Remember that everything we do is for your safety!
If you are going to have general anesthesia (asleep) or a deep IV (intravenous) sedation for your surgery, the process starts the night before. Do not gorge the night before in preparation for the needed dietary changes (soft foods) that will accompany your post-op instructions! Eat a normal meal, and do it well before 11:59 PM! When you awaken, remember that you cannot have anything to eat or drink after midnight. That is for your own safety under anesthesia! A sip of water is fine, especially if we have asked you to take any of your normal medications, but not a soda, cup of coffee, or scrambled eggs! Please follow this instruction carefully!
Wear loose clothing, especially so that your sleeves will easily move above your elbows without being tight.
Try to do your best to remain calm, with the knowledge that we will not hurt you. We are there to make your visit as easy as we can. It is best to use the restroom in the hallway prior to coming back for the procedure. Once in the surgical room, please ask any questions you have on your mind.
Next, I will lean you back. If you have any restrictions in positioning, we will make every effort to accommodate.
For your safety, placement of an IV before going to sleep is ideal. If you have a fear of needles, nitrous oxide (laughing gas) breathed through your nose will make placement of the IV virtually painless. Once in place, medication is given, which at first will give a very relaxed feeling. If general anesthesia is used, the next thing you know, you will be done. You will awaken without pain, because local anesthesia is given while you are asleep.
If deep sedation has been offered, you will not technically be all the way asleep. Because of the amnestic effects of the drugs, over 95% of my patients who are deeply sedated remember nothing about their surgery. This has the benefits of general anesthesia and is what is offered for any patient who has medical or physical problems that make a full general anesthesia in the office more risky for them. Deeply sedated patients also receive local anesthesia for their procedure. Patients who are told they will be going under general anesthesia have a 100% loss of memory of the procedure.
All patients with an IV in place are fully monitored with the same care taken in a hospital setting. Blood pressure, heart rate, EKG, pulse oximetry (for oxygen concentration), and capnography are watched closely at all times. I am ACLS certified.
When patients are more alert, the IV is removed and oral medication is started in the office prior to them leaving. Postoperative instructions are given to the patient and their ride, along with my personal cell number to reach me day or night with questions. Medications are faxed to their pharmacy, and in most cases are waiting for you to pick up when you drive by. We escort all patients to their car. You should not move around much at home for the first few hours, and avoid stairs.
Most patients remain drowsy for at least one day. You should not drive the rest of the surgery day, or if the narcotic medication given as a backup prescription makes you drowsy. Some patients can notice prolonged drowsiness from either general anesthesia or deep sedation, sometimes lasting for days. Please call us if you have any questions!