What happens on the "work up" day?

One to three days before surgery you will come to the Orthopedic Clinic for what we call your "pre-op workup." You should plan on being at the hospital most of this day. The doctor will make sure you are in healthy for surgery. If you are sick on this day, or a few days before, let the doctor or nurse know.  Your surgery may need to be postponed if you are sick. 

The doctors and nurses will ask you and your parents some questions.  They will answer any questions you have. This will help them to give you the best care while you are hospitalized. They will tell you what will happen the day of your surgery, what to expect after surgery, and give you general information about being in the hospital. You should make plans to be in the hospital for about 3-5 days.

One of things that we will talk about is how we will take care of your pain after surgery.  One of the ways your pain will be treated is with a machine that is called a PCA pump (patient controlled analgesia). This machine has a button you can push to give yourself pain medicine through your IV, which is a special tube like a straw which is placed in your vein. We'll give you a booklet about the pump so you'll know all about how it works. We'll also talk to you about how you can rate your pain for us. 

The nurses will talk with you about how to use a breathing exercise device, called an incentive spirometer. We will ask you to use this after surgery. It helps you to ‘exercise’ your lungs by making you cough and breathe deeply. Coughing and deep breathing are very important to help clear your lungs and prevent pneumonia. The nurses will talk about how you'll need to roll after your surgery. This is called logrolling (turning as a unit). They will teach you leg and ankle exercises to keep the blood moving in your legs while you are getting stronger again.  The nurses taking care of you after surgery will also talk about all of these things with you.

A urine sample, blood samples, and X-rays are taken. The nurse will take pictures of your back.  This will help us compare how you look before and after surgery.

The nurse will give you special cloths and explain how to use them the night before surgery. You will need to wash your hair the night before surgery.  If you have long hair you need to put it up.  Pigtails or braids are good suggestions.  All finger or toenail polish should be removed. 

You will go to a special laboratory for an EEG (electroencephalogram).  The EEG shows the nerve messages going through your spine before and during your surgery. The hospital staff do this by putting special wires on your head and your legs. This doesn't hurt. The wires will be taken off after this first test and then put back on the day of your surgery.

You will spend some time talking to the doctor who will be putting you to sleep before your surgery. This doctor, the anesthesiologist, will explain how they put you to sleep.  The doctor will answer any questions you have. You will talk about any medications that you take on a daily basis. The anesthesiologist will tell you about whether or not to take your medications the morning of your surgery with a small sip of water. You should tell the doctors or nurses about any allergies you have to medications, foods, tape or latex (rubber products).

Your stomach needs to be empty when you go to sleep. Therefore, you may not eat or drink anything after midnight the night before surgery. This will help keep your stomach from getting upset afterwards. You may want to avoid salty foods the night before surgery to prevent waking up feeling thirsty.

You cannot have a sunburn, bad rash, or sores on your back at the time of surgery.  These could be a potential source of infection.

Please feel free to ask any questions you might have, even if you think they sound silly or stupid. We want to make sure you know everything you need to before you leave the hospital on your workup day.

The pre-surgical area staff will call you the evening before your surgery to tell you what time you need to be at the hospital. You do not have to spend the night before your surgery in the hospital.