Scheduling Surgery

Drs. Anthony and Gonzales are proud to perform surgery out of Saint Barnabas Medical Center, Union Surgery Center, Surgicare Center of Central Jersey, and the Surgical Center of Millburn.

Below is information regarding the process of surgery.


Preparing for Surgery


Knowledge is power. And knowing what to expect can help achieve the best outcome. We are here to make your surgical experience a positive one!



Checklist:

  • Plan for surgery with Dr. Gonzales or Dr. Anthony

  • Follow up with the surgical scheduler, Lisa, for surgery date/time/location

  • Complete all discussed pre-admission testing and have results faxed to

(949) 655-2639 Attn: Lisa

  • Schedule pre-op consultation for 1 week prior to surgery to discuss your post-op care and obtain any prescriptions for any post-op medications

  • Make arrangements for the day of surgery transportation to/from the facility

  • Consider/obtain equipment for your recovery period

  • Confirm with your primary care physician/internist which medications to continue/stop/adjust before your surgery

  • Review your financial responsibilities with both Lisa and the surgical facility

  • Attend your pre-op appointment with Dr. Gonzales or Dr. Anthony

  • If applicable, fill your post-op prescriptions at your pharmacy

  • Set up your home to ease your recovery

  • Schedule your first post-op appointment (typically one week after surgery)

  • Follow the arrival instructions provided by the surgical center (generally arrival time is 1 hour prior to your surgical time)

  • Bring your photo ID, insurance card and list of current medications/medical history

  • If your surgery is elective, schedule it for the best time in terms of your work, school, and personal life.

  • Lisa is the surgical scheduler and will work closely with you, the surgical facility and your insurance company to plan your surgery. You can reach Lisa at Lisa@dynamicfootankle.com with any questions.


Pre-Admission Testing & Medical Clearance


  • At the time of surgical planning Dr. Anthony or Dr. Gonzales will give you a prescription for required pre-op testing. These tests may include chest X-rays, blood work and an EKG.

    • Blood work can be done up to 30 days before your procedure

    • EKGs are valid for 6 months, as long as there have not been any changes in your symptoms

  • It is important that you obtain your pre-op testing prior to your pre-op visit with Dr. Anthony or Dr. Gonzales

  • Schedule time with your primary doctor/internist to obtain medical clearance for surgery and discuss possible pre-op medication adjustments

** Medications Can Increase Bleeding or Interfere with Anesthesia **

Some medications impair the body’s ability to form a clot & stop bleeding. Be sure to discuss these with your physician:


  • Aspirin: Aspirin should be discontinued prior to elective surgery

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Non-selective COX inhibitors (i.e. Advil, Motrin, Mobic, Aleve, Naproxen) should be discontinued prior to elective surgery. Selective COX inhibitors (i.e. Celebrex) can be continued.

  • Vitamins, Supplements, Herbals: Herbal medications and supplements may increase bleeding and/or interact with medications used for anesthesia.

  • Coumadin, Heparin, Plavix, Lovenox: Despite their effect on clotting, in some cases, these medications should be continued.


Speak to your primary doctor regarding each medication you are taking and confirm which medications to continue/stop/adjust. Follow the instructions given to you.



Schedule Pre-Op Consultation


  • Once you have a surgery date, schedule a pre-op consultation with the doctor performing your surgery (Dr. Gonzales or Dr. Anthony).

During this visit, you will:

  • Discuss the details of your surgery and recovery, and get answers to all your questions

  • Obtain necessary prescriptions for after your surgery

  • Bring any disability paperwork required to be completed

  • Pay any balance due

  • Schedule your first post-op visit


Transportation Arrangements


  • Most procedures use intravenous sedation. Therefore, you must not operate a motor vehicle for 24 hours

  • Make arrangements for a someone to drive you home on the day of surgery

  • Due to the post-op effects of the anesthesia, you will not be permitted to take public transportation home alone

  • Each surgical facility has its own Covid protocol for where your driver must wait.



Preparing Your Home


Plan ahead and be proactive. Take time now to consider what you may need during your post-op weeks.

  • If your bedroom is upstairs, consider setting up a temporary bedroom on the ground floor. Negotiating stairs will be difficult for a while

  • Make sure there’s a clear path so you can easily move from room to room

  • Consider/obtain equipment for your recovery period

  • Cast bag for bathing without getting the incision site wet (we recommend DryPro)

  • Rolling knee scooter if you will be non-weightbearing (many first aid squads and Facebook groups offer these for free)

  • Shower stool in the bathroom

  • Go shopping and stock up on your favorite foods

  • Line up others to help out with future tasks and chores

  • Create a home base near a chair and gather often-used items to have them handy (e.g. phone charger, computer, clock, television clicker, books, snacks, pad and pen, medications)



What do I need to do the day BEFORE surgery?


  • Notify the office if you have a cold, cough, fever, or other illness

  • The surgical facility will call you to confirm the time of your surgery and when to arrive

    • Arrival time is usually 1 hour prior to your surgery time to ensure you have the opportunity to meet the team that will be caring for you

  • Rest!

  • Make sure to drink lots of fluid prior to fasting. After surgery, we will be sure to get you a snack!

  • If you smoke, stop. Or at minimum, reduce your smoking prior to the operation. Studies have shown that smoking increases post-op healing time up to 33%

  • Do not drink any alcohol for 24 hours prior to your surgery

  • Eat a light supper

  • After midnight, you should not eat or drink anything by mouth.

This includes gum, candy, water, coffee, tea or food of any kind



What do I need to do the DAY OF surgery?

  • Wear comfortable clothing

  • Do not bring jewelry, large amounts of money or other valuables

  • Remove all eye makeup and nail polish before coming to the facility

  • Per you prior discussion with your primary doctor, take any required medications with only tiny sips of water

  • Do not take: chewable antacids, water pills, diabetic pills, potassium, weight reduction agents or vitamins unless directed by your doctor

  • If you wear glasses, contacts, dentures or hearing aids, bring along a case

  • Bring your photo ID, insurance card and list of current medications/medical history

  • Arrive at the surgical facility accompanied by another adult or with a plan for your ride home. You will not be permitted to drive for 24 hours after having anesthesia


What can I expect when I arrive at the surgical center?


  • The intake nurse will review your medical history with you

  • You will be introduced to your operating room nurse

  • Your anesthesiologist will review your medical history, explain your care and answer any questions

  • Dr. Anthony or Dr. Gonzales will review your procedure with you and answer any last-minute questions not previously discussed at your pre-op appointment


Post-Op Instructions


  • Activities

  • Have a responsible adult available to you for 24 hours

  • Do not drive or operate machinery for 24 hours

  • Do not make important personal/business decisions or sign legal documents for 24 hours

  • Limit your activities for 24 hours. Do not engage in sports, heavy work or heavy lifting

  • Per instructions, use one of the following (see discharge paperwork):

  • Surgical shoe for partial weight-bearing to the heel, or

  • Crutches for partial weight-bearing, or

  • Crutches for non-weight-bearing


  • Wound Care

  • A small amount of blood is to be expected; do not be alarmed

  • If you feel the bleeding is excessive (i.e. general oozing that saturates the dressing completely or bright red bleeding) apply pressure to the area, elevate if possible, and contact your surgeon at once

  • DO NOT change the dressing or remove packing until you see your surgeon

  • Keep the dressing and wound dry


  • Care of Extremity

  • Your operation site will remain numb for several hours after surgery

  • Call your surgeon if the affected extremity becomes cold to the touch, appears blue, remains numb for more than a few hours after surgery, feels tingly, or if you have excessive swelling or pain

  • Elevate the affected extremity, as much as possible, to the level of your heart

  • Apply ice for 15-20 minutes at a time per hour while awake


  • Call the office IMMEDIATELY if you:

  • See signs of infection: increased pain, redness, temperature over 100°, chills, nausea, shortness of breath

  • Are unable to pass urine within 8 hours of surgery

  • Observe your bandage becomes saturated with blood

  • Bump or injure your surgical site

  • Are having an adverse reaction to medications such as a rash, itching, shortness of breath, severe nausea, vomiting, or diarrhea

  • Are having calf pain

  • Observe bandage has become wet

If you experience any of the above, and are unable to get in touch with your surgeon or the on-call physician, go immediately to the EMERGENCY DEPARTMENT of your local hospital.


  • Medications

  • Resume your daily medication schedule upon discharge

  • No alcoholic beverages for 24 hours after surgery or while taking prescription pain medications

  • No driving for 24 hours after surgery or while taking prescription pain medications

  • Go to your post-op appointment with Dr. Anthony or Dr. Gonzales

  • Call (973) 366-1016 with any questions. After business hours, press 3 to reach the on-call physician


What about pain control?


  • Elevating as often as possible is a key to reducing pain. Your foot/ankle should be at the level of your heart. Try lying on the couch with your foot on the armrest or with pillows underneath your legs

  • Ice effectively reduces pain and swelling. Apply ice for 15-20 minutes at a time per hour. For surgeries requiring large bulky bandages, try placing the ice behind your knee to cool the major blood vessels that travel to your foot

  • If pain persists, the outer Ace bandage may be too tight, causing increased pressure and pain. Try loosening the outer bandage. DO NOT loosen the dressing or packing

  • Narcotic pain medication may be prescribed for the short-term. Read the instructions and take your medication only as prescribed. Do not exceed the dose. Hydrate to prevent constipation

  • Stay ahead of the pain by making a medication schedule and sticking to it. Pain is easier to manage before it becomes intense. If you are still having pain, your surgeon may recommend over-the-counter medication to add to your regimen


Getting Around


  • Enlist the help of others to provide transportation

  • If your right foot was operated on, ask when you can resume driving

  • Determine if you will need to get a temporary handicap parking placard


Handling Your Work


  • Discuss your return-to-work date with Dr. Anthony or Dr. Gonzales

  • If you will require disability paperwork to be completed, please bring it to your pre-op appointment




WE ARE HERE FOR YOU!


Start your surgical experience on the right foot by asking questions.

The Dynamic Foot & Ankle Team is here to guide you through the entire process.

And remember, by knowing what to expect and planning ahead for your recovery, you will significantly improve your post-op experience.


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