Pre-Surgery Checklist

Please follow these general guidelines to prepare for your surgery:

Please bring to our attention any medical conditions such as high blood pressure, diabetes, or any cardiac problems. Such conditions should be stabilized prior to surgery. Please also let us know if you are under any medical treatment for.

• Anticoagulants (i.e. coumadin).
• Diuretics.
• Insulin or oral hypoglycemic drugs.
• Medications for high blood pressure.
• Thyroid supplements.

Please let us know if you take any routine medications.

Four weeks prior to surgery.

• Discontinue any over-the-counter blood thinners.

Two weeks prior to surgery STOP:

• Drinking alcohol
• Smoking or chewing tobacco
• Vitamin E
• Saint John’s Wort
• Garlic
• Ginseng
• Also discontinue aspirin and aspirin-containing products no later than two weeks prior to your surgery. These products may interfere with healing and contribute to excessive bleeding during surgery.
• If you smoke, plan to quit 2 weeks prior to surgery, but no later than one week before. We know this is difficult, and it is not an absolute requirement, but your procedure will go more smoothly if you quit. If you smoke, you can expect slower healing and an elevated risk of complications. Please see your pharmacist for an over-the-counter “stop smoking remedy”, and please plan to quit now.

One week prior to surgery:

• If you normally have low platelets, begin Prednisone or other cortisone supplement according to your Pharmacist’s instructions to boost your immune system and raise your platelet levels.

The day before surgery.

• Shampoo and shower twice.

The night before surgery.

• Do not eat or drink anything after midnight.
• Do not eat 8 hrs. before surgery.

On the day of surgery.

• Do not wear make up, creams or lotions.
• Remove any contact lens.
• Brush your teeth and take a regular shower.
• Approved routine medicines may be taken with a sip of water in the morning.
• Wear comfortable loose fitting clothes. Avoid anything that must be put over your head if you are having facial, breast, or abdominal surgery, wear button front shirts for easy removal. Do not wear high heels, tight jeans, rings, jewelry or nail polish. Leave all valuables at the Costa Rica Medical Center Inn, except your passport and method of paying the doctor (i.e. credit card or travel checks). The hospital has safes for the protection of the items you bring.

On the day of surgery.

Pre-op tests (lab tests) will be necessary before surgery. For your convenience, you may have them done at home within 4 weeks prior to surgery and bring them with you, or have them done here after your pre-surgery consultation. If done here, they are included in your price quote (excluding EKG, mammogram or ultrasound, which are extra).

If 45 years of age or under, and if having lab tests done at home, please ask your local doctor or lab for the following standard pre-op tests.

- Complete blood count (CBC) - HGB HCT RBC, - Platelets, Prothrombin Time (PT), - Partial Thromboplastin Time (PTT), - HIV - Complete urine test

If 45 years of age or older, and if having lab tests done at home, please ask your local doctor or lab for the following standard pre-op tests.

- Complete blood count (CBC) - HGB HCT RBC, - Platelets, Prothrombin Time (PT), - Partial Thromboplastin Time (PTT), - HIV - Complete urine test - BUN, Creatinine - Glucose - Cholesterol, Triglycerides - EKG

If you should develop a fever, cold, flu, migraine, sore throat, diarrhea, rash or other illness, please let us know. Surgery may have to be postponed under certain conditions.

Please keep away from mosquitoes to avoid being bitten. Excessive poison in the blood will result in the postponement of your surgery.

Avoid overexposure to the sun before surgery, and please do not go on a stringent diet, as both can inhibit your ability to heal. If sunburned, surgery will need to be postponed. Exercise is an important way to prepare yourself for surgery. If you don't regularly exercise, start now, but gently. Don't exercise to soreness, especially if surgery is near. Regarding medical tests, you may bring the test results with you, or you may have them done here as part of your pre-op visit at our hospital. If you are uncertain of your health, it would always be best to have tests done at home prior to making travel arrangements.

If you have not yet done so, it is important that you arrange post-op recovery accommodations with the Costa Rica Medical Center Inn to coincide with your pre-op consultation, surgery date and follow-up appointments. Dr. Pacheco visits his post-surgery patients there on a daily basis as needed.

Please write to us if you have any questions.