Pre-operative testing and medical clearance

The pace of life in New York can be very hectic. Try to remember that your decision for surgery reflects the fact that you have decided to take a proactive step to fix a health problem. Do not be shy about asking for help from your family and loved ones.

Sphygmomanometer — Make certain to schedule all of the pre-operative testing and clearance you have been given. We welcome your outside diagnostic tests and laboratories. You may prefer to have these tests through the office of your primary care physician or referring specialist.

Prior to your surgery, you will need to have routine tests that are required of all patients undergoing a procedure under anesthesia. These may include routine blood tests, electrocardiogram, chest x-ray, urinalysis, and echocardiogram. Depending on your age and your other medical problems, we will determine which of these tests you need and whether you will require a letter of medical clearance from your regular doctor. Pre-operative testing can be arranged through our office or through your medical doctor’s office. Results need to be faxed to our office within two weeks of the day of surgery.

If you wish to have your medical tests performed in or close to Dr. Belsley’s office building then consider the following:

There is a branch of LabCorp in the lobby entrance of the Brodsky building. This is room 1A located just past the security guards to the right of the elevators. Open 8 am until 6:30 pm for all walk-in appointments.

Chest X-rays are offered in the radiology suite inside Mt. Sinai West on the fourth floor. They can offer accomodate walk-ins and same day requests.

IV Catheter — Insurance coverage and the prices for blood work varies significantly across New York. You are welcome to use the laboratory affiliated with your insurance company or primary care physician and have them send us the results.

Mental preparations and planning

Adequate preparation can reduce stress. This is an important planning and preparation time. Follow all of the good health habits you have begun. Put your schedule together for the day before, day of and first few days following the surgery. Share this with all of your key support people.

Medications to avoid

STOP taking the following for the duration before your surgery. Taking any of the following can increase your risk of bleeding and other complications:

Aspirin and medications containing aspirin, Blood thinners including Plavix and Coumadin, Garlic Supplements, Ibuprofen and anti-inflammatory agents, Green Tea or green tea extracts, Vitamin E, Estrogen supplements, St. John’s Wort and other herbal supplements.

Please note that some topical pain patches contain high levels of anti-platelet medication that can also increase the risk of bleeding. These patches should be discontinued one week before surgery as well.

Clove of Garlic — Garlic supplements may lower blood pressure and help with cholesterol. It may also increase bleeding during surgery and therefore garlic and other health food supplements should be stopped one week before your operation.

Special Instructions for Patients taking GLP-1 Receptor Agonists

These medications decrease gastric emptying and pose an increased risk of a “full stomach”, regurgitation and pulmonary aspiration. The medication should not be taken for a minimum of 2 dosing intervals which corresponds to a minimum of 15 days.

Patients also must be on clear liquids the entire day before the procedure starting at 8 AM. While a normal breakfast can be consumed the day before surgery before 8 AM, these patients must be on clear liquids only after 8 AM until midnight where they should be strict NPO. This means that nothing additional after midnight prior to the procedure except for critical medications with a sip of water.

Fitness:

Don’t over-do it. Avoid anything strenuous or that could potentially cause injury. Do not decide to get in shape last minute for your operation. Light exercise is fine.

No Smoking

Specifically, do not smoke cigarettes, cigars, hookahs. Vaping is also bad for your health. Stay away from second-hand smoke, too. Your healing and health depend heavily on this.

Lead a healthy lifestyle:

Practice good hand-washing and avoid large crowds or individuals who are ill. Do not risk catching a virus or cold: no sharing beverages or other high risk opportunities for contacting viral or other illnesses.

Avoid sun exposure:

Sun damaged skin can more readily produce irregular scars or cause pigmentation irregularities following surgery.

Salmon on grill — Maintain a balanced and healthy diet. Following good nutrition is something that can improve your quality of life and help with longevity. Stay in a steady state prior to your operation. Do not go out of your way to either gain or lose significant weight.

ONE WEEK BEFORE SURGERY

Confirm your day of surgery plans with our office, your job and your family. You should think of your transportation and after-care. It is best to have available a responsible adult for the first 24 hours after your arrival home who can help you with everyday tasks. Do your grocery shopping beforehand. Please make sure that you have thought of your living situation and where you plan to recover. New York City walk-ups can be daunting for those recovering from surgery. You may also need to arrange child care and pet care as well.

Review your prescription orders and instructions

You should discuss the prescription medications that you take with Dr. Belsley and decide which of those medications you will take the morning of surgery and which you will not take the morning of surgery.

Confirm all lab results and medical clearance paperwork have been received by Dr. Belsley if you have not already done so.

Continue to practice healthy habits, nutrition and fitness

No strenuous exercise. No saunas, hot tubs, steam baths or mud wraps. No smoking or alcohol.

Relax

Get plenty of rest.

Call our office with any unusual anxiety or concerns. The best way to reach us during normal hours is with the EPIC chat function using your Mt. Sinai EPIC MyChart App.

Glossary