Preparing for Your Surgery

Medical Clearance

• Primary Care — Most patients will need clearance from their primary care physician.
• Cardiology — If you have a cardiologist, you will also need a pre-op evaluation.
• Laboratory Work — Bloodwork and other labs may be ordered as needed.
• Pediatric Patients — Healthy children with no medical history may not need additional testing until the day of surgery.

Nutrition

From now until at least 3 months after surgery, we recommend:

• High-protein diet — Supports wound healing.
• Vitamin D, 2000 IU daily — Improves bone quality (especially important for rotator cuff surgery).
• Vitamin C, 500 mg twice daily — May help reduce pain after surgery.

Post-Operative Brace, Splints & Crutches

• Any necessary brace, splint, or cast will be applied before you leave the hospital or surgery center.
• Crutches, if required, will be provided either just before or right after surgery.

Medications

• Postoperative prescriptions are usually sent 1–3 days before surgery.
• Please pick them up before surgery, but do not take them until after your procedure unless instructed otherwise.
• Continue your vitamin supplementation as above.
• Keep your phone on — Dr. Thomson may call with additional instructions.

The Night Before & Day of Surgery

• Fasting — Do not eat or drink anything after midnight, unless otherwise instructed.
• Arrival — Plan to arrive about 2 hours before your scheduled start time.
• Clothing — Wear loose, comfortable clothing: shorts or loose pants for knee surgery; a button-down shirt for shoulder surgery.
• What to Avoid — No contact lenses, jewelry, or unnecessary personal items.
• Time Commitment — Expect to spend most of the day at the hospital or surgery center (pre-op, anesthesia, surgery, recovery, and possibly therapy).
• Nerve Block — Many patients are offered a nerve block to reduce pain after surgery and minimize opioid use.
• Operating Room Time — Total time may be 45–60 minutes longer than the actual procedure, due to anesthesia, positioning, sterilization, and dressings.
• Transportation — You must have a responsible adult to drive you home. Rideshare services are not permitted.

1–2 Days After Surgery

Dr. Thomson will call to check on you. Please keep your phone nearby.

Post-Operative Appointment

• Your first follow-up visit should occur 10–14 days after surgery, depending on the procedure.
• If you don't have this scheduled, please call the office.

Rehabilitation

• Physical therapy and/or occupational therapy is essential for recovery.
• A referral will be provided before or on the day of surgery.
• Schedule PT according to Dr. Thomson's guidance.

Shoulder Replacement — Additional Instructions

To help reduce infection risk, the Centers for Disease Control and Prevention's most recent guidelines recommend that patients shower or bathe with an antiseptic agent on at least the night before the operative day.

We recommend using a special soap called chlorhexidine gluconate (CHG) — a common brand name is Hibiclens. Chlorhexidine reduces the number of microorganisms on the skin and keeps that number down for several hours.

Prior to your operation, two chlorhexidine antiseptic showers are recommended.

When to Use

• First Shower — The night before surgery.
• Second Shower — The day of surgery, before you come to the hospital.

How to Use

• Wash your hair and body as usual with your regular shampoo/soap.
• Thoroughly rinse your body with warm water.
• Turn off the water to prevent rinsing the CHG soap off too soon.
• Apply the minimum amount of Hibiclens necessary to cover the skin around the planned surgical area — typically from the base of the neck down the arm, with a lot of attention to the armpit. Use it as you would any other liquid soap.
• Do not scrub too hard. Apply gently and wash for 5 minutes with a wash cloth, paying special attention to the area of surgery.
• Turn the water back on and rinse thoroughly with warm water.
• Pat yourself dry with a clean towel.
• Do not apply lotion, powders, or perfumes to the areas cleaned with Hibiclens.
• Put on clean clothes.