Pre-Procedure Instructions
for Procedures at Fairfax Hospital

You will be scheduled for a procedure at Fairfax Hospital. It is very important that you read the following information. We hope you will find this information helpful. Our office will make every effort to make this procedure as stress free as possible.

  1. DO NOT EAT OR DRINK ANYTHING after 12 o'clock midnight the evening prior to your procedure. For procedures scheduled after 2 p.m., a very light breakfast is allowed (i.e., toast but, no sooner than eight hours prior to the procedure). You may also have 8 ounces of clear liquids (one cup) (i.e., water, black coffee, black tea, apple juice, ginger ale, Sprite, Jell-O – NO CREAM OR ORANGE JUICE).

  2. Unless instructed otherwise on the day of the surgery you may take all your routine medications with sips of water, with the following exceptions:
    1. Oral Hypoglycemics (Diabetes Medications)
    2. The insulin dosage may be adjusted. The usual procedure is to administer half the usual dose in the morning. The interviewing nurse or your primary care physician will be able to help you with this matter.
    3. ALL ASPIRIN AND NON-STEROIDAL ANTI-INFLAMMATORIES SHOULD BE DISCONTINUED 10 DAYS PRIOR TO YOUR PROCEDURE. (e.g. Motrin, Ibuprofen, Advil, Aleve, Naporsyn, Vioxx, etc.) this also includes over the counter Medicines: Vitamin E, Ginkgo Biloba and glucosamine-chondroitin. Tylenol may be used for pain relief.
    4. If you take COUMADIN, HEPARIN OR LOVENOX it is usually discontinued 3-5 days prior to the procedure. Again, the interview nurse or primary care physician an /or cardiologist will be able to assist you with the exact directions. In some cases we will be informed and in return will inform you on any instructions.

  3. It is very important that you arrive at Fairfax Hospital an hour and a half prior to your procedure. It will enable the hospital to prepare you for your procedure.

  4. The usual routine for our office is to obtain the pre-surgical authorization from your insurance company with the understanding that some procedures will not be covered by your insurance company. If that is the case, you will be contacted by my office and other arrangements will be made. There are some instances where we will need a referral from your primary care physician and will request your help in obtaining that information for us.

  5. Please contact your insurance company to find out where your insurance company allows you to have your preoperative testing.

  6. Please call Pre-Surgical Services of Fairfax Hospital 8503 Arlington Blvd #200 as soon as possible at 703.208.2525. They will help you schedule your preoperative blood work, and EKG if needed, and your pre-surgical interview with a Fairfax Hospital nurse. This all must be done prior to the surgery. The blood work is best done within 2 weeks prior to the procedure. If you have your preoperative testing done at another facility other than Fairfax Hospital, please have them fax the results to our office at 703.876.0290 ASAP.

  7. Sometimes it is required to have a medical clearance from a physician. All that means is that you need to have a physical for pre-op purposes from your primary care physician, internist, and/or cardiologist. If this is the case, you will be informed by our office.

  8. If your procedure is done on an outpatient basis you will be allowed to go home the same day. YOU WILL NEED TO HAVE A RIDE HOME! YOU MAY NOT TAKE A TAXI.

  9. Please bring comfortable clothing for your ride home.

  10. If you are planning on donating your own blood or having another person donate for you, you must obtain the proper request forms from our office. The donation center's phone number is 703.204.3366. THIS MUST BE ARRANGED AT LEAST 3 (THREE) WEEKS PRIOR to your procedure.

  11. You Do or You Do Not need pre-operative testing. If you do, please use the testing order form(s) enclosed.

  12. Special Instructions from your doctor:___________________________________

Please call our office if we can assist you in any way!

Arrival Time to Hospital: ____________________

Estimated Time of Surgery: __________________

Date: __________________


Commonwealth Urology

3020 Hamaker Court, Suite B-111
Fairfax, Virginia 22031-2220
Tel: 703.876.0288
Fax: 703.876.0290
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