Following the consultation, if surgery is agreed then you will be placed on a waiting list. The time it takes for you to have your operation varies but on an average is around 12 weeks.
On the day when you are added to the waiting list, you will be seen by the nurse in the Pre-Op Assessment unit. The purpose of this assessment is to serve as a check point in making sure that you will be fit for the operation and any medical problems that could potentially interfere with the operation can be if identified and addressed. This will include optimising your medications, arranging any investigations, advice regarding stopping any tablets (like clopidogrel), questions about home and work circumstances etc.
During the pre-operative assessment, you will be asked to complete a medical questionnaire. If some of the answers triggers certain responses, then you will undergo further tests like, blood tests, ECG etc. Urine analaysis and MRSA swab are routinely taken.
If it is detected that you are a carrier of MRSA, do not panic. MRSA (Methicillin Resistant Staphyllococcus aureus) is a bacteria which is generally harmless and only in selected situation it can give raise to infection. More often than not, it is not harmful to you; but when it spreads in the hospital, it can give raise to infection to others who are not carrier to this bacteria. If MRSA is detected
you will be asked to undergo decolonisation treatment with use of antiseptic solutions and soap to minimise the risk of cross infection.
My preference is to stop any blood thinning agents before surgery if safe to do so. These agents include aspirin, warfarin, persantin, clopidogrel etc. However, if you need to take them to prevent serious consequence (for example you may have an artificial mechanical heart valve which mandates keeping blood thin or previous history of DVT>PE) we can make alternative arrangements like using injectable blood thinner whilst you stop these tablets. The nurse in the pre-assessment clinic will be able to give you detailed information.
You will be assigned a routine or urgent priority based on the severity of the condition and your theatre slot will be allocated accordingly. It is generally not possible to give a precise date for surgery at the time of listing. The clerk at the booking office or my secretary (in private hospital) may be able to give you some indication. Please let us know if you have any holiday planned; 2 weeks of leeway is permissible.
You can opt to go on a ‘short-notice’ list and you will be informed if there are any cancellations. If it is practical, then you can take that slot. Your position in the main waiting list will not be compromised if you cannot take the short notice place.
You will be given adequate warning about the actual surgery date and therefore you will be able to give notice to your employer regarding the time off. For most operations, you will not be able to return back to manual work for 6 weeks.