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Patient guide: before, during and after surgery
What to bring to the first visit, how to prepare for surgery, what to expect afterwards, and the signs that mean calling without waiting for the appointment.
Before the first consultation
Bring your original studies on disc or USB, not only the written report. That is the most overlooked point and the one that most limits a consultation: the report of whoever read the ultrasound or the CT is an interpretation, and the surgeon needs to see the images himself. If you have had endoscopy or colonoscopy, bring the report and the images too.
Bring the complete list of medications you take — supplements and herbal remedies included — recent labs, summaries of previous operations, and your questions written down. In the room they get forgotten; on paper they do not. And come accompanied if you can: two people remember more than one.
During the consultation
The first part is clinical history and physical examination. Your studies are then reviewed on screen and you are told what is there and what it means. If there is a surgical indication, the technique, risks, alternatives, cost and prognosis are explained.
Before signing a consent form you should be able to answer five things in your own words: what will be done, why now, what can go wrong, what the alternatives are, and what happens if you do not have surgery. If any is unclear, ask again. Nobody serious minds.
Before surgery
Labs will be requested and, depending on your age and conditions, an ECG, a chest film or a cardiology review. The most delicate point is blood thinners: warfarin, acenocoumarol, apixaban, rivaroxaban, clopidogrel and aspirin are usually stopped days beforehand, and that pause is coordinated with the doctor who prescribed them, never on your own.
Stop smoking. This is not brochure advice: tobacco worsens wound healing, increases respiratory complications of anaesthesia and raises the risk that a repaired hernia comes back. Follow the fasting instructions exactly — usually eight hours without solids — and remove nail polish, jewellery and contact lenses. If you are diabetic, ask specifically what to do with your insulin or oral medication on the morning of surgery.
After surgery
Expect fatigue: it is the most consistent and most underestimated symptom, even after laparoscopic surgery that «was nothing». Walk short distances several times a day rather than one long outing: that is what prevents thrombosis and helps the bowel wake up. Keep the wounds clean and dry as instructed.
Respect the restrictions on exertion even when you feel well. After a hernia repair, feeling well does not mean the mesh has integrated: lifting weight too early is the commonest cause of recurrence. And follow the diet progression you are given; in bariatric and colonic surgery that progression is not a suggestion, it is part of the treatment.
Call without waiting for your appointment if you have any of these
Fever or a red wound
Fever above 38 °C, spreading redness, discharge or opening of the wound.
Abdominal pain that increases
Pain that grows instead of settling in the days after surgery.
Persistent vomiting
Vomiting that prevents keeping fluids down, or that returns after settling.
No gas or bowel movement
Abdominal distension with no passage of gas or stool.
Bleeding
Vomiting blood, black or bloody stools, or bleeding from the wound.
Difficulty breathing
Shortness of breath, chest pain or palpitations.
Pain or swelling in one leg
Calf pain with swelling or redness.
A hard hernia that will not reduce
A lump that has turned hard and painful and cannot be pushed back in.
Bring your studies and settle the question
One consultation with your ultrasound or CT in hand is worth more than ten internet searches. Book by phone or through the form and you will be told what is there, what it means and what your options are.