Shoulder surgery, whether for a rotator cuff repair, stabilization, or joint replacement, requires comprehensive preparation for a successful procedure and efficient recovery. The weeks and days leading up to surgery are important for patients to work closely with their medical team and modify their environment. Taking proactive steps in the pre-operative phase helps minimize complications, manage pain effectively, and smooth the transition back to daily activities.
Coordinating Medical Requirements and Tests
Physical readiness for shoulder surgery begins with clinical compliance, often starting several weeks before the scheduled date. Surgeons typically require pre-operative testing to ensure the patient is healthy enough for anesthesia and the procedure. This may involve routine blood work to check for infection or anemia, an electrocardiogram (EKG) to assess heart function, and sometimes a chest X-ray, particularly for patients with a history of smoking or lung conditions.
Patients with existing medical conditions, such as diabetes or heart disease, must obtain medical clearance from their primary care physician or specialists, like a cardiologist. This clearance verifies that chronic conditions are stable and well-managed before the stress of surgery. A review of all medications, including prescription, over-the-counter drugs, and supplements, is necessary to minimize the risk of excessive bleeding during the operation.
A physician will instruct the patient to stop taking blood thinners, such as Coumadin, Plavix, or low-dose aspirin, a specific number of days before the procedure, often around seven days. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) and naproxen (Aleve) must also be discontinued, as they interfere with blood clotting. Certain supplements, including fish oil, Vitamin E, and ginkgo, are also known to increase bleeding risk and should be stopped at least one to two weeks prior.
Patients should stop smoking entirely for a period before and after surgery, as tobacco use significantly impairs blood flow and delays wound healing. Maintaining good hydration and following a balanced diet rich in nutrients can enhance the body’s ability to recover. All medication changes must be confirmed directly with the surgical team to ensure patient safety and adherence to the specific timeline for the procedure.
Arranging Logistical Support and Home Modifications
Preparing the home environment is necessary since the operated arm will be immobilized in a sling for a significant recovery period, limiting the ability to perform simple tasks. The patient should establish a dedicated “recovery station,” typically a recliner or a bed propped up with several pillows, as sleeping semi-upright is often more comfortable immediately after surgery. This station should have necessary items, such as the telephone, remote control, and medications, placed within easy reach of the non-operative arm.
Mobility will be restricted, so clear pathways of tripping hazards like loose rugs or electrical cords. In the bathroom, a shower chair and a long-handled brush or sponge can make personal hygiene manageable with one arm, along with placing toiletries at waist level. Clothing should be loose-fitting and feature front closures like buttons or zippers, making it possible to dress without lifting the arm over the head.
The patient must secure a reliable support system, as driving and lifting will be prohibited. This includes arranging transportation to and from the hospital and ensuring a competent adult can stay with the patient for at least the first 24 to 72 hours, especially if it is an outpatient procedure. Preparing meals in advance, such as freezing individual portions, or stocking up on easy-to-prepare items helps minimize the need to navigate the kitchen while incapacitated.
Administrative tasks should be completed before the surgery date to reduce stress and allow the patient to focus on recovery. This involves confirming insurance coverage details, understanding potential co-pays, and signing consent forms during a pre-operative appointment. Obtaining assistive devices, such as a shoulder sling, ice machine, or reaching grabber tool, before the day of surgery ensures they are available immediately upon returning home.
The Immediate Steps Before Hospital Arrival
The final 24 to 48 hours before surgery involve steps to prepare the body for anesthesia and the procedure. The most important instruction is the NPO rule (nil per os or “nothing by mouth”), typically enforced after midnight the night before surgery. This means no food, liquids, chewing gum, or hard candy, as an empty stomach reduces the risk of regurgitation and aspiration into the lungs while under anesthesia.
Some protocols allow for clear liquids, such as water or clear juice without pulp, up to two hours before the scheduled arrival time, but the patient must confirm this detail with their surgical facility. Patients who take daily prescription medications, especially for conditions like high blood pressure or seizures, will be instructed by their physician on which ones to take the morning of surgery with only a tiny sip of water. Diabetic patients will receive specific instructions on adjusting their insulin or oral medication dosages.
A required hygiene protocol often involves showering with a special antiseptic soap the night before and the morning of surgery to minimize bacteria on the skin near the surgical site. The patient must remove all jewelry, including wedding rings and body piercings, as post-operative swelling can make removal difficult later. Before arrival, several items must also be removed to allow for proper monitoring and to reduce the risk of flammability in the operating room:
- All makeup.
- Nail polish.
- Body lotions.
- All jewelry, including wedding rings and body piercings.
On the day of surgery, the patient should bring photo identification, insurance cards, and any required paperwork. Wearing loose-fitting clothing, such as a button-down shirt and elastic-waist pants, makes it easier to dress after the procedure over the sling and dressings. Confirming the exact arrival time and location at the hospital or surgical center beforehand helps ensure a smooth check-in process and prevents delays.