ERAS Program – Colorectal Surgery – Albany Medical Center


(upbeat music) Hello. I’m Doctor Brian Valerian, colorectal surgeon here at Albany Med. Our colon and rectal surgery program is considered the place to turn for colorectal surgery. As one of the best and busiest practices in the capital region, you’re in good hands with the Albany Med team. Known for our expertise and quality care. In this video, we’ll walk you through every step of your colorectal procedure. Preparing for surgery, what to expect the day of surgery, and your recovery both here at the medical center and after returning home. Understanding your care plan will help set you up for success and give you the best possible outcome. We’re glad you’ve chosen Albany Med for your care, and we’ll be with you every step of the way. After your surgery is scheduled, you’ll meet with one of Albany Med’s nurse navigators. They’ll be there to guide you throughout your care process and answer any questions you may have. Preparing yourself for colorectal surgery is the first step to getting better. Your surgeons want you to reduce stress and be as healthy as possible before your procedure. Some ways you can do this include being physically active every day, quit smoking and avoid alcohol for at least 24 hours before surgery. You should make a plan with friends and family, mapping out transportation, meals, and other tasks. The day before surgery, it’s very important to thoroughly clean your body. Hospital staff will explain instructions on the proper way to use the chlorhexidine bath wipes provided to you. Depending on your type of procedure, your surgeon will decide if you need to have colon preparation using a laxative. If you will be taking a laxative, drink only clear liquids the day before surgery like juice, broth or coffee and tea with no milk. Take your bowel prep as instructed. Make sure you drink plenty of fluids like water and Gatorade in the evening, and do not have any solid food, dairy products, or juice with pulp. If you are not instructed to take a laxative, eat and drink normally until midnight. After midnight, do not have any solid food including dairy products and juice with pulp. This could delay or even cancel your surgery. The morning of your surgery, use the cleansing wipes before leaving home and wear clean clothing. Don’t wear lotion, perfume, makeup, nail polish or jewelry and don’t shave the area being operated on. Remember, you can’t have solid food, milk or juice with pulp. You may drink clear beverages stopping one hour before arriving at the hospital. Be sure to bring your completed surgery guide booklet that lists your medications and physician contact information. Your booklet also has directions and parking information. When you arrive at Albany Med, report directly to the preoperative care unit check-in desk. A staff member will check you in, answer any questions and explain the next steps leading up to your surgery. After registering, a preoperative nurse will help you get ready for surgery. One family member or friend can accompany you to the preoperative area. During the surgery, they can wait in the surgical waiting area. Your nurse will have you change into a hospital gown, then check your weight and vital signs, go through a checklist with you, review your plan of care, place an IV, and give you any necessary medications. Albany Med’s multi-disciplinary approach means you’ll be cared for by several teams. The surgery team will perform your surgery and manage your care afterward. The pain team will explain and prep you for pain control, giving you a nerve block to numb your stomach. The anesthesia team will make sure you are asleep and pain-free during surgery. The nursing team will care for you before, during and after your surgery. After surgery, you’ll wake up in the post-anesthesia care unit. You will have an IV for fluid and medication, an oxygen mask and a urinary catheter. A nurse will be there to check your bandage and vital signs, as well as offer you a drink and ask about your pain. Although pain is to be expected after a major surgery, our goal is to make your pain tolerable and allow you to be functional. There are different pain management options that your pain doctor may decide are best for you. You’ll receive a nerve block, an infusion of local anesthetic to keep your stomach numb. When your care team decides you’re ready, you’ll be moved to another room to continue recovery and prepare for discharge. Your nurse will give you pain killers by mouth on a scheduled basis to help make you more comfortable. Morphine-like medicines are used sparingly because they can slow you down and cause serious side effects like breathing problems, nausea, and constipation. Your goal is to get out of bed and get your bowels moving again as soon as possible. After surgery, moving and exercise is important to restart your bowels and prevent serious complications like pneumonia and blood clots. The nursing staff will explain and help you with various leg, breathing and coughing exercises to do throughout your stay at the hospital. You are expected to get out of bed the day of surgery. There are daily goals to meet to ensure you can recover quickly. You will be able to go home when you are able to eat and drink well, start passing gas, are mobile, and can control pain with medicines by mouth only. When you return home to continue recovery, you may experience some pain for a couple weeks. Tylenol and your anti-inflammatory are safe to take for relief. If your pain doesn’t subside, call your doctor. To help your bowels stay regular and continue to heal, drink lots of fluids, eat whole grains, fruits and vegetables, start regular exercise, and take stool softeners if your doctor recommends it. You are allowed to shower and let water and soap wash over the area, but don’t scrub or take a tub bath for two weeks. It’s normal for your incisions to be slightly red and uncomfortable for one to two weeks after surgery. You should call your surgeon if your incision becomes warm, more red, hard, or drains pus. You have a fever, cannot drink fluids or keep them down, or you have pain that your medication does not help. Follow the nutrition and diet guidelines from your surgeon, avoiding foods you find upset your stomach. Foods high in protein will help your body heal. Don’t be alarmed if your bowel habits change after surgery. They will develop a normal pattern over time. Continue to be physically active and try to walk several times a day. When you are no longer in pain, you may resume most normal activities. We’re happy you’ve chosen Albany Med for your care. As one of our patients, you’ll be treated like family. Our goal is to make you as informed and comfortable as possible throughout your colorectal surgery and recovery. Be sure to talk to your surgeon and care staff about any questions or concerns you may have. We look forward to seeing you the day of your surgery, and supporting you through your healing process. (upbeat music)

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