When you and Dr. Mullen decide that surgery is the best course of treatment, the scheduling process starts with Dr. Mullen filling out a surgery booking form. The OR scheduling team needs that form to determine the type of procedure, its duration, the hospital or surgical center selected, and any special equipment needed for the case. There are certain patients/surgeries where Dr. Mullen’s anesthesia team may want pre-operative testing such as lab work, EKG, and/or a chest x-ray. His scheduling team will let you know if that’s the case. If because of your history you require a cardiologist for medical clearance, this must be set up and completed prior to scheduling any elective surgery.
After you and Dr. Mullen decided to have surgery, and after you discuss the decision with family members, loved ones, trusted colleagues, and in some cases your place of work, Dr. Mullen’s surgical coordinator will notify you by phone and you may pick a surgery date and set up your testing (if required). Once the surgical coordinator has completed the paperwork and booked your surgery with the hospital or surgical center, she will send a message to the billing office staff who will contact your insurance company for any required precertification.
You will need to come back and see Dr. Mullen or his Physician Assistant, Kelly Connor, to complete a history and physical and to get any prescriptions and/or medical equipment that may be needed for after surgery. If Dr. Mullen has ordered testing or referred you to another physician for perioperative evaluation, he will usually have all the results available before that visit.
We do get precertification for you but all insurance plans are different and ultimately it is your responsibility to know what is and is not covered. You, as a patient, may want to check with your insurance company to see if your benefits vary depending on the hospital.
NSAIDs (Advil, Ibuprofen, Aleve, full strength aspirin) and Plavix need to be discontinued 10 days prior to surgery. Over-the-counter vitamins often have ingredients that may thin the blood and must be discontinued 7 days prior to surgery. Warfarin or Coumadin needs to be discontinued 5 days prior to surgery. Eliquis and Xarelto need to be discontinued 3 full days prior to surgery. Not doing so puts you at risk for excessive bleeding, and may result in cancellation of the surgery. Ask Dr. Mullen and his team about any specifics or concerns you may have with regards to your blood thinners.
Night Before Surgery
On the night before surgery:
Take a complete bath or shower.
Take your usual medications (not blood thinners) unless specifically ordered by your doctor.
Do not eat anything (including any food, chewing gum or mints) after midnight.
Do not drink alcoholic beverages 24 hours before surgery and avoid heavy foods.
Day of Surgery
On the day of your surgery, make sure you bring the following items with you to the hospital:
Your insurance card, driver’s license, and social security card to ensure your insurance company is appropriately billed.
A living will, durable power of attorney, or other advanced directive, if you have one.
A list of all your medications and their strengths, including aspirin, birth control pills, vitamins, herbal supplements, and prescription medications. Also please make sure to let us know if you are allergic to any medications.
The names and telephone numbers of people to contact in case of an emergency (contacts can include family members, friends, or neighbors.)
Any written orders your physician has given you.
Children may want to bring a book, favorite toy, or blanket.
Many facilities have WiFi, and you are invited to bring an electronic device to pass the time in case of delays.
Furthermore, please remember:
Do not eat anything before surgery unless otherwise instructed by your physician. The only thing you may have is water, nothing else, and even that cannot be taken in the 6 hours that precede your surgical start time. Eating and drinking can increase the possibility of problems and may cause your surgery to be delayed or canceled.
Notify your physician if there is any change in your physical condition, such as a cold, fever, or infection that may cause your surgery to be delayed.
If you are a diabetic, check with your physician about the use of insulin or oral hypoglycemic agents.
You may wear your contact lenses or glasses, but bring a case for storing them during surgery. You may wear your hearing aid, but bring a case for storage and an extra battery. Bring a container for dentures as they need to be removed during surgery.
Do not smoke the morning of surgery.
Do not wear makeup or jewelry, and do not shave area to have surgery.
Leave all valuables at home.
Be sure to bring loose‑fitting clothes to change into after your surgery that can be easily removed once you return home.
A responsible adult must be available to receive instructions about your care and drive you home from the hospital after your surgery.
Arriving at the Hospital
Plan to arrive at the hospital one and a half to two hours before your surgery is scheduled or as otherwise indicated. This is necessary to allow enough time for a thorough pre‑surgery evaluation.
After you are registered, you will be taken to a private same day surgery holding room where you will change into a hospital gown. A nurse will take a brief medical history and check your vital signs. You will also meet with an anesthesiologist. Parents may remain with children during this time.
When the nurse is taking your history, please remember to mention:
If you wear dentures, including permanent dentures such as bridgework caps or crowns.
Medication you have taken or brought from home.
Special orders from your physician.
Colds, fever, or infection.
In the case of a child, any serious or chronic illness the child has had.
Any problems you have had with previous surgery or anesthesia.
Any family members who have had trouble with anesthesia.
Once it is determined that you are in a safe condition to have surgery, your family or friend may wait with you until you are taken to the pre‑operative holding room or to surgery. The preoperative holding room is where patients undergo regional anesthesia such as nerve blocks prior to surgery.
It is sometimes necessary for us to change the operating room schedule. We will do our best to keep you informed of any changes that might delay the scheduled time of your surgery.
While you are in surgery, your family members and friends may remain in our Surgical Waiting Area. Dr. Mullen will meet with the family following surgery to discuss the details of the case.
After Your Surgery
While you are recovering, your nurse will closely monitor your blood pressure, heart rate, and respirations. You may feel dizzy, tired, or nauseous. This is due to the action of the medicine used during anesthesia. It is important to let the nurse know if you are having any pain. He or she will be able to give you medication to help control the pain or discomfort you might experience.
If your surgery was done in an Outpatient Surgery Center, you will remain in the recovery room until your physician and nurse have determined it is safe for you to go home. That is usually one to two hours. Before you leave the hospital, your nurse will make sure that you are able to walk, urinate, and take liquids.
Dr. Mullen usually provides his patients their post‑operative instructions days before surgery in his pre‑surgical packet for them to study and reference later. Your recovery room nurse will go over post‑anesthesia instructions with you. Due to the memory‑dulling effects of anesthesia, we highly recommend that you arrange to have someone present who can listen to the recovery room nurse and ask questions on your behalf. You are always invited to call Dr. Mullen’s office the following day if you still have questions.
Please arrange in advance for a responsible adult to stay with you for 24 hours following surgery.
When You Return Home
When you return home, please:
Do not drive, operate any equipment, sign important papers, or make any significant decision during the first 24 hours after your surgery.
Resume your food intake slowly, starting with chipped ice and sips of cola, ginger ale, or lemon/lime drink.
Avoid alcoholic beverages for 24 hours after medication or anesthesia.
If severe dizziness, elevated temperature, excessive bleeding, prolonged nausea, or other alarming symptoms should occur, call your physician immediately.
If You Need to Be Admitted:
Avoid alcoholic beverages for 24 hours after medication or anesthesia.
If you are to be admitted to the hospital after your surgery, a room assignment will be made accordingly. Although it cannot be guaranteed, Dr. Mullen tries to reserve private rooms for all of his patients.
Reasons to contact your physician:
Excessive redness, swelling, drainage, or foul odor from your incision
Temperature elevation over 101 degrees
Leg swelling, calf tenderness, or increased leg pain
Discomfort not controlled by medication
Chest pain, shortness of breath, or breathing problems