Booking Surgery
Once you have agreed to surgery in the clinic:
- Dr. Kamel’s Surgery Scheduler or medical assistant will call you within 3- 5 days weeks and will book and or confirm your surgery date. If you need to cancel or change this date, please do so at least six weeks in advance.
- You will receive an email with an itinerary of additional information regards to preoperative and postoperative which includes any preoperative appointments and post operative appointments
- Preoperative clearance may include blood work, chest x-ray, EKG, medical clearance, or specialty clearance may be needed and will be advised by your surgeon's medical assistant and or surgery scheduler. These items are time sensitive, so do testing as advised.
- If you are required to have physical therapy, you will be provided with a referral for therapy. Please schedule your post-operative therapy appointment before your surgery date.
- You may receive additional documents that need to be read and signed by Dr. Kamel for the surgery they will be performing.
- The facility where your surgery will be performed may also have some preoperative documents for you to complete online as well.
Before Surgery
- Approximately 3 – 7 days prior to surgery, you will be contacted by the pre-screening department at the facility in which you are having surgery.
- They will either perform a telephone interview or ask you to come into the facility for routine blood work and/or medical consultation.
- The pre-operative unit uses specific criteria to determine if you will need blood work, preoperative medical consultation, etc.
- Surgery times will be provided to you within 1- 3 days prior to surgery depending on the facility in which your surgery will be performed.
- A pedicure is ok to have done a week prior to the surgery however no polish or gel polish.
Morning of Surgery
- Please thoroughly shower and wash body with an antibacterial soap
- If you have walkers, crutches, braces or any other DME (Durable Medical equipment) please bring them with you.
2 Hours Before Surgery- (Please note times are approximate)
- You will check in at the front desk.
- They will request your ID, Insurance card.
- They will review pre-registration information with you.
- Additional documents may be needed for surgical facilities.
- You may receive a wristband for identification purposes and an allergy wristband if applicable.
- Your family/friends will be given instructions on how to receive real-time updates about your location via text message (i.e. when you enter the OR, when the surgery begins, when the surgery ends, etc.).
- One family member must be present after surgery to drive you home.
1.5 Hours Before Surgery- (Please note times are approximate)
- You will wait in the lobby until they direct you to the pre-operative department.
- Once settled, they may allow your family members to join you.
- The Pre-op nurse will review important medical information, current medications/supplements, allergies, etc. The nurse will confirm your surgery, surgical site, and consent form.
- You will have an IV started.
30 Minutes Before Surgery- (Please note times are approximate)
- You will meet the nurse from the OR. The nurse will review important medical information, allergies, etc. The nurse will confirm your surgery, surgical site, and consent form.
- The Anesthesiologist will see you and discuss the anesthetic plan (general vs. local anesthesia). Please be sure to discuss any anesthesia concerns with your Anesthesiologist.
- Dr. Kamel will meet you and confirm your surgery, surgical site, and consent form. He will mark the surgery site with a marker. Any last questions will be answered.
5 Minutes Before Surgery- (Please note times are approximate)
- You will be taken into the OR by the OR nurse and the Surgical Assistant.
- Your family will be escorted to the waiting room.
- Your family members will receive real-time text messages updating them on the progress.
- Following surgery one family member will be able to visit you in the recovery room.
Facilities in which we perform surgeries:
- Casa Colina Hospital and Centers for Healthcare
255 East Bonita Ave, Bldg. 2, Pomona, CA 91710
Main: (909) 596-7733
Fax: (909) 596-7845
- Casa Colina Surgery Center
255 East Bonita Ave, Bldg. 3B, Pomona, CA 91710
Main: (909) 593-3550
Fax: (909) 593-5223
- Ontario Advanced Surgery Center
1211 West 6th Street, Ontario, CA 91762
Main: (909) 981-8755
Fax: (909) 981-9462
- San Antonio Regional Hospital
999 San Bernardino Rd, Upland, CA 91786
Main: (909) 920-4924
Fax: (909) 920-4727
Medications Management
The following recommendations are provided to help you manage your medication concerns before surgery:
- Bring all medications in their original containers with you the day of surgery. We may need to confirm the details on the container.
- On rare occasions, we may need to use your medication during your stay.
- Always check with your prescribing physician if you are uncertain about any information 2 weeks prior to surgery.
- Please stop taking all herbal supplements 2 weeks prior to surgery including energy drinks, weight loss drugs, glucosamine, and chondroitin.
Some supplements may cause complications. You should stop taking all herbal medications at least two weeks before surgery. If there is not enough time to stop your herbal medications before surgery, bring the product in the original container.
- Blood thinner or anti-inflammatories: such Celebrex, Coumadin, Plavix, Eliquis (Apixaban), Warfarin, Lovenox (enoxaparin), Xarelto (Rivaroxaban) Prednisone and/or Aspirin, check with your surgeon or prescribing physician and take only as directed. If you are unsure about your medication, please contact the prescribing physician.
- Erectile Dysfunction (ED) Meds (Cialis, Viagra, Levitra) - Stop 72 hours before surgery.
- Estrogen Supplements: Stop two weeks before surgery. Stop all hormone replacements with estrogen, including Evista.
- Insulin: For day of surgery: Check with the physician that monitors your insulin or with the hospitalist staff about any adjustments needed the day of surgery.
- Blood Pressure Medications: You may be given special instructions regarding this medication class. Do not adjust unless instructed.
- Tylenol/Tylenol Products: You may continue to use Tylenol or over the counter products with Tylenol up until the day of surgery.
Additional Important Information to Know
Food and Drink: You will be given specific instructions on when to stop eating and drinking, it is imperative to follow the exact instructions to protect your lungs.
Stop Smoking and All Tobacco Use and or Illicit drugs: Smoking and nicotine or any other illicit drugs can increase your risk for infection and blood clots after surgery and can have a negative effect on your body’s ability to heal wounds.
Contacts/Glasses: It is recommended that you wear your glasses instead of contacts, as contacts will have to be removed on the day of surgery. Please bring your glasses case and/or your supplies if you are unable to wear your glasses.
Pacemaker or Defibrillator: Please bring all the information about your pacemaker or defibrillator to the hospital.
Call Your Surgeon: If there are any changes in your health before surgery such as a fever, skin infection or a new illness, please call your surgeon as soon as possible.
ADDITIONAL SUPPLEMENT INFORMATION:
Please STOP taking the following supplements 2 weeks prior to surgery.
If taking a supplement under direction of a treating provider please consult them regarding your supplements.
Supplements That Can Cause Bleeding Problems:
- Arnica montana
- Baical skullcap root.
- Bak foong pill
- Birch Bark
- Black Cohosh
- Bromelain
- Capsaicin
- Cayenne
- Chines peony
- Chinese agrimony
- CoQ10 (may interact with blood thinners like warfarin and diabetes drug insulin)
- Cumin
- Dan Shen
- Devil’s claw
- Dong Quai
- Feverfew
- Fish oils (omega-3 fatty acids)
- Fritillaria bulbs
- Garlic
- Geum japonicum
- Ginger
- Gingko Biloba
- Ginseng
- Glucosamine and chondroitin
- Grape Seed Extract
- Green tea
- Guilinggao (tortoise jelly)
- Japanese honeysuckle
- Kangen-karyu
- Licorice
- Milk Thistle
- Oil of wintergreen
- Poncitrin (jishi)
- Primrose Oil
- Saw palmetto4
- Seasonal tonic tea
- St Johns Wort
- Ta gastronol tea
- Turmeric and curcumin
- Vitamin E
- Supplements That Can Have Cardiovascular Effects
- Black Cohosh (blood pressure decrease)
- Ephedra (causes hypertension, palpitations, and tachycardia)
- Garlic (can cause hypotension)
- Ginseng
- Goldenseed
- Gotu Kola
- Herbal tea
- Hoodia (possible arrhythmia)
- Kava6
- Licorice
- Ma Huang (another name for ephedra)
- Milk Thistle
- Yohimbe
- Supplements That Can Cause Drug Interactions
- Echinacea7
- Goldenseal
- Kava root
- Licorice
- St. John's Wort / Goat weed
- Tumeric (prolong the duration of many drugs)
- Valerian
- Supplements That Can Have Anesthetic Effects
- Kava
- St. John's Wort / Goatweed (sedation, blood pressure changes)
- Valerian
Supplements Known to Cause Other Types of Adverse Events
- CoQ10 (may lower blood sugar levels in diabetics and interact with warfarin)
- Ginseng (can cause hypoglycemia)
- Hoodia (changes in blood sugar)
- St. John's Wort / Goatweed (can cause photosensitivity, especially after laser or chemical peels)
- Supplements Safe To Take Before Surgery
The following supplements are fine to continue before surgery.
- Calcium
- Folate
- Iron
- Magnesium
- Phosphorous
- Potassium
- Protein and Amino Acids
- Vitamin A
- Vitamin B (complex) / B1 (Thiamine), B2 (Riboflavin), B3 (Niacin), B6, Biotin
- Vitamin B12
- Vitamin C
- Vitamin D
- Zinc
Preparing for After Surgery
Safety at Home
- Remove all loose scatter type rugs. These increase your risk of slipping and falling at home.
- Find a firm chair with arms that you will use after surgery. It is very difficult to get in and out of soft chairs or chairs with no arms after surgery.
- Minimize clutter that may cause you to trip or stumble.
- Make sure you have handrails on all flights of stairs.
- Make sure you have handrails in the bathroom near the toilet and in the shower. Check with your surgeon about showering after surgery.
- Get your cleaning done before surgery. You won’t have the energy or the interest to clean for a while after your surgery.
- Do your grocery shopping before surgery. Plan your meals for two weeks and make sure you have lots of nutritious foods like vegetables and fruits available. Protein rich foods are also important to your recovery. If you are usually bothered by nausea after surgery, be sure to have ginger-ale or 7up, as well as crackers.
- Arrange for help from family and friends. You may also need help with bathing, dressing, even walking for the first few days you are home.
- Apply clean bed sheets the day prior to arriving for surgery to decrease risk of infection.
- Keep your incision clean and dry according to Dr. Kamel’s instructions. Do not bathe or soak in a bathtub, pool, hot tub, take or any other body of water until approved by Dr. Kamel.
- Do not apply creams, lotions, or ointments to a healing incision. These can inhibit new skin growth and/or introduce bacteria.
- Do not drive until approved by Dr. Kamel.
- Do not drive while you are still taking narcotic medications.
- Check with Dr. Kamel before starting any new exercise regimens.
- Observe any precautions regarding lifting, sitting, and moving.
- Plan accordingly for pets. For your arrival back home and for their care during your recovery. Walks, feedings etc.
Medications After Surgery
Your physician and the nursing staff can provide guidance about resuming your medications after surgery. Take all medications as prescribed. Call your prescribing physician if you have any additional questions or concerns.
- Insulin or Pills for Diabetes: Diabetic patients are advised to check with the physician that manages their diabetes if they are uncertain how to resume taking their medications for blood sugar after surgery.
- Blood Pressure and Heart Medications: Patients should resume their medications for blood pressure or heart disease unless told otherwise by their cardiologist or prescribing physician.
- Vitamins/Supplements: You may take your vitamins and other herbal type supplements after surgery unless your surgeon instructs otherwise.
- Blood Thinners: Patients taking Arixtra, Aspirin, Coumadin, Eliquis, Lovenox, Heparin, Xarelto or any medication prescribed to prevent blood clots should have clear instructions how to take the medication, how long to take the medication and when to contact their prescribing physician.
Contact Dr. Kamel and your primary care provider right away if you notice blood in your bowel movements or urine or are having frequent bloody noses.