post-surgical care will yield the best results. Part 1 focuses on pre-surgery preparations.
How Do I Prepare Myself for Surgery?
Make a list of questions and discuss them with your surgical team at your pre-operative visit. Understand the details of your surgery and what to expect afterward. Bring a comprehensive list of your medical conditions and medications (including prescription, over-the-counter, and herbal/nutritional supplements) along with the dosage for each.
Will I Need Medical Testing Before Surgery?
Depending on your health conditions and the planned surgery, you may need to undergo pre-surgical testing. This can include blood work, X-rays, EKGs, and sometimes medical clearance from your primary care provider or specialists like a cardiologist.
Do Certain Medications Need to Be Stopped Before and/or After Surgery?
Certain medications can be dangerous when taken just before or after surgery. Your surgeon will advise you on which medications to stop, such as:
- Aspirin: Can increase bleeding during surgery.
- NSAIDs (e.g., ibuprofen, naproxen, Celebrex, Mobic): Can increase bleeding and slow down bone healing.
- Certain steroids: May slow down wound and bone healing.
- Hormone replacement therapy and/or birth control pills: May increase the risk of blood clots post-surgery.
- Metformin or related diabetic medications: Should be stopped at least 24 hours before surgery due to potential anesthesia reactions.
- Certain OTC supplements and herbal preparations (e.g., fish oil, St. John's Wort): Can increase bleeding during surgery.
Does the Use of Nicotine Affect Surgery?
Nicotine, found in cigarettes, electronic cigarettes, cigars, and chewing tobacco, can slow blood flow to the surgical area, increasing the risk of bone, soft tissue, and wound healing problems, infections, and blood clots. To achieve the best surgical outcomes, stop using nicotine products well before surgery. Discuss quitting with Dr. Kamel or primary doctor.
What Devices Do I Need After Surgery?
Post-surgery, depending on what type of surgery you’ve had, you won't be able to put weight on your operated leg for some time. You'll need an assistive device like crutches, a walker, a knee scooter, a knee walker, or a wheelchair. Other helpful equipment may include a bedside commode, shower chair/stool, or transfer board, especially if you are non-weightbearing on both legs. Many of these devices may be covered by insurance.
Is Physical Therapy (PT) Needed Before Surgery?
Training with an assistive device may require physical therapy. Dr. Kamel might schedule a PT session before surgery to familiarize you with the device, fit it properly, and improve balance, arm strength, and the strength of the opposite leg.
When Should I Stop Eating and Drinking?
You will generally be instructed to stop eating and drinking after 11:59 PM the night before surgery. This includes no coffee, chewing gum, or water in the morning. If your surgery is later in the day, you might be allowed to drink clear liquids until 6-8 hours before surgery.
Why Is This Important?
Having an empty stomach at the time of anesthesia reduces the risk of nausea, vomiting, or an upset stomach, and decreases the chance of aspirating stomach contents into your lungs, which can be serious. It takes at least 6-8 hours for food and drink to leave your stomach, so not eating or drinking after midnight ensures your stomach is empty. Exceptions may be made for certain morning medications, which can be taken with small sips of water. Review your medications with Dr. Kamel and anesthesiologist before surgery.