ABDOMINAL AORTIC ANEURYSM SURGERY, Dr. Alan Lossing, Vascular Surgery, St. Michael's Hospital, Toronto, Canada

IT IS THE DAY OF MY SURGERY. WHAT HAPPENS NOW?
ABDOMINAL AORTIC ANEURYSM SURGERY Dr. Alan Lossing
B E F O R E
Now that Dr. Lossing has given me a date for my abdominal aortic aneurysm surgery, what happens next?
Now that you have a date for your surgery it is very important to remember to call the number listed in the pamphlet you were given on the weekday afternoon before your surgery between 12:30 and 2:30 p.m. The phone number is (416) 864-5736. You will then be told what time to arrive at the hospital the next day for your surgery.
PLEASE READ THROUGH THIS PAGE AND REMEMBER THAT IT IS VERY IMPORTANT THAT YOU;
	Do not eat or drink anything after midnight the night before your surgery.
Avoid smoking for at least 24 hours prior to your surgery.
	Take a shower the morning of your surgery and do not wear any make-up, nailpolish or body lotions.
When you arrive at the hospital, which will be approximately two hours before your surgery, go to the Admitting Department and register there. You will then proceed to the 5^th Floor of the hospital
After you register you will be asked to change into a hospital gown and your clothes will be taken to your hospital room later.
	A nurse will then take your vital signs, your blood pressure, temperature and pulse. You will be asked a series of questions, asked to fill out a questionnaire and then you will be given a short explanation of the procedure. It is okay to be nervous, that’s normal.
You will then be asked to wait in the waiting room until somebody comes to get you shortly before your surgery time.
It is wise to bring a book or magazine with you, as you may be waiting for a while.
A little while before your surgery time, transportation personnel will come to take you to the operating room in a wheelchair.
	You will then be seated in a holding room. A nurse will come to ask you some questions and explain a little of the procedure to you. Please feel free to ask any questions at any time.
D U R I N G
	On the operating table, the anaesthetist will put a needle in your hand or arm. This is an intravenous and it is used for medications. He/she will then put round sticky pads on your chest and hook wires to them. This is to monitor your heart. A blood pressure cuff will be put on your arm and you may feel a squeeze when your blood pressure is being taken.
A clip will be put on your finger. This monitors your pulse throughout your surgery. The last thing is a blue square sticky pad that will be attached to your leg. This is for an instrument that will be used by Dr. Lossing. Before you go to sleep a needle may also be put into your back. This is called an epidural and it helps with pain management during and after your surgery.
Now you will go to sleep. The surgery will take approximately 3 to 4 hours and Dr. Lossing will speak to your family members after the operation in the Sullivan waiting room on the 5^th floor.
A F T E R
After your surgery, you will be taken to the I.C.U. (Intensive Care Unit). You may not remember being transferred there but that is where you will wake up. When you wake up you will still be connected to a heart monitor to watch your blood pressure and pulse.
You will also have a tube down your nose, this is called a Nasogastric tube and it keeps everything out of your stomach so you will not get sick. You may also have more than one I.V. in your neck or other places besides the one in your hand before you went to sleep. You MAY also have a tube down your throat that will be taken out shortly after you arrive in I.C.U. This is called an endotrachial tube (breathing tube). The epidural that was put in before you went to sleep will also most likely still be in your back too. A catheter (tube) will also have been inserted to help you void (urinate).
	You will also notice that you have a bandage covering your entire abdomen. This is the dressing that covers the staples that were put in after your surgery, this dressing will be taken off after you leave the Intensive Care Unit. You will probably stay in the Intensive Care Unit for 24 to 48 hours.
After you leave the Intensive Care Unit you will be transferred to the Vascular Floor in the hospital and you can expect to stay there anywhere from seven to fourteen days. During this time Dr. Lossing and his team will be taking care of you. They include; the senior fellow, surgery residents in Vascular Surgery, a Nurse Practitioner and other nursing staff on the Vascular floor. While on the floor most of the needles and tubes will eventually be taken out. The nasogastric tube (the tube down your nose) will eventually be taken out and then you will be permitted to sip fluids. Once you are taking enough fluids then the intravenous in your arm or hand will come out. You will start to eat small portions of food while you are still in the hospital but you may not have an appetite just yet. Once you are eating and walking again you will be discharged, and given a follow-up appointment to have your staples removed at the Wellesley Site Vascular Clinic.
AFTER CARE QUESTIONS
Will I have to take any medication when I get home from the hospital?
	Before you leave the hospital you will be given a prescription for Tylenol #3. If you experience any pain you can fill this prescription. If you are allergic to codeine or Tylenol another medication will be used. If you were taking any other medications regularly before your surgery it is important to also resume taking these medications as well, unless instructed otherwise by your physician.
What about my staples? Sometimes the staples are removed prior to discharge but if they are not you will be given an appointment to see Dr. Lossing in 1-2 weeks at the Vascular Clinic (Wellesley Site). Dr. Lossing likes to see all his patients 1 to 2 weeks after their surgery for review and staple removal. If there are any problems with the appointment given to you please contact the Vascular Clinic at (416) 926-4826. It is also important to contact Dr. Lossing’s office at (416) 368-8886 to make follow-up appointments after your staples have been removed. You will have to come back for an appointment 1-month, 3 months, and 6 months after your surgery so that Dr. Lossing can make sure that everything is going fine with your recovery.
Can I take a shower or bath with my staples in?
You may have a shower or bath when you get home from the hospital, but remember that it should not be too hot, just warm water. Make sure not to soak the incision.
What about my diet? Will my diet ever get back to normal when I get home? Your normal diet and appetite will eventually return, but in the mean time you can eat anything as long as it is in small portions. Try not to eat large quantities and portions of food at one sitting.
What is normal? In general the following are normal; General weakness is common. Small amounts of discharge from your incision is normal. 3. Bruising around the incision is also very common. The odd ache and pain in the abdomen is normal. Your appetite will usually be diminished and minor weight loss may be experienced. 6. Your bowel habits may be altered. (This may be aggravated by the Tylenol #3)
How long after my surgery until I can travel in an airplane? It is all right to fly two to three weeks after your operation.
What about my activity level? Can I exercise?
It is important that you take it easy when you first get home from the hospital. REMEMBER you have had major surgery and it will take your body awhile to get back to normal. It is OK to resume your normal activities but do not overdo it and it is OK if you have to take a few breaks in between, light activity is permitted.
It is important that you discuss your activity level with Dr. Lossing, so he can determine whether you are doing too much.
*What about lifting? How much can I do?*
	It is essential that you do not do any heavy lifting for at least six to eight weeks after your surgery. Do not lift anything larger than the telephone book.
*Can I drive my car or any other motor vehicle?*
You should not drive until you have spoken to Dr. Lossing in your follow-up visit at the Vascular Clinic. Therefore, someone should come to the hospital to pick you up when it is your time to leave.
How long until I can go back to work?
	Every patient is different but do not go back to work until you have discussed it with Dr. Lossing. During your follow-up visits Dr. Lossing will then decide when it is appropriate for you to go back to work.
*What about the forms for work?*
Please bring any forms to the follow-up appointment in the clinic with the date of your surgery and how long you stayed in the hospital filled in and Dr. Lossing will fill in the rest.
What if I am worried about anything that is not covered on this website?
If you are worried about anything that is not covered in this booklet, feel free to contact Dr. Lossing at (416) 368-8886 at any time with your concerns.
We hope that this web site has been helpful. If you feel any changes or additions should be made, we welcome your suggestions.