Surgery Patient Guide

Surgery Patient Guide 2012 & 2013 (830) 997-4353 hillcountrymemorial.org | hcmdocs.com Remarkable Health Care Tests Welcome! Check off or write...
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Surgery Patient Guide

2012 & 2013

(830) 997-4353 hillcountrymemorial.org | hcmdocs.com

Remarkable Health Care

Tests

Welcome!

Check off or write in tests ordered by your health-care provider.

We are so pleased that you have chosen Hill Country Memorial Hospital for your Peri-Operative experience. Our goal is to anticipate your needs and exceed your expectations in order to deliver personalized care to all of our patients, family, and friends. This patient guide was designed to prepare and educate you, in order to promote a more successful surgical outcome. We encourage you to review the information provided in this guide and if you have any questions please let us know. It is important for you to follow the instructions in this booklet in preparation for your procedure. Please read through carefully. Again, we are happy to answer any questions or concerns that you might have, so please don’t hesitate to ask.



Blood Tests Urine Test X-rays Electrocardiograms

(type)

(ECG or EKG)

Medication Changes to Medication Schedule as instructed by your doctors:

Your procedure is scheduled for: Date__________________________________ Proposed Procedure Time*_______________ Surgeon_______________________________ Phone Number_________________________

Notes *This time is subject to change. Please provide us with the best telephone number in order to notify you of any changes. If your surgery is delayed for any reason we will provide you with the most up-to-date information on the status of your surgery so that you and your family stay informed throughout the surgical process.

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Inpatient and Outpatient Surgery Inpatients are usually admitted immediately following surgery and remain in the hospital for a few additional days. Outpatients are admitted the day of the surgical procedure and go home the same day to recuperate. Occasionally, a medical or surgical need may require an overnight stay in the hospital. If this occurs, your physician will discuss the situation with you.

Your Surgical Team Surgeon The Surgeon is the skilled physician who will perform your surgical procedure. Anesthesiologist An anesthesiologist is a physician who administers the appropriate amount of anesthesia in order to make the patient comfortable during the surgical procedures. The anesthesiologist monitors the patient throughout the surgery from beginning to end to ensure the safety of the patient.

sterile and safe for the patient. The nurse works side by side with the Surgical Technologist to help maintain the sterile field in the operating room. The circulator nurse prepares the patient for the procedure and handles the preparation for the operating room before the surgery takes place.

Nurse Anesthetist The Nurse Anesthetist works with the Anesthesiologist in the oversight and care of the patient during the surgical procedure, as well as attending to the patient during the immediate recovery from the procedure.

Surgical Technologist The Surgical Technologist prepares and sets up the instruments, as well as providing equipment to surgeons during surgery. They also ensure that the operating room remains a sterile environment and perform other similar tasks.

Pre-Operative Nurse The Pre-Operative Nurse monitors patients to determine if their condition has changed prior to surgery. This includes checking vital signs and ensuring that all medications are properly administered. They also assess the patient’s frame of mind and attempt to relieve any anxiety the patient may have over the impending surgery.

Post Anesthesia Care Unit (PACU) Nurse A PACU, or postoperative care unit nurse is responsible for caring for patients after surgery. This includes monitoring vital signs and surgical sites and ensuring that all medications are properly administered. They also manage the patient’s post operative pain and any changes in the patient’s condition. In addition, the PACU nurse will ensure all home care/discharge instructions are clear and provide a written copy of the discharge instructions to the patient before going home.

Nurse Circulator A Nurse Circulator is a registered nurse who works in the operating rooms monitoring the procedures. The circulator ensures that the surgical room is

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PAT department will contact you the day before surgery between 2:00 and 4:00 pm to confirm your arrival time.

Seven to Ten Days Before Surgery Pre–Operative Visit to Surgeon You should have an appointment in your surgeon’s office 7 – 10 days before surgery. Pre-Admission Testing The Pre-admission Testing (PAT) nurse will be calling you to review your medical history and provide you with any pertinent information prior to your procedure date. Please have available a list of your medications you are taking, including any over-the-counter non prescription drugs, vitamins, and herbal supplements. We will need to know the dosages for all and how often you take them. Also, please have information available about any allergies, past surgical procedures, and other non-surgical hospitalizations you have had. The PAT nurse will give pre-operative instructions after considering your medications and medical history. This phone call is an opportunity to ask any questions or voice any concerns, including any anticipated needs during or after your surgical experience. 4

When you were scheduled for surgery, you should have received a medical clearance letter from your surgeon. The letter will tell you whether you need to see your primary care physician and/or specialist. Please follow the instructions in the letter. If you need to see your primary care doctor, it will be for pre-operative medical clearance (this is in addition to seeing your surgeon pre-operatively). In addition to obtaining appropriate medical clearance from your primary care doctor, you may also be asked to complete laboratory testing prior to your surgical procedure. If so, you should have received a laboratory testing letter from your surgeon. Follow the instructions in this letter and complete all required laboratory tests prior to the date of your surgery. PAT department will contact you the day before surgery between 2:00 and 4:00 pm to confirm your arrival time.

Medications It is very important that prior to surgery you discontinue all anti-inflammatory medications such as Motrin, Naproxen, Vitamin E, etc. These medications may cause increased bleeding. If you are taking a blood thinner, you will need special instructions for stopping the medication. Patients should also consult with their doctor regarding discontinuing the use of any herbal medicines prior to surgery, as they can interfere with other medicines. Examples of herbal medicines include, but are not limited to: Echinacea, ginkgo, ginseng, ginger, licorice, garlic, valerian, St. John’s wort, ephedra, goldenseal, feverfew, saw palmetto, and kava-kava.

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It is extremely important to follow all the instructions given to you prior to surgery.

Preparing For Surgery Since you will likely come to the hospital on the same day as your surgery, you may need to do some preparation while at home. It is extremely important to follow the instructions given to you prior to surgery regarding when to stop eating and drinking. • You should not take medications unless instructed to do so by your nurse or physician. • Unless otherwise instructed by your physician or the PAT nurse, do not eat or drink anything after midnight the night before your procedure. This includes chewing gum, candy, dipping snuff, or tobacco. Your physician may ask you not to take some of your regular medications. If your physician instructs you to take your medications, please do so with only a small sip of water. If you use an inhaler or eye drops or CPAP/BIPAP machine, please bring them with you to the hospital on the day of your procedure. It is also important to prepare your home for your return from the hospital. The following is a guided checklist to assist you in this task. Put things that you use often on a shelf or surface that is easy to reach Check railings to make sure they are not loose • Clean, do the laundry, and put it away • Put clean linens on the bed • Prepare meals and freeze them in single serving containers • Cut the grass, tend to the garden, and finish any other yard work • Pick up throw rugs and tack down loose carpeting • Remove electrical cords and other obstruction from walkways • Install night-lights in bathrooms, bedrooms, and hallways • Install grab bars in the shower/bath tub. Put adhesive slip strips in the bottom of the tub • Arrange to have someone collect your mail and take care of pets

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Plan to get Specialized Equipment you will need Get specialized equipment you will need after surgery, such as rolling walker, dressing change supplies, a cane, bedside commode chair, etc. You will bring your walker with you to the hospital, if you should require a walker following surgery. Protect the Integrity of your Skin Taking good care of your body (including your skin) is important, especially in the week before surgery. Avoid doing anything that might injure the skin of the surgical site. Wear protective clothing when working outdoors. Insect bites, cuts, or infected areas on the surgical site could become a reason to delay or cancel your surgery. Call your surgeon if you have any questions.

Advanced Medical Directives It is our policy to place the patient’s wishes and individual considerations at the forefront of their care and to respect and uphold those wishes. If a patient has an Advanced Directive or has appointed a Medical Power of Attorney and is no longer able to express his or her wishes to the physician, family, or hospital staff, Hill Country Memorial is committed to honoring the wishes of the patient as they are documented at the time the patient was able to make that determination. • ADVANCED DIRECTIVES are written instructions that explain your wishes for health care if you have a terminal condition or irreversible condition from which your physician expects you to die in 6 months. • MEDICAL POWER OF ATTORNEY is a document that lets you name a person (your agent) to make medical decisions for you, if you become unable to do so. If you have an Advanced Directive or Medical Power of Attorney paperwork, please bring copies of the documents to the hospital with you so they can become a part of your Medical Record. If you do not have an Advanced Directive, these documents can be found on the website at www.hillcountrymemorial.org under patient information. You can also contact the Community Relations office at (830) 997-1307 or Pastoral Care (830) 990-6125 and they will be happy to assist you in filling out the forms.

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Do wear loose fitting, comfortable clothing. You may want to bring a pair of warm socks to wear during your procedure.

What To Bring To The Hospital Bring personal hygiene items (toothbrush, powder, deodorant, razor, hair brush, comb, etc.); comfortable loose fitting clothes (shorts, tops, culottes, or loosely fitted exercise pants); and flat shoes or tennis shoes. If you have adaptive equipment, such as a walker or reachers, you may have them brought to you after your surgery. You must bring the following to the hospital: • Your patient handbook • A copy of your Advanced Directives and/or Medical Power of Attorney • Your insurance card, driver’s license or photo ID, and any co-payment required by your insurance company • Rolling walker, if applicable • If you use a BIPAP or CPAP machine for sleep apnea, bring it with you • OPTIONAL: reading material, electronic devices, music – e reader, etc… Special Instructions: • DO NOT take medication for diabetes on the day of surgery • Please leave jewelry, valuables, and large amounts of money at home • Makeup must be removed before your procedure • Nail polish must be removed before your procedure

Surgery “Do’s and Don’ts” • DO be on time. •  DO bring personal items such as a comb, brush, books or other items you may like to have. Your personal items will be stored in a secured locker during surgery. 8

•  DO arrange for transportation to and from the hospital and for someone to accompany you home. You will not be allowed to drive. •  DO wear loose fitting, comfortable clothing. You may want to bring a pair of warm socks to wear during your procedure. If you are having leg surgery, please bring crutches (if you have them) or walker and wear shorts or pants with loose legs. If you are having arm surgery, bring a sling (if you have one) and wear a shirt that opens in the front and/or has loose sleeves. A pair of rubber sole shoes or slippers will provide safety during ambulation. •  DO bring a copy of any Advanced Directive you may have (Durable Power of Attorney for Health Care or a Living Will). •  DO let your surgeon know if you have a sensitivity to latex or rubber. •  DO take a shower or bath with Hibiclens soap the evening before and the morning of your surgery. Hibiclens soap can be bought over the counter at most drug stores. •  DO bring your contact lenses in the case, along with solution, because contacts may NOT be worn during surgery. •  DO keep the lines of communication open. If you have not received a call from us or have not been interviewed by a nurse by 4:00 pm on the day before your procedure, please call (830) 990-1836. •  DO NOT take any medications unless instructed to do so by your physician. •  DO NOT wear jewelry, makeup, or nail polish. Please leave all valuables at home. • DO NOT shave for 24 hours before surgery except facial hair. • DO NOT drink any alcoholic beverages 24 hours prior to surgery. •  DO NOT smoke 24 to 48 hours before surgery. Quit smoking or at least cut down a week before surgery. Hill Country Memorial Hospital is a tobacco-free environment. If you use tobacco, talk with your physician or a nurse about options. Notify your physician or the PAT department at (830) 990-1836 no later than the day before the scheduled procedure if any of the following conditions have occurred: • If you develop a persistent cough, cold symptoms, fever, or if you get a cut, scratch, or bite in the area where you’re having surgery. • If an emergency arises that may require canceling your surgery. Due to privacy and security guidelines, no photography, including cell phone photography, is allowed at the hospital.

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Do not eat or drink anything after midnight, even water, unless otherwise instructed to do so. The preadmission nurse might instruct you to take your usual morning medications with a very small sip of water, just enough to get the medications down.

The Day Before Surgery

The Morning Of Surgery

Find out your arrival time at Hill Country Memorial A pre-admission nurse will call you between 2:00 p.m. – 4:00 p.m. the day before surgery to confirm your arrival time the next morning. You will be asked to arrive 2 hours before your surgery to give the nursing staff sufficient time to start IV’s, prep, and answer any questions. It is important that you arrive on time because occasionally surgery start times are moved up at the last minute and your surgery could start earlier. If you are late it may create a problem with our ability to start your surgery on time. In some cases, lateness could result in moving your surgery to a much later time.

Do not eat or drink anything unless you have been instructed to take medications with a sip of water. Do not chew gum, use mints, throat lozenges, or eat hard candy. Clean your surgical site and body by taking a Hibiclens shower before coming to the hospital. When you arrive at the hospital, please come to the Admissions entrance and check in at the front desk. Our admissions staff will complete your registration and assist you to the pre-op holding department located on the second floor.

Important skin preparation before surgery The night before your surgery you will need to shower and then use a special antibacterial cleansing wipe to prepare for your surgery. Please follow the directions below:

Consent Form

1. Take a Hibiclens shower the night prior to surgery. 2. Dress as usual, wearing clean, loose comfortable clothing.

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Your surgeon will explain the surgery. The Pre-Op Nurse will ask you to sign a surgical consent form giving permission to perform the procedure. This form will serve as an acknowledgment that the surgeon has discussed the procedure with you. You will be actively involved in identifying the surgical site with your physician and nurse before the procedure is performed. The surgeon may use a skin marker to mark the site, if appropriate. This added safety measure will ensure that everyone is clear on what the surgery will be and where it is to be done. If you have any questions regarding the procedure or the consent form, please be sure to discuss these concerns with your surgeon.

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Your anesthesia provider will discuss the risks and benefits associated with the different anesthetic options.

Anesthesia An anesthesiologist or a Certified Registered Nurse Anesthetist (CRNA), the person responsible for putting you to sleep or giving medication to block pain, will visit with you before your surgical procedure and obtain a brief medical evaluation of your overall health status. At the end of the pre-anesthesia evaluation, you will be told what anesthesia you will receive. There are two types of anesthesia that are routinely used during surgery. Regional Anesthesia involves the injection of a local anesthetic to provide numbness, loss of pain, or loss of sensation to a large region of the body. Regional anesthetic techniques include spinal blocks and peripheral nerve blocks. Medications are also given to make you sedated or deeply hypnotic during the procedure. General Anesthesia provides the loss of consciousness and immobility Sometimes general anesthesia may be preferred. Will I have any Side Effects? Your anesthesia provider will discuss the risks and benefits associated with the different anesthetic options as well as any complications or side effects that can occur with each type of anesthetic. Nausea or vomiting may be related to anesthesia or the type of surgical procedure. Although less of a problem today because of improved anesthetic agents and techniques, these side effects continue to occur for some patients. Medications to prevent and treat nausea and vomiting will be given as needed. The amount of discomfort you experience will depend on several factors and your doctor and nurses will do everything possible to relieve pain and keep you safe. Your discomfort should be tolerable but do not expect to be totally pain-free. The staff will teach you the pain scale to better assess your pain level. A combination of oral pain medications will be administered to optimize your comfort level. 12

Understanding Pain All patients have a right to have their pain managed. Pain can be chronic (lasting a long time) or intense (breakthrough). Pain can change through the recovery process. If you need more help with your pain management, talk to your nurse or your doctor. Pain Scale Using a number to rate your pain can help the nursing staff understand the severity of your pain and help them make the best decision to help manage it. Your Role in Pain Management Using a pain scale to describe your pain will help the team understand your pain level. If “0” means you have no pain and “10” means you are in the worst pain possible, how would you rate the pain? With good communication about your pain, the team can make adjustments to make you more comfortable. Try to relax. When you are relaxed, your pain medication works better.

Pre-Op/Holding Area Upon arrival to the pre-op/holding area your weight will be obtained. You will meet the pre-op nurse and surgical consents will be reviewed and signed. Privacy will be provided for you to change into a surgical gown. Your medical history and current home medications will be reviewed. A physical assessment and vital signs will be assessed. Your surgeon and anesthesiologist will visit you in the surgery holding room. An Intravenous Line (IV) will be started to give you fluids and medications during your procedure.

Recovery Depending on the type of surgery you had, you will be taken to either Post Anesthesia Care Unit (PACU) and subsequently discharged or taken to the inpatient nursing unit. After the surgery, your physician will meet with your family to discuss your condition and answer any questions. The nurse will use monitoring equipment to check your progress. To measure your vital signs, the nurse will use a blood pressure cuff, a cardiac monitor (pads on your chest), and a pulse oximeter (placed on your finger to measure oxygen in your blood). You will spend approximately one hour recovering, depending on the surgery you had and the anesthesia used. 13

Visitors After Surgery Intensive Care Unit (ICU) will be individualized to each patient based on severity of illness, patient needs, and activities taking place in the ICU. Always check with a nurse before entering an ICU patient’s room. During emergencies, visitors may be asked to leave the ICU.

Family Waiting Room The surgical waiting room is located on the second floor and you will be escorted there by our team. • The waiting room telephone extension is 1363 (from outside, dial (830) 997-4353 and ask for extension 1363). • The surgeon will visit your family after the surgery is completed. If surgery takes a particularly long time, the surgeon or a surgery staff member will give the waiting family members a report. • Vending machines are located in the snack bar on the first floor and 2 South across from Elevator 3. • The cafeteria is located on the first floor and serves breakfast and lunch. Breakfast is served from 7:00 am – 9:30 am and lunch is served from 11:00 am – 1:30 pm. • The hospital chapel is located on the first floor. A chaplain is available by calling (830) 990-6125. • The hospital gift shop is located in the main lobby. • Restrooms are located outside the surgery waiting room on the left. • Cell phone can be used throughout the hospital with the exception of the Intensive Care Unit (ICU) room when the patient is on a ventilator. 14

• PACU: One family member at a time due to privacy and recovering patients. • INPATIENT: Two visitors at a time are allowed at bedside. • Visiting hours on 2 North and 2 South nursing units are from 11:00 am – 9:00 pm. • Immediate family members may visit a patient before surgery. In order to do so, you must arrive at least an hour before the scheduled time of surgery. • Children under the age of 12 are discouraged from visiting the hospital because of their inquisitive nature and their tendency to want to touch and investigate things that could harm them or spread bacteria to other patients. • Please check with the patient nurse to make arrangements for special visitation needs.

Discharge Planning When you meet discharge criteria, your nurse will review and provide you and your family with a written copy of all homecare instructions. It is important that you follow all instructions. You may feel weak and drowsy. It is essential that a responsible adult be present for your post-operative instructions, to drive you home and care for you for the next 24 hours after surgery. You will not be allowed to drive or travel by yourself, because you may still be feeling the effects of the anesthetic which will result in slower reaction time and judgment.

Tips For Successful Recovery Stop Smoking It is essential to stop smoking before surgery because smoking impairs oxygen circulation which is vital to the healing process. Smoking constricts the size of your blood vessels and decreases the amount of oxygen circulated in your 15

blood. Smoking can also increase your risk of forming blood clots, as well as increasing your blood pressure and heart rate. If you quit smoking before surgery, you will increase your ability to heal. If you need help quitting, ask about hospital resources. Breathing and Coughing Deep breathing and coughing are important in the prevention of potential problems such as pneumonia for all patients following surgery. Deep breathing expands the lungs and aids in circulation which promotes healing. If you are recovering in the hospital, you may be asked to use a special breathing device called an Incentive Spirometer to expand your lungs. Deep Breathing • To deep breathe, you must use the muscles of your abdomen and chest • Breathe in through your nose as deep as you can • Hold your breath for 5 to 10 seconds • Let you breath out slowly through your mouth. As you breathe out, do it slowly and completely. Breathe out as if you were blowing a candle (this is called “pursed lip breathing”). When you do this correctly, you should notice your stomach going in. Breathe out for 10 – 20 seconds. • Take a break and repeat the exercise 10 times The first time you are asked to cough will be the hardest. If you have had abdominal surgery, sometimes holding a pillow over the incision will provide support and decrease the pain. Use the auxiliary pillow that was provided to you at discharge. Coughing • Take a slow deep breath. Breathe in through your nose and concentrate on filling your lungs completely • Breathe out through your mouth and concentrate on your chest emptying completely • Repeat with another breath in the same way • Take another breath, but hold your breath and then cough hard. When you cough, focus on emptying your lungs • Repeat all steps twice Eating Your digestive system may be slow after surgery. If you are an inpatient, you may be fed with an IV tube following your surgery. Your diet will then gradually progress from liquids to solid food. If you are an outpatient recovering at home, be sure to follow your physician’s orders. 16

Walking Walking wakes up your entire system. It helps pump blood and oxygen to your cells and that will assist your body functions in returning to normalcy. For your safety, be sure to have someone assist you the first time you get out of bed. First begin by sitting on the edge of the bed and then slowly stand up. If you feel unsteady, sit down. Watching for Blood Clots and Pulmonary Embolus Following Surgery Surgery may cause the blood to slow and coagulate in the veins of your legs, creating a blood clot. This is why you take blood thinners after surgery. If a clot occurs despite these measures, you may need to be admitted to the hospital to receive intravenous blood thinners. Signs of Blood Clots in Legs • Swelling in thigh, calf, ankle that does not go down with elevation. • Pain, heat, and tenderness in calf, back of knee, or groin area. • NOTE: blood clots can form in either leg. Preventing Blood Clots • Perform ankle pumps. • Walk several times a day. • Wear your compression stockings. • Take your blood thinners as directed. A Pulmonary Embolus is an unrecognized blood clot that could break away from the vein and travel to the lungs. This is an emergency and you should CALL 911 if suspected. igns of a Pulmonary Embolus S • Sudden Chest Pain • Sweating • Difficult and/or rapid breathing • Shortness of breath Preventing Pulmonary Embolus • Prevent blood clot in legs • Recognize if a blood clot forms in your leg and call your physician promptly.

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• Pain medication that contains narcotics can cause constipation. Use stool softeners or laxatives, if necessary. • Change your position every 45 minutes. Body Changes • Depending on the anesthetics used you may have some numbness following surgery. This is not uncommon. The sensation may resolve slowly over time or be permanent. The surgery team will explain all risks associated with your surgery. • Your appetite may be poor. Drink plenty of fluids to keep from getting dehydrated. Your desire for solid food will return. • You may have difficulty sleeping, which is normal. Do not sleep or nap too much during the day. You should return to your normal activities gradually - according to your physician’s guidelines. • Your energy level will be decreased for at least the first month.

At Home After Surgery The success of your recovery depends on how well you follow your surgeon’s instructions during the first few weeks after the procedure. If you have any problems or concerns that you believe warrant a physician’s care, please call your surgeon. Listed below are guidelines that will assist you in your care at home. Be Comfortable • Take your pain medication as instructed by your physician. • If your pain medication is ineffective or you are unable to keep it down due to nausea, please contact your surgeon for further instructions. • Pain medications are most effective if you don’t allow pain to get too severe prior to taking it.

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Caring for your Incision • Written instructions on how to dress and care for your incision will be provided. • Wash your hands before touching your incision. Your incision should be kept clean and dry. If your dressing becomes wet from moisture or drainage, replace it with a clean, dry one. • Keep your incision covered with a light, dry and clean dressing until your staples/stitches are removed; if applicable, usually about 10-14 days, unless instructed otherwise. • Do not remove staples/stitches yourself. Your doctor will do this at your follow up appointment. • Wear clean clothes daily, especially those that cover your surgery site. • You may shower 3 – 4 days after surgery, unless instructed otherwise. Keep the incisional area dry by covering it. After showering, clean the incision carefully with soap and clean wash cloth, and dry thoroughly. Then apply a clean, dry, dressing. • Inspect incision daily. Notify your surgeon if there is increased drainage, redness, pain, odor, or heat around the incision. • Take your temperature if you feel warm or sick. Call your surgeon if it exceeds 100.5 degrees. • Once your incision has fully healed, massage the incisional site firmly for a few minutes, several times a day. Using a lotion can make this more comfortable. This self-massage will increase circulation to the area, speed healing, and keep uncomfortable adhesions from forming.

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When To Call Your Physician

Helpful Information Phone Numbers

Lodging in our Community

Contact your physician if you have any of the following: • Signs or symptoms of infection • Increased pain, swelling, redness, and/or warmth at the incision site • Purulent (pus) drainage from the incision • Change in color, amount, or odor of drainage • Oral temperature of 100.5 or greater • Increased bleeding, a small amount is normal • Numbness or tingling • Blueness in fingers or toes

HCM Main phone number (830) 997-4353 Preadmission Testing Unit Coordinator (830) 990-1836 Registration/Admission/Insurance (830) 997-1326

Lodging discounts are offered to HCM patients and their visiting friends and family members at all motels/hotels

Outpatient Surgery Department (830) 997-1315 Surgery Waiting Room (830) 997-4353 (ask for ext. 1363) Intensive Care Unit (ICU) Nursing Station (830) 997-1267 2 North Nursing Station (830) 997-1255 2 South Nursing Station/Restore (830) 997-1299

Fredericksburg Inn and Suites 201 South Washington 800-446-0202 or (830) 997-0202

Chaplain (830) 990-6125 Patient Relations (830) 997-1307 Financial Counselor (830) 992-2552

The Sunset Inn 900 South Adams 800-880-9581 or (830) 997-9581

After your surgery discharge you will receive a follow-up phone call and all concerns will be addressed by our nurses. Do not hesitate to contact us with any questions that you might have. HCM Surgery Department (830) 997-1263 and Emergency Department (830) 997-4353. These are some general rules regarding following up with your physician: • Every 1 – 3 weeks, unless instructed differently by your physician. • Anytime you have mild pain or swelling for more than a week. • Anytime you have moderate or severe pain.

Preparation for a Remarkable Patient Experience To “empower others” and “create healthy” as our HCM mission states, please make sure we answer all your questions before, during, and after your surgical experience. 20

Why do I need to have surgery? Do I need to have it right now? Are there alternatives to surgery? Can a family member or friend stay with me before surgery? What are the risks and potential complications from this surgery? What are expected benefits? How much pain can I expect to have? How will it be treated? When will you talk with me about how surgery went? How long will my recovery take?

Comfort Inn and Suites 723 South Washington (830) 990-2552

LaQuinta Inn and Suites 1465 East Main Street (830) 990-2899 Quality Inn 908 South Adams (830) 997-9811 Sunday House 501 East Main (830) 997-4484

Super 8 514 East Main or Highway 290 East (830) 997-6568 or 877-776-7283

Welcome to Remarkable Health Care

H C M R AT I N G S a n d R E V I E W S

www.hillcountrymemorial.org

PO Box 835 / Fredericksburg / (830) 997-4353 The Hill Country’s Hospital / hillcountrymemorial.org