Pre-Operative Instructions

Pre-operative preparations include completing necessary tests, stopping medications seven days before surgery, following pre-operative instructions, arriving as instructed on the day of surgery, and preparing for discharge.

Pre-Operative Instructions Print Out

Pre-Operative Work-Up

Before your surgery, you may be asked to complete the following:

Blood work
Chest x-ray
EKG
Medical clearance by primary care physician (possible)
Cardiac clearance by a cardiologist (possible)

Please see your pre-operative order sheet for the specific requirements for your surgery. Fax all results to 703-248-0046. It is the patient’s responsibility to make sure all testing has been completed prior to your scheduled surgery and sent to our office in a timely manner. If we do not receive your results at least 1 week prior to your surgery, the surgery will likely be rescheduled.

Testing is valid for the following time frame:

Laboratory blood work and medical clearances are valid for 1 month
Chest X-rays and EKGs are valid for 6 months

If any of the studies have been completed within the above time frame, they do not need to be repeated unless otherwise requested by your primary care physician.

Pre-Operative Screening and Blood Typing (703-558-6159):

Contact the “Pre-Operative Screening Unit” at Virginia Hospital Center to schedule a phone
Interview and undergo blood typing. Your blood typing must be done within 72 hours of surgery and must be done at Virginia Hospital Center. You can make your appointment by calling 703-558-6159. Please make sure you have received orders for blood typing from our office and give the order to the screening department during your appointment.

7 Days Before Surgery:

You should stop taking all blood-thinning medications (e.g. aspirin, Plavix, Coumadin/warfarin, Xarelto, Eliquis, Pradaxa, NSAIDs, etc.) at least 7 days prior to surgery, unless specifically instructed by your surgeon to continue them.

The Night Before Surgery:

Please take a thorough shower the night before surgery, including using shampoo on your hair and soap on your entire body. If you are not scheduled to be the first surgery of the day, you may take a shower the morning of surgery.
Do not have ANYTHING to eat or drink after 11:59 PM the night before surgery.
- This includes gum, mints, candy, and any tobacco/nicotine products. You may brush your teeth but do not swallow any water.
- If you were instructed to take any medications on the day of surgery, you may take them with a sip of water.

*FAILURE TO FOLLOW THESE INSTRUCTIONS MAY RESULT IN RESCHEDULING*

Day of Surgery:

When To Arrive

You will receive a call the day before your procedure informing you of your arrival time for the
day of surgery. Some patients are asked to arrive for their surgery as early as 5:30 am, while
others may not be asked to arrive until the afternoon. Please make arrangements to
accommodate both an early and late arrival. Report time is not your surgery start time; your
surgery will begin after you have checked in and the operating room is ready for you. Because of the required preparations, you will arrive several hours before you will actually go into surgery.

Where To Arrive

Report to the 2nd floor/Outpatient Surgery area, when you arrive at the hospital the day of your surgery. You may park in the Zone A/Blue parking garage the day of surgery.

What To Bring

Pack lightly and wear loose, comfortable clothes. Bring a case for any glasses, dentures, or hearing aids that you are bringing to the hospital.
Do not bring ANY money, jewelry, or valuables with you to the hospital.
If you wear a wedding band, you will be asked to remove it prior to going to surgery and, therefore, may want to leave it at home.
Bring any essential medications in the original bottles. While most medications are available through the hospital pharmacy, some specialized medications may require you to bring your own supply.
Please bring your MRI/CT with you on the morning of surgery. If the imaging studies were performed at Virginia Hospital Center or your surgeon has the CDs, you do not need to obtain a secondary copy to bring with you.

Medication Instructions

Blood-thinning medications should be held for 7 days prior to surgery. These medications include, but are not limited to, the following:

Aspirin and anti-platelet medication (Aspirin, Plavix, Anacin, Bufferin, Bayer, etc.)
Anticoagulants (Coumadin, warfarin, Eliquis, Pradaxa, Xarelto, etc.)
Drugs that contain aspirin (Alka Seltzer, Anaprox, Ascriptin, Coricidin, Darvon, Dristan, Duragesic, Ecotrin, Excedrin, Fiorinal, Midol, Percodan, Sine-off, Triaminicin, Vanquish)
NSAIDs (non-steroidal anti-inflammatories) (Advil, Aleve, Cataflam, Clinoril, Diclofenac, Dolobid, Feldene, Ibuprofen, Indocin, Medipren, Mobic, Motrin, Nalfon, Naprosyn, Nuprin, Relafen, Rufen, Tolectin, Toradol, Trilisate, Voltaren)
Other medications or supplements that may cause bleeding (Vitamin E, Fish Oil, St.
John’s Wort, Gingko Biloba)

*You may take Tylenol and/or acetaminophen-containing products.

Diabetes medications: If you are diabetic and take either insulin or pills to control your diabetes, you must be given special instructions on when to hold these medications. Please discuss with the doctor who prescribes these medications prior to your surgery date to determine the best plan for holding these medications on the morning of surgery.

Rheumatoid medications: If you take medications for rheumatoid arthritis or lupus, these medications should be held at least one week prior to surgery. This should be discussed with the doctor who prescribes these medications.

Discharge Preparation:

You will be given advanced notice of your discharge date by the neurosurgery team or medical hospitalist. In addition, you will receive written discharge instructions specific to your surgery.
Please have a designated person to pick you up or escort you home. You must have a responsible adult to accompany you on the day you are discharged. If you are planning to take public transportation or a private car (cab, Uber, Lyft, etc.), the driver cannot be considered your escort. Failure to have a responsible adult to accompany you home can result in cancellation of your surgery (if outpatient) or delay of your discharge.

If you have any questions about any of the information provided, please call 703-248-0111 and request to speak to the surgical coordinator.