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Patient name: _____________________________

3277 South Lincoln Street  Englewood, CO 80113-2512  Tel 303-762-0808  Fax 303-762-9292 Pre-Surgical Instructions/FAQs

When should I stop eating and drinking?

 Stop solid food after midnight or at least 8 hours before surgery. (includes candy, gum, milk)
 You may have clear liquids up to 4 hours before surgery.
o Clear Liquids Include the Following:  Water
 Sprite/7-Up/Pedialyte
 Apple or Cranberry Juice
 Coffee/Tea without cream or sugar
NO Jell-O or Pudding is allowed.
o Prevention of serious anesthesia complication such as Aspiration Pneumonia (inhaling stomach o If you violate the above, the anesthesiologist will cancel your surgery.

Should I take my usual medications the day of surgery?

 Day of surgery, you may continue to take oral medication pills as usual with a small sip of water except for
the medications listed below:
o Do not take medicines that instruct you to: “Take with food or milk”.
o “Bulk medications” such as psyllium (Metamucil, Citrucel, etc).
o Diuretics (“water pills”): Should not be taken the morning of surgery except when using for
o Inhalers for asthma or emphysema: Use as scheduled and bring these to the hospital for use during
o Anticoagulants
Aspirin: Stop 14 days before surgery (includes cardiac protection dose of 80-325mg/day)
NSAIDs: (Non-Steroidal-Anti-Inflammatory-Drugs) Stop 10 days before surgery.
(Motrin/Advil/Alleve/Relafen/Celebrex/Bextra/ibuprofen/naproxen/diclofenac plus many
more!)

Vitamin E and herbal remedies such as Garlic, Ginseng, Ginko: Stop 10 days  Plavix: Prescribed “blood-thinning” agents. • Have prescribing physician lower dose and monitor until INR is  Warfarin (Coumadin): Prescribed “blood-thinning” agents. • Have prescribing physician lower dose and monitor until INR is o This must occur before surgery.
o Surgery will be canceled if blood is still too thin (INR>1.3)

Oral hypoglycemic agents
(oral diabetic medicines such as Flucophage, sulphonylureas, etc)
• Do not want to decrease blood sugar too much, since you have stopped eating. o Insulin your dose the day of surgery may be determined by your anesthesiologist, primary
physician or surgery. If you have not received specific instructions regarding your insulin by the morning of your surgery, then take one half your usual dose and monitor your blood sugars closely. o Controlled substances: Narcotic pain medications and/or sedatives may not be brought into the
hospital. This is a violation of Federal and State laws. o Transdermal systems: Skin patches may be worn into the hospital. Includes narcotic, fentanyl
(Duragesic) patches as well as hormonal, cardiac and nicotine systems.  Please notify surgical team and floor nursing staff so this medication can be ordered.
What are some standard medications that people usually take up to the time of surgery?

o Pain medications, which contain no aspirin. o Acetaminophen (Tylenol) o Muscle relaxers o Hormone therapy, anti-depressant/anxiety/seizure/Parkinson medicines o Cardiac/blood pressure/cholesterol medications (discontinue cardiac protective aspirin). o Nutrient Supplements: iron, calcium, multivitamin, vitamin A,B,C,D; but excludes vit. E. o Herbal remedies: Only those approved by the anesthesiologist. (Recommend not taking: Ginko-biloba, Ginseng, Garlic, Ginger, Vitamin E (may thin blood)

What else can I do to make the pre-surgical process easier?

 If you become ill within 7 days from surgery (fever, flu, cough, “colds”) contact your physician &  Have an updated list of current allergies and medications with proper dose/frequency available for o Your medical history and surgical experiences will be discussed with the anesthesiologist when you arrive at the hospital prior to your surgery. o Important medical history, such as high blood pressure, asthma, diabetes or any other serious conditions effecting brain, heart, lung, liver, kidney, gastrointestinal, skin and other organ/systems must be discussed with the surgical team.  Smokers: No smoking in hospital. May want to consider nicotine replacement therapies prior to surgery. Your surgeon may also require that you participate in a smoking cessation program prior to surgery.  Address any further medical questions to the surgical clinic, anesthesiologist, or primary care Contact the following for further pre-surgical information: o Colorado Comprehensive Spine Institute at: 303-762-0808 or www.coloradospineinstitute.com o South Denver Anesthesiologists, PC at: 303-761-5646 oro Health One – Swedish Medical Center at: 303-788-6009 oro Porter Adventist Hospital at: 303-778-1955 or  Remember – if you disregard the above, your surgery may need to be cancelled
Preparing for the hospital admission
* Bring all forms from your surgeon’s office.
* Bring Insurance Card & Photo ID the day of surgery.
* Bring storage case for glasses, contacts, hearing aids, dentures, etc
* Visits by family and friends are limited to the Pre-Op Holding area
* Leave luggage/personal items in car. Family to retrieve after surgery
* No mascara or body lotion: make up at a minimum
* Leave all valuables at home: money, credit cards, jewelry
* Wear loose, comfortable clothing; easy wear after surgery
* Visitors are not allowed in the recovery room area
11/2013 Colorado Comprehensive Spine Institute, LLC

Source: http://www.coloradospineinstitute.com/pdf/231113Pre-SurgicalInstructionsFAQ.pdf

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Assessment of Residual Periodontal Maintenance Populations S.L. Campbell*, A.R. Biesbrock, R.W. Gerlach Procter & Gamble Co., Cincinnati, OH, USA ABSTRACT Patients undergoing routine periodontal maintenance may Patients with moderate-to-severe disease often complete present with residual disease. To evaluate residual disease initial care (scaling and root planing with or withou

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