Patient Pre-Operative Education

• Pre-Operative Testing & Medical Clearance
• Medications to Avoid Before & After Surgery
• Pre-Operative Appointment with Dr. Kim
• Blood Type and Screen
• Getting Your Home Ready
• Home Assistance
• What to Bring to the Hospital
• Eating & Drinking Restrictions Before Surgery

Pre-Operative Testing & Medical Clearance

Before your spine surgery, it is necessary to have blood work done and a urine test. If it has been some time since you have seen your primary physician and you have a lot of medical problems, you should see your medical doctor ASAP before your surgery date:

1. Take the packet and orders to your primary care provider for the required clearance for your surgery.
2. Have your primary care provider send us a note of clearance and the results for the attached testing.
3. Please fax results ATTN: Dr. Jun S. Kim to (212) 636-3102 or email it to Kalli.Barrett@mountsinai.org and Mark.Henry@mountsinai.org

Medications to Avoid Before & After Surgery

Medications that increase the chances that you will bleed excessively after surgery:

• Medications that increase the chances that you will bleed excessively after surgery:
• Aspirin: Ideally stop two weeks before surgery.
• Coumadin^®: Discuss with the prescriber as to the best time to stop this medication before surgery. Usually at least seven days before and five days after surgery. 
• Ibuprofen (i.e. Advil^® and Motrin^®): Stop three days before surgery.
• Naproxen (Aleve^®): Stop 3 days before surgery.
• Plavix^®/Brilinta^®: Discuss with the prescriber as to the best time to stop this medication before surgery. Usually seven days before surgery and five days after surgery.
• Medications that increase the chances that you will form a clot in your legs or in your lungs:
• Hormones and birth control will need to be stopped one month before surgery, and can be re-started two weeks after surgery.

Herbal supplements that can also affect bleeding:

• Chondroitin
• Danshen
• Feverfew
• Fish oil
• Garlic tablets
• Ginger tablets
• Ginko
• Ginsen
• Quilinggao
• Vitamin E
• Co Q-10

• For anyone getting a fusion procedure, AVOID Aleve^®, Advil^®, Motrin^®, aspirin, ibuprofen, Celebrex^®, and naproxen medications until Dr. Kim says that it is okay to start taking them. All of these medications delay bone healing.  
• After surgery, you may take Tylenol^® (acetaminophen) and Tylenol products, but take no more than a total of 3000mg in 24 hours. Percocet^® and Vicodin^® have 325mg of acetaminophen in each pill—so two pills have 650mg. If you take more than 3000mg of acetaminophen a day, it can result in permanent liver damage and death.

Pre-Operative Appointment with Dr. Kim

Dr. Kim requires that all patients see him within 30 days of their surgery date. If a pre-op appointment hasn’t been made for you already, please call (877) 636-7846 to schedule this appointment. You may want to consider coordinating your pre-operative appointment with Dr. Kim and any additional testing that needs to be completed at one of our facilities.

Blood Type and Screen

For patients having larger surgeries, you will be required to have a type and screen (your blood type) drawn at Mount Sinai West prior to your surgery. This allows the hospital to cross-match your blood prior to your procedure so they can make sure that there is blood available for your surgery, if needed. The lab is walk-in. You can complete this test before or after your pre-operative appointment with Dr. Kim. If you are unsure if you need to complete this test or not, please ask Kalli Barrett.

Getting Your Home Ready

Before you have spinal fusion surgery, you should prepare your home for your post-operative condition. After a spinal fusion you will need to follow spinal fusion precautions called BLTs: no bending, no lifting, no twisting and no stooping/squatting. To comply with these precautions, you may need to make some changes to your home.

• Move frequently used items to more easily accessible locations. Items that you use every day should be somewhere that you can reach without assistance.
• During your recovery you should try not to lift more than 10 pounds, unless instructed by Dr. Kim. Please make arrangements before surgery to have any heavy items purchased before surgery such as dog food, etc.
• Clear a safe pathway in your home. Move area rugs or other tripping hazards so you are able to walk around your home for exercise. You will also want a clear pathway to the bathroom and kitchen.
• Showering: Please install a handheld shower head in the shower you will use. This will help you keep your incision dry while showering.
• Sleeping: You may sleep in your own bed as long as it is not low to the ground or a water-bed.
• Adaptive Equipment: Some homes have low toilets that are hard to get up from. If you have a home with a lower toilet, you may want to buy or rent a bedside commode to use over the toilet. This is more stable since it has four legs and arms. If you do not have room in your bathroom for a bedside commode, a toilet seat riser would work.

Home Assistance

• Help at Home: Make arrangements before you have surgery to have help at home once you’re discharged. Friends and family can take turns. You will likely need someone with you at all times for the first one to two weeks after surgery. Once you are feeling steadier, you won’t need as much help. This will vary by patient.
• Chores: You will be limited by your precautions, so make sure you have someone to help you manage your home.
• Services: Grocery delivery, home cleaning, dog walking/pet care, laundry service, and car service (like Uber) can make your life after surgery easier.
• Dog Walking: In order to comply with your precautions after surgery, you will not be allowed to walk your dog on a leash. Please make arrangements for someone to care for your pet or hire a dog walker.

What to Bring to the Hospital

• Photo ID and insurance card.
• Toiletries. Basic toiletries such as toothbrushes, toothpaste, combs, brushes, deodorant, soap, shampoo, conditioner, and lotion are available at the hospital. If you’d prefer to use your own toiletries, bring them.
• A list of your home medications. If you take any medications for migraines or have a specific formulary medication, please bring that in the original bottle for the pharmacist to review.
• Comfortable clothing. Loose-fitting clothes with elastic waistbands are recommended after discharge as they are easier to put on and take off and you may have some post-operative swelling. You may bring rubber-soled slippers and a robe for out-of-bed activities.

Eating & Drinking Restrictions Before Surgery

Do not forget! The night prior to your surgery, DO NOT DRINK OR EAT ANYTHING AFTER MIDNIGHT.

It is suggested to eat light meals the day before surgery and make sure your bowels have been regular prior to surgery.