• Do you take any blood thinning medicines?
• Are there any changes to your health condition, or are you feeling unwell at any time leading up to your surgery?
   

Please contact the hospital now, and let us know.

Blood thinning medicines

If you take any blood thinning medicines you must get special instructions from your doctor or the hospital.

Do you take: Warfain (Coumadin), Pradaxa, Aspirin, Clopidogrel (Plavix), Apixaban, Dabigatran, Rivaroxaban, heparin, clexane, Alteplase, Ardeparin, Urokinase or any medicine prescribed to thin your blood or stop clots ? If you take blood thinning medicine tell the hospital now.

Feeling unwell?

If you are unwell within 3 days before your surgery you will need to call the hospital or contact your local doctor for advice.

If you are too unwell for surgery, it may be postponed until you are feeling better and it is safer for you to have an anesthetic.

Also, with early notice, someone else waiting can be contacted to have their surgery.

If you have any of the following, please call us:

Keeping fit and strong before your surgery will help your recovery. More active people also have less risk of problems during surgery.

If you need to stay in hospital until your surgery ask to see a physiotherapist for help.

You will need advice about what exercise is best for you. This depends on the type of surgery you are having and how soon it is. It can be beneficial to see an exercise physiologist or physiotherapist before starting exercises. Ask your local doctor or surgeon about what to be most careful with.

It is important to be comfortable with the type of exercise you do. If something feels uncomfortable you should stop doing it.

Australian Physical Activity Guidelines

Everyone is different, but we should all aim to do some regular exercise.
It helps to improve your fitness, control weight and keep your muscles and joints healthy before surgery.  Staying active before your surgery will help you to avoid putting on weight.
Being at a healthy weight before surgery lowers your risk of problems.  It also helps you to have a faster recovery.

Try to:

• Be active on most days. Doing any physical activity is better than doing none
• Build up to 30 minutes or more of moderate intensity physical activity each day
• Do muscle strengthening activities on at least 2 days each week

Special considerations: 

For more information go to:  

• Active and Healthy
• Exercise and Sports Science Australia 
• Australian Physiotherapy Association 
• Exercise Right 

Good nutrition is important for health.  It is very important in the time leading up to your surgery.
 
Your body is in its best state to deal with the stress of surgery when you eat a healthy, balanced diet. It may also help with a faster recovery process.
 
Poor nutrition can lead to poor outcomes after surgery. Patients who do not eat well are more likely to have problems after surgery. Your wounds may take longer to heal, you may get infections and have a longer stay in hospital.

Click these links to find out more:

• What does a healthy diet look like?
• What if I am having trouble eating?
• Protein and energy in food – helping with recovery

For more information go to:

• Australian Dietary Guidelines
• Dietitians Association of Australia

What does a healthy diet look like?

Eating from the 5 food groups is important to ensure your body gets all the nutrients it needs. This includes protein, vitamins and minerals.
 
It is best to be eating a wide variety of healthy foods. It is also important to drink plenty of water and avoid drinking too much alcohol. More than 2 alcoholic drinks a day can increase your risks.
 
Older people should eat nutritious foods and keep physically active to help maintain muscle strength.
 
Staying in a healthy weight range is also important. Speak with your local doctor about seeing a dietitian if you are concerned about your weight. Older people should eat nutritious foods and keep physically active to help maintain muscle strength.
 
Being overweight increases the chance of diabetes. Diabetes can cause difficulties before, during and after surgery. Have you talked to your local doctor about your risk?

What if I am having trouble eating?

Poor food intake can lead to problems after surgery. Your wounds may take longer to heal, you may get infections and have a longer stay in hospital.
 
If you are having difficulty eating due to a poor appetite, or have recently lost weight without trying, please let your local doctor or nurse know. A visit with a dietitian might help you. If you are underweight, increasing both protein and total energy (kilojoules or calories) may help you gain weight.

Protein and energy in food

Protein is used for growth and repair of body tissues and muscles. To increase protein and energy and help your recovery, try the following:

• Include protein foods as part of every meal and snack
• Eat three (3) meals and three (3) nourishing snacks each day
• If your appetite is poor; serve meals on small plates
• Eat with family & friends or in pleasant surroundings
• If you are not hungry at meal times try to have a nourishing milk drink or dairy dessert. Not eating may make you feel sick in the stomach
• Avoid filling up on low calorie foods such as tea, coffee, water, vegetable juices, diet drinks and clear soups

It is important to keep up healthy food and drinks after surgery to help your wound to heal.

Fasting means going without all food and liquid. Sometimes in hospital we call this "Nil By Mouth".  It is a medical instruction to stop food and fluids. Experts have researched safe fasting times for patients.  

Fasting or being Nil By Mouth also applies to patients who have special nutrition feeding tubes into the nose or stomach. This is called “Nil By Tube”.
Fasting is needed before general anaesthesia or sedation medicine. This will minimise the risk of vomiting and breathing in food or fluid into the lungs.

Adult patients can have special fluids (called Preoperative oral fluids) until 2 hours before surgery. This should be no more than 2 cups or 400mls.

In general before your surgery:

• You can have solid food until 6 hours before surgery - this should be a light meal
• Do not chew gum or lollies- these count as food because they cause the stomach to produce extra acid
• Patients need tube feeding can continue until 6 hours before surgery

 Preoperative oral fluids can include:

• Water
• Apple juice, other pulp free clear fruit juice or cordial
• Clear lemonade with no pulp
• Black tea or coffee with no milk
• Commercial rehydration fluids such as “Hydralyte”
• Fat-free, protein-free nutritional supplements such as “preOp” brand drink
• Sports drinks such as “Gatorade”- light colours only
• Ice blocks made from any of the above clear fluids
• Fat-free clear soup like chicken broth

Preoperative oral fluids must not include

• Alcohol- never just before surgery
• Fat
• Protein
• Insoluble fibre such as “Metamucil”
• Prune juice, tomato juice or orange juice
• Nectar, canned and fresh fruits
• Thickened fluids
• Milkshakes or smoothies
• Drinks that are red, blue or purple in colour: Even if these drinks are clear
• Cream, milk or soy protein
• Salt and pepper

The hospital staff will contact you in the days before your surgery. They will tell you exact instructions about when to eat and drink.

You must follow the fasting instructions very carefully or your surgery may be cancelled. This is to help keep you safe.

Our hospitals are Smoke Free for your health and the health of others. There is no smoking allowed inside any of the buildings or on hospital grounds by patients, visitors or staff. This includes the hospital stairwells, toilets or outside the front of our buildings.

If you are a smoker, for the sake of your own health, you are encouraged to think about quitting. Please talk to your local doctor about the choices that are available to support your decision to quit.

To avoid complications you should avoid smoking. Think about quitting at least 60 days before any surgery.

There are many ways to make stopping smoking easier and less stressful. Some are medicines that are available only by prescription, so talk to your local doctor. Over the counter treatments such as nicotine patches, gums, lozenges and sprays work well.  They need to be used correctly to get the best from them. Nicotine replacement patches are cheaper if you get a script from your doctor. You can combine them with some nicotine gum, lozenges or spray for the best effect. Ask your doctor or nurse to arrange these for you if you feel the urge to smoke during your stay in hospital.

The Quitline (Call 137 848) can answer any questions you may have. It is confidential and free.

You should not smoke before and after surgery as cigarette smoke can increase your risk of lung and wound infections. Smoking can slow down wound healing. Most patients tell us that even the smell of cigarette smoke can make them feel sick after an anaesthetic, so you should also ask your family and friends not to smoke before visiting you.

If you drink alcohol regularly, talk with your medical team.  It can affect your recovery from surgery. Heavy alcohol use can cause bleeding during surgery and affect healing afterwards. More than 2 alcoholic drink each day increases your risk.

If you use illicit drugs, please tell your medical team. This can affect your anaesthetic during surgery and your recovery afterwards. Drugs can change the way your body responds to pain medicines after surgery. We have specialist teams to help people who use drugs.

We need to know. We want you to tell us.

Here are some services that you and your family can access for help:

• Illawarra Drug And Alcohol Service (IDAS) - 1300 652 226
• After hours stimulant support 1800 101 188
• 24 Hours – Alcohol & Drug Information and Referral Service 1800 422 599
• Quitline – 137 848
• AA – 4285 6788
• Al-Anon (for families) – 1300 252 666
• Family Drug Support 1300 368 186
• National Cannabis Prevention & Information – 1800 30 40 50

Your body needs iron to make more red blood cells when needed. Having enough iron in your blood is like having a full tank of petrol. You wouldn’t plan a road trip with an empty tank. In the same way you should make sure you have enough iron ‘in your tank’ before major surgery.

Your health care team want to:

• Help your blood to work better
• Reduce your change of bleeding
• Reduce your chance of needing a blood transfusion

This will help you have:

• Lower risk of complications
• Faster recovery after surgery
• Shorter stay in hospital.

Click here for more information about iron:

• How can I make sure that I have enough iron in my blood?

• What can happen if I don't have enough iron in my blood?

The word anaesthesia means ‘loss of sensation’. It can be a simple injection that numbs a small part of the body. It can also involve using powerful medicines which cause unconsciousness. This makes it possible for your body to go through a surgical procedure. The medicines work by blocking the signals that pass along your nerves to your brain. When the medicines wear off, you start to feel normal sensation again.

As well as the brain, these medicines also affect the heart and the lungs. As a result, general anaesthesia is only given under the close supervision of an Anaesthetist. This doctor is trained to decide the best way to give you an effective anaesthetic, while keeping you safe and well.

Your anaesthetist will:

• Check if you are fit enough to have the anaesthetic for your operation
• Talk to you about which type of anaesthetic might be best and get your permission (consent) for it
• Give the anaesthetic and organise pain control afterwards
• Look after you straight after the operation in the recovery room or in an intensive care unit.

 More information about Anaesthesia

When you are healthy your body has very good ways of fighting infection. One of the first lines of defence is our skin.

When you come into hospital to have surgery, this first line of defence will be broken. This can happen when you have a drip put in. It can also happen as a result of the surgical cut through your skin.

When these things happen there is a small chance that your normal germs, or germs from another person or the environment can get into your body and cause an infection.

There are a things you can do to make this less likely to happen.

Using special pre-operative body wash

You may have been provided with a special type of skin cleaner to use in the days before you come to hospital for surgery. This before-surgery (preoperative) body wash will help reduce the amount of bacteria and germs on your skin.

Even if you haven’t been given a special body wash, you should still have a shower using a good lather of skin cleaner on the morning of your surgery. Do not use harsh soaps that damage your skin.

Also, a risk in any surgery is that the surgical site may become infected with bacteria from your own skin. In the operating room all staff and equipment have followed a strict disinfection procedure. The surgical site is cleaned, but it is important to wash your whole body if you have been given a before-surgery body wash.

There are also some things you should see your healthcare team do to protect you while you are in hospital. We work hard to prevent infections and need your help.

More information about:

• Skin steps leading up to surgery

• Staff steps to protect you

• Two (2) pairs of clean pyjamas/nighties (labelled with your name).
• Dressing gown and slippers (non-slip sole)
• Toiletries (soap, toothpaste, toothbrush, hairbrush/comb, razor, tissues)
• Small amount of money under $10 (for phone or newspaper)
• Current medicines (these will be returned to you when you go home) and a list of ALL of your medicines
• Comfortable clean day clothing
• Glasses, hearing aids and non-electric walking aids (labelled with your name)
• Any letters from your doctors
• All relevant x-rays, scans and blood test results
• Medicare card and (if applicable) private health insurance fund card/book, veterans affairs repat card, details of workers compensation, public liability or third party case

What NOT to bring (Theft does occur in hospitals):

• Valuables (any jewellery or large amounts of money over $10)
• Radios without headphones
• Mobile phones (they can get lost or become a target for thieves)
• Electrical appliances (including electric shavers)
• Pot plants or flowers
• Large bags or excessive clothing- bring only the bare minimum
• Alcohol or illegal drugs
• Video games

The hospital staff cannot accept responsibility for your belongings if they are lost or stolen. Please leave them at home. 

Wollongong Hospital

24 hour Switch Board: 4222 5000
Day Surgery Unit: 4255 1290
Pre Admission Clinic: 4255 1210

The Main Entrance with a space for patient drop off is via Loftus Street, Wollongong. Public buses stop just outside our Crown Street entrance. Wollongong train station is a 9 minute, 800m walk.

The Day Surgery Unit and Operating Theatres are on Level 2 in the A Block, near the Loftus Street Main Entrance. There is a lift.

Elective surgery booking are made many months in advance. Occasionally delays may occur on the day of your operation due to other peoples’ urgent medical conditions. Your booking time for surgery may change throughout the day due to unplanned or emergency surgery. If you have any concerns or questions, please don’t hesitate to ask the staff.

Parking: There are two ways to get into the car park off Dudley Street. There are also two ways to get into the car park off New Dapto Road. There is a fee to park with the price displayed at the entrance. Disabled and concession parking up to 3 hours is free - check at the entry and at the ticket machine on Level 4 for more information. Very little free parking is available on the streets around Wollongong hospital. Please check the signposts as there are strict time limits.

Shellharbour Hospital

Switch Board: 4295 2500

The Main Entrance with a space for patient drop off is via 15-17 Madigan Boulevard, Mount Warrigal. Public buses stop just outside Madigan Boulevard or Lake Entrance Road, Mount Warrigal. There is a short walk to the hospital. Oak Flats train station is 4km away. 

The Day Surgery Unit and Operating Theatres are through the Main Entrance. Go to the chairs at Day Surgery Waiting area before surgery.

Our hospitals have coffee carts, cafés and lounge areas. You family is encouraged to sit in the café or lounge while they wait for your surgery. They will not be allowed into the operating theatre. The doors are closed to keep our theatres clean and private. 

Parking: You can access the hospital car park via Madigan Boulevard, Mount Warrigal. Disabled parking is available. Some parking is available on the streets around the hospital. Please check the signposts as there may be time limits. 

Shoalhaven Hospital

Switch Board: 4421 3111
Theatre Bookings (enquires about surgery dates and deferrals): 4423 9446
Pre Admission Nurses (Monday – Friday 1:30pm-3pm enquires about illness, medications, surgery preparation) : 4423 9571
Day Surgery/ 23 Hour Ward: : 4423 9717
Patient Flow Managers (urgent afterhours contact): 4423 9738

The Main Entrance with a space for patient drop off is via Scenic Drive, Nowra. Public buses stop just outside our Scenic Drive entrance. Nowra (Bomaderry) train station is 3km away. 

The Day Surgery Unit and Operating Theatres are near the Main Foyer on the Ground Floor.

After surgery some patients may be moved to the Transit or Discharge Lounge. Here patients can wait for medicines or paperwork.  The hospital will tell your family if you have been moved to the Discharge Lounge

Parking: You can access the hospital car park via Scenic Drive. Disabled parking is available. Some parking is available on the streets around the hospital. Please check the signposts as there are time limits 

Milton-Ulladulla Hospital

Switch Board: 4455 1333
 
The Main Entrance with a space for patient drop off 104-106 Princes Highway, Milton.

Parking: You can access the hospital car park via Princes Highway. Disabled parking is available. Some parking is available on the streets around the hospital. Please check the signposts as there are time limits.

Once you arrive in the Perioperative Unit/Admissions, please go to the reception area.

You may be asked to sit in the waiting room until it is time to have your operation. Sometimes you may notice people going in to have their operation before you. People are seen according to their place on the operating list.

Visitors are welcome, but space is very limited, so we ask you to bring no more than two people with you.

A nurse and a doctor will then ask you questions and take your pulse, blood pressure and weight, and you will need to change into a hospital gown in preparation for your operation.

You will be asked many times during your visit what your full name and date of birth is. Doctors and nurses ask this every time they do a procedure. This is for your safety.

If you are going home on the same day you will come back to the Perioperative Unit where you will be given something to eat.

You will be able to leave the hospital once you have recovered from your operation and received your medicines to take home. This is usually between 2-6 hours after your operation.

Please make sure you have a responsible adult to take you home and stay with you for the next 24 hours. If this is not possible, please talk with your nurse.

If you are staying overnight or longer, you will be taken to a hospital ward bed. We will tell you which ward on the day of your operation.

Want to know more about your surgical procedure?

Visit the Australian Government’s Health Direct website (link below). This has a comprehensive list of surgical procedures. Each has detailed information, specific to the procedure - why patients have this type of surgery, how to prepare, what happened during and after the surgery, any associated risks, and links to more information.

• Health Direct – Surgery (surgical procedures A-Z)

Whether or not to have surgery is a big decision. No matter how much advice you get, ultimately the decision is yours. Asking your doctor plenty of questions can help guide you towards making the right decision.

There are a lot of things that you can gather information on to help you make the important decisions – Should I have surgery? How do I find a surgeon? What are the costs?

The Australian Government’s Health Direct has helpful information about what questions to ask. It also has a useful Question Builder tool to help you create question lists for your doctor’s appointments.

• Questions to ask before surgery

• Choosing your surgeon

• Question builder

We need to talk

The hospital may contact you in the days and weeks before your surgery.

If we call you, the number might be shown as “External Number”, “No Caller ID” or “Caller ID Blocked”- don’t worry. This is because our hospitals use large computerised telephone systems. Please help us by answering the phone in the days before your surgery.

If you’d prefer contact on your mobile phone, please make sure we know the number. If you change phones; tell us. If you don’t own a mobile phone, it helps us if you give a phone number of a close relative or friend.

Sometime we send messages out via SMS. Please read the message very carefully as it might tell you what to do on the day of your surgery.

Some patients will need to get ready for surgery by coming to one of our Pre Admission Clinics. The Pre Admission Clinic will organise tests and help plan your care after your surgery. We will tell you if you need to come to the Pre Admission Clinic.