Your pre assessment appointment prepares you for your operation. You’ll meet some of the members of your treatment team at this appointment. You usually have this appointment 1 or 2 weeks before your operation.
Tests to check you are fit for surgery
You have tests before your operation to check:
- your fitness for an anaesthetic if you need one
- that you'll make a good recovery from surgery
You might not need all of these tests if you had them when you were diagnosed. Tests include:
- blood tests to check your general health and how well your kidneys are working
- an ECG to check your heart is healthy
- breathing tests (called lung function tests)
- an echocardiogram (a painless test of your heart using sound waves)
- a chest x-ray to check your lungs are healthy
Pre assessment clinic
One or two weeks before your surgery you have an appointment at the hospital pre assessment clinic.
Your pre assessment appointment prepares you for your operation. You meet members of your treatment team at this appointment.
The doctor will tell you what to do on the day of your operation. This includes instructions about when to stop eating and drinking, and whether to stop taking any of your medicines. Do not stop taking your regular medicines unless the doctor tells you to.
Your doctor might invite you to join a clinical trial as part of your treatment.
Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
You can ask more questions when you go into hospital so don’t worry if you forget some. At the hospital you might meet:
A member of the surgical team will tell you about:
- the operation you are going to have
- the benefits of having surgery
- the possible risks
- what to expect afterwards
The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you are fit enough for surgery.
The clinical nurse specialist
The nurse checks your:
- general health
- blood pressure
The nurse also checks what help and support you have, to see what you will need when you go home. They are your point of contact and care for you throughout your treatment.
These nurses also provide support and advice about having a stoma.
The dietitian gives you help and advice about managing your diet. They:
- help you get as well as possible before your operation
- explain how the surgery affects your diet
- give useful tips on how to increase your nutrients and calories
They might give you nutritional supplement drinks to have before surgery.
Some people need a feeding tube in their stomach or small bowel. This makes sure you get the nutrition you need before surgery.
The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.
Helping you recover
Your doctor and nurses might tell you about the enhanced recovery programme. This is a way of caring before, during and after your surgery to help you recover more quickly after a big operation. It includes advising you about:
- being physically active
- stopping smoking
- drinking less alcohol
- how to eat well before your surgery
Learning breathing and leg exercises
Breathing exercises help to stop you from getting a chest infection after surgery. If you smoke, it helps if you can stop at least a few weeks before your operation.
Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin.
You start the injections after your operation. You might also wear compression stockings and pumps on your calves or feet to help the circulation.
Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.
This 3-minute video shows you how to do the breathing and leg exercises.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a huff. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
Going into hospital
You’ll probably go into hospital on the day of your operation or the day before.
What to take with you
- nightgowns or pyjamas
- dressing gown
- contact lenses, solution, glasses and a case
- wash bag with soap, a flannel or sponge, toothbrush and toothpaste etc
- sanitary wear or tampons
- small amount of money
- medicines you normally take
- magazines, books, playing cards
- headphones and music to listen to
- a tablet or smartphone for web browsing, entertainment and phone calls
Time in hospital
The length of your stay depends on the type of operation you have and your recovery.
You might be in hospital from a few days to a week. In rare cases you may need to stay longer.
It’s worth sorting out a few things before you go into hospital. These might include:
- care for children or other loved ones
- care for your pets
- care for your house
- cancelling your milk or newspapers
It may help to prepare or buy some meals in advance that you can just heat up once you are at home.
Family and friends
Before you go into hospital, it might be worth checking:
- whether the ward is allowing visitors
- if they have set visiting times
- the best number for friends and family to phone, to find out how you are
The letter you receive before your operation may contain this information. But if not, you can phone the ward or hospital reception to find out.
You can use your mobile phone in hospital. But there may be some time before and after your operation when you won’t have your mobile nearby. And you may not feel like talking.
On the day of your operation
Your nurse will go through a series of questions on a checklist to make sure you are ready for surgery. They ask you to:
- tell them when you last had something to eat and drink
- change into a hospital gown
- put on a pair of surgical stockings
- take off any jewellery (except for a wedding ring)
- take off any make up, including nail varnish
- remove contact lenses if you have them
- put on 2 hospital identification bands, usually one on each wrist
If you have false teeth you can usually keep them in until you get to the anaesthetic room.
For some types of surgery, you may need to remove some of your hair around the operation area. The nurse might do this for you when you’re under anaesthetic in the operating room.
Having an anaesthetic
You have an anaesthetic so that you can’t feel anything during the operation. You have this in the anaesthetic room, next to the operating theatre.
All the doctors and nurses wear theatre gowns, hats and masks. This reduces your chance of getting an infection.
The anaesthetist puts a small tube into a vein in your arm (cannula). You have any fluids and medicines you need through the cannula including the general anaesthetic. This sends you into a deep sleep. When you wake up, the operation will be over.
Before you go to sleep your anaesthetist might put a small tube through the skin of your back. It goes into the fluid around your spinal cord. They can attach a pump to this tube to give you pain medicines during and after the operation.