What to expect from your surgical procedure by Houston Methodist Sugar Land

WHAT TO EXPECT FROM YOUR SURGICAL PROCEDURE

OUR VISION Houston Methodist Sugar Land Hospital is the premier hospital in the Fort Bend community that provides exemplary care through the loving hands and hearts of top quality physicians and staff. We promise to cultivate a safe, spiritual and healing environment.

16655 Southwest Fwy. Sugar Land, TX 77479 281.274.7000 houstonmethodist.org/sugarland

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082018

Your doctor and the surgical staff at Houston Methodist Sugar Land Hospital are committed to providing you with the best care possible during your stay with us. Some of the care actually starts before you arrive, in the comfort of your own home. Please read and follow these instructions carefully.

SURGERY DATE: TIME: ARRIVAL TIME:

PREADMISSION TESTING

To schedule your preadmission testing appointment, please call 281.274.7087. Hours of operation are: Monday – Friday, 7:30 a.m. – 6 p.m. Appointments take approximately one to two hours.

AT YOUR PREADMISSION TESTING VISIT, YOU WILL:

• Check in at the front reception desk on the first floor of the Main Pavilion. Please bring your license, or other form of photo ID, and insurance card. • Visit with a nurse to complete surgical and medical history as well as go over your medication list. Please include all prescription, over-the-counter and herbal medicines. • Complete laboratory and/or diagnostic testing, such as blood work, EKG, chest X-ray, etc.

If you have questions about your billing, please call 832.667.5900..

Thank you for choosing Houston Methodist Sugar Land Hospital.

WELCOME TO HOUSTON METHODIST SUGAR LAND HOSPITAL

We hope to make your stay a pleasant one. This brochure will explain what you can expect before your surgery, during your stay and after your surgery.

Schedule your preadmission testing appointment After your physician schedules your

surgery, please call 281.274.7087 to schedule your preadmission testing appointment. Calls for appointments are returned within 24 hours during

the week. Preadmission testing is available between the hours of 7:30 a.m. and 6 p.m., with the last appointment available at 5 p.m., Monday through Friday.

We suggest you come for preadmission testing no later than one week prior to the date of your surgery.

Check in and meet with your nurse Please check in at the front reception desk on the first floor of the Main Pavilion

(see map on page 8). We will need the following information:

After you check in on the first floor of the Main Pavilion, you will then meet with a nurse in the preadmission testing area on the second floor for the following: • Review your medical history • Sign your surgical consent • Receive presurgery instructions to prepare for your surgery day • Answer any questions you may have

It is important that you give us a complete and accurate list of all your current medications with dosages and frequency as well as a history of all previous surgeries.

Complete diagnostic screenings During preadmission testing, it may be necessary for us to obtain lab work, an

EKG and/or chest X-ray, depending on your medical history. Please note, this process may take up to two hours. Thank you in advance for your patience.

• Driver’s license or other form of photo ID • Current list of medications and dosages • Contact information • Insurance card • Payment method • Employer (if applicable)

% FURTHER COMMUNICATION You may receive a call from Houston Methodist Sugar Land Hospital if further patient or payment information is needed. Please note due to privacy laws the message will be brief. At your earliest convenience, please return the call.

PREPARING FOR YOUR SURGERY

THE NIGHT BEFORE YOUR SURGERY

Medications

Food and Drink

It is important that you provide an accurate list of all your current medications with dosages and frequency as well as a history of all previous surgeries.

Unless otherwise directed by your surgeon, do not eat or drink anything after midnight the day before your surgery. This includes water, hard candy or gum. Take only those medications instructed by your doctor. It is very important to have an empty stomach during surgery to avoid vomiting and associated complications.

Please be sure to talk to your doctor about any medications you are currently taking, especially for heart, diabetes, blood pressure or diet; be sure to mention any other over-the-counter medications such as aspirin, ibuprofen or any herbal supplements. Your doctor will give you instructions about medication use prior to surgery.

Illness Prior to Surgery Notify your doctor’s office immediately if you develop a cold, fever, sore throat, cough or any other illness prior to your surgery.

Stop Smoking Well in Advance of Your Surgery Patients who smoke are three times more likely to develop a surgical site infection than nonsmokers and have significantly slower recoveries and longer hospital stays. To take the first step, visit houstonmethodist.org/events and search for Beat the Pack or call 281.274.7500 to register.

Do Not Shave Surgical Site Razors can create small nicks in the skin through which bacteria can enter. If hair must be removed before surgery, clippers will be used at the hospital instead of a razor. For areas of the body outside the surgical site, please consult your physician to see if shaving is restricted before surgery.

Practice the Stir-up Regimen Prior to surgery, practice the stir-up regimen (see page 5) to help decrease the risk of complications and your length of stay in the hospital.

Shower with Chlorhexidine Gluconate (CHG) The latest medical research recommends a standardized skin cleansing protocol with a 4% solution of Chlorhexidine Gluconate as the most effective barrier to the environmental germs that may cause surgical site infections. Therefore, we have incorporated this into your plan of care by providing you with the presurgical wash. Before opening the solution provided by the hospital, wash your face and hair with your usual soap or shampoo. Antibacterial soap is a good choice. Step 1 • Turn water off to avoid rinsing soap off too soon. • Use CHG solution with a clean wash cloth to wash entire body from neck down. • Avoid eyes, ears, nose and mouth. • Gently scrub the body, paying special attention to the area where your surgery will be performed. • Leave soap on for five minutes, then turn water on and thoroughly rinse your body. Do not wash with your regular soap after using CHG. Step 2 Use a clean towel to dry off. Do not apply any lotions, oils, perfumes or powders after your shower.

THE DAY OF YOUR SURGERY Shower Again with CHG Repeat shower instructions on page 2.

Where to Park Surgery patients should park in front of the Main Pavilion and enter through the main entrance (see map on page 8). For your convenience, free valet parking is also available unitl 7 p.m.

Once You Arrive

What to Wear Dress in clean, laundered clothes. Wear nonbinding comfortable clothing (warm-ups, loose dress, roomy pants or shorts) and closed-toe shoes. You may brush your teeth and use mouthwash the morning of surgery; however, remember not to swallow any water. At the hospital, you will change into a hospital gown. Make sure to bring your contact lens or glasses case with you and be sure to notify the nurse if you have dentures or partial plates.

What Not to Bring You will not be allowed to wear jewelry of any type during surgery. Please leave all valuables at home, including jewelry and personal electronics. If you have no one to keep your valuables, they may be placed in the hospital safe. However, please remember that the hospital will not be responsible for your valuables.

What to Bring Please bring personal grooming items if you will be staying overnight at the hospital.

Medical Power of Attorney and Advance Directives

• Report to the front reception desk on the first floor of the Main Pavilion. • After registration, you will be directed to the surgery desk on the second floor of the Main Pavilion. • You will be escorted to your room in the admission observation discharge (AOD) unit and asked to change into a hospital gown and place all nonvaluable items in a bag provided for you. • You will receive a soft hospital gown that wraps completely around the body for a modest, fullcoverage fit. The gown also has an easy-to-use, handheld temperature controller. We encourage you to warm yourself 30-60 minutes prior to surgery. Prewarming before surgery is associated with decreased complications after surgery. • A nurse will complete preparations, including starting an intravenous line (IV) and monitoring additional vitals such as blood pressure, respiration and pulse. • A member of the anesthesia team will see you in your AOD room prior to going to the operating room. • Your surgeon will visit with you prior to your procedure to answer any questions you may have.

If applicable, please bring any medical power of attorney and/or advance directives paperwork to the hospital on the day of your procedure. Go to houstonmethodist.org/advance-directives to access the forms online.

BILLING

Hospital charges that are not covered by your insurance will be due prior to the surgery. You may pay with cash, personal check or credit card. You will receive separate bills from all specialty physicians who cared for you during your stay, such as the pathologist, radiologist, cardiologist, surgical assistants, etc. Your surgeon will bill you separately from the hospital, as well as the anesthesiologist. Please note, a hospital employee may call and leave a brief message regarding payment. Due to privacy laws, the message will be brief. At your earliest convenience, please return the call.

Surgery We will make final surgical preparations in the admission observation discharge (AOD) unit. You will be met by your operating room nurse, who will check your identification band and ask you a few questions. At this time, feel free to ask any questions you may have.

Anesthesia Care Team Anesthesia services are provided by an anesthesia care team overseen by board-certified anesthesiologists. The team also includes certified nurse anesthetists with special training in providing anesthesia care. Your anesthesiologist will speak with you before surgery and answer any questions you may have. Be sure to talk to your anesthesiologist about any medications you are currently taking, including over-the-counter drugs. The appropriate type of anesthesia will be determined by your surgeon in consultation with the anesthesiologist. There are four types of anesthesia. • Local: This type of anesthesia only numbs the area being operated on. Your surgeon, not an anesthesiologist, administers this type of anesthesia. • Monitored Anesthesia Care (MAC): This type of anesthesia relieves pain and uses sedatives and other agents, but the dosage is low enough that patients breathe without assistance. An anesthesiologist and nurse anesthetist administer this type of anesthesia and monitor you throughout the procedure. • General: This type of anesthesia puts you to sleep during the entire procedure. An anesthesiologist and nurse anesthetist administer this type of anesthesia and monitor you throughout the procedure. • Regional Nerve Blocks: This type of anesthesia can be used to help “block” the sensation of pain from a specific area of your body during and after surgery. An anesthesiologist injects numbing medication around the nerves of your body that are involved in the surgery.

AFTER YOUR SURGERY Your Recovery Experience After your procedure, your surgical team will bring you to the recovery area, which will either be the postanesthesia care unit (PACU) or the AOD unit, depending on your type of surgery or anesthesia. Specialized nurses will monitor your progress through the immediate postanesthesia phase. Your length of stay in recovery will depend on various factors, but our goal is to return you to your family as soon as possible. Your family will be able to see you as soon as you have been transferred from PACU to AOD or your inpatient room. Your nurse will check your blood pressure, pulse, respirations and the bandage over your incision. When you return to your room, you will still have an IV, which provides your body with fluids. Your nurse will discontinue the IV when it is no longer necessary. Aromatherapy and/or antiemetic medication may be given through an IV line to alleviate nausea and vomiting.

Pain Management Your health care team will work with you to minimize pain and discomfort after surgery. We want to keep you comfortable. While you are recovering, your doctors and nurses will frequently ask you to “measure” and describe your pain using the pain rating scale below. You can expect to receive: • Information about pain and pain relief methods • A commitment to pain control • Quick response to reports of pain

Wong-Baker Faces® Pain Rating Scale

Family and Friends Your family and friends will be asked to return to the waiting room with your belongings. It is important that at least one person be designated to speak with the physician when your procedure is completed.

www.WongBakerFACES.org

For Your Comfort Your nurse will provide warm blankets and utilize the heated gown to circulate warm air, as you may experience shivering following surgery. A music player will also be offered in the postanesthesia care unit (PACU) as you wake up. Listening to music throughout your PACU stay may positively affect your pain experience and improve comfort.

The Stir-up Regimen To prevent complications after surgery, you will be encouraged to cough, change your position and take deep breaths using an incentive spirometer. Your nurse will assist you with these activities as needed. 1. Deep breathing Take a deep breath, hold your breath for three to five seconds, and then exhale. An incentive spirometer will also be given to assist you with deep breathing. To use the incentive spirometer: a. Place the mouthpiece of the spirometer firmly in mouth b. Breathe air in c. Hold your breath at the end of inhalation for about three seconds d. Exhale slowly e. Perform the procedure about 10 times in succession, repeating the 10 breaths with the spirometer each hour during waking hours 2. Coughing While in a semi-upright sitting or side-lying position, hold a pillow against your abdominal incision or surgical site (ex: hernia repair, gallbladder removal) for support. This is called “splinting” your incision; splinting helps ease discomfort when coughing. Take a rapid deep breath and then cough multiple times. Your nurse will let you know if your type of surgery does not allow coughing.

3. Positioning When possible, position yourself in a semi-upright sitting or side-lying position. Frequent repositioning (every hour) is essential in preventing atelectasis (a condition in which one or more areas of the lungs collapse or don’t inflate properly) and formation of blood clots in extremities. 4. Mobilization Move your legs and arms while flexing your muscles to improve circulation. Your nurse may also assist you to walk as your type of surgery permits.

Physical Activity After Surgery Remember, you are an active participant in your care. The sooner you can resume activity, the faster you will recover. Therefore, once your physician says you are able to be up at the bedside or ambulatory, ask for assistance from the nursing staff and participate fully.

Length of Stay The amount of time spent in PACU will depend on factors such as type of surgery, response to anesthesia and medical history. A longer stay may be necessary to ensure that you receive the best care possible and that you are comfortable before being discharged home or transferred. You will be transferred from the PACU to an appropriate patient room (for an extended stay), or AOD (before discharge home) after meeting specific discharge criteria. If you are staying in the hospital, a room is assigned as soon as one is available. Although surgery is prescheduled in most cases, inpatient rooms are not assigned until you are ready to leave the PACU.

GUEST RELATIONS Surgery and patient status updates are available at the concierge desk in the surgery waiting area from 8 a.m. to 4 p.m. If the patient, family or friends have any questions or concerns, please call guest relations at 281.274.7806 and they will gladly assist you.

FAMILY & FRIENDS

Spiritual Care

• The Garden Café is located in the atrium of the Main Pavilion and is open seven days a week: Monday – Friday, 7 a.m. – 7 p.m. Saturday – Sunday, 7 a.m. – 2 p.m.

Our Department of Spiritual Care and Values Integration desires to provide you with excellent spiritual attention during your stay in our facility. Our staff chaplains and on-call volunteers offer 24-hour pastoral support as well as spiritual resources, including Bibles (in English and Spanish), scripture cards, prayer ministry, bereavement support and more. We can also assist you with establishing your living will and/or medical power of attorney. Regardless of your religion or faith, we strive to provide you with the resources you need to fulfill your spiritual needs with excellence. Our chapels, located on the first floor of the Sweetwater Pavilion near the patient elevators, and the first floor of the Brazos Pavilion near the patient elevators, are open 24 hours. A prayer room is located on the second floor of the Main Pavilion. The Muslim prayer room is located on the first floor of the Sweetwater Pavilion. If you are in need of pastoral assistance, please call 281.274.7164. For any emergencies, please ask your nurse to contact the on-call chaplain.

• For your convenience, there are three Starbucks locations:

For Your Comfort

Parking Enjoy the convenience of free parking throughout the campus, including two parking garages available (see map on page 8). The surgery area is easily accessible from the second floor of the main parking garage. Family and friends are encouraged to use the main parking garage and enter the hospital using the sky bridge on the second floor.

Wireless Internet Wireless internet access is available by choosing MethodistGuestWiFi; no password is needed. For assistance with the wireless connection, please call the IT Help Desk at 832.667.5600.

Food Services

• Main Pavilion — First Floor Monday – Friday, 7 a.m. – 7 p.m. Saturday – Sunday, 7 a.m. – 2 p.m.

For your comfort, please bring a sweater or a light jacket while in the waiting area as the temperature is kept low.

• Main Pavilion — Second Floor (near surgery waiting area) Monday – Friday, 7 a.m. – 2 p.m. Saturday – Sunday, closed • Sweetwater Pavilion — First Floor Monday – Friday, 7 a.m. – 4 p.m. Saturday – Sunday, closed

DEPARTURE You will not be allowed to leave the hospital on your own. Therefore, please make sure someone is available to drive you home. If you take an Uber or any other ride-sharing service, you must have someone accompany you home. You will not be permitted to leave the hospital in an Uber by yourself. Upon your departure, you and your family will be instructed on the care you must receive at home to complete your recovery. Your surgeon may prescribe medication for use at home, which can be filled at the pharmacy of your choice. For your convenience, bedside prescription services are available and provided by the Walgreens located on the first floor of Medical Office Building 3. Please remember to bring your prescription insurance card.

CAMPUS MAP

HOUSTON METHODIST SUGAR LAND HOSPITAL 16655 Southwest Fwy., Sugar Land, TX 77479 | 281.274.7000

AMC THEATRE

CHAPEL DINING

T O W N C E N T E R B LV D . S O U T H

ELEVATOR GIFT SHOP INFORMATION MUSLIM PRAYER ROOM PARKING RESERVED PARKING

ENTRANCE

RESTROOM EMERGENCY ROOM

Cancer Center

ENTRANCE Heart & Vascular Center

LEVEL 2 SKYBRIDGE CONSTRUCTION ZONE

MEDICAL OFFICE BUILDING 2

Infusion Center

ENTRANCE

Breast Care Center

MAIN PARKING GARAGE (FREE)

SWEETWATER BLVD.

IV Therapy

SOUTH ENTRANCE

SWEETWATER PAVILION Outpatient Imaging & Lab

EMERGENCY ENTRANCE

Main Imaging

Childbirth Center

SWEETWATER PARKING GARAGE (FREE)

WALGREENS

MEDICAL OFFICE BUILDING 3

Wound Neuroscience Care & Spine Program Center

ENTRANCE

Main Conference Center

MAIN PAVILION ENTER HERE

BRAZOS PAVILION Brazos Conference Center

NORTH ENTRANCE

MEDICAL OFFICE BUILDING 1

ORTHOPEDICS & SPORTS MEDICINE

ENTRANCE

MAIN ENTRANCE

ENTRANCE

SOUTHWEST U.S. 59 FRONTAGE ROAD FWY.

Attention Patients

Please park in front of the Main Pavilion and enter through the main entrance. The best place for visitors to park is in the main parking garage on the left side of the map. For your convenience, free valet parking is also available until 7 p.m.

For the health of our patients and visitors, this entire campus is tobacco free.

IMPORTANT PHONE NUMBERS Houston Methodist Sugar Land Hospital: 281.274.7000 Preadmission Testing Department: 281.274.7087 Billing: 832.667.5900 Spiritual Care Department: 281.274.7164 Guest Relations: 281.274.7806 IT Help Desk: 832.667.5600 8

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WHAT TO EXPECT FROM YOUR SURGICAL PROCEDURE

16655 Southwest Fwy. Sugar Land, TX 77479 281.274.7000 houstonmethodist.org/sugarland

Connect with us.

082018