Preparing for surgery involves more than just a hospital bag; it requires strict adherence to pre-operative guidelines to ensure a safe procedure and smooth recovery. The week leading up to your operation is a critical period where certain actions must be avoided to minimize risks such as excessive bleeding, complications with anesthesia, and poor wound healing. Understanding and following these instructions is a fundamental part of patient safety.
Stop Taking Certain Medications and Supplements
Many common medications and health supplements, including those available over-the-counter, can significantly increase the risk of bleeding or interfere with anesthesia. A week before surgery is typically when a patient must stop taking them, though the exact timing varies. Always consult your surgical team or primary care physician for a personalized list of what to stop.
Medications to discontinue
- Blood Thinners and NSAIDs: Over-the-counter and prescription blood thinners and non-steroidal anti-inflammatory drugs (NSAIDs) must be stopped. This includes common medications like ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin. Some powerful prescription anticoagulants like warfarin, Eliquis, or Plavix often require longer cessation periods, or a temporary switch to an alternative.
- Dietary Supplements and Herbals: Herbal supplements such as garlic, ginger, ginkgo biloba, fish oil, and St. John’s Wort can affect blood clotting and interact with anesthesia. Most vitamins, with the exception of some like Vitamin D or Calcium if approved, should also be stopped. Your doctor should be aware of every supplement you take.
- Specific Prescriptions: Certain antidepressants (like MAOIs) or weight loss medications can interfere with anesthetic drugs and may need to be stopped weeks in advance, though the specific protocol should be determined by your doctor. Some diabetes or blood pressure medications may be held the morning of surgery as well.
Cut Out Alcohol, Nicotine, and Cannabis
These substances can have a profound negative impact on surgical outcomes and must be avoided. The week before surgery is an absolute minimum for abstinence, with doctors recommending a longer period where possible.
Effects of these substances
- Alcohol: Excessive alcohol consumption can thin your blood, increasing the risk of bleeding during surgery. It also interacts with anesthesia and pain medications, potentially making them less effective or dangerously sedating.
- Nicotine: Smoking and other nicotine products impair blood flow and wound healing by reducing oxygen delivery to tissues. This dramatically increases the risk of wound infections, blood clots, and other cardiopulmonary complications.
- Cannabis and CBD: Marijuana and CBD products can affect heart rate, blood pressure, and pain control. They must be discontinued in the days leading up to the procedure to prevent adverse reactions with anesthesia.
Avoid Intense or New Exercise Programs
While maintaining overall fitness is beneficial for recovery, the week before surgery is not the time to push your limits. Intense exercise can cause dehydration, muscle soreness, and fatigue, all of which are counterproductive to preparing for the physical stress of surgery.
The right approach to exercise
- Stick to light activities: Gentle stretching, walking, or low-intensity water aerobics are acceptable if you are already accustomed to them.
- Avoid aggressive training: Refrain from heavy lifting, high-intensity interval training (HIIT), or starting a new, strenuous workout program. You don't want to sustain an injury or tire your body out before surgery.
- Rest the day before: It is crucial to get plenty of rest the day before surgery to ensure your body is calm and ready.
Refrain From Specific Hygiene Practices
Certain preparations are required to prevent infection and allow medical staff to monitor your health effectively. These are typically restricted to the day or two before surgery but are critical to remember.
Critical hygiene rules
- Do not shave the surgical site: Shaving can create microscopic cuts in the skin that increase the risk of infection. Your surgical team will prepare the area if needed.
- Avoid makeup, nail polish, and lotion: On the day of surgery, your skin should be bare. Nail polish can hide important signs of blood circulation, and makeup, lotion, or deodorant can interfere with medical equipment.
Comparison of Pre-Op Restrictions
| Item | 7 Days Before Surgery | 24 Hours Before Surgery | Day of Surgery |
|---|---|---|---|
| Aspirin / NSAIDs | Must stop | Must stop | Must stop |
| Herbal Supplements | Must stop | Must stop | Must stop |
| Alcohol | Must stop | Must stop | Must stop |
| Smoking / Nicotine | Must stop (ideal is longer) | Must stop (at least) | Must stop |
| Intense Exercise | Avoid new/intense routines | Rest | Rest |
| Eating Solid Foods | Normal diet (unless instructed) | No solid food after midnight | No solid food |
| Drinking Clear Liquids | Unlimited (unless restricted) | May be allowed up to 2 hours before | Stop 2 hours before |
Prepare Logistically, But Don’t Bring Valuables
In the week before surgery, you should finalize practical arrangements, but on the day itself, it's about minimizing risk and distraction. Making plans for post-operative care and transport is essential. However, valuables are a liability.
Logistical planning
- Arrange for transportation: You will not be allowed to drive yourself home after receiving anesthesia. Arrange for a responsible adult to take you home and ideally stay with you for 24 hours.
- Leave valuables at home: This includes jewelry, expensive electronics, and large sums of money. Hospitals cannot be responsible for their safety.
- Gather necessary items: Pack a list of medications, insurance information, a photo ID, and cases for glasses or dentures.
Other considerations
- Monitor your health: If you develop a fever, cold, or any other signs of illness, contact your doctor immediately. Your surgery may need to be postponed.
- Brush teeth carefully: The morning of surgery, you can brush your teeth but must avoid swallowing any water.
Conclusion
Understanding what you should not do 7 days before surgery is critical for patient safety. By following these guidelines, you can significantly reduce the risk of complications and ensure the best possible outcome. Always remember to communicate openly with your surgical team, sharing all information about medications, supplements, and any recent health changes. Proactive preparation and strict adherence to instructions are your best tools for a successful procedure and recovery. For more detailed instructions specific to your procedure, always defer to your surgical team. A resource such as the American Society of Anesthesiologists provides detailed patient information on pre-surgical preparations.
