Lima Memorial Pre-Operative Clinic

Ankit Patel, MD
Dr. Ankit Patel serves as the Medical Director of Anesthesiology and the Enhanced Recovery After Surgery Program at Lima Memorial Health System. With over 10 years experience as an Anesthesiologist, Dr. Patel has honed his abilities in examination and treatment planning, providing a firm foundation for the ERAS Program.

Kasey Harrod, MSN, CNP
Kasey Harrod is a Certified Family Nurse Practitioner and clinical lead of the Pre-Operative Clinic and Enhanced Recovery After Surgery, or ERAS, Program. Her expertise in patient counseling, treatment planning, and interdisciplinary teamwork have driven great results for the patients she cares for.

It is critical that you speak with the Pre-Operative Clinic prior to your surgery date. During your call, we will review your medical history, provide you with all your needed instructions, and get your questions answered. We prefer to speak with you no later than a week prior to your surgery to ensure that there are no delays on surgery day. Depending on your medical history or type of surgery, we may ask that you come in for this appointment. If we are unable to speak with you prior to your surgery, there is a risk that your surgery will be rescheduled.

Please feel free to give us a call at 419-998-4690 or email us at ERAS@limamemorial.org with any questions or concerns. We are always here for you and will be glad to help.

Click HERE for an outpatient map to our surgery department as seen below.

Good nutrition is a key player in your surgical success, helping you heal quicker and protect against infection. We recommend that you choose a well-balanced diet, which includes fruits and vegetables, and foods that are whole-grain, low-fat and high in protein. Make sure that you are drinking enough water and decrease your caffeinated and sugary drinks. Once you are out of surgery and beginning the work of recovery, slowly increase your diet back to normal, again focusing on high protein. Be sure to follow your surgeon’s instructions of any dietary restrictions.

It is important not to skip meals and if you cannot eat enough, try a protein drink.

On the morning of surgery, you may be able to safely drink clear liquids up to three hours before surgery. This has many benefits, including keeping you hydrated and preventing nausea after surgery. Acceptable clear liquids include water, black coffee, and sugar-free sports drinks or juice. Please discuss this with the Pre-Operative Clinic or your surgeon.

Sometimes after surgery, it can take some time to get your bowels moving again. We recommend that you chew a piece of gum or take a mint every four hours in the early days after surgery. This will help wake up your intestinal tract and improve your appetite.

When preparing for surgery, it is important to have very good control of your blood sugar. Patients who have too low or too high blood sugars are at an increased risk for complications, which makes it difficult to heal and recover. The Pre-Operative Clinic will provide instructions to help you control your blood sugar before and after surgery.

There are important things you can do to prevent an infection after surgery, such as quitting smoking and controlling your diabetes. Please shower with antibacterial soap the night before surgery and on the morning of surgery. You should wash your entire body and take special care to wash the area on and around your surgical site. If you come in for an appointment with the Pre-Op Clinic, we may also offer you a special surgical soap.

We also ask that you brush your teeth before surgery, sleep on clean sheets, and do not allow your pets to sleep with you right before surgery or during your recovery. After surgery, your surgeon will give you additional instructions about how to care for your wounds.

During surgery, you may be asleep but your body is working very hard. We compare it to running a marathon. Marathon runners prepare for the race by building up their exercise tolerance. Keeping active before your surgery will give you the strength and energy needed to be up and moving quickly after your procedure. We recommend you maintain your normal activity level and increase it as you are able to tolerate. If you feel any discomfort or pain during activity please be sure to discuss this with a member of your healthcare team. We recommend tracking your daily step count so you are aware of how many steps you were taking before your surgery. This will help you understand how you are progressing with your recovery after surgery.

It is important to prepare your lungs for surgery. Staying active and practicing taking deep breaths several times a day can help improve the strength of your lungs and prevent breathing complications after surgery. If you start to feel dizzy or light-headed, we recommend you stop and try again later. After surgery, you may receive an Incentive Spirometer, or breathing exerciser. We recommend you perform a session every hour while awake until you are back to your normal activity level. For step-by-step instructions about how to use the breathing exerciser, please refer to the instructions below.

• Hold the spirometer upright in front of you while sitting or standing up straight.

• Breathe out normally, then close your lips tightly around the mouthpiece. Do not block the mouthpiece with your tongue.

• Take a slow, deep breath through your mouth, breathing as deeply into your lungs as you can.

• As you breathe in, the piston in the large chamber will move up. Try to move the piston as high up as you can, or at the level that the provider has recommended.

• When you cannot breathe in anymore, hold your breath for 2 to 5 seconds. Try to keep the moving circle in the area indicated.

Smoking

• Smoking or vaping tobacco increases your risk of experiencing a complication after surgery. Smoking can impact your healing ability, affect your breathing, and increase your risk for infection. We strongly recommend quitting smoking as soon as possible before your surgery. Quitting can improve your overall long-term health and help you recover better. If you need help to quit smoking before your surgery, please make sure that you talk to a member of your healthcare team today. We are here to support you in any way.

Sleep Apnea

• If you have obstructive sleep apnea, you should use your CPAP or BIPAP machine daily. We recommend that you bring your CPAP or BIPAP machine with you when you arrive for surgery. This is very important to ensure we have all of the right tools to take care of you before and after your surgery.

It is extremely important to understand what medications you can or cannot take in the days surrounding your surgery. Please bring a list of all your medications, vitamins and supplements with you to your pre-operative appointment. The Pre-Op Clinic will review your list and offer specific instructions about how to take your medications before surgery. After surgery, you will receive further instructions on how to manage your medications.

Depending on the type of surgery you have, you will experience varying degrees of discomfort during your recovery. At Lima Memorial Surgical Services, it is important to us to do everything we can to help minimize your pain. Your surgeon may prescribe narcotics, or prescription pain medications, to help with your pain after surgery. It is important to follow the instructions provided to you about how to safely take these medications, as they can be addictive and cause other side effects. In order to decrease these risks, take your pain medicine only as prescribed, do not drive while taking these medications, and you may also need to take stool softeners to prevent constipation. In order to minimize the amount of narcotics you require after surgery, we may also offer you alternatives to reduce your pain. These options may include other types of medications and nerve blocks. It is important that you communicate any symptoms of pain to your healthcare team right away.

Please be sure to report any past or current drug use or the overuse of alcohol and prescription medications. This can greatly impact the way anesthesia and pain medicine affect you. We want to be sure to keep you as safe and comfortable as possible.

Some patients may experience nausea after surgery. We will utilize methods to help prevent nausea and treat it if it occurs. You may have a medication patch applied behind your ear or receive medications through your IV during your surgical stay. It is important that you communicate any symptoms of nausea to your health care team right away.