Remarkable Health Care
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Guide t
Recovery Colon
Surgery
Prep A-Patients Guide
Fredericksburg, Texas
(830) 997-4353
hillcountrymemorial.org
r en ew
W e lco me
Welcome to Hill Country Memorial’s enhanced recovery program for colon
surgery. Each step is designed to encourage the best results, leading to a
discharge from the hospital 2 days after surgery.
The re new program includes:
•
Pre-operative patient education
•
Surgical and pharmacologic advancements
•
Optimal pain management
•
Dedicated nurses trained to work with colon surgery patients
•
Private patient rooms
•
Emphasis on a speedy return to normal eating and physical activity
•
Caring, compassionate team focused on your renew experience
My Surgery Date:
My Surgeon:
Number to Call with Questions:
My Nurse Navigator: Sabrina Ortagon
Wh o i s m y c a re team?
Renew brings an expert team of healthcare professionals together to help
you get ready for surgery, to help you through your hospitalization, and to
continue to support your recovery after you’ve gone home.
General Surgeon: The General Surgeon is the skilled physician who will
perform the procedure to repair your diseased colon.
Nurse Navigator: Your renew nurse navigator is available to call upon
with questions and to provide care oversight. The nurse navigator will meet
with you prior to surgery so you can learn what to expect from your renew
experience, check-in throughout your stay and as you transition home. Your
nurse navigator is your renew advocate.
Skilled Nurse and Nurse Aide: Much of your care will be provided by a
nurse responsible for your daily care. Your nurse will ensure orders given
by your physician are completed, including dispensing medications and
monitoring your vital signs. Nurse Aides are also available to assist you with
bathing, toileting and walking, as needed.
Anesthesia Department: The Anesthesiologists and Certified Registered
Nurse Anesthetists have developed a specialized protocol for preparing you
for surgery and for keeping you as comfortable as possible during and after
your surgery. Their specialized protocol will be individualized to fit your
needs.
Pharmacist: A pharmacist will review all of your medications before you
come to the hospital in time to get you ready for your surgery.
Case Manager: A specially trained RN case manager will be on your team
to help you make the transition from hospital to home and ensure you have
everything you need when you leave the hospital.
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Wh a t d o I n e ed to know ab ou t hos pit al ar r iv al?
Please arrive at the hospital at least 2 hours early to ensure ample time
to get you checked in and prepared for surgery. You will not need to preregister at the hospital, as this is handled over the phone the week prior to
surgery. A pre-admission nurse will call you to discuss your health history
and current medications and will notify you of your arrival time and
estimated surgery start time. These pre-arrangements are made to help
your surgery day be as stress-free as possible. Let us know how we can
help you.
Supply List
Please purchase the items below for pre-surgery bowel prep.
❏❏ Pick up 4 prescriptions at your pharmacy (Erythromycin,
Neomycin, Reglan and Zofran)
❏❏ Hibiclens-one bottle
❏❏ Dulcolax stool softener gel caps–9 tablets total
❏❏ Miralax powder 510 gm (17.9 oz.)
❏❏ 64 oz. Gatorade, any flavor
❏❏ Aloe vera flushable wipes or baby wipes (for comfort during
your bowel prep cleanse)
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Wha t c a n I e xpect before surgery?
Pre-operative Checklist
1
1.
2.
3.
WEEK BEFORE SURGERY
Please have the following testing completed one week prior to your surgery.
You may check in to admissions at HCM for all testing. No appointment
is needed.
❏❏
Labwork if needed (no fast needed)
❏❏
EKG if needed
❏❏
Chest x-ray if needed
❏❏
Pick up 4 prescriptions at your pharmacy
❏❏
Pick up over-the-counter bowel prep items
❏❏
Stop taking aspirin and all blood thinners* 5 days before your
procedure. Your last dose should be on
. Take all other daily
medications as normal until the day of surgery. *If taking blood thinners,
please be sure to discuss this with your physician.
3
4
DAYS BEFORE SURGERY
❏❏
Stop eating fresh fruits, raw vegetables and high fiber foods.
2
DAYS BEFORE SURGERY
❏❏
Take 2 Dulcolax gel caps in the evening.
❏❏
Maintain a low-fiber diet as listed above.
ist
Checkl
Pre-operative Checklist continued
THE DAY BEFORE SURGERY
there.
Hang in do it!
n
You ca
❏❏
Take 4 Dulcolax gel caps when you wake up.
❏❏
Follow a clear liquid diet all day. You may drink coffee, tea, soft drinks,
water, clear fruit juice, bouillon, sports drinks, popsicles, Italian ice and
Jell-O. Do not eat solid food or drink milk products. This will help flush
out the colon and keep you well-hydrated.
NOON
❏❏
Take Zofran and Reglan
1:00 PM
❏❏
Take 3 Dulcolax gel caps with 8 oz. of clear liquids.
❏❏
Mix entire container of Miralax in 64 oz. of Gatorade. Mix well. Drink
8-12 oz. of the Gatorade mixture every 15-20 minutes until ALL 64 oz.
ARE CONSUMED. It is very important to drink all of the Gatorade/
Miralax mixture within 6 hours.
❏❏
Take Zofran and Reglan
2:00 PM
❏❏
Take Erythromycin one gram and Neomycin one gram by mouth with a
glass of water.
4:00 PM
❏❏
Take Erythromycin one gram and Neomycin one gram by mouth with a
glass of water.
5
Pre-operative Checklist continued
7:00 PM
❏❏
Take Erythromycin one gram and Neomycin one gram by mouth
with a glass of water.
❏❏
Prior to bedtime, cleanse your body with Hibiclens.
MIDNIGHT
❏❏
Clear liquids are allowed until midnight. Nothing by mouth is
allowed after midnight.
MORNING OF SURGERY
❏❏
Do not eat or drink anything, unless you have been instructed
to do so.
❏❏
Do not take diabetes medication, even if you usually do, because you
will not eat this morning.
❏❏
If you usually take blood pressure medicine or seizure medicine, take
it this morning with a very small sip of water.
❏❏
Clean your body again with Hibiclens. Start at your surgical site.
❏❏
Arrive at hospital 2 hours before surgery time.
Take a
deep b
reath.
.
.
6
ahead
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to you comfort.
Listen
dis
of any
Wha t c a n I e xpect after surgery?
Post-operative Checklist
Pain Management: You may take prescription pain medication with
Advil / Motrin / Ibuprofen / Aleve for pain control. Do not take Tylenol
in addition to prescription pain medications, as most prescription pain
medications have Tylenol added to them.
Lifting: No lifting greater than 15 pounds for 4 - 6 weeks. Listen to your
body and do NOT over do it too soon.
Wound Care: You may remove dressings/bandages and keep the incision
area open to air. Do not apply lotion, powder, Neosporin, or any other
product on or around the incision(s).
You may shower at any time. Clean the incision(s) with mild soap and
water daily. Do not remove the steri-strips or dermabond (skin glue) from
the incision until they loosen and begin peeling up around the edges
(usually at least 2 weeks after surgery). If you have staples, they will be
removed at your post-operative appointment in the office.
Personal Care: You may shower. No bath tubs, hot tubs or swimming
pools until released.
Be watchful for signs of infection:
If any signs of infection appear, call your surgeon’s office. These include:
•
Wound becomes red, swollen, tender or warm
•
Wound begins to fester or drain
•
Red streaks appear around the wound
•
Fever greater than 101°F
•
Persistent nausea or vomiting
•
Marked increase in abdominal pain
Very im
port
ant!
7
Post-operative Checklist continued
nt!
porta
Very im
Pain medicine causes constipation:
Because of the nature of your recent surgery, it is very important that you:
•
•
Drink at least 8 cups of water a day and eat foods high in fiber.
Take a stool softener (Colace, Dulcolax) and a mild laxative (Miralax) to
keep things moving until you are seen by your surgeon.
Start to feel renewed:
This timeline helps you anticipate what to expect for your post-operative
renew recovery. Please keep in mind that everyone heals at their own rate.
Day of Surgery - Liquid diet until you feel able to eat solid foods. Be up
and moving by evening.
Post-op Day 1 - You will be walking. IV and catheter will likely be removed.
Post-op Day 2 - You can expect to go home once you transition to a regular
diet, have had one or more bowel movements, and your pain is under
control. These milestones may not be reached by some until post-op day 3
or later. As a reminder, a high fiber diet is good for colon health.
Follow Up: It is important that you keep your follow-up appointment with
your surgeon. Call your surgeon’s office if you need to reschedule for any
reason. Wait for your surgeon’s approval to return to your full activities.
Thank you for choosing HCM!
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Welcome to Remarkable Health Care
HCM RATINGS and REVIEWS
hillcountrymemorial.org
PO Box 835 / Fredericksburg, Texas / (830) 997-4353
hcmmedicalgroup.com | hillcountrymemorial.org