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Plymouth Pre-Surgical Patient Checklist

A surgery has been scheduled for you or a family member. This checklist will help you prepare for your surgery and your return home. Following this checklist will assist our team in caring for you; reducing your worry as much as we can is important to us.

  • Have any testing done that your doctor may have ordered including blood tests, x-rays or EKG.
  • Pre-register by telephone if either your doctor or the hospital asks you to do so.
  • A nurse from the surgery team will contact you before your procedure to discuss your health history. Be prepared to list all of your medications, their strength and how often you take them; include vitamins, herbs or supplements, and over-the-counter (OTC) medications. The nurse will also ask about any allergies you have.
  • Arrange for someone to drive you home after your surgery and to stay with you after you return home, at least for the night.
  • Stock up on food that is easy to prepare, such as soup, crackers, clear soda and frozen foods.
  • Plan for easy access to your bathroom, if possible.
  • Check with your doctor or insurance company to be sure you have the referral, pre-certification or other required approvals.
  • If your doctor instructs you to donate blood, please do so.
  • Ask if any special equipment will be needed when you return home, such as crutches, walker, sitz bath, etc. Make arrangements for equipment you need.
  • Ask your surgeon to estimate your time off work.
  • Drop off family medical leave papers at your surgeon’s office before your surgery. 
  • Do not drink alcohol during the 24 hours before surgery.
  • Do not eat or drink anything after midnight the night before your surgery, unless you are told that you can by your doctor or the hospital.
  • You may brush your teeth and rinse your mouth; avoid swallowing the water. If you have been told to take any medication, take them with a sip of water.
  • Check with your doctor if you are taking any of the medications listed below. You may be instructed by your surgeon to stop taking a medication a few days before surgery.
  • Adipex (Phentermine)
  • Advil
  • Aleve
  • Aggrenox
  • Anaprox
  • Ansaid
  • Aspirin
  • Cataflam
  • Clinoril (Sulindac)
  • Coumadin (Warafin)
  • Daypro (Oxaprozin)
  • Diet Aids (OTC)
  • Disalcid (Salisalate)
  • Dolobid (Diflunisol)
  • Feldene (Piroxicam)
  • Herbals (All herbals)
  • Ibuprofen
  • Indocin (Indomethicin)
  • Lodin (Etodolac)
  • Lovenox
  • MAO Inhibitors (Azilect, Marplan,  Nardil, Parnate, Selegiline)
  • Motrin
  • Naprelan (Naproxen Sodium) 
  • Naprosyn (Naproxen)
  • Orudis (Ketoprofen)
  • Oruvail (Ketoprofen)
  • Plavix
  • Pletal
  • Relafen (Nambumetone)
  • Tolectin DS
  • Toradol (Ketoralac)
  • Trilisate
  • Vitamin E
  • Voltaren (Diclofenac Sodium)
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Saint Joseph Regional Medical Center  |  5215 Holy Cross Parkway, Mishawaka, IN 46545  |  574-335-5000

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