Pre-Admission Clinic

What can I expect at the Pre-Admission Clinic?

Your doctor or hospital will tell you when to come in for your Pre-Admission Clinic visit. This visit usually happens up to two weeks before your surgery, and may take three or four hours. If possible, bring a friend or family member with you to this appointment.

You will need to bring any medications, vitamins, herbal or natural supplements that you take at home. Be sure to bring them in their original containers.

Your Pre-Admission Clinic visit may include:

• Taking heart tests and blood tests. You may also need an X-ray.  As well, depending on the results of tests completed during the pre-admission clinic, surgery may be postponed if follow up tests are needed or a health concern is identified.
• Talking with a nurse about your health, including your medical history and any surgeries you’ve had. The nurse will prepare you for your surgery. This will include telling you when to stop eating and drinking, and the location and arrival time at the hospital before your surgery.
• Talking with an Anesthesiologist – a doctor who specializes in administering anesthetics and pain medications – about the type of pain control medicine you will need during and after your surgery.
• Advice on how to manage your medications before and after surgery. Some medications and supplements must be stopped 1-2 weeks before surgery to avoid problems with bleeding or sleepiness. Talk to your surgeon if you have questions about your medicines.
• Request to participate in a research study. Research is one of the key tools to improving patient care: your participation in a reserach study is strictly voluntary.

Your surgery may need to be postponed if you have an active infection in your body (such as a cold or flu) or a skin infection over the joint. If you are feeling sick before your surgery,  please call your surgeon, orthopaedic clinic, operating room booking, or the number you were given.

Will I be given anesthesia?

Anesthesia is the clinical word for the pain medication that helps you deal with your pain during and after surgery. Each hospital deals with your anesthetic and pain control differently.

Many people who have joint replacement surgery have spinal anesthetic. This is similar to the freezing you get at the dentist, except this freezing goes into your back and makes you numb from the chest down to stop you from feeling pain. The doctor will make sure you are comfortable throughout the surgery, giving you medication through your IV that makes you relaxed and sleepy. If you have a spinal anesthetic, you will not be able to move your legs for up to 4 hours after surgery.

Some people receive general anesthetic. This is a combination of drugs that will make you unconscious during the surgery. Feel free to ask your doctor what kind of drugs you will be given.

In some cases, the doctor may give you a nerve block. This injection of “freezing” medication only freezes the surgical area of your body, making it feel numb and pain-free. A nerve block is usually done together with a general or spinal anesthetic.

A nerve block can also help reduce pain after your operation has finished. In some cases, a small tube is left in place to give you constant freezing medication to control your pain for more than 24 hours.  

The type of anesthetic you receive will depend on the type of surgery you are having and your overall health. Talk to your surgeon and the Anesthesiologist about the type of pain medication you will be given. The Anesthesiologist is a doctor who is trained to give anesthetics and pain medicatications and monitor you throughout your surgery. The doctors can answer your questions and discuss any concerns you may have.

Here are several questions you might want to ask:

• What type of anesthetic will I be having?
• What are its potential side effects and complications?
• What can I do to prevent getting complications before and after surgery?
• If I am having a spinal anesthetic, will I hear and see what's going on in the operating room?

NOTE: You will be told not to eat or drink anything the night before surgery. For your own safety, be sure to follow the orders given by your surgeon.

What kind of tests will be performed on me?

You will require an ECG (electrocardiogram) heart test and blood tests. You may also have an x-ray done.

As well, depending on the results of tests completed during the pre-admission clinic, surgery may be postponed if follow up tests are needed or a health concern is identified.

Should I bring my medications from home?

When you come for your pre-admission visit, bring all medications, vitamins, herbal or natural supplements that you are currently taking at home with you. Make sure to bring them in their original containers.

Some medications and supplements must be stopped 1-2 weeks before surgery to avoid problems with bleeding or sleepiness. Talk to your surgeon if you have questions about your medicines. If you are taking anti-inflammatory drugs (such as Aspirin) you may need to stop taking it prior to surgery. You will receive instructions on this from your doctor’s office and/or pre-admission clinic.

Bring any questions you have about your medications to your Pre-Admission appointment. Don’t forget to tell the doctor if you have any allergies.

Meeting the Healthcare Team

During your pre-admission visit, you may meet with various members of the healthcare team to assess your general health, help you prepare for surgery, and plan your discharge. During this time you will also have a chance to ask questions about your surgery and recovery.

• A nurse will inform you of what to expect when you come to have your operation.
• An anesthesiologist will talk about your anesthetic options and pain control after surgery.
• A laboratory technician will take your blood.
• An electrocardiogram (ECG) technician will do an ECG to measure the activity of your heart.
• An X-ray technologist will perform X-rays if your surgeon says you need them.

You may also need to meet with other members of your healthcare team. These may include:

• An occupational therapist - to discuss how to manage your daily activities, such as dressing and bathing, when your surgery is done.
• A physiotherapist and/or a physiotherapist assistant – to discuss exercise and activity (e.g. walking and climbing stairs) after surgery.
• A respiratory therapist – to discuss breathing issues related to smoking or other breathing related concerns.
• A social worker or discharge planner - to talk about what you need to plan for when you leave the hospital, including finding support resources in your community to help you after surgery.
• A research coordinator or research assistant - may ask you to participate in one of the hospital’s studies.  Health research is a vital method to improve care in the future.  Your participation in a research study would be greatly appreciated but is 100% voluntary.
• A pharmacist - to discuss any questions you have about your medication.

Meeting your healthcare team is a great time and place to ask questions and talk over any concerns you have. Be sure to make a list of questions and bring it with you!