Frequently Asked Questions- Before Surgery

Do I need pre-operative testing?
Most patients over 50 years of age will be required to have pre-operative testing. Any pre-operative testing required will be determined by your surgeon, anesthesiologist or as instructed by the pre-operative nurse.

May I pre-register for my surgery?

Yes. We strongly encourage you to have completed all the registration forms, any necessary payments, and all preoperative documentation before the day of surgery.

What should I do if something comes up and I need to cancel my surgery?
Please call both your surgeon’s office and Gateway Surgery Center at 425-374-5160 as soon as possible. If you call after hours, an answering service will take your message.  Early notification can help us better accommodate you and other patients.

How do I know if my insurance company will cover my surgery?
Please check with your insurance carrier to review your benefits and determine if pre-authorization is required. If you need assistance with this, the surgical center billing department will be happy to help you.

Why can’t I eat or drink anything after midnight?
SAFETY. Undigested food and liquids in the stomach can cause complications and your surgery is likely to be postponed if you forget to follow this instruction.  The gastric acids in your stomach that help to digest food are extremely harmful to your delicate lung tissue.  If you were to vomit while unconscious, these acids could accidently enter into your lungs and this is a medical emergency.  You need to strictly abide by our recommendations. Do not eat or drink anything after midnight the night before your surgery, including water, juice, coffee, chewing gum or mints, unless instructed otherwise by the surgery center pre-operative nurse. 

Why can’t I smoke?
Smoking may interfere with the anesthetic and frequently produces nausea during the recovery period.  After surgery, you need to replace the anesthesia gas lingering in your lungs with fresh oxygen, not with smoking.

Should I take my usual daily medication?

We generally request that you hold all medications until after your surgery. We will usually hold diabetic medicines and manage your blood sugar at the surgery center. We generally will have patients take, with a sip of water on the morning of surgery, blood pressure and heart medications, acid reflux medications, anti-seizure medications, Parkinson's medications, and asthma medications/inhalers. You will be contacted by a preoperative nurse who will discuss your medication list and advise you on which medications to take. Please bring all your medications with you.

People using inhalers must bring them to the surgery center on the day of surgery.

Some medications will be stopped for the surgery, particularly diabetes medication/insulin and blood thinners (like Coumadin/Warfarin, Plavix, Ticlid, Lovenox, Heparin.) You should bring these medications with you the day of surgery. Please call us with any questions you may have.

May I continue my herbal medications?

Herbal medications may have harmful effects on the surgery. Many of these remedies may effect your clotting mechanism and interfere with the anesthetic agents. (The list of drugs and their side effects are too great for this site.) We generally request that you stop these medications two weeks before surgery. Please remember to mention these remedies with your surgeon at the preop visit and when being asked about your current medications.

What time is my surgery?  Why did my time change?
Gateway Surgery Center staff will call you 24-48 hrs before your surgery to tell you the time to arrive at the surgical center. Surgery schedules may have changed from the time that you originally scheduled your surgery.  There are many factors that dictate surgery schedules.  So, if you have not received a call from us, please telephone the surgical center nurses station at 425-374-5174 to ask about your surgical and arrival time and to review final preoperative instructions.

What if I am pregnant?
The pre-operative nurse will ask you if there is a chance you may be pregnant.  It is very important that the surgery center is aware of any possibility of a pregnancy. This is important because anesthesia and medications may be harmful to your developing baby.  We may perform a urine pregnancy test upon your arrival.  Elective surgery is not performed on pregnant mothers here at Gateway Surgery Center.

Will I be contacted before my surgery?

Yes. We call each patient before the surgery to gather information and to helpful to us and hopefully answer any of your questions. Preoperative instructions will be given by the nurse who calls you. You can also call Gateway Surgery Center directly at 425.374.5160 with any questions. 

Why do you ask about illegal drug and alcohol habits?
A patient’s response to the anesthesia drugs may vary based on drug and alcohol usage.

Can my significant other watch my surgery?
For safety and sterility reasons, the surgical center does not allow family members or others not on the surgical team to observe surgeries.

Why is the operating room so cold?
The operating room temperature is kept low for the maintenance of our equipment and to maintain sterility of our supplies. You will be kept warm throughout your procedure.  Please let us know if you are uncomfortable or cold.

What happens if something goes wrong in surgery?
The surgical center is fully equipped with state of the art emergency equipment and supplies. The surgical center utilizes the same Anesthesia providers as the hospital. The recovery room nurses are well  trained and are ACLS (Advanced Cardiac Life Support) certified. In the event of an emergency, the patient is stabilized, then transferred via ambulance to Providence Hospital or Stevens Hospital.

Will I need an IV?
All patients receive an IV except those having local anesthesia.  If you are having local anesthesia, you may still require an IV for antibiotic administration if ordered by your surgeon.

Do I have to fill my pain medication prescription?
Patients are often comfortable when leaving the surgery center and do not think they will need anything as strong as a prescription pain pill. Your pain will be better controlled when you take your pain medication as prescribed. It is much easier to keep your pain under control than try to alleviate it with more medication once you are very uncomfortable. IT IS BEST TO STAY AHEAD OF THE PAIN.  We recommend that you fill your prescription prior to your surgery or have your ride fill it while you are in surgery. (Please note that most pharmacies will not fill prescriptions for narcotic pain medications over the phone.)

What should I wear?

Please wear comfortable clothing. Loose, button-down shirts or blouses are best. Wear comfortable, non-slip shoes. Leave all jewelry at home, including body-piercing jewelry. If you wear contact lenses, you will probably have to remove them for the surgery, so consider bringing your glasses. If you have to wear your contacts, please bring contact solution and contacts case. Please do not wear any make-up as this can hide certain clinical signs.

Should I bathe and wash my hair before leaving home?

Yes. Please take a shower, bathe, brush your teeth, etc. Please do not use make up, hair spray, nail polish or toiletries. These may interfere with the anesthesia monitoring and possibly hide clinical signs from the anesthesiologist.

Who may accompany me?

You are welcome to bring one person with you to the surgery center. That person will be allowed to sit with you after the surgery in the recovery room if you so choose.

When a patient is a child, often two parents and/or guardians will accompany him or her to the surgery center. We will do our best to accommodate everyone, however, one parent and/or guardian will be permitted into the recovery room at a time, and one parent and/or guardian MUST remain in the waiting room while the child is undergoing their procedure in the OR.

Please refrain from bringing young children to the surgery center as guests.

Will I receive sedation before going into the operating room?

We will individualize each patient's care. Most patients walk into the operating room themselves. Therefore, preoperative medication is minimized.

Will I be able to drive after my surgery?

If you are having surgery under anesthesia, you cannot drive home and you must be accompanied home by a responsible adult. This policy is for your safety, and is strictly adhered to. You cannot walk home, cannot take public transportation home, and you may not take a taxi home, unless accompanied by a responsible adult also taking the taxi home with you. Please make the appropriate arrangements.  The few patients who have procedures performed under "local only" anesthesia could possibly drive home if permission from their surgeon is obtained.  

May I speak to my anesthesiologist before the surgery?

All patients will be seen by the anesthesiologist on the day of surgery prior to entering the operating room. Sufficient time should be spent to answer any questions you may have. If you need to speak to the anesthesiologist before the day of surgery, you are welcome to call Gateway Surger Center and we will arrange for you speak with an anesthesiologist. We can also arrange a preoperative interview if you desire.

What if I have special needs?

We will make every effort to accommodate any special need you may have. We strongly encourage you to call the surgery center in advance so that we can properly prepare to make you comfortable. Do not hesitate to call and suggest anything that may make your day easier.

What If I need an Interpreter?

Gateway Surgery Center will make arrangements for a professional interpreter to assist you on day of surgery.  Please speak with your surgeon at the time of your clinic appointment or with the surgery scheduler about advance arrangements for professional interpreter services being arranged.

Should I bring my special needs equipment?

Yes. Please bring any walkers, post-op crutches, hearing aids, glasses case, contact lens solution/case, etc.

What must I bring with me on the day of surgery?

• Bring case for eyeglasses or contacts
• Bring insurance identification cards, driver's license, completed billing forms, copayments  

Please bring your list of medications, including the dosages. Also include a list of any supplements, herbal preparations and vitamins that you take.

• Bring with you all medications, including inhalers and insulin
• Bring your portable CPAP machine if you have sleep apnea
• Wear comfortable, loose fitting clothing (Is the arm sleeve or pant leg big enough to fit your surgical splint or bandage after surgery?)
• Leave all jewelry and valuables at home (including rings, watches, necklaces, earrings, and money). While we do our best to safeguard your belongings, they are best secured at home.
• Bring special equipment like crutches, walker, sling, etc...
• Bring pillows to elevate your surgical site for the ride home
• Make sure you have a ride home and someone to care for you at home for 24 hrs

Please bring any paperwork given to you by your surgeon. 

How will my pain be managed?

The management of your pain is of great importance to us. We will be assessing your level of pain from the time of admission until you receive our postoperative call at home. We need to inform and prepare you for each step of the process. This education will begin with our first contact. You will be repeatedly asked to rate your pain from a numerical scale (#1 being just a little pain, #10 being the worse pain ever.) Using the results of our communication, we will alter the therapy as needed in order to ensure your comfort.

The management of your pain will be taken very seriously. We will often use a combination of different modalities to help make you comfortable, choosing from oral medications, intravenous medications, nerve blocks, injection of local anesthetic during the surgery, etc. and prior to the surgery, the management of your pain should be discussed with both your anesthesiologist and surgeon. Please feel free to bring up any concerns or fears you may have. Remember that information on pain management gives you the appropriate expectations and hence a smoother, more comfortable recovery.

What do I do the day before surgery?
Please go to the "What to Expect" tab of this website to review what to do "Before Surgery".

What If I have a Latex Allergy?
Please notify the nurse when she makes your preoperative call.  Knowing that you are allergic to Latex will help us to eliminate your exposure to latex during your surgery and prevent unnecessary waste.

Why do I have to remove my piercings and jewelry?
SAFETY.  While under anesthesia, you may not be able to feel if an earring is poking you or caught on something. Also, in the case of an emergency, a nose piercing or tongue piercing may impede your emergency care, or even cause further problems like getting dislodged into your airway during resuscitation.  Furthermore, any metal on the body could conduct an electrical current when your surgeon uses electrocautery equipment, causing a burn on your body.  Therefore, you must remove all piercings and jewelry please. 

Will my family be able to visit me immediately after my procedure?

As soon as you are stable and comfortable in recovery room, one family member will be able to sit with you in post operative recovery room

Can I keep my hardware?

If you are having your hardware removed and would like to keep it, please ask your OR nurse and we will sterilize it and send it home with you. 

What happens to my body part?  Can I keep my specimen?

No.  Specimens may be sent to pathology and are then incinerated.  Tissue removed from the body is considered biological waste and hazardous so we cannot send these things home with you.   

Additional information
It is very important that you are well prepared for your upcoming surgery. Please review the "What to Expect" tab of this website for detailed instructions regarding your surgery.