12/11/2019 Program Summary - Emmi

Program Summary

WHAT TO EXPECT WHEN HAVING A PROCEDURE

Your Doctor Visit
To give you the best care possible, your doctor needs to know all about you and your health. Even if
you've been seeing your doctor for years, other people on your healthcare team may not know you as
well.

To help with this, make a list and bring it with you. Write down:

Any medical problems you may have like asthma, diabetes, or high blood pressure.

If an illness or condition runs in your family.

If you have any kind of bleeding problem or have had a blood clot in your leg or lung.

Allergies you may have to medicines (like penicillin), foods (like shellfish), or materials (like
latex).

Any operations you've had in the past like a C-section, your appendix or gallbladder removed, or
your tonsils taken out.

If you or anyone in your family has ever had any trouble with anesthesia.

Make a list of everything you take, how

much you take, and how often you take
it. This includes:

All prescription drugs

Over-the-counter drugs like aspirin

Diet pills

Herbal supplements (herbs like Gingko

biloba can increase the risk of
bleeding)

Vitamins

Recreational drugs

Smoking or using anything with

nicotine (nicotine patches or gum)

Smoking
If you smoke or use anything with nicotine in it (including nicotine patches or gum), make sure your
surgeon knows this. These things may cause problems with healing and some treatments. To be on
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the safe side, you may need to cut them out in the weeks before your procedure. Again, check with
your surgeon.

Talking with your doctor

This visit with your doctor is the right time to ask questions about your condition, the procedure you're
going to have, and what you need to do to get ready.

Don't be shy about asking questions. After all, you need to have the facts if you're going to make the
right decisions for yourself. There's no such thing as a silly or dumb question. Your doctors and nurses
are there to help you.

Before Your Procedure

Find out what your doctor would like you to do before your procedure. Ask if there are any special
instructions about your medications. Ask if you should stop any of your regular medications or start
any new ones.

Write things down

There could be a lot to remember, so don't rely on your memory alone. Write down all the instructions
and follow them.

Support
It's a good idea to ask a family member or a friend to go with you for comfort and support. Think of this
person as your partner in care. Doctors and nurses like to have one person as the "go to" person for
all communication. He or she should be able to speak up for you, ask questions, and give information
about your health. Be sure to introduce this person to your doctors and nurses so they know it's OK to
share your health information with them.

Have someone drive you home

Make sure you have someone drive you home from the hospital or surgery center. Even if you think
the anesthesia's worn off, it's just not safe to drive yourself.

Night before your procedure

You'll probably get a list of instructions telling
you what to do. One thing that's very
important is to find out when you need to
stop eating or drinking before your
procedure. If there's anything in your
stomach and you throw up during the
procedure, it can be very dangerous.

Find out exactly what your doctor's

instructions are for you — you'll need to
follow them, or your procedure may need to
be rescheduled.

Morning of the procedure

On the morning of the procedure, your doctor may have you take some or all of your regular
medications. You may need to take them with just a sip of water.

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At the hospital or surgery center

Before anything can begin, someone on your healthcare team will double check with you to make sure
that you're in the right place and having the right procedure.

They'll probably mark the area where your procedure will be done. This is especially important if your
procedure is on a part of the body that you have 2 of (like your knee). Don’t be surprised if they double
check with you to make sure it's the correct area. It’s a standard safety check.

Anesthesia
Anesthesia is medication used to make you comfortable during the procedure. There are 4 different
kinds of anesthesia.

Local anesthesia
Local anesthesia numbs a small area of the body, usually with a shot under the skin. If you've had a
cavity filled at the dentist, you probably had a shot of local anesthesia to numb your mouth. Same idea
here.

Regional anesthesia (block)

Regional anesthesia (also called a block) is used to numb a larger area. For instance, blocks can
numb an entire arm or foot.

You may have heard of epidural or spinal anesthesia. These make you numb from the waist down.
With an epidural, numbing and pain medicine are sent into the fluid around your spine in your lower
back. Your legs will start to feel warm, heavy, and numb. That feeling will rise up to your waist.

Moderate sedation
This is medication that makes you drowsy, but it doesn't completely knock you out or "put you under."
Moderate sedation is sometimes given by mouth or it can be given through an IV line. You may be
able to speak and respond with this kind of anesthesia, but you probably won't remember anything
about the procedure afterward.

General anesthesia
General anesthesia puts you into a deep sleep. They'll start your medication through an IV, and you'll
feel relaxed and calm. Then you'll fall completely asleep, so you'll be "out" during the operation and
you won't remember anything about the procedure.

Once you're asleep, a tube may be placed in the back of your throat or down your windpipe to help
you breathe. This may sound scary, but you won't feel the tube going in. When you wake up, your
throat may feel a little sore. You won't remember anything about the procedure.
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Combination
Depending on the procedure you'll have, your doctors may give you 2 kinds of anesthesia together.

You'll be monitored
With all kinds of anesthesia, your anesthesia care provider will monitor you the entire time.

Ask if you have questions

If you're not sure which kind of anesthesia you'll have, or you have questions, ask your doctor or your
anesthesia care provider.

Recovery
If you are staying in the hospital, clinic, or surgery center, there are a few things you should know
about recovering safely.

Do NOT try to get out of bed by yourself.

When you wake up and feel groggy, do NOT try to get out of bed by yourself. You want to make sure
you don't fall. To be on the safe side, ask a nurse or someone to help you get out of bed.

Hand washing helps stop germs from spreading.

As they care for different people, healthcare workers can accidentally pass germs from one person to
another. Simple hand washing can protect you from getting an infection. If you don't see a healthcare
worker wash their hands before they touch you, it's OK to remind them. You actually help them by
speaking up.

What else can you do?

Wash your hands carefully after using the bathroom.

Keep your bandages clean and dry. If you notice that a bandage is loose or wet, let a nurse
know.

If someone wants to visit you when they or their kids are a little sick, tell them to please just stay
home.

Double check the medication you get.

If there's any kind of confusion, you could help prevent a medication mistake. Those can be serious.
Make sure the nurse checks your ID bracelet. Ask questions about what he or she is giving you to
take.

Simple questions to ask:

"Can you tell me again what this medicine is for?"

"Can I take this with other medicines?"

"Are there any side effects?"

These questions can really help keep harmful mistakes from being made. If you're asleep, have your
support person ask questions for you.

Make sure you're getting the right medication, and don't take it before you know what it is.

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Going Home

Before you leave the hospital,

make sure you:

Have written instructions about

how to take care of yourself at
home.

Ask if you don’t get an

instruction sheet or don’t
understand something you
read.

Have instructions on how to

use a medical device, if you go
home with one.

If you're having surgery learn to take care of your wound:

It's usually best to keep it clean and dry while it heals.

Find out what your doctor's instructions are when it comes to showering or bathing.

Soaking in water, hot tubs, or pools can lead to infections.

Other things to look for on your instruction sheet and ask your doctor about before going
home:

When can I get back to work and other activities?

Can I lift anything heavy?

Can I bend at the waist?

What should or shouldn't I eat or drink afterward?

Which medications should I take and which should I avoid?

When should I come back for another appointment?

Call your doctor's office if there are any problems at home, such as:

A fever

Pain that gets worse

Trouble breathing

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Chest pain

Any pain or swelling in one or both of your legs

General rule: call your doctor if you experience anything unusual. If something just feels wrong, don't
be afraid to call.

Risks
All procedures and surgeries have some risks. Some have very few risks, while other procedures are
more difficult and have more risks.

Complications don't happen often. Your age, past surgeries, your overall health, and other health
conditions can make a difference. The risk of a procedure can be very low for some people and higher
for others.

5 general risks are listed here, but there may be others for your procedure. Do not consider this list
complete.

There is a risk of infection. In rare cases, more surgery may be needed to treat an infection.
Although your doctor will take great care to prevent it, you may get an infection in the area where the
procedure was done, or in other parts of your body (like in your lungs or bladder).

Signs of infection include:

Redness
Swelling
Fluid draining from the area where surgery was done
Pain that gets worse
High fever or chills

If you feel any of these things, call your doctor right away. Most of the time, antibiotics alone can get
rid of an infection. In very rare cases, you may need to be admitted to the hospital for surgery or other
treatments.

There is a risk of bleeding both during and after surgery. In rare cases, a blood transfusion or
surgery may be needed.
With any operation, there's a risk of bleeding. In most cases, your doctor will be able to control any
bleeding. Very rarely, you may lose too much blood and need a blood transfusion. Although banked
blood is checked for diseases (like HIV/AIDS or hepatitis) to make sure it's as clean as possible, there
is still an extremely small chance you could get a virus or your body could reject the blood.

While it's rare, you may have bleeding on the inside of your body in the days after surgery. If this
happens, you may need another operation.

Signs of internal bleeding include:

Strong pain and swelling in your belly

Feeling lightheaded

If you think you may have bleeding, please call your doctor or get emergency help right away.

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There is a risk of blood clots that, in rare cases, can be life threatening.
Blood clots can form in your blood vessels during or after surgery. In rare cases, a blood clot can
travel to the heart or lungs. This can be very dangerous and can even be life threatening.

Signs of blood clots include:

Sudden shortness of breath

Severe chest pain
Pain, redness, or swelling in one or both of your legs

If you have any of these signs, call your surgeon or get emergency help right away.

There is a risk of bad or allergic reactions to the anesthesia, medications, or materials that are
used. While it's very rare, you can die from a serious reaction.
Some people may have bad reactions to anesthesia. For example, they may feel sick to their stomach
or throw up after their procedure. An allergic reaction happens when your body tries to get rid of
something it doesn't want. It's your body's response that can be serious.

Signs can include:

Dizziness
Swelling
Rash
Trouble breathing

Your healthcare team is trained and ready to respond to allergic reactions. But in rare cases, people
can die. If you've ever had an allergic reaction, or know you're allergic to any drugs, foods, or
materials (like latex), please let your doctors know. Let them know if you or anyone in your family has
ever had a serious reaction to anesthesia.

There is a risk of a stroke, heart attack, or death. These things are extremely rare in healthy
people.
How your body handles surgery depends on what kind of condition your body is in. Some bodies are
stronger and can handle surgery better than others. Age, illnesses, heart conditions, past strokes, and
other things (like being very overweight) may make it harder to perform surgery successfully. It is
possible you could have a stroke or a heart attack during surgery or as you recover. These attacks
can be mild or severe. Although the risk of death is small, you may die during surgery or the recovery
period from any of the risks mentioned above or for other reasons.

Medication Safety
While your healthcare team will do their best to treat you safely, there are some things you should
know about medication safety.

Write things down

Find out if there are any medications you should stop taking or any new ones your surgeon wants you
to start taking. Some drugs should NOT be taken with other drugs.

Make sure you understand how and when to take any medications.
Ask your surgeon or pharmacist to repeat it. In fact, it's a good idea to repeat it back to him to make
sure you've got it down.

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Read the label.

If the label says "Take on an empty stomach," that means
you should NOT eat anything before and after you take
the medicine. Usually it's 1 or 2 hours, but read the label
so you know exactly how long.

Blood thinners
If you take a blood-thinning drug, you'll need to talk to the
doctor who put you on this medication to find out exactly
what to do. These include medications like warfarin
(Coumadin®), Plavix®, Pradaxa®, Xarelto®, Eliquis®, and
many others. Do NOT stop taking this kind of medication
on your own. Your doctor needs to help you do this safely.

Remembering to take your medications

Set your watch, a clock, or your cell phone to remind you.
Or stick a note on your fridge or your bathroom mirror.

DOs and DON'Ts:

Store your medicine in a dark, cool, dry place that's safely away from children.

Never share your medicine with anyone or take medicine that wasn't prescribed for you.

Keep the right pills in the right bottles (the bottles are designed to keep light out).

Unless your doctor tells you to, do NOT crush or open capsules, pour them into a drink, or mix
them with food. The medicine can get into your blood too fast and cause problems.

If you have any problems or side effects, let your doctor know. DON'T stop taking it on your own.

DON'T stop taking your medication if you're feeling better. You want to finish taking all the
medication you were prescribed. Stopping early can cause problems.

If you have questions, ask, ask, ask. You're the front line of defense. The more you know, the more in
control of your health you'll be.

Health Information Forms

After you print this summary, you can fill out the following forms. Keep a copy at home and take a
copy to your next doctor's appointment.

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DISCLAIMER

This Emmi® program is for your information and education only. Using this program does not take the place of conversations
between you and your healthcare provider. This program gives general information about how some health problems may be
treated. This information is extra education in addition to your appointments with your healthcare provider. This Emmi program
is meant to educate you about medical conditions and/or surgical procedures, but it does not cover everything. This program
may go over the most common possible risks and complications of medical treatments or surgical procedures. But there may
be other problems, known and unknown, that can happen after treatment or surgery. No guarantees or warranties are made
about the treatment or surgery itself.

This Emmi program is not meant to give exact medical or surgical advice to anyone. And it does not replace the informed
consent process you will go through with your healthcare provider. Please talk with your healthcare provider about any
questions or concerns you have about the information in this program. Also talk with your healthcare provider in person about
what kinds of problems you may have if you do not have this treatment.

©2017, Emmi Solutions, LLC. All rights reserved.

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