Surgery Expectations

How to Prepare for Surgery

Preparing for surgery can sometimes bring about feelings of stress or anxiety.  At the M Health’s Gynecologic Oncology clinic, we are here to answer your questions and assure your comfort and safety throughout this process. 

Within 30 Days of Surgery

  1. Schedule a physical exam with your family or primary care physician.  If your family provider is outside of the M Health or Fairview network, please have your records sent to the M Health Gynecologic Cancer Clinic. 
  2. Tell your care team if:  
    • You have a pacemaker or ICD (implanted cardiac defibrillator).  If you do, please remember to bring the ID card with you on the day of surgery. 
    • You are a smoker.  Those who smoke have a higher risk of infection after surgery.  If you would like to quit smoking, please talk to your doctor about smoking cessation programs you can partake in. 
  3. If you are a diabetic.  Please work with your endocrinologist to ensure your diabetes is controlled and you have a plan for the day of surgery.  If your blood sugar is not well controlled, we may need to delay surgery (or you may have problems healing afterwards). 
  4. If your surgeon requests that you see a dentist, you will need to complete any treatment or dental work before your surgery.  Please have your dentist send a letter to the M Health Gynecologic Cancer Clinic clearing your for surgery. 
  5. Call your health plan/insurance to find out what they will and will not pay for.  Ask if you need a prior-authorization or pre-approval to have the surgery (the specific procedure and coverages will depend on your plan and coverages).  If you do not have health insurance, please contact M Health’s Financial Services team at 763-782-6639.

At least 10 days before Surgery

  1. To ensure a smooth check in process, please register your health information with the M Health surgery center.  You will need to have your insurance information readily available.  (Skip this step, if your procedure will take place at the University of Minnesota Health Clinics and Surgery Center.)
  2. Arrange for someone to drive you home after surgery.  If discharged the same day as your procedure, you will not be able to drive, take a cab, or ride public transportation alone.
  3. Plan for someone to stay with you a minimum of 24 hours after you are released from the hospital or surgery center.  This person must be a responsible adult, 18 years of age or older. 

2-3 days before Surgery

  1. If you take prescription medication, please follow your doctor’s instructions on when stop, reduce, or if you should continue taking them as prescribed.  This plan will be individualized based on the medication, procedure, and patient.  If you have questions, please contact your provider or nurse.
  2. A nurse will contact you, at the preferred phone number in your patient chart, to review your medical history and provide surgery instructions (this call is not about your insurance or payment details).  If you do not receive a call by the business day before your surgery, please contact your surgeon’s office. 
  3. If there is a change in your health, contact your surgeon immediately.  This includes any signs/symptoms of a cold or the flu (sore throat, runny nose, cough, rash, and/or fever).  

The Day Before Surgery

  1. Do not smoke, chew tobacco, drink alcohol, or take over-the-counter medication for 24 hours before and after surgery, unless otherwise instructed by your surgeon/physician.
  2. Take a shower or bath the night before surgery according to the following guidelines. Instructions
Day of

What to Expect the Day of Surgery

The preparation for surgery is just as important as the care you receive afterward. Please be sure to follow all instructions provided to you by your surgeon or oncologist.  Again we are here to answer any questions and ensure that you are comfortable and safe throughout your procedure.

What to bring with you

  • Insurance and prescription cards
  • Money or credit card for co-pay and parking (if needed).  Leave extra cash, money, jewelry, or other valuables at home.  
  • A list of all medications you take, do not bring the pill bottles with you.  Include any vitamins, minerals, herbs, and over the counter medications you take.  Additionally, please note any drug allergies.  
  • A copy of your advanced care directive, if you have one.  This tells us what treatment you would want, and/or who would make health care decisions on your behalf, should you no longer be able to speak for yourself.  You can request this form in advance or download it here
  • Your CPAP machine or inhaler, if you use either at home.  

The Morning of Surgery

Please follow the instructions below, the morning of your surgery, to ensure you are prepared for your procedure.  
  1. Wash your hair and body as you normally would, using regular shampoo/conditioner and soap.  Be sure to rinse the shampoo and soap thoroughly.
  2. Using clean hands, apply 2 ounces of antiseptic surgical soap (as provided by your clinic) on your skin from the neck to your toes.  Use on your groin area last.  Do NOT use this soap on your face or head.  If you get any soap in your eyes, ears, or mouth rinse immediately.
  3. Repeart step 2.  It is very important to let the soap stay on your skin for at least 1 minute. 
  4. Rinse well and dry off using a clean towel.  If you feel any tingling, itching, or other irritation, rinse your body right away.  It is normal to feel some coolness on the skin after using the antiseptic soap.  Your skin may also feel a bit dry or tight after the shower, but do NOT use any lotions, creams, or moisturizers.  Do not use hairspray or other hair products.  
  5. Dress in loose clean clothing.  
If you have questions about showering with or have an allergy to the CHG (antiseptic) soap provided, please contact the clinical nurse at the hospital you are having surgery performed. 
  • Regions Hospital: 651-254-3572
  • University of Minnesota Medical Center - East Bank: 612-273-4333
  • Methodist Hospital: 952-993-5475

When you arrive

Upon arriving to the surgery center, you will need to complete the following:
  1. Check in.  If you are under the age of 18, you must be accompanied by a parent or legal guardian.  
  2. Receive a copy of the Patient's Bill of Rights.  If you do not receive a copy, please be sure to ask for one.  
  3. Change into surgery garments, typically an open back hospital gown, provided by your periop nurse.  
  4. Meet with your care team.  Your oncologist/surgeon will explain the procedure to you and he/she may use a marker to indicate the area on your body that surgery will be performed.  The anesthesia team will then discuss with you the medication they will be using to ensure you are comfortable during the procedure, if applicable.  In some instance, a patient may not require general anesthesia and a local agent will be used instead.  This will be discussed with you prior to your procedure and the day of. 
  5. You will be asked to sign a surgical or care consent form.  By signing this document, you are allowing us/your oncologist to perform your surger.  Before you sign and date the form, please be sure to read it carefully and ask any quesitons you may have.  
For safety reasons, we will ask you some routine questions throughout your stay.  Such as, your name, date of birth, what day it is, who is the president.  Your family and support system are welcome to stay with you until the time of surgery.  When it is time for surgery, you will be transported into the operating room and your family will be asked to move into our waiting room/lobby area.  Once the surgery is complete, your family will be notified and you will be moved into a recovery room. 
  
Please note, cell phones are not allowed in some areas of the hospital, including peri-operative rooms.    
We'll let you know when you're ready to leave the surgery center. Before you leave, we will tell you how to care for yourself at home and prevent infections. If you don't understand something, please say so. We will answer any questions you have.

What to Expect after your Surgery is Complete

Immediately following your procedure you will be moved to a recovery room, where a nurse and medical teal will closely watch you.  If you have any pain or discomfort, tell your nurse, and they will try to make you comfortable.  The length of your stay and recovery will depend on the type of anesthesia/medication you recieved, your medical condition, and the type of surgery you underwent.    
  • If you are staying overnight, we will move you to your hospital room shortly after you wake from your anesthesia.
  • If you are going home, we may move you to another room, where your friends and family can join you.  
During your recovery and stay, a nurse will check your comfort levels often to ensure we are managing your pain accordingly.  Remember:
  • All pain is real.  There are many ways to control it and we're here to help find what works best for you. 
  • Ask for pain medicationi when you need it, don't try to "tough it out," as this can make you feel worse.  Always take your medications as prescribed. 
  • Medication does not work the same for all individuals. If your medication is not working, tell your nurse or care team.  There may be alternative medications or treatments available to you.  
We will let you know when you are ready to leave the surgery center or hosptial.  Before you leave, we will give you detailed instructions on at home care, to prevent the risk of infection.  If at anytime you have questions or do not understand something, please let your care team know.  We are here to ensure your safety, healing, and understanding of your health and care plan.  

Care Plan for your Stay in the Hospital

This care plan will help you better understand what to expect while you are in the hospital.  Your care plan may change depending on your needs and recovery.  Please ask questions if you are not sure of something or do not understand.  

Your care team:

Your health care team will be made up of doctors, nurse practitioners, nurses, physical therapists, occupational therapists, dietitians, chaplains, social workers, care coordinators, and other medical specialists/care providers.

What you can expect in the hospital:

  • Staff will routinely be checking your vitals (blood pressure, pulse, and temperature), even at night. 
  • If you have pain or feel nauseated, please ask your nurse for medication. 
  • We will ask you to cough or use a spirometer (breathing device) to keep your lungs strong and clear. 
  •  We may give you an antibiotic prior to surgery to prevent infections. 
  • When you are stable, you will be moved from the recovery unit to your hospital room.  Hospital staff will help you walk from the stretcher to the bed.  
  • You will receive fluids and medications through an IV line until you are able to take liquids and food by mouth. 
  • You may have a thin tube/catheter inserted into your bladder (through the urethra) to drain urine and limit your need to use the restroom.  This will be removed by 6 a.m. the morning following surgery. 
  • Initially you will be started on a clear liquid diet, to ensure you tolerate it before adding more liquids and food.  
  • We will help you walk 4 times a day.  You will be asked to sit in a chair for all meals.  
  • You will be allowed to shower 24 hours after surgery. 
  • We will provide medications to prevent constipation.  Typically senakot, 2 times a day with 1 rectal suppository, unless you have had a bowel resection.
  • You will be given medication to help with pain management and a nurse will routinely check your comfort level.  
  • All pain is real.  We will work with you to find the method that works best to keep you comfortable and manage your pain. 

Your goals:

With the help of you care team, you will work to:

  • Be as comfortable as possible and manage your pain levels.
  • Walk at least 4 times a day. 
  • Sit in a chair for all meals or at least 3 times per day.
  • Wear compression boots (SCDs) in bed to help prevent blood clots (DVTs)
  • Use a breathing device/spirometer at least 10 times each hour while you are awake.  This will help clear your lungs and prevent infections. 
  • Wear a binder around your belly to support your incision. 
  • Pee/urinate without problems.  Or, if needed, learn to care for a catheter/bladder tube. 
  • Describe the signs of infection. 
  • State your follow-up plan. 

What you can do:

You will heal faster if you do as much as you can for yourself while in the hospital. 

  • You should be more active every day.  
  • Please let us know your feelings and concerns. 
  • Talk to family or friends about what you may need after you leave the hospital.  

Family members and friends:

We support family members who wish to take part in their loved ones care.  Below, please find some general guidelines and information about the hospital for guests.  

  • Please make visits between the hours of 9:00 a.m. and 8:30 p.m.  If possible, limit the number of guests in the room at one time to ensure a quiet environment conducive to rest and healing. 
  • Children under the age of 16 are welcome as long as they are accompanied by an adult. 
  • There are restrooms next to the public elevators on each floor.  Please refrain from using patient bathrooms.  
  • Always wash your hands before visiting or when entering a room.  Do not visit your loved one if you are sick or have symptoms of an illness. 
  • If your loved one is in a shared room, please do not plan to stay overnight in their room.  The nursing station has a list of nearby hotels. 
  • The Bridges Cafe, located on the 8th floor, is open from 6:30 a.m. to 7:30 p.m. Monday through Friday, and 7:00 a.m. to 7:30 p.m. on weekends.  
  • Valet parking is available at the front entrance of the hospital.  

Sharing information:

  • Nursing staff will have brief meetings at your bedside between 7:00-7:30 a.m. and 3:00-3:30 p.m. to discuss your care plan.  This is a good time to ask questions or express feelings.  
  • We are legally required to protect your information, if you wish to share this information with your family, we will need your permission. 

Getting ready to go home:

We will always inform you ahead of time when you will be discharged home.  Your care coordinator will help you create a home care plan to ensure your safety after discharge.  Before leaving the hospital you will be taught:

  • Signs of infection
  • When you should call your doctor or nurse
  • Tips for good nutrition and eating habits
  • How to take your medications
  • How to return to your regular activity
  • Wound care
  • Drain care, if applicable

A social worker can meet with you to discuss:

  • Emotional concerns
  • Family issues
  • Adjusting to your diagnosis
  • Community services/resources
  • Financial or insurance concerns

You will need to make a follow-up/post surgical appointment with the cancer clinic.  If you have staples, they will need to be removed 10-14 days after your surgery, your doctor can perform this in clinic.  

Plan for Home Care after Gynecologic Surgery

This care plan will help you better understand what to expect while recovering at home.  Please note your care plan may change depending on your needs and recovery.  Please ask questions if you are not sure of something or do not understand.  

Wound care:

  • If you have a bandage, you may remove it after 24 hours.  Keep a dry, clean bandage on teh wound if it is draining.  
  • Once the wound has stopped draining, leave it open to the air.  You can cover the wound with a clean bandage during the day, if it will be exposed or rubbed by clothing.  
  • Keep the wound clean and dry.  Do not use ointment on it, unless told otherwise by your doctor.  
  • You may shower 24 hours after surgery.
  • Do not soak in the tub for at least 4 weeks.

Activity:

  • Try to cough, breathe deeply, and use your breathing device (spirometer) every 15-30 minutes when awake.  This will help to prevent breathing problem and fevers. 
  • When coughing or sneezing, you may want to hug a pillow for added support, if you had surgery on the abdominal area.  This will help to reduce any pain.  
  • For 6-8 weeks, do not lift anything over 20 pounds, refrain from heavy exercises or those that require the use of core/abdominal muscle groups (i.e. yoga, pilates, swimming, weight lifting). 
  • You may walk as much as you wish.  Try to increase your activity each day, walking stairs is okay.  
  • After a hysterectomy, do not put anything in your vagina for 8 weeks.  This includes: tampons, intercourse, douche washes.  
  • You can expect light spotting and discharge for up to 6 weeks, post surgery.  If bleeding becomes heavy, please contact your surgeons office.  

Medicines:

  • Take pain medications, such as Tylenol, Ibuprofen, or Naprosyn with food. This will reduce the risk of an upset stomach or nausea. 
  • If you have nausea, vomiting, or a rash, stop taking the medication and call your doctor. 
  • Do not drive, make important decisions, or use heavy machinery while taking narcotic pain medications. 

Diet:

  • You may eat a normal diet, unless otherwise instructed by your doctor. 
  • A high-fiber diet and plenty of fluids will help prevent constipation.  

Constipation:

Constipation is common after surgery.  To alleviate this symptom, drink plenty of water.  You can take stool softeners (Senokot-S) for 6 weeks, unless you experience loose stools or diarrhea.  If you remain constipated or are unable to pass stool, please try one of the following measures:  

  • Milk of magnesia: 30 ml (2 tablespoons), twice daily
  • Metamucil: 2 tablespoons mixed with 12 ounces of fluid
  • Dulcolax oral or rectal suppositories
  • Prunes or prune juice
  • Miralax once daily

You will need to make a follow-up/post surgical appointment with the cancer clinic.  If you have staples, they will need to be removed 10-14 days after your surgery, your doctor can perform this in clinic.  

If you are experiencing symptoms and are unsure if you should reach out to your clinic or doctor.  The guidelines below will help to outline when it is important to call us.  

When should you call your surgeon?

You should call your oncologist or surgeon is you are experiencing or have any of the followig symptoms:
  • Temperature greater than 100.5F (38C)
  • Nausea and vomiting that have not stopped or subsided
  • Severe or uncontrolled pain
  • Signs of infection: increased pain, swelling, redness, odor or green/yellow discharge coming from the wound
  • Trouble breathing, headaches, or vision problems
  • Hives
  • Dizziness or feelings of light-headedness
  • Extreme fatigue

EMERGENCY/AFTER HOURS CONTACT INFORMATION

After-hours Care
If you are experiencing symptoms or need to reach us outside our normal business hours, please contact us at 612-273-3000, and ask to speak with the on-call gynecologic oncologist. 
 
Emergency Care
In the case of an emergency, call 911 or go to the nearest Emergency Room

Clinic Numbers

You can contact our clinics by dialing hte numbers below, according to location. 
  • M Health Gynecologic Cancer Clinic: 612-676-4200, option 4
  • Maple Grove Gynecologic Cancer Clinic: 763-898-1600
  • Park Nicollet Women's Center, Gynecologic Cancer Clinic: 952-892-2108, option 2
  • Regions Gynecologic Cancer Clinic: 651-254-9600