Before Surgery

Meeting With Doctors

• Plan to meet with the hematologist and HTC treatment team before the surgery
• The hematologist, who will lead the planning for the surgery, will likely ask you to talk with one or more surgeons—a great chance to learn as much as possible about the surgery
• A caregiver should be involved in meetings before the surgery, as he or she will play an integral role in your preparation, recovery, and rehabilitation

Assessments

The HTC team and the surgeon may conduct the following assessments prior to surgery:

• Blood tests including a Bethesda assay to monitor your inhibitor levels
• Testing to determine the likelihood of an anamnestic response and potential for thrombosis

Preparing for Surgery

The best thing you can do to prepare for surgery is to follow the instructions of your treatment and surgery team, which could include the hematologist, surgeon, nurse, physical therapist, and social worker.

The team will provide clear instructions on what to eat, what to drink, what medicines to take, how much exercise or activity should done, and where to go on the day of surgery.

Here are some tips if you are getting ready for surgery:

• Medicines

  Provide doctors with a complete list of medicines, vitamins, and supplements you may be taking.

• Smoking

  Smoking can limit the body's ability to heal and can lead to complications, so if you smoke, you should seriously consider quitting.

• Get ready to come home

  The recovery at home may require special adjustments because movement may be limited. Think ahead about sleeping arrangements, groceries, and bathing.

• The night before surgery

  The doctor provides strict instructions about what foods and drinks can be consumed before surgery. It is important to follow these instructions.

During Surgery

The surgeon and the hematologist will have a plan in place for managing bleeding during surgery. The surgeon will have worked closely with the entire surgical team, especially the anesthesiologist, to ensure everything goes as planned. The anesthesiologist will make sure that you are comfortably in a state of sleep and pain-free during the procedure.

After Surgery

Immediately after the surgery, you will be moved to a recovery area where a nurse and the anesthesiologist will monitor blood pressure, breathing, and other vital signs. As the anesthesia wears off, the surgical team will manage your care, which includes the use of pain medications. During this time, the surgeon will talk to your family or caregiver to let them know your status.

After you have been cleared from postoperative recovery, you will be transported to your room in the hospital, where your recovery will be monitored by nurses and nurse assistants. The staff will seek to get you active as quickly as possible to promote healing and avoid postsurgical complications. The surgeon will receive updates on your recovery and check in on you to evaluate how the surgical site is healing.

The amount of time you will be in the hospital will be affected by many factors, including the type of surgery, whether there were complications, your state of health before the procedure, your age, and how well your body responded to surgery.

Surgical patients who follow the instructions of their doctors and nurses have the best chance for a good recovery. It is especially important that you include the following in your recovery:

• A lot of rest, good nutrition, and plenty of fluid intake
• Rehabilitation and proper exercise
• Collaboration with the physical therapist at the HTC