What should I do when I get to the surgery number 16?

First make sure that the surgery is correct; it would be unfortunate to wait, by mistake, at the wrong (). Next go in and make sure we see you: otherwise we won’t know you’re here and may keep you waiting unnecessarily or see patients that had a later appointment before you.

Although we try to keep the waiting time as small as possible, do remember that the appointment time is approximate owing to the fact that the duration of each visit cannot be accurately predicted: some cases need more attention or time than others. Moreover, unforeseen events often occur and if either of these would be your cases you would also like to be attended immediately, so patience while waiting is never out of order. If something does not seem normal, however, do contact the nurse.

What should I do when I enter the Hospital?

Go to the front desk of the Hospital entrance and show your ID card or passport. It is important to show some documents that identify you to avoid errors when writing your name: while these errors do not, in general, create problems to assist you they do provoke administrative problems. If you request a report in the future, or if your stay is to be charged to an insurance company, these errors are likely to cause a refusal to bear the costs involved in your treatment.

Is hospital admission required and, if so, how long will my stay be?

Much depends on the procedure to which you will be submitted to. Most percutaneous procedures (those performed with needles) may be ambulatory, i.e. no admission will be needed or stay half a day only. In general, the average postoperative stay ranges from 1 to 2 days in the surgery of the spine and about 3 to 5 days in brain surgery, though it depends on case and procedure. Do not hesitate to ask for your case and we will gladly give you an estimate. Even though we do not account for complications, which may slightly lengthen your stay, in these estimates, they do give a rough idea.

What type of anaesthesia is going to apply?

It generally depends on the procedure or surgery to which you will be submitted to. Most percutaneous procedures are performed under local anaesthesia and sedation, which facilitates quick recovery and discharge. In some cases, other diseases that you may have can lead us to recommend a different type of anaesthesia, which would suit you better.

In any case, our anaesthetic team will assess your individual case and make its recommendation. Remember to leave any dentures before going down to the operating theatre. They are a nuisance during the procedure and, at a time of surgical stress, may be lost.

Can a relative stay in the room with me?

All hospital rooms have a sofa bed for use by a relative or companion and there is no additional charge for it. You can ask the nurses for sheets.

Nevertheless, please reduce visits to the minimum, especially in the first days of after your operation, since more visits pose a higher risk of infection of the wound.

What if I have a question for you?

Do not hesitate to contact us at any time. It is better to ask than to maintain a problem unresolved to avoid bothering.

Can you contact my regular doctor?

We will happily call your regular doctor to discuss with them your case and take the best decisions for your specific case.

What is Magnetic Resonance Imaging (MRI)?

MRI is a non-invasive, non-radioactive and pain-free method of evaluating the human body. It uses strong magnets and radio-waves. An MRI evaluation usually takes from 15 minutes to 1 hour to complete and only requires remaining as motionless as possible: even any slight movement damages the quality of the images. Normal MRI machines consist of an elongated tube through which the patient passes while laying on their back on a sliding platform. With this type of machine there are limitations for people who are very overweight (over 350 lbs.), very young or with claustrophobia. “Open” MRI machines have more space between the magnets, allowing the patient to lay flat on a table without having to pass through the tube and providing a less constricted environment. These machines are better suited to handle over-seized patients, young children and people with a fear of tight spaces, but the quality of the images is inferior to those of the traditional tube-type MRI due to the lower strength of the magnetic field.

How should I prepare for an MRI?

Wear loose-fitting, comfortable clothing that has no metal buttons, zippers or buckles. There is no need to fast or restrict fluid intake prior to an MRI unless you are undergoing a test that requires the injection of gadolinium, in which case two hours of fasting are strongly recommended. Before the procedure you must remove any metal-containing devices like hair pins, keys, coins, eyeglasses, jewels, hearing aids, or clothing containing metallic zippers. Bear in mind too that credit cards, watches and mobile phones are damaged if exposed to the MRI magnetic field. They can also damage some medical implants such as pacemakers, some types of valves for hydrocephalus (not all), prostheses and aneurysm clips (only non-titanium). Most of aneurysm clips used since 1985 are compatible with MRI. For this reason, we will ask about your medical history

WHO should NOT get an MRI?

Titanium implants are MRI compatible. However, since the MRI is magnetically generated, it is not recommended in the presence of the following medical implants: ferromagnetic cerebral aneurysm clips, cardiac pacemakers, electrical nerve stimulators, metal foreign bodies in the eyes, and cochlear implants.

Most joint implants are ferromagnetic but as are firmly attached inside bone they will not move and so do not pose a problem.

People with long bone or pelvic external fixation devices, with retained bullet fragments or with internal metallic surgical staples from previous healed surgeries should be evaluated prior to the procedure. Although stainless steel metallic instrumentation in the spine is not a contraindication to MRI evaluation, it can obscure the images and so patients are advised other diagnostic testing methods, like CT scans. Nowadays, however, most spinal instrumentations are made from titanium and are thus compatible with MRI imaging.

Pregnant women, especially those in the first term, and those with severe claustrophobia are also advised against MRI.

What happens with any medicinal herbs I take?

People take herbs for many reasons, amongst which we may find to improve health, to care for chronic conditions, or to treat pain. However, the fact that they are herbs does not make them less dangerous than drugs. Actually, if they are useful it is because they have some chemical agent that takes the desired action. Like all drugs prescribed by doctors, herbs can have the desired benefits but may also have adverse side effects or cause unwanted drug interactions, just like drugs, as well as causing problems such as gastric bleeding and kidney lesions.

Another problem is the tendency to think that, since herbs are good, the higher the dose, the better the results. In fact, however, the chemical constituents of herbs can be harmful if the dose is too high and calculating the exact dose is very difficult, for each batch of herbs may contain a different dose of active product. In addition, herbs have many components that can function differently depending on when you harvest the herb and how it is processed or packaged, and there may be contamination during these processes: traces of heavy metals have been found in some Asian herbal products.

Even the herbs that are generally safe may be dangerous or have side effects under certain conditions, e.g. they may interact with drugs used for anaesthesia or complicate any surgical intervention if they slow blood clotting.

Many supplements contain active ingredients that cause very strong biological effects and are not safe for everyone. Dietary supplements including herbs may pose risks under certain circumstances, such as pregnancy, lactation, or if the patient has a chronic disease. These risks include diabetes, hypertension, heart disease, liver or kidney disease… However, vitamins and mineral supplements can generally be taken without problem.

So tell us without shame about any medicinal herbs you are taking, especially if you are having surgery, because many of these herbs alter blood clotting. For example, the Sintrom ® (an anticoagulant), ginkgo biloba (an herb), aspirin (an anti-aggregating) and vitamin E can reduce blood clotting. Thus, taking these products at the same time may increase the risk of bleeding. And St. John’s work reduces the effectiveness of anti-AIDS medication, may aggravate kidney disease, and reduce the effectiveness of drugs used in heart disease, nervous depression, seizures, certain cancers or birth control pills.

To avoid any problems it may be advisable to stop taking herbal medicines at least 1 week before surgery. The most dangerous herbs most dangerous are those which alter the coagulation or blood pressure.

Remember not to trust the specifications that come in the packaging of herbs. On one hand there is not always state control (Ministry of Health) on what is said on the package, and on the other the herbs are often imported from other countries where health controls are not as strict as might be desired.