Pre-Op Information

Pre-Operative Instructions

Final surgery time is determined one day prior to your procedure. You will receive a phone call from the surgery office 1 day prior to your date of surgery to confirm arrival time for surgery. Failure to arrive on time may result in the cancellation of your surgery.

Please remember your surgery time is approximate. On some occasions, due to emergencies, your procedure may be delayed. Our goal is to stay on schedule but sometimes unforeseen circumstances arise and may delay your surgery.

PREOPERATIVE CLEARANCE GUIDELINES

All patients scheduled for surgery must have preoperative clearance from their primary care/family doctor or a nurse practitioner between 7 and 30 days prior to your date of surgery. Testing over 30 days will need to be repeated. Results must be faxed to the surgery center at

It is your responsibility to schedule your preoperative appointment. If you do not have a primary care/family doctor, ask your surgical coordinator about other options.

If you see a cardiologist, pulmonologist or vascular doctor, you must follow up with them to get clearance for your surgery. This should also be faxed to the surgery center at

Your surgical coordinator will call you if there is a problem. If you have any questions about your preadmission testing, please call the surgery center at

DAY OF SURGERY

You MUST have someone available to take you home from the surgery center. You will not be permitted to leave the surgery center alone nor will you be permitted to drive or leave in a cab or ride share alone.

Your anesthesia during the surgery will be decided after discussion between you and the anesthesia provider. Typically, most patients are given a general anesthetic and in shoulder surgeries a regional block is given as well.

SURGERY INSTRUCTIONS: Important- Please read carefully.

STOP: ALL Aspirin, Aspirin Products, Anti-Inflammatories such as Motrin, Aleve, Advil, Naproxen, or Anticoagulants such as Warfarin (Coumadin) or Plavix seven (7) days prior to your date of surgery UNLESS otherwise directed by your primary care physician or specialist. If you are unsure which medications to stop, please check with your primary care physician or the physician prescribing the medication.

STOP: ALL over the counter herbal supplements and any medication in an oil capsule such as vitam or fish oil seven (7) days prior to your surgery.

STOP: ALL Sodium-glucose cotransporter-2 (SGLT2) inhibitors. Members of this class include: Jardia (Empagliflozin), Farxiga (Dapaglifozin), Invokana (Canaglifozin), and Steglatro (Ertuglifozin) 3-4 days prior to surgery.

Take your morning medications the day of surgery as directed by your medical doctor, with a small sip of water only. If you have any questions regarding which medications you should take, please check with the physician who prescribed the medication.

If you are a diabetic, do not take your diabetes medication the morning of surgery, unless directed by your medical doctor.

DO NOT EAT OR DRINK ANYTHING PAST 12 AM (MIDNIGHT) THE NIGHT BEFORE YOUR SURGERY REGARDLESS OF THE TIME OF YOUR SURGERY unless directed by hospital staff. No mints, gum, candy, water, etc. Your surgery will be cancelled if you eat or drink after midnight. When you are under anesthesia, anything in your stomach places you at risk for aspiration and lung complications.

Keep the area of surgery (knee, shoulder, etc.) clean prior to surgery. If there are any cuts, scratches, etc. around the surgical site, please let Dr. Slabaugh know as soon as possible since these may increase the risk for infection and might delay the surgery until they are completely healed. Dr. Slabaugh will mark your operative extremity on the day of surgery. Please do not place any marks on any of your extremities prior to the surgery.

The night before and the day of surgery it is important that you shower with anti-bacterial soap/cleanser. Please change/wash your bed linens the day before the surgery. Please do not shave the area prior to surgery. The OR nurse will do this prior to the surgery.

Do not apply any deodorants, make-up, lotions or perfumes to any part of your body after midnight prior to surgery. You do not need to remove fingernail or toenail polish. Wear loose, comfortable clothes that can fit over a bulky dressing. Wear a non-slip shoe with a back, no slides or flip-flops. Do not wear jeans or tight-fitting clothes. If you are having shoulder surgery, do not wear a top that goes over your head; wear a shirt/blouse that buttons down the front.

Bring glasses and hearing aids (leave contact lenses at home). Do not wear barrettes, hair pins or hair pieces.

Do not wear jewelry or bring valuables to the surgery center.

Bring your insurance cards, prescription cards, photo id and list of your medications to include the name of the medication, strength and dose with you to the surgery center the day of surgery.

Knee surgery patients: If you have crutches, bring them with you on the day of surgery. If you do not have your own crutches, please ask the surgical coordinator for a prescription. You may take this to a pharmacy or durable equipment store of your choice. You will need these on the day of surgery to get from the car into your home after surgery and for the post-op period.

You will receive a narcotic medication (i.e. oxycodone) to be taken after surgery. These are typically taken for the first 2-3 days after the surgery. Pain will be your guide and dictate how long you will need the narcotic medication. Our goal is to minimize the pain (not eliminate it) so that you can begin therapy. While taking narcotics you should be on a stool softener such as Metamucil or Colace with a high fiber diet.

Please make arrangements for transportation to and from physical therapy visits after your surgery. Most, if not all surgeries, will need to have some physical therapy and typically starts within 3-21 days after the surgery. While you are taking pain medications or are in an Orthopaedic device you will be unable to drive to therapy.

Please ensure you schedule a post-operative appointment with the surgical scheduler, typically 10-14 days prior to surgery.

If you have to cancel your surgery, for any reason, please give us at least 1-week notice so we can reschedule another patient in your place.

DISABILITY/FAMILY LEAVE/WORK FORMS: Any type of forms to be filled out must be faxed, mailed or dropped off to the attention of Victoria Barron or text them to Dr. Slabaugh’s PA via EPIC. The fax number is . Please allow 2 weeks for completion of the forms. If you have any questions regarding your forms, please call the surgeon's secretary at

PAYMENT FOR SERVICES: Our office will call your insurance company to verify coverage and obtain authorization. If your health insurance has changed in any way prior to your surgery date, please call the office with the new insurance information or your surgery may be cancelled if the correct insurance has not been provided. If your insurance does change and we are not notified by you, you will be responsible and billed for any charges incurred as a result of your surgery.

MEDICATIONS TO STOP BEFORE SURGERY

NSAIDS & Anti-Inflammatories- STOP 7 DAYS PRIOR TO SURGERY

• Aspirin & Aspirin Products (Examples: Aspirtab, Bayer, Ecotrin, Excedrin)
• Ibuprofen (Examples: Advil, Motrin, Midol)
• Naproxen (Examples: Aleve, Naprosyn)
• Meloxicam (Examples: Mobic, Vivlodex)
• Ketoprofen (Examples: Oruvail)
• Voltaren
• Diclofenac
• Voltaren

Anticoagulants (Please discuss with your prescribing doctor for their official instruction. If it differs from our recommendation, please call us.)

• Xarelto: Stop 3 days before surgery
• Eliquis: Stop 3 days before surgery
• Pradaxa: Stop 3 days before surgery
• Coumadin: Stop 5 days before surgery
• Plavix: Stop 7 days before surgery
• Aspirin: Stop 7 days before surgery
• Lovenox: Stop 12 hours prior to surgery

ALL Individual Vitamins & Herbal Supplements (See examples below) STOP 7 DAYS PRIOR TO SURGERY

• Multivitamins
• Vitamin B, C, E, K
• Turmeric
• Omega 3
• Gingko
• Fish Oil
• Flaxseed Oil
• CoQ10
• St. John's Wart

- (You can continue Calcium, Vitamin D and Iron)

Medications for Weight Loss/Diabetes/Heart Failure

Sodium-glucose cotransporter-2 (SGLT2) inhibitors - For Diabetes And/Or Heart Failure- STOP 3 DAYS PRIOR TO SURGERY

• Jardiance (Empagliflozin)
• Farxiga (Dapaglifozin)
• Invokana (Canaglifozin)
• Steglatro (Ertuglifozin)
• Brenzavvy (Bexaglifozin)
• XigDuo (Dapaglifozin)
• Synjardy (Empagliflozin)

Glucagon-like peptide-1 (GLP-1) agonists - For Diabetes & Weight Loss IF YOU TAKE DAILY, HOLD DAY OF SURGERY IF YOU TAKE WEEKLY, HOLD 7 DAYS PRIOR TO SURGERY

• Ozempic (Semaglutide)
• Wegovy (Semaglutide)
• Trulicity (Dulaglutide)
• Byetta (Exenatide)
• Rybelsus (Semaglutide)
• Victoza (Liraglutide)
• Mounjaro (Tirzepatide)
• Bydureon (Exenatide)