As a patient of Oklahoma Surgicare, we the staff want you to be educated about your risks for blood clots, and pain. We also want you to know what you can expect from us to help prevent and treat these occurrences. Please read over this information and ask any of the staff if you have any questions or concerns about this information.
You have the right to pain relief. If you are having problems with pain control, talk with your doctor or nurse. He or she will find ways to help you. In order for your nurses and doctors to help you control your pain, they need to know the following information:
- Where your pain is located and when it started
- Whether you have pain all the time or just sometimes
- What makes you feel better or worse (position, medications, etc)
- How bad it feels on a 0-10 scale (0 meaning no pain and 10 meaning excruciating pain)
- What is the level of pain that you have on a normal day
- What it feels like
- What you think the reason for your pain is
- What effect pain has on your life (appetite, sleep, etc).
- Anything else we should know about your pain
- People who take pain medicines such as Percocet, Vicodin, Demerol, OxyContin, Dilaudid and Morphine for more than a few days will almost always have constipation. It is important that you discuss treatment for this problem with your doctor or nurse. Unless otherwise contraindicated, people should take their pain medications with food.
- Patients who have taken pain medications daily for long periods of time may build up a tolerance to all pain medications that function the same way. It may also be more difficult to control the pain of patients that take large amounts of pain medications for long periods of time. The staff will do everything possible to get the patients pain at a tolerable level before discharge. Although the staff will treat your pain to the best of our ability, you can expect to have some pain when discharged, depending on your surgical procedure. Because you have had an invasive procedure, pain is expected and all pain cannot be completely eliminated without sedating you, and because you must be awake and alert to go home safely, we cannot keep you sedated to eliminate all your pain.
- It is important to take all pain medications only as instructed. If this does not make your pain tolerable, please contact your physician for further instructions.
- Do not drive a vehicle or operate machinery if you take pain medicines such as those listed above.
- Pain medicines are made to treat pain just as antibiotics are made to treat infections. If a person has pain and needs medication to control it, he or she is not an addict. Addiction to pain medications occurs when a person takes the medication for reasons other than pain or takes the medication in larger doses or more often than prescribed. Addiction rarely occurs in people who take pain medication for pain control for short periods of time.
- Many people believe that shots are stronger than pills for pain. This is not true if the dose of the pill and the shot are the same.
- If your doctor advises you to take medications with acetaminophen (Tylenol), be aware of the following information: The adult maximum dose of acetaminophen (Tylenol) over a 24-hour period should not exceed 4,000 milligrams because more than that can damage your liver. One regular Tylenol tablet has 325 milligrams of acetaminophen. Check for the “hidden” acetaminophen in many over-the-counter cold medications and pain medications such as Percocet, Vicodin, and Lortab. Do not drink alcohol if you are taking acetaminophen (Tylenol); doing so can cause liver damage.
Blood clots or DVT (Deep Vein Thrombosis)
Deep vein thrombosis or DVT is the formation of a blood clot in the deep veins of your arms, legs, abdomen, or around the brain. When a patient is immobile for long periods of time, as in recuperation from surgery, blood can pool in the calf area of the lower leg, causing small clots to form. It can block the flow of blood through the vein. Every patient scheduled for a procedure will be evaluated for risks of developing a blood clot or deep vein thrombosis (DVT). This evaluation and any steps deemed necessary to help prevent DVTs will be done pre-operatively and continue throughout your stay at the Surgery Center. Things that have an influence on the risk of developing DVTs include:
- Patient’s age and weight
- Type of procedure you are scheduled for
- Tobacco usage
- Prior use of anticoagulants such as aspirin, warfarin, etc
- Blood clotting or bleeding disorders
- History of recent pregnancy, miscarriage or surgery
- Heart, Kidney or Bowel disease
- Length of time you will be under anesthesia
- Home medications such as estrogens or other hormones, such as birth control pills
- History of or present diagnosis of cancer
- Personal or family history of blood clots
- Your activity level following your surgery
A DVT can occur after surgery in any extremity, even if it has or hasn’t been operated on. There are several signs and symptoms that may occur if you develop a DVT. IF you develop any of these signs and symptoms, please contact your physician immediately or go to the nearest emergency room.
Signs and symptoms of DVTs are:
- The most common is leg pain and tenderness in calf muscles
- One leg may swell or change color to purple or blue
- Pain or tenderness in the leg may be present in only one leg and present when walking or standing.
- Skin that is warm to the touch in the leg
- Chest pain and/or palpitations(irregular heartbeat)
- Signs may be sudden or develop over a short time
- Swelling of the leg
- Fatigue and/or fainting
- Coughing/coughing up blood
- Red or discolored skin
- Unexplained shortness of breath
- Anxiety and/or sweating
- Fatigue and/or fainting
There are several things the clinical staff and you as the patient can do to aid in the prevention of DVTs. As with any instructions, please follow your specific instructions for pain, diet, medication, and activity following your surgical procedure.
Your surgeon and pre-operative nurse will assess your clinical information, history and risk factors to determine if you will need sequential compression devices (SCDs), thrombo-embolic deterrent (TED) hose, or low-dose anticoagulant medications during your stay at the Surgery Center. If your medical team determines that you need one or more of these treatments, they will be started in the pre-operative area before you surgery starts.
- TED hose are tight fitting, knee high or thigh high stockings that keep mild graduated pressure on the legs to prevent blood from pooling in veins while you are not moving your legs during surgery and shortly after.
- SCDs are sleeves that wrap around you legs and are connected to an air pump. Air is then forced into different parts of the sleeve in sequence, creating pressure around the calves and improving blood flow.
- Low dose anticoagulant medications are medications given usually in shot form before or after surgery to temporarily thin the blood, making it easier to circulate and to prevent blood from clotting too easily. It can also help prevent existing clots from increasing in size.
You as the patient can also help prevent clots from forming after you are home recovering. Things you can do at home to decrease your chance of developing blood clots are:
Prevention aids for DVTs
- If you cannot get out of bed, move your legs in a bicycle motion at least once every 2 hours during waking hours
- If you are able to get out of bed and walk, do so at least once every 2 hours during waking hours
- Drink plenty of non-caffeinated fluids to stay hydrated
- Stop smoking
- Make sure your blood pressure is within normal ranges
- Continue your pre-operative medications as instructed by your physician
- Manage your weight
- Eat a healthy balanced diet
- Avoid crossing your legs for long periods of time
- Avoid wearing tight short socks for long periods of time
- If traveling long distances by car exercise legs every 1-2 hours
Signs and symptoms of PE (pulmonary embolism)
- Unexplained shortness of breath
- Pain with deep breathing
- Coughing up blood
- Rapid breathing
- Fast heart rate
- If you develop any signs or symptoms of DVT or Pulmonary Embolism, call your doctor immediately, call 911 or go to the nearest ER.
You are a part of the team
The clinical staff of Oklahoma Surgicare strives to make your stay with us the safest and most comfortable experience possible. We do not just think of you as the patient, but consider you a member of the surgical team. Each member of the surgical team plays an important part in ensuring that your surgery and recovery go as free of complications as possible. As a part of your surgical team, we want to provide the utmost care to you and your family by educating you on important points such as falls, pain, and blood clots before, during and after your surgical procedure, and give you the tools to aid in a smooth recovery. It is important that you take part in preventing certain complications and hope that this information has given you the information to do just that. Please feel free to talk to any member of the clinical staff about any questions or concerns you may have concerning these or other risks relating to your surgical procedure.
To provide comfort and seating for every patient and their driver(s) while waiting in the lobby, we highly encourage patients bring only 2 people with them. For patient privacy and infection control prevention, only 1 person will be allowed to be with you in the Pre-Op and Recovery Areas. Visitors will not be allowed to alternate. For the patients that will be spending the night with us, you will be able to have visitor(s) once you are in your overnight room.