What happens after I have agreed to surgical treatment?
If you are having treatment as a private patient, you will be given a code(s) for the surgical procedure by either ourselves (the surgeon) or by our secretaries. You will need to contact your insurance company to seek authorisation to proceed with surgery. You will need to let them know:
- that you are having a surgical procedure,
- the relevant codes for the procedure,
- the hospital where the surgery will take place.
If you are unsure of any of the above please contact our secretaries.
If you are self funding please contact our secretaries who will organise a quote for the cost of surgery from your chosen hospital(s).
You will then be contacted by the hospital where the procedure will be carried out. They will run through a pre-operation questionnaire. You may need to have some pre-operative checks (blood tests, ECGs and x-rays) to make sure you are medically fit for anaesthesia and the surgical procedure.
It is sensible to see your physiotherapist pre-operatively to familiarise yourself with exercises that will be involved in your post-operative care. They will also help keep the shoulder mobile before surgery.
Keep hydrated and eat sensibly on the days leading up to surgery. Take all of your normal prescribed medication unless instructed otherwise. Medications that will need to be stopped a few days prior to surgery include medications that thin the blood (eg warfarin / clopidogrel / dabigitran etc).
If you are a smoker, you should quit smoking in advance of surgery. Smoking increases the risk of complications associated with surgery.
The preoperative nurse in the hospital where surgery is planned will give you more information about what to do with you medication before surgery.
Precautions relating to Coronavirus
It is advisable for all patients having surgery to practice comprehensive social distancing for two weeks before and after surgery. If you have any underlying health conditions that place you at greater risk, you should consider self-ioslating for two weeks before and after surgery. You will also be required to have a swab test for Coronavirus three to four days prior to surgery. The hospital will provide you with further information regarding this.
Day of Surgery
You will have been contacted by the hospital regarding admission times. For a general anaesthetic you will need to have had nothing to eat for at least 6 hours before surgery. In general term if your operation is in
- the morning: you may have something to eat for dinner the night before but nothing after midnight
- the afternoon: you may have something to eat for breakfast at 0700hr but nothing afterwards
You may drink clear fluids (such as water, pulp-free juice and tea or coffee without milk) up until 2 hours before surgery.
Things to bring/wear
You should wear comfortable clothes to come into hospital. It is sensible to bring
- a button up shirt or a loose-fitting t-shirt as it will be easier to wear after the surgery when you go home
- comfortable loose trousers that are easy to put on
- non-lace up shoes or slippers
- a wash bag and essential toiletries
You should avoid bringing in any valuables.
What type of anaesthesia will I have?
Most upper limb surgery will be performed using general or regional anaesthesia or a combination of the two. Regional anaesthesia or "nerve block" involves injection of local anaesthetic around the nerves, which run into the arm. This numbs the arm and keeps it pain-free often until the day after surgery. The arm may feel heavy and you will need to wear a sling to support the arm following surgery.
For general information on anaesthesia including what to expect, side effects and risks click here.
Further information on nerve blocks can be obtained here.
How long will I need to stay in hospital?
This will depend on a number of factors such as your age, general health and the magnitude of the operation you are having. Most patients having arthroscopic procedures of the shoulder and elbow may be able to go home the same day if the surgery is performed in the morning or afternoon. If the surgery is performed in the evening, or if you have other health issues, you may have to stay in hospital overnight. It is worth coming prepared with the essentials to spend a night in hospital. Patients having shoulder or elbow replacements or major open surgery will usually have to spend at least one night in hospital.