My Surgery: Aortobifemoral and Axillobifemoral Bypass

Pre-Admission Visit

You will have an appointment at the Pre-Admission Clinic within two weeks before your operation. This visit is very important to assess your health and help you prepare for your operation and recovery. Plan for your visit to take 2–5 hours. On the day of your pre-admission visit, take your medications and eat as usual, unless you were given other instructions.

What should I bring to my pre-admission appointment?

• Your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver's license or passport.
• Any other insurance cards. You will need the policy number of your extended health insurance, if you have any.
• Your spouse/partner, a trusted friend or family member (to offer you support and be a second set of ears).
• All the medications you take in their original containers. This includes prescription medications, over-the-counter medicines, vitamins, supplements and herbal or natural products.
• A copy of your power of attorney for personal care and/or advanced directives.
• A list of any questions that you may have about the operation and recovery.
• The name or phone number of your pharmacy, as well as any medical specialists that you have seen in the past 3 years.
• If you have had a cardiac stress test, echocardiogram and/or a pulmonary function test in the past 3 years, it would be helpful to bring a copy of the final report with you to this appointment.

What happens during my pre-admission visit?

• You will have blood tests and routine skin swabs. The swabs are taken from your nose and other areas of your body to check for germs that can cause infections.
• You may also need an electrocardiogram (ECG) to check your heart and a chest x-ray to check your lungs.
• You will meet many health care providers during your pre-admission visit. Please feel free to ask them any questions that you may have.
• A pre-admission nurse will review your health history and give you information to prepare you for your operation, including directions for cleaning your skin, eating before your operation, taking your medications and pain management.
• A pharmacist will review your medications.

Depending on your needs, you may also meet:

• An anesthetist who will review your health history, discuss your anesthetic plan and pain relief after your operation.
• A member of the medicine team, if you have other complex health problems.

The day before your surgery

• You must have a shower with soap and water to clean your skin the night before and the morning of your surgery to reduce the chance of infection after your operation.
• If you smoke, do not do so for 24 hours before your operation.
• Do not drink alcohol for 24 hours before your operation.
• Remove all nail polish and body piercings.

 Stop smoking before your surgery: learn how smoking and tobacco can affect your recovery after surgery, and how quitting can improve your health.

What Should I do the day of my surgery

Arrive 2 hours before your scheduled operation time.

What can I expect to have on my body?

After your operation, you will go to the Post Anesthetic Care Unit (recovery room) where the nurses will care for you until you wake up. When you are ready, you will go to the Step-Down Unit in the Cardiovascular Intensive Care Unit (CVICU). After a day of intensive care, you will go to the Vascular Surgical Inpatient Unit for the rest of your hospital stay.

You will continue to recover when you return home.

Activity	How to manage at home
	Eating well helps your body heal and recover. Eat a variety of foods from the four food groups.
	Some pain medications can cause constipation. To prevent constipation, drink lots of fluids and eat foods that are high in fibre, such as fruits, vegetables, whole grain breads and cereals. Avoid excessive straining when you have a bowel movement.
	Check your incisions each day. You may notice some bruising at first and they may be tender to touch. Keep your incisions clean and dry. Do not put cream, ointment, powder or lotions on your incisions. Some swelling in your operated leg is normal. This will gradually get better.
	You can have a shower 2 or 3 days after your operation. Gently wash your incision with soap and water. Rinse well and pat dry with a clean towel. It is best to wait to have a bath when your incisions have healed.
	Do not do strenuous activities or lift anything heavy (over 10 pounds or 4.5 kilograms) for 4 to 6 weeks
	Regular physical activity can help you recover and return to your usual activities as soon as possible. Being active also has long-lasting benefits for your health. Start slowly. Take short walks around your house, with rest periods in between. Gradually walk a little farther and a little faster. You are likely to feel tired at first, but this will slowly get better. Plan time to rest during the day. As you get stronger, you can gradually take on your usual activities.
	Do not drive for 4 to 6 weeks after your operation.

Where and when

About 1 week after your discharge, you will follow-up with your family doctor.

About 4 to 6 weeks after your operation, you will follow-up with your surgeon's office.

Who do I call with general post-operative questions?

For non-emergency questions, call one of the Vascular Surgery Nurses below.

Sue DeVries, Nurse Practitioner
416 340 4266

Cindy Dickson, Vascular Clinic Nurse
416 340 3857

Please do not call these nurses to book appointments.

Call your surgeon's office:

Who do I call if I experience complications

Go to the hospital nearest emergency room if you have:

• Symptoms of a stroke (you suddenly can't see, you have trouble speaking, you can't move your hand, arm or leg or you lose consciousness.)
• New neck swelling.
• Difficulty breathing.
• Difficulty swallowing.

Call your surgeon's office if you notice the following symptoms:

• New headache.
• Leaking from your incision.
• Increasing redness, warmth and tenderness around your incision.
• Chills or fever greater than 38.5℃