Prepare for a Procedure
The information below is designed to help you and your family prepare for your scheduled surgery and postoperative recovery. As you read each section carefully, you may call us at 410.955.4424 with any questions or concerns.
Preparation for Surgery
Surgical Consultation: On the day of your consultation, your physician will discuss the reasons surgery is being recommended and any risks involved. You will have a chance to ask any questions you may have and will sign consent forms giving you physician permission to perform the surgery. A date for the procedure will also be discussed.
Insurance Authorization: The Johns Hopkins Hospital Admitting Office will obtain authorization for the surgery from your insurance company before the day of your procedure. The Spine Center will do everything we can to work with you to obtain insurance clearance before the procedure. Occasionally, however, there are unforeseen procedures required by the insurance company that will cause a cancellation or rescheduling of your procedure.
If you are a patient of Dr. Gokaslan and are covered by Blue Cross/Blue Shield or Medicare, please contact our office prior to your procedure for more information about your coverage.
Diagnostic Tests – Preoperative Appointment: You will be scheduled for a preoperative appointment in the lower level of the Johns Hopkins Outpatient Center. This testing must be completed within thirty days prior to the scheduled surgery date. Where and when you should report for surgery will be confirmed at this appointment.
At the preoperative appointment, you will meet with a Nurse Practitioner or Physician’s Assistant who will gather general history and conduct a physical examination. You may also be scheduled for a consultation with an anesthesiologist. The following tests will be conducted:
- Complete Blood Cell Count (CBC), including platelets
- Electrolyte testing (BMP)
- Type and screen to determine your blood type
- PT/PTT to test your blood clotting
- Urinalysis
- Chest x-ray
- Electrocardiogram (EKG)
Additional testing may be required prior to this appointment if you have certain medical or cardiac conditions that require clearance from your primary care physician or cardiologist.
Medications: It is important that you do not take aspirin or any product that contains aspirin during the two weeks before your surgery. Also, do not take anti-inflammatory medications, vitamins or herbs. All of these can affect bleeding and clotting. Examples of these medications include, but are not limited to, the following:
- Pain Relievers: Advil, Aleve, Aspirin, Celebrex, Ecotrin, Ibuprofen, Motrin, Naproxen, Relafen, Soma Compound, Vioxx
- Blood thinners: Aggrenox, Arixtra, Coumadin, Fragmin, Garan, Heparin, Innohep, Lovenox, Plavix, Ticlid
- Vitamins and herbs: Vitamin E, garlic, ginkgo biloba, green tea, fish oil, St. John’s Wort
- All chemotherapy
It is important that you inform your doctor or nurse about all prescription and over the counter medications you are currently taking.
Diet: Do not eat or drink any food or liquids after midnight on the night before your surgery.
Admission to The Hospital: Please report to the hospital as directed the day of your procedure. You will be assigned to your specific room after surgery.
Hospital Stay
After Surgery: Depending on the extent of your procedure, you will be taken to the Neurosciences Critical Care Unit (NCCU) or the Post-Anesthesia Care Unit (PACU). You will then be transferred to your hospital room on the neurosurgical floor of the hospital. Typically, if you recover in the PACU, you will transfer to the floor after a couple of hours. If you recover in the NCCU, you will transfer to the floor the following day. If your surgery is extensive, you may need to stay in the NCCU for more than one night.
Medical Care: Many different health care professionals will take care of you during your hospital stay. This includes several doctors, nurses, physical therapists and others. The medical team will see you each morning and evening to check on your progress.
Pain Management: You will be prescribed pain medications and other necessary medications after your surgery. If you are having pain or feel nauseous, please ask your nurse for medication.
Surgical Site: You may have sutures or staples over your incision or sutures under the skin. Once the doctor removes your dressing, your suture line may remain uncovered. If visible sutures or staples are present, you may cover the suture line with plastic wrap in order to take a shower. If the site gets wet, just blot it dry. Visible sutures or staples should be removed 7-14 days after the surgery. Sutures under the skin do not require removal.
Activity: Once you are transferred to the neurosurgical floor, a physical therapist and occupational therapists will evaluate you and determine your needs at discharge. Inpatient therapy, outpatient therapy or home therapy may be recommended.
Visitation: Once you arrive for surgery, your family will be directed to the waiting room. They will receive periodic updates on the status of your surgery. When your surgery is complete, they will be directed to an appropriate waiting room or floor while you recover. Visitors must be at least 12 years old. The NCCU allows two visitors at a time from 12:00-2:00 and 5:00-8:00. Visitors are permitted on the floor from 12:00-8:00.
Hotel Accommodations: If your visitors would like to stay locally while you are in the hospital, they may contact Travel Guide (1.800.492.5916) to receive assistance. Furnished townhouses located across the street from The Johns Hopkins Hospital are also available through The McElderry House Lodging (1.800.295.4131). Shared or private residences are available.
Home Care
Pain Management: You may be prescribed pain medications to take at home. It is important to take your medications as instructed by the doctor and nurse at discharge.
Activity: Your body will require approximately 4 to 6 weeks to return to a normal activity level. A full recovery could take up to 4 to 6 months or longer. You may return to your normal activities as you can tolerate. You should avoid strenuous physical activity, however, until it has been approved by the doctor.
Follow-Up Care
Return Visits: Your sutures or staples may be removed by a health care professional approximately 7-14 days after surgery. You should also schedule follow-up appointments with your physician at one-month, three-month and six-month intervals after surgery. When you call for your follow-up appointment, you should also ask about getting any imaging studies done prior to your visit.
