PRE-OP INSTRUCTIONS

Special note to patients using COUMADIN or WARFARIN. DO NOT stop your medication prior to surgery. Doing so increases your risk for stroke, deep vein thrombosis, and pulmonary embolism. Most patients on coumadin have no bleeding problems with skin surgeries if the medication level is in the therapeutic range.

Your surgery will be performed at our Clive Office. If you were originally seen in Newton, Pella or Indianola, please note that you need to come to the Clive office for your surgery. Directions to our office area available on our office answering system or at www.heartlandderm.com in the "Driving directions" section.

PREPARING FOR YOUR SKIN SURGERY

You may shower and shampoo the night before or the morning of surgery.

Wear a shirt that buttons all the way down (not a pull over). Wear no jewelry. If you're having face or neck surgery, do not wear make up and pull your hair back away from the surgery site.

Eat normal meals before surgery.

We recommend you bring a driver or make arrangements to be driven home if your surgery is going to be on the nose, upper face, around the eyes, or if you have a history of fainting with injections, medical or dental procedures.

Avoid ALCOHOL (wine, beer, whiskey) 48 hours before and 72 hours after surgery.

Smoking slows healing. DO NOT smoke 2 hours before and after surgery.

Tell the doctor if you have any allergies to medicines or have a bleeding problem.

Take all of your regular medications unless the doctor tells you not to.

Avoid taking vitamin E, niacin, fish oil tablets, or herbal supplements (garlic, gingko, ginseng, ginger) for two (2) weeks before surgery.

Don't use any aspirin-containing medications fourteen (14) days prior to surgery because they increase bleeding. Don't take aspirin unless your doctor has prescribed it for a medical problem. Only discontinue the aspirin for two (2) weeks before surgery IF YOUR FAMILY DOCTOR or Internal medicine doctor says this is okay. Other medications in the aspirin family can also increase the risk of bleeding and should be stopped 1 week prior to surgery (Motrin, ibuprofen, Aleve, Advil, etc).

TYLENOL DOES NOT CAUSE BLEEDING and may be used before and after surgery for headaches or aches and pains. This is a non-prescription medicine.

Please ask if you have any questions before, during, or after surgery. We want to work with you to make your surgery successful. The nurses can be reached at 515-224-7088 ext. 114