If you are scheduled to arrive at 6:00am please ensure you allow for traffic conditions, rain etc and arrive punctually at 6:00am.
As you are having a General Anaesthetic you need to have no food or drink for at least 6 hours prior to your procedure. Check with Canossa Hospital for the time of your procedure.
You will be given a General Anaesthetic for this procedure which means that you will remain drowsy for up to 24 hours following the procedure. For this reason, you must arrange an adult to care for you during this period.
We also ask that you do the following:
1. Due to the sedation, you will also legally not be able to drive for 24 hours. Please arrange for transportation home after your procedure and for transportation back to the surgery the next day for your check up. The person who you arrange for this must be nominated with their contact details at the end of this form. This must be an adult that you know and cannot be an Uber or taxi driver.
2. If you live alone and are unable to arrange a carer for the 24 hours following surgery, we can recommend that you contact Right At Home – In home care and assistance.
Phone: 1300 362 609 1300 363 192 0478750192
www.rightathomeaustralia.com.au
3. Furthermore, you should also not operate machinery or sign any important documents in the 24 hours following surgery. Also avoid being in a situation where you will need to negotiate stairs or an unfamiliar environment.
4. Avoid aspirin, aspirin-containing or aspirin-like medications (Eg: arthritis medicines, some cold and flu remedies, Nurofen or Brufen), Vitamin E, (or multi vitamins that contain Vitamin E) fish oil, glucosamine supplements, gingko biloba, ginseng, valerian, black cohosh and chondroitin sulphate, These have been known to thin the blood and prolong bleeding. Many other herbs have also been known to work in the same way. Avoid these for 3 weeks before surgery.
5. If you use prescription “blood thinners” such as Warfarin, be sure to discuss this with your doctor well in advance of your surgery.
6. Unless you are advised otherwise, continue using all of your regular medications in their normal dosages. Be sure to discuss this with your doctor.
7. Stop smoking at least six weeks prior to surgery.
8. Avoid alcohol for two weeks prior to your surgery and for three weeks following your surgery. This also acts to thin the blood and prolong bruising.
A prescription for Keflex, Panadeine Forte, Mersyndol and stemetil will be posted to you prior to the procedure. Please have the prescription filled at least 2 weeks prior to surgery and start using the arnica spray 4 puffs, 3 times daily underneath the tongue for 2 weeks prior to surgery. If you log onto www.epharmacy.com.au you will find a list of discount pharmacies in your area.
9. Allow for 4 days away from work in order to recover if your job is not too physically demanding. If your work requires physical energy you’ll need to allow more time for recovery.
ON THE MORNING OF SURGERY
· Wash with PHISOHEX . Also do this the night before surgery. Start by washing your breasts, then after that, wash your whole body.
· DO NOT WEAR JEWELLERY, WRISTWATCHES OR ANY METAL THAT CAN CONTACT YOUR SKIN. Also do not wear hairpieces. Do not bring articles of value with you.
· Wear loose-fitting comfortable clothes that do not have to be pulled over the head. Avoid tight collars or belts. Wear loose fitting tracksuit pants.
· If you use prescription medicine or eye drops on a regular basis, take your regular dose on the morning of surgery. This is especially important with blood pressure medicines.
· If you develop any sign of infection, pustules or boils on the face or body before surgery the doctor should be notified immediately.
· BRING ALL YOUR MEDICATIONS TO THE SURGERY
THE OPERATION FROM THE PATIENT’S PERSPECTIVE
Following signing of the surgical consent you will be taken to a room to be prepared for surgery.
While the nursing staff should already have a copy of your medical history and physical examination from your doctor, be sure to discuss any special or unusual medical requirements or concerns with the staff, including allergies to medications, problems with abnormal bleeding, or asthmatic reactions.
You will be asked to put on a surgical gown and then a small intravenous cannula will be inserted into your hand to be able to receive the anaesthetic drugs once you are in the surgery. You will also be given a dose of antibiotics into this tube. You will also be given an anti-nausea medication and a sedative. All your particulars will be double checked by the nurse.
You will then be moved into the operating room and monitoring equipment will be attached to you. Your arms will be placed onto arm rests outstretched from your body and you will then be put to sleep.
Your surgery is performed under General Anaesthetic so you will not be aware of anything during the surgery.
After the procedure, you will be fitted with a compression garment. This should be left on until your check up the following day.
You may also have drains. If the nurse at Canossa Hospital advised you how to empty these, then empty them if they are full. Otherwise, please leave them alone we will advise you about them the following day.
ON THE AFTERNOON AND EVENING OF SURGERY
You should rest as much as possible. Watching television is acceptable.
Discomfort or pain will occur, post procedure. In this instance, Panadeine Forte (for strong pain) can be taken every 6 hours. Alternatively, Mersyndol (for mild pain) can be taken every 6 hours. Do not take both together as both preparations contain paracetamol. Also, do not take these medications closer together than every 6 hours because excessive paracetomol is dangerous. The maximum combined dose of these 2 tablets in 24 hours is 8. ie: if you have taken 4 Panadeine Forte in 24 hours you can only take 4 Mersyndol in 24 hours. As the pain reduces, use only Mersyndol as it is less likely to cause nausea. If you are prone to nausea then just take Panadol. Remember to take Stemetil 1 tablet 3 times a day to reduce nausea if you are taking Panadeine Forte. If you are not experiencing any pain then do not take any of the above medications.
If your stomach is not upset, you may resume your diet immediately.
Excessive Paracetamol is dangerous, please follow these instructions carefully.
Rest as much as possible and keep your feet elevated, but try to keep your calves active by moving your feet up and down.
It is good to walk around the house a few times from the day after surgery in order to keep your calves active. Wear the TED stockings for 3 days post operation. If, at any time, you develop calf pain then call the surgery or Dr Szalay immediately.
Providing you are not nauseous, start taking Keflex (if you are allergic to Penicillin, you will be taking Clindamycin instead). It is best to take these with some yoghurt. If you are nauseous, wait until this subsides before you start your antibiotics.
You will continue taking the antibiotics until 1 week after your surgery date.
Swelling and bruising will occur and will gradually subside over the next 7 to 14 days. Continue to use the Arnica spray taking 2 puffs under the tongue, three times a day for 3 days. This may be helpful in reducing any bruising.
BEGINNING THE NEXT MORNING
You will have an appointment for your first post-op check and dressing. You must attend this appointment as we give important wound care instructions. It is also important to enable Dr Szalay to assess your results post procedure.
Leave the compression garment intact until your appointment. The garment should remain on all the time for 3 weeks for the best result.
Only continue the Panadeine Forte for as long as you are experiencing significant pain. Please note that these medications do cause drowsiness.
LATER INSTRUCTIONS AND INFORMATION
Keep the steristrips on until they fall off naturally. When there are no scabs apply Strataderm gel. The dressings need to continue until all the scabs have gone. The wounds must be kept dry during this time.
Should any problems occur after surgery contact Dr Szalay.
For example: if your temperature becomes elevated, if one of your breasts is noticeably more swollen and tender, painful, red or inflamed, or if you develop increasing discharge from a breast.
You should also let Dr Szalay know if you develop a side effect to your medication such as a rash, nausea, vomiting or diarrhea.
You will have a check up with Dr Szalay 3 weeks after the operation and again 3 months.
You may experience a burning sensation in your nipples for about several weeks, but this usually subsides as bruising fades. Occasionally it can last some months. The swelling in the breast may take 3 to 12 weeks to resolve. It is normal for you to experience swelling of your stomach area for several days post operation – it will resolve within 1 week.
Your breast will be sensitive to direct stimulation for several weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually 3 to 4 weeks after surgery. Some nipple sensitivity can persist for some months.
Moderate activity can be resumed after 4 days, although bending and straining should be avoided for 7 days. Moderate exercise (easy walking) may be resumed in 7 days. Avoid driving for 1 week following surgery. Exercise can be gradually increased.
You need to keep the wound dry, so bath instead of showering until the wound is completely healed with no scab.
If at any time you notice the wound become increasingly red or painful then contact the practice immediately.
The scar will then continue to fade and soften for about 12 months or more.
In order to minimise the scar, we recommend that you apply Strataderm gel when there are no scabs. Continue this for 6 months, twice daily.
The incision may feel slightly tender for a few months. Itching is common. If at any time you feel a prickly feeling when you touch the wound, it may be an internal stitch coming through. Apply Betadine twice daily on this until it is no longer there but also come in so Dr Szalay can check it as soon as you notice it. If this area gets red or painful, antibiotics must be started immediately.
Do not try to evaluate the success of your surgery during your early recovery. Allow 3 months for complete recovery.
PICK UP ARRANGEMENTS FOR AFTER SURGERY
Please describe the arrangements you have made for someone to drive you home following the procedure and to the appointment the following day.
Dr. M Szalay 