Orthopaedic Surgery

Be prepared, know what to do,
and feel free to ask questions.

Guidelines for Surgery Preparation

Please call our nurse after 2:00 PM at (210) 259-8155 the business day before your scheduled surgery to confirm your arrival time for surgery and to review any special instructions. Below are guidelines to help prepare you for surgery and recovery.

Dr. Katz peforms surgeries at the Foundation Surgical Hospital of San Antonio and Methodist Ambulatory Surgery Hospital. Visit their site to learn more about their location, their facility, their mission and more.

It is your responsibility to make sure that all requested blood tests, ordered studies, or any requested medical evaluations by your primary care physician are delivered or faxed to our office at (210) 259-8155 in a timely manner before your scheduled surgery. If our office does not receive your medical clearance for surgery (if requested) and/or test results, then your surgery may be rescheduled.

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DO NOT EAT anything after midnight before your surgery. This includes NO gum, mints, or any hard candies. You may drink clear liquids only (such as water or apple juice) UP UNTIL 6 hours before your scheduled ARRIVAL time (for example, if instructed to arrive at 11 AM, you may have clear liquids until 5 AM). WITHIN 6 hours of your scheduled ARRIVAL time, you must NOT drink, smoke, or eat including ice, gum, or hard candy. This is VERY IMPORTANT and for your protection. You may brush your teeth and use mouthwash, but DO NOT swallow any water. You may take your medically required medications with a sip of water only. If you have anything to eat or drink, without having been instructed to do so, your surgery may be delayed or canceled.

Guidelines for children:
Less than 6 months old - Nothing to eat or drink including breast milk WITHIN 4 hours of scheduled ARRIVAL time for surgery.
6 to 36 months old - Nothing to eat or drink WITHIN 6 hours of scheduled ARRIVAL time for surgery.
Over 3 years old – As above for adults.

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Your ARRIVAL time to the hospital for surgery will be 1½ to 2 hours prior to your actual surgery time because of necessary registration and preparation for anesthesia. We apologize in advance for any unexpected emergencies that can occur and may cause delay or even cancellation of your scheduled surgery.

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Please bring a current list of your medications and/or your actual medications with you on the day of your surgery.

There are some drugs (like aspirin) that can have an effect on the coagulation or clotting of your blood and can contribute to excessive bleeding during surgery.

Please STOP the following medications 1 WEEK prior to the scheduled surgery. If you are not sure whether a medication contains aspirin, please check with your pharmacist before taking the medication. Your surgery may be CANCELED if you have any of these medications within a week prior to surgery:

“Blood thinning” medications:
*Aspirin-Including Acetylsalicylic acid, ASA, ECASA, Baby Aspirin, CAMA, Ecotrin, Fiorinal, Aggrenox
*Vitamin E, Ginseng, Garlic, Gingko Biloba, Feverfew, Fish Oil
*Percodan, Disalcid, Zorprin.
*Arthropan (Diclofenac, Cataflam)
*Dolobid (Diflunisal)
*Lodine (Etodolac)
*Nalfon (Fenoprofen Calcium)
*Ibuprofen, including Advil, Excedrin, Medipren, Medadol, Midol-200mg, Motrin, Motrin IB, Nuprin, Pamprin-IB, Rufen, Saleto 200, 400, 600 and 800, Trendar.
*Indocin (Indomethacin)
*Orudis (Ketoprofen)
*Doan's Pills, Magan, Mobidin (Magnesium Salicylate)
*Meclomen (Meclofenamate)
*Ponstel (Mefenamic Acid)
*Relafen (Nabumetone)
*Aleve, Anaprox (Naproxen)
*Daypro (Oxaprozin)
*Feldene (Piroxicam)
*Butazolidin (Phenylbutazone)
*Amigesic, Argesic-SA, Arthra-G, Disalcid, Mono-gesic, Salflex
*Salsitab (Salsalate)
*Rexolate, Tusal (Sodium thiosalicylate)
*Clinoril (Sulindac)
*Tolectin (Tolmetin)
*Lovenox

Coumadin (Warfarin) and Plavix medications It is very important that you inform us that you are on a “blood thinning” therapy or anticoagulation prior to scheduling surgery. You should continue to take these medications UNTIL your Primary Care Physician or Cardiologist determines the appropriate time for discontinuation of the drug. Surgery will then be scheduled accordingly.

MAO inhibitor medications: It is critical that you tell us if you are taking one of these drugs. The most common ones include Nardil and Parnate.

Methotrexate, Humira, Remicade medications: You need to inform us of these medications, commonly used for rheumatoid arthritis, prior to scheduling surgery. These drugs can inhibit tissue healing and affect the immune system which can lead to wound complications and infections. Discontinuation of these drugs and scheduling of your surgery will be coordinated with your Rheumatologist.

Insulin or diabetic medications: You need to contact the Physician who manages your diabetes for instruction on use of these drugs the day before surgery, the day of surgery, and the day after surgery.

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If any changes in your physical condition or illnesses such as a cold, fever, significant cough, respiratory infection, urinary tract infection (UTI), open skin sores, or any cuts on your skin near the surgical site occur prior to surgery, please contact our nurse before the day of surgery at (210) 259-8155.

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A responsible adult must be available to drive you home after surgery. You are not allowed to leave the hospital unaccompanied or to drive after surgery. You must discuss directly with the hospital regarding other possible means of transportation such as a taxi.

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Prior to surgery, our office will contact your insurance company for pre-authorization for surgery. If your surgery is for a work–related injury, approval must and will be obtained from your worker’s compensation insurance adjuster before surgery can proceed. Typically, depending on your health insurance benefits and plan, a portion of your deductible and /or expected coinsurance payments may be collected by our office in advance of your scheduled surgery. Any questions related to financial arrangements for payments to our surgeons can be directed to our office staff at (210) 259-8155. Please bring a copy of your insurance card and some type of identification on arrival to the hospital. Specific questions regarding your financial responsibilities to the surgical facility should be directed to the hospital business office.

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Please clean and trim your fingernails and wash your skin with soap and water thoroughly the night before surgery if your hand or fingers are not bandaged.

Remove all jewelry including any body piercings.

False fingernails and/or fingernail polish may need to be removed depending on the type of surgery.

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At the hospital, you will need to undress and wear a gown for surgery. Additionally, you may be sent home wearing bulky bandages or a splint which will not fit through most clothing sleeves. We suggest that you wear casual, loose fitting clothing with large open sleeves or short-sleeves to the hospital.

Please do not bring valuables to the hospital (watches, rings, earrings, etc.).

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Guidelines for Recovery After Surgery

After your surgery is completed, you will receive care in the Post Operative Recovery Area until you are released to return home or admitted to the hospital overnight depending on the type of surgery performed. Stay in the Recovery Area is typically 30 minutes to an hour.

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If you had any sedative anesthesia drugs for your surgery, DO NOT drive, drink alcohol, sign legal documents, or operate complex machinery for at least 24 hours following surgery. If you are released to work, your means of transportation to work is between you and your employer.

KEEP YOUR HAND ELEVATED AT ALL TIMES. Specifically, it means keep the hand higher than the elbow. For surgeries on the elbow, try to maintain the elbow at the level of the heart or higher with the hand slightly higher than the elbow. Use of pillows under the elbow can help achieve appropriate elevation. This will help reduce swelling and decrease pain. Unless given specific directions not to use ice, we suggest placing ice packs around the surgical site directly on the bandages as often as possible during the initial 72 hours from surgery. Ice packs can be very effective to reduce swelling and pain even when placed over bulky dressings or splints. Please do not remove dressings for ice application. Direct placement of ice on the skin for prolonged periods of time (over 10 to 15 minutes) can cause skin damage. If the dressing becomes too tight and the fingers are swollen, you may loosen and rewrap the ace bandage. DO NOT GET THE BANDAGES OR SPLINT WET. If a sling is used, do not allow the hand to hang below the level of the elbow.

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Pain medication prescriptions for surgery will be either provided to you prior to surgery at the time of your evaluation in the office or provided to you on the day of surgery. Our policy is to accept requests or inquiries about new prescriptions and refills only during our regular office hours: 8 AM to 4:30 PM, Monday through Friday at (210) 259-8155. Please have the complete telephone number of your pharmacy when you call our nurse.

Understand that not all requests for pain medication will be provided or refilled until your case has been reviewed with our physician to determine medical necessity.

If you should need additional prescription pain medication, please plan accordingly by calling early in the day during the normal business week as we will not be able to accommodate your request after 4:30 PM on weekdays or on weekends. If you should feel that a prescription for pain medication or a refill is needed outside of our normal hours of operation, then you will need to be seen in an emergency room or an urgent care center and be evaluated by a physician.

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A follow up appointment will be arranged prior to surgery or discussed with you on the day of surgery. Therapy, if necessary following surgery, typically will be coordinated with your follow up visit. In the interim before your follow up visit, if you have any questions, please do not hesitate to contact our office to speak with our nurse at (210) 259-8155.

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Our staff will complete disability forms for a fee for each form. Please allow 7 to 10 business days for these forms to be completed. Please bring these forms to our office and leave them with our front desk staff where payment can be collected.

On the disability forms, your work restrictions will be given. Although we will determine your work restrictions, your disability company will determine whether disability payments are appropriate to grant.

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You will be provided an excuse from work providing limitations of activity following surgery. It is your responsibility to present the limitations to your employer so that the workplace can determine when you should return to work. We will determine your restrictions, and your employer will determine your employability.

We make every effort to provide the most comprehensive care for our patients. Every consideration is given in making determination of one’s ability to continue working throughout the recovery period. Medical indications for a patient to be placed on an “out of work or cannot work” status includes: no use of both hands, hospitalization, and conditions requiring daily medical treatment.

It is the responsibility of you and your employer to determine if work is available that will accommodate the restrictions provided by your physician.

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