Patient Information for Surgery | About Cadogan Clinic

Before Your Surgery

PRE-OPERATIVE QUESTIONNAIRE

If you have not already completed these, attached to the email confirming your surgery details, both a pre-operative and psychological screening questionnaire will be included, which must be returned to us prior to your surgery via email, post or in person. Failure to do so may mean a delay in your surgery.

HOW TO PREPARE FOR YOUR PROCEDURE

You must arrange to be looked after for the first 24 hours by a responsible adult this can be a relative or friend. If you are taking a taxi home your ‘responsible adult’ must accompany you and if you have children at home you must ideally arrange childcare for the first 24 hours. How long this will be required will depend on the type of procedure you are undergoing.

Lastly, please ensure that you wear loose, comfortable clothing which is easy to put back on when you go home.

ITEMS TO BRING WITH YOU ON THE DAY

Any tablets, medicines or inhalers that you are currently taking (tablets in their original boxes please)
Something to help you pass the time such as a book, magazines or your Kindle / iPad etc
Spectacles /contact lenses
You will have a small locker next to your bed for personal possessions. Storage space is limited so please only bring essentials

FASTING BEFORE YOUR SURGERY (NIL BY MOUTH)

You should not take any solid food or milk in the 6 hours before your procedure. However, you will be able to continue to take any prescribed medicines. The email confirming your surgery date will inform you of your admission time and scheduled time of procedure. It is essential that you follow the fasting instructions as if you do not fast we may have to postpone or cancel your procedure.

WHY YOU NEED TO FAST

It is essential for your own safety during sedation or anaesthetic that your stomach is empty. If there is any food or liquid in your stomach during your anaesthetic, it could come up into the back of your throat and then go into your lungs. This would cause choking, or serious damage to your lungs.

If you have diabetes or have concerns about fasting please contact your consultant or the clinic nursing staff who can advise you.

Smoking prior to your surgery greatly increases the risk of anaesthetic complications. If you smoke you will be advised by your consultant to stop at least 2 weeks prior to your procedure and in some cases for an even longer period of time. This is for your own safety as smoking decreases healing and consequently allows infection and poor scarring.

Please note that the Cadogan Clinic recommends you stop smoking in the weeks prior to your surgery, do be aware that your consultant or anaesthetist has the authority to postpone your surgery if you do not adhere to these guidelines, in which case you would be subject to rescheduling fees (detailed later).

DO AND DON'T CHECKLIST

DO refrain from applying fake tan for a period of 7 days prior to your operation date
DO NOT apply any moisturiser to your skin for a period of 24 hours prior to your operation
DO NOT drink any alcohol 48 hours prior or post surgery
DO ensure you are well hydrated the day before your surgery, and if your procedure is in the morning please try and have a snack in the evening before going to bed
DO remove false eyelashes or nails including acrylic and gel overlays, makeup and piercings before you arrive at the clinic
DO Shower either the evening before or the morning of your operation
DO NOT apply anything topically to your skin after showering including deodorant
DO tie your hair up if it is long
DO wear loose fitting clothes to clinic so that you can change easily both before and after your procedure
DO advise your nurse before surgery if you think there is any chance you may be pregnant
DO NOT smoke or take recreational drugs prior to surgery – for many procedures such as such as; breast surgery, abdominal reshaping and facelifts, one should stop 2 weeks before surgery

Day Of Your Surgery

Before and after your procedure at the Cadogan Clinic you will be cared for by your Consultants and our nursing team in our shared Ambulatory Care room.

The Ambulatory Care area of the unit is open plan with individual bed areas screened off ensuring your privacy and confidentiality at all times. If you would like to discuss your treatment with your Consultant this will be arranged in a room at any time, Please just make the nurse caring for you aware.

Once you have been admitted to the unit by your nurse, any relatives, friends or escorts will not normally be allowed to remain with you during your stay; however they may briefly come into the Ambulatory Care area to check that you are settled in.

This is at the discretion of the Ambulatory Care lead Nurse as they will have to balance your visitors’ wishes with the needs of the other patients present.

As a day case procedure, you will be discharged on the same day as your surgery. It is likely to be 1-4 hours following your procedure, however this can vary depending on how you feel and when your consultant is satisfied you are comfortable enough to return home.

Your admitting nurse will provide your relatives or escort an estimation of the time you will be ready to go home to allow them to plan your transportation needs.

The Cadogan Clinic offer day case clinic procedures meaning that you to go home on the same day of your surgery, allowing you to rest and recuperate in the comfort of own home.

There is no need for our patients to stay overnight due to the anaesthesia technique we use called TIVA (Total Intravenous Anaesthesia). This is a variant of general anaesthesia and is administered by our team of highly specialised anaesthetists.

TIVA allows our anaesthetists to monitor anaesthetic depth more closely and on specialised computers to maintain an optimal level of sleep. When they need to wake you up, it can be done quicker and with fewer side effects.

TIVA also reduces the risk of nausea and vomiting and won't give you that groggy, confused feeling that other anaesthesia's can. You will wake up feeling much better than with traditional alternatives and ready to go home in no time at all.

Our nurses will help you feel as comfortable as possible during your stay at the clinic. They will let you know about any follow-up appointments and explain any post-operative instructions too.

When you arrive at the clinic a member of the reception staff will greet you and your personal details will be checked and confirmed. You may spend a little time in the reception area before being admitted. A nurse will meet and escort you to your allocated bed-space and will complete a checking/safety questionnaire.

You will be given a hospital identity bracelet with your name and details on it. If you are allergic to anything such as some food, types, medication or latex please tell your nurse and this bracelet will be made red. We will weigh you; take your temperature and check your blood pressure.

You will be asked to wear a cotton procedure gown and in some cases disposable underwear. Please let the staff know if you are required to keep your head covered due to religious belief.

Only essential items will be allowed in the operating theatre and all jewellery, body piercings and contact lenses must be removed before entering the theatre. You may however keep your wedding ring on – this will be covered with tape. To ensure the safety of your belongings please ensure you leave the rest of your jewellery at home.

Hearing aids and dentures will be left in place.

Your anaesthetist and surgeon will explain your proposed procedure. If you are having an operation on a particular part of your body this may be marked with an arrow or other markings may be made by your Surgeon and when theatre is ready for you your Nurse will double check personal details before walking with you to the procedure room. Many procedures require the surgeon to make more complicated skin markings which will be photographed in a separate room beforehand.

If you had a general anaesthetic you will initially be taken to the recovery area, where you will start to wake up.

Once you are more awake you will be taken back to the Ambulatory Unit where you will be able to relax and have something to eat and drink.

This recovery period varies from individual to individual and could take anything from one - four hours.

The Surgeon and Anaesthetist may visit you in the Ambulatory Unit to let you know how things went during your operation and to check how you are recovering.

Your Nurse will advise you when it is safe for you to leave, provide you with postoperative guidance and schedule your wound care follow up appointment (usually 1 week following surgery).

Being Discharged – Going Home

Following your surgery you may experience a degree of discomfort, your surgeon will provide you with pain relief or other medications to take home with you - your Nurse will explain these medications to you fully and go through all of your post procedure information to ensure you feel relaxed and comfortable when home.

Before leaving the unit, the nurses will discuss any post operative instructions and care with you and provide you with appropriate advice leaflets. It is beneficial for your responsible adult to be present at this point as they will be helping care for you during your recovery. Your responsible adult must then accompany you home by car or taxi – public transport is not suitable.

After Surgery

When You Get Home

You may feel tired; so only do as much as you feel comfortable and do not take any sleeping tablets or recreational drugs.
Do not operate machinery or drive a car or motorbike for 24 hours due to your anaesthetic – specific guidance based upon the surgery you have had will apply.
You must not take sole care of any children.
Due to being nil by mouth, you must rehydrate yourself - Drink plenty of fluids and eat light meals to raise blood sugar levels – this will aid recovery and help alleviate any side effects. Do refrain from drinking alcohol for at least 24 hours.
Please follow specific Nursing and Consultant advice when taking prescribed medication – including painkillers.
Do not make any important decisions or sign any contracts for at least 24 hours after a general anaesthetic.

Side Effects of Anaesthesia - What to Expect

You may experience a sore throat, a headache or feel tired and a little confused a few days following your surgery – this is completely normal. Some patients report feeling slightly nauseous following their surgery but all symptoms are usually quite mild, are easily managed with medication and tend to subside within a day or so after surgery. It is very unlikely you would suffer a delayed severe allergic reaction to anaesthesia but if in doubt please contact us on the emergency numbers provided.

The type of sedation that we use for all patients know as ‘TIVA’ or ‘Total intravenous anaesthesia’ is a technique administered solely via the intravenous route meaning that the more ‘traditional style’ of gas based products is not required – it is this that typically leaves patients feeling unwell so with TIVA, you should feel back to yourself within hours after your surgery.

In the case of an emergency please contact your consultant in the first instance. Only if you are unable to reach your consultant please call: 07899 964893 and speak with a senior member of staff.

If you have any questions or concerns regarding your procedure or recovery please feel free to contact the Cadogan clinic and speak with the nursing team who are available from 7am – 8pm Monday to Friday on: 0207 901 8500

Advice for Carers (Responsible Adult)

You must escort your friend or relative home by either taxi or a car. Public transport is not appropriate following surgery. The type of care your friend or relative will need depends on the type of procedure they have had.

General responsibilities are:

Escort your friend or relative home by car or taxi (not public transport).
Stay with them for the 24 hours following surgery in your or their home.
Help with household activities, such as cooking and cleaning.
Offer the patient plenty of fluids to drink (no alcohol).
They may need help with washing/bathing and getting dressed.
Ensure they take regular painkillers or medication as prescribed/advised.
After 24 they should be feeling considerably better and will need less support and help. You might not need to stay overnight, but perhaps could still offer some daytime support, such as shopping, cooking or child minding.

Post Surgical Pain Relief

After surgery you experience a little discomfort which can be easily managed with painkillers. You may even be prescribed a combination depending on your operation and level of comfort (which is typically hard to predict). Each of the below drugs can be taken together effectively and do not interfere with one another. Please note if you do experience any side effects you must stop taking that painkiller and rely on another, any undesired side effects wear off rapidly.

Paracetamol: Often the most effective painkiller and provides satisfactory pain relief with very few side effects. Paracetamol can be combined well with other drugs but advice provided on this must be followed. Use of any drug must be discontinued if you feel unwell or experience any unusual or undesired side effects.

CoDydramol: When taking this medication, you must not take addition paracetamol – it is a combination of Paracetamol and Dihydrocodeine. This is quite a strong painkiller and can sometimes cause constipation after taking it for a few days. If your discomfort is moderate or low we would recommend switch to just paracetomol.

Ibuprofen: This is an anti inflammatory drug which works similarly to Asprin. If you have or suffer with stomach ulcers or gastritis due to excessive amounts of stomach acid we would advise you avoid this medication. It is a very effective drug but can increase bleeding and bruising in the first 24hrs after breast surgery so we would advise to avoid taking it until the next day.

Tramadol: This is classed as a medium strength painkiller. A small number of patients can experience a little excess sweating, anxiety or nausea after taking it. It is usually reserved for more painful or extensive surgeries. It can be particularly useful when neither codrydamol and ibuprofen are not enough.

Patient Comments and Questionnaire

We strive to offer the best possible care at the Cadogan Clinic. To help us to maintain and improve our level of care we will ask you to complete a questionnaire about your visit and treatment at the Clinic. We would be most grateful if you can take the time to complete this and provide honest feedback.