See your family doctor or nurse practitioner
It is best that you see your family doctor or nurse practitioner prior to your surgery as they will be familiar with you and will let us know about any medical conditions you may have. This history and physical examination should be completed at least two weeks in advance of your surgery date to allow us enough time to review their findings and the results of any lab tests. If you do not have a family doctor or nurse practitioner, please let our admissions nurse know so that we can make alternate arrangements.

Complete the Patient Survey and History and Physical Exam forms
You will receive these forms in the mail or you may download and print them (see links below):
The History and Physical Exam is to be completed by your family doctor or nurse practitioner, then they should encrypt and e-mail, or fax the completed form to us (fax = 250-595-1518).
Download the History and Physical Exam form. (PDF)
The Patient Survey form is to be completed by you. It provides us with detailed information that is important to the anesthesiologist and for your care during your admission. The completed form should be scanned and e-mailed to the e-mail address provided by our admissions nurse or faxed to us at 250-595-1518.
Download the Patient Survey form. (PDF)

Get the required lab tests
You may be scheduled to have pre-operative tests such as blood work, ECG, etc. This is often determined from information provided by your surgeon, family doctor, or your patient survey form. If you need lab work or tests, we will contact you by phone or e-mail and forward the requisition to you or to the appropriate lab. Your tests should be completed at least one week prior to your surgery. You must complete all of the required lab tests in time for us to review them before your surgery, otherwise your procedure could be deferred or cancelled. If no lab tests are required, you will not receive a requisition.

Read the Pre and Post Operative Instructions
As you have no doubt realized by this point, there are a lot of steps to get you ready for surgery. There is also a lot of information for you to process, but this is important for your safety and helps create the best surgical result. We give you a copy of your post-op instructions prior to your surgery so that you can review these instructions when you are relaxed and more likely to remember. We will of course review these instructions with you again after the surgery. You may receive these instructions in the mail but if not you may download them here:
Pre-and Post-Op Instructions for GENERAL anesthesia or SEDATION. (PDF)
Pre-and Post-Op Instructions for LOCAL anesthesia (PDF)

Stop Herbs and Vitamins
You must stop taking all vitamins and herbal remedies ten days before surgery. Vitamins and herbal remedies contain chemically active substances, and the exact amount of these substances is variable. Some of these substances are known to interact with anesthetic drugs and cause complications. Others will increase the chance of bleeding during and after the surgery.
Download the Society of Anesthesiologists Herbal Guide.

Think about the Anesthetic
The type of anesthetic offered at Victoria Surgery will depend on the nature and location of the surgery, as well as the wishes of the patient and the judgment of the physicians. In simple terms, there are three different techniques:
Local anesthetic only:  If the surgical procedure is simple and involves a very small area it may be possible to use only local anesthetic. An anesthesiologist is not required in this circumstance.
Local anesthetic plus intravenous sedation:  If the surgical procedure is more complex and covers a larger area local anesthetic alone won't provide enough comfort. An anesthesiologist can give intravenous sedation throughout the procedure to render the patient comfortable and free of anxiety.
General anesthetic:  Many procedures require that the patient be completely unconscious.
As with most things, there are advantages and disadvantages to each technique. The surgeon and anesthesiologist will discuss your options and provide the anesthetic that is best suited to you. Please contact Victoria Surgery if you wish to discuss your anesthetic prior to your day of surgery.

Don't eat or drink
You must not eat any solid food or drink fluids containing any solid material from midnight the day before surgery; and you may drink only clear fluids (water, jello) from midnight until 4 hours before the time your surgery is scheduled to start. Nothing by mouth at all from 4 hours before your surgery time until the start of surgery.

What time to arrive
Victoria Surgery will contact you approximately five to seven days prior to your surgery to confirm your expected arrival time. We usually ask you to arrive 45 minutes before the scheduled surgery time.

What to bring
On the day of your surgery please wear comfortable, loose fitting clothing that will be easy to put on after surgery. Please leave your valuables at home. If there are special requirements Victoria Surgery or your doctor's office will inform you in advance.

Check-in and admission
When you arrive promptly at the pre-arranged time you will be greeted by a member of our nursing staff and shown the way to your private admission room. These comfortable admission rooms feature heated tile floors, wi-fi and a television. We will review your admission paperwork and consent process, and then leave you so that you may change into a patient gown and robe. One of the operating room nursing staff, your surgeon and your anesthetist will then visit you separately in the privacy of your admission room to review your upcoming surgery, health concerns, and answer any questions.

The operating room
You will walk across the hall from your admission room to the operating room. The operating room nursing staff, anesthesiologist and surgeon will greet you, confirm your procedure and identify the exact site of the surgery. We will ask you to identify yourself and tell us what surgical procedure you are having, in order to confirm that the operating room is set up correctly and that your consent form is accurate. Several physiologic monitoring devices will be applied and an intravenous will be started. If you are having a general anesthetic you will be asked to breathe some oxygen through a mask just as the anesthetic drugs take effect. The anesthesiologist and operating room nursing staff remain with you throughout your surgical procedure and will transfer you to the recovery room in your recovery bed.

The recovery room (PACU)
You will be cared for in the recovery room until you meet criteria for discharge and your nurse is confident that you are ready to return home with your caregiver. The length of time you stay in the recovery room is dependent on how quickly you recover from the surgery and anesthesia; and that is related to the type and length of your procedure, whether you are affected by nausea, and your pain management. The recovery room is fully equipped to monitor patients after surgery and specialized nursing staff is observing you at all times. Your intravenous will remain in place during your stay so that your nurse can administer medication for control of pain and nausea. Every effort is made to prevent nausea. Our nurses have considerable experience at making patients comfortable while minimizing the side effects of the various drugs.

Discharge
When you meet discharge criteria and are ready to go your nurse will give specific, detailed instructions to you and the responsible adult picking you up. They will discuss optimizing your pain control, care of the surgical site, and what to do if any complications develop.
Please make arrangements for your ride to be available at any time during your expected recovery. We will call them approximately 45 minutes before you are ready to leave. We discharge all patients who have had an anesthetic via wheelchair to their car.

Instructions
Managing your pain control, looking after dressings and resuming normal activities will be the key issues after you leave the facility. Before you came to Victoria Surgery you received some general post-op instructions and these will be supplemented with some that are more specific to your procedure. Your nurse will review these in the presence of the person who is picking you up because they may be able to remember the details best. You will receive specific instructions on how to use the different pain medications to their best effect. Good pain control can make all the difference so we put a lot of effort into ensuring that you are well informed.

Follow-up
Before you leave we will make sure arrangements have been made as to when to see your surgeon next. Victoria Surgery or your surgeon's office will contact you by phone one day post operatively and again in about a week to ten days. We will ask several questions as to your experience at our facility, the quality of care, and if you experienced any problems or complications. It is very important that we hear the good and bad – it can only make us better.

Complications
Potential complications of any surgery include bleeding, infection, wound breakdown, pneumonia, and the possibility of unexpected blood clots forming in the leg veins. Some can occur within a day of the surgery while others happen up to weeks later. It is really important that you have a plan in the event of something unexpected.
If you suddenly become desperately unwell, call an ambulance or go straight to the nearest Emergency Department. If you have a more gradual problem contact your surgeon through their office. If your surgeon is unavailable there will be another one on call to cover their patients. The on-call surgeon can be located by calling the Emergency Department at either Victoria General Hospital or the Royal Jubilee Hospital.