Preoperative Instructions

Christopher Miller, MD Pre-operative Instructions After Foot & Ankle Surgery

Thank you for allowing me to assist in your care. It is a privilege to be able to take care of you. Should you have any questions about your pre-operative care, please call my office at 617-667-3940 during business hours and either myself or Brianna Whitehouse, PA-C will address any questions or concerns you may have. If this is an urgent matter at night or on weekends please call 617-667-7000 and ask the operator to page the covering 1^st call orthopaedic physician.

Our goal is to make your pre-operative preparation and post-operative recovery as easy as possible. We know that planning for and undergoing surgery is confusing, stressful and sometimes scary.

*****These are general guidelines for pre-op care and are sufficient for the majority of my patients and surgeries. You specific instructions may differ slightly. You should call my office if you have any questions or concerns.******

PREPARING FOR SURGERY :

If Dr. Miller’s staff request, please call you primary care physician’s office to set up an appointment for a pre-operative physical and lab tests. These must be done within 30 days of your surgery date if needed. All results and note should be faxed to 617-667-2155.

You will likely be NON WEIGHT BEARING on the operative foot after surgery. You will need to plan for this prior to surgery to maximize your safety. This means that you cannot put any weight at all on the operative foot until the doctors says that it is safe.

To this end, you should evaluate your home critically.

1. How will you get into and out of your house after surgery?
   1. Is someone available to help you?
2. Do you have steps to climb? If so, how many?
   1. Can you use a railing to help?
3. Can you enter the house without using stairs?
4. Where will you sleep?
5. How will you get to the bathroom?
6. How will you fix your meals?

Have a plan before surgery for how to get home safely and practice doing so beforehand.

You should plan to use assistive devices to help you mobilize. Often crutches or a walker are sufficient, however, sometimes a rolling knee scooter or walking knee crutch can be helpful as well and can allow you to mobilize while being relatively “hands free.” These items are typically not covered by insurances plans but they are great assistive devices that offer advantages to some patients over walkers or wheelchairs. They can be purchased for $120-150 online. See the “Rolling Knee walkers” tab on the Patient Info page of the website for more information.

DRIVING:

1. You will NOT be able to drive immediately after your surgery.
2. You will be given powerful medications to keep you comfortable and calm during the surgery. You must have someone who can take you home from surgery.

If you are having same day, outpatient surgery, you MUST have someone who can drive you home. Unfortunately you cannot take a Taxi or Uber home. We must be able to discharge you into the care of someone who can help care for you post-operatively. We have had to cancel surgeries because of this.

THE DAY BEFORE SURGERY:

1. Do not eat anything after midnight the night before your surgery.
2. Some centers will allow you to drink clear liquids up until 2-3 hours before arrival to the hospital. Call to confirm or ask when the center or office calls you to tell you the surgical time.If you are unsure, I advise abstaining. Also, moderation is key. Common sense would suggest that you should not drink a half-gallon of water 2 hours before your surgery no matter what any policy might say.
   1. Clear liquids include: Water, Gatorade, Coffee (with no milk), any liquid you can see through
   2. Clear liquids DO NOT include: orange juice, milk, protein shake, etc.
3. Some medications are acceptable to take prior to surgery with a small sip of water. When the OR calls prior to surgery they will instruct you on what you can and cannot take.
4. Do not consume alcohol for 24 hours prior to surgery. Smoking and recreational drug use prior to surgery can lead to serious side effects under anesthesia.
5. You must have a responsible adult (18 years or older) to drive you home and stay with you to assist for 24 hours after surgery.
6. Ensure you know the time and location of the surgery. We have had patients come to the wrong location or wrong time and we had to cancel their procedure. Call my office if you have any questions. 

THE DAY OF SURGERY:

1. Wear loose, comfortable clothing that can fit over a bulker dressing/cast. Do not wear jeans.
2. You will receive a call a day or two prior to surgery to confirm the location and time of surgery. You should arrive 2 hours before the scheduled start of surgery. My office or the hospital will call to tell you when to be present.
3. Give yourself plenty of time to get to the hospital or surgical center, find parking and make your way to registration.
   1. Beth Israel Deaconess Medical Center East Campus, Shapiro 3^rd Floor
      1. 89 Binney St, Boston, MA
   2. New England Baptist Hospital Outpatient Surgical Center, 2^nd Floor
      1. 40 Allied Drive, Dedham, MA
   3. Do not wear contact lenses, barrettes, hair pins or hair pieces
      
   4. No make up, artificial nails, jewelry, or watches should be worn during surgery
   5. Please bring a photo ID, insurance card and prescription card to your surgery check in
   6. Bring a list of current medications and drug/food allergies
   7. Bring 3-4 pillows to elevate your foot on the ride home.

You will receive post-operative instructions at the time of your surgery. You can see general guidelines on the website on the Patient Info page under “Postoperative Instructions.” The specifics of your weight bearing and dressing management may differ slightly from what you see online, but most of the information is the same regardless of surgery. Call my office for any questions or concerns.