Care and Compassion You Deserve.

Care and Compassion You Deserve.
Surgery Preparation Guide
IMPORTANT SURGERY INFORMATION
Date of Surgery:
Time of Surgery:
Suture/Dressing Appointment:
First Post-Operative Appointment:
Remember not to eat, drink or smoke anything after
midnight on the day before your surgery!
NOTES:
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About The NeuroSpine Center
Welcome to The NeuroSpine Center, a specialized outpatient surgery center dedicated to spine.
The NeuroSpine Center is equipped with a large, comfortable reception and waiting area, a
private preoperative area, two operating rooms and a recovery area. We pride ourselves on
providing each patient with a positive surgical experience and top-notch customer service.
The NeuroSpine Center is located on the second floor of the Eden Road Medical Center at 730
Eden Road, adjacent to Lancaster NeuroScience & Spine Associates’ Main Office.
OUR NEUROSURGEONS
STANDING:
Eddy Garrido, MD
James Thurmond, MD
Christopher Kager, MD
Keith Kuhlengel, MD
SEATED:
Kristine Dziurzynski, MD
William Monacci, MD
Contact Information
FOR ALL EMERGENCIES:
717.569.5331
After office hours, weekends, and holidays, the Medical Bureau will answer and
the doctor on call will contact you as soon as possible.
MAIN OFFICE NUMBERS
LEBANON OFFICE NUMBERS
MAIN OFFICE:
717.569.5331
800.628.2080
MAIN OFFICE:
717.454.0060
MAIN OFFICE FAX:
717.569.4210
MAIN OFFICE FAX:
717.454.0062
NEUROSPINE CENTER OFFICE NUMBERS
MAIN OFFICE:
717.509.6510
MAIN OFFICE FAX:
717.509.1890
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PREPARATION FOR SURGERY
PREPARING FOR SURGERY
Your doctor will discuss your operation with you. Be sure to tell your doctor about any
medications you may be taking and ask whether or not you should take them on the day of
surgery.
You will receive a phone call from a member of the nursing staff at The NeuroSpine Center
within one week prior to your surgery. If you do not hear from the staff please call The
NeuroSpine Center at (717) 509-6510 between 8am and 3pm for your instructions. It is
very important to answer all questions honestly. All information provided will be kept
confidential.
It is important for you to receive your preoperative instructions. Your surgery could be
cancelled if we are unable to reach you prior to surgery.
If a change occurs in your physical condition prior to surgery, such as a cold, rash, sore
throat, cough, fever, or upset stomach, notify your surgeon. The doctor may wish to
reschedule your surgery.
TRANSPORTATION ARRANGEMENTS
If you are receiving anesthesia or sedation you must make arrangements for someone to
accompany you during your entire stay at The NeuroSpine Center as well as providing
transportation to and from your home. If you have general anesthesia, a responsible adult
must be at home with you for the 24 hour period immediately following your procedure.
Patients under the age of 18 must be accompanied by a parent or guardian who will be
required to remain in the center at all times during the minor’s surgery. If you are unable
to arrange for an escort, please inform us as soon as possible, as it may be necessary to
reschedule your surgery.
A waiting room is available for the comfort of your escort with complimentary coffee, tea
and hot chocolate, as well as a vending machine if needed. Complimentary Wi-Fi is
available throughout The NeuroSpine Center.
To ensure safety and confidentiality, we do not routinely allow family members or
companions in our recovery area until time of discharge instructions.
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PREOPERATIVE INSTRUCTIONS
PREOPERATIVE CHECKLIST
• The NeuroSpine Center office staff will provide you with the time you should arrive at The
NeuroSpine Center the day of your surgery. Your arrival time is typically 1 to 1 1/2 hours
prior to your scheduled surgery.
• You will have specific bathing instructions to be completed on the evening before your
surgery and the morning of your surgery to reduce the number of germs present on your
skin. Please refer to the bathing instructions on page 6.
• Do not eat, drink, or smoke anything after midnight the day before your surgery.
VERY IMPORTANT
• You may brush your teeth but do not swallow any liquid.
• Do not chew gum, lozenges, hard candy and/or chewing tobacco.
• Please remove all nail polish.
• If you are having any arm or hand surgery you will need to remove all artificial nails.
• If you are diabetic you must check with your physician as to the dose and time to take
your medication prior to arriving at The NeuroSpine Center.
• If you routinely take a medication that thins the blood, you must speak with your surgeon
about when to stop this drug and if you need any blood tests before surgery.
• You must stop aspirin, anti-inflammatory medications and/or anti-coagulants for 7 days
prior to your surgery.
• Plavix must be stopped 10 days prior to surgery.
• Vitamin E, fish oil and all herbal supplements must be stopped 7-14 days prior to surgery.
• If you use a continuous positive airway pressure (CPAP) machine to sleep at night, you will
be instructed to bring your machine with you to the NSC on the day of your surgery.
• Do not bring valuables such as jewelry, purses, money, etc.
• If you are unable to keep your appointment or you are delayed, please contact The
NeuroSpine Center at (717) 509-6510 immediately.
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IMPORTANT BATHING INSTRUCTIONS
COMPLETE THE SHOWER OR BATH ON THE EVENING PRIOR TO AND THE
MORNING OF SURGERY.
PURPOSE
To reduce the number of germs present on your skin.
SUPPLIES
1. Obtain one (4) ounce 4% Chlorhexidine Gluconate (CHG) bottle.
• CHG is a soap used to clean the skin.
• Hibiclens is the brand name and it is available at local drug stores.
• CHG soap can be purchased at the surgeon’s office for $5.
2. Freshly laundered towels for bathing and clothes to wear after bathing.
INSTRUCTIONS
1. Moisten skin with water.
2. Apply CHG soap to a clean wash cloth like any other liquid soap. Use approximately
half of the bottle. Save the other half for the following morning.
VERY IMPORTANT
3. Wash your body from the neck down including skin folds, armpits, groin, fingers and
nails. Turn off the shower and wait 5 minutes before rinsing.
4. Rinse thoroughly.
5. Avoid getting CHG into your eyes, ears or mucous membranes (vagina). If CHG gets
into your eyes, rinse for 15 minutes and seek medical attention.
6. Use a clean dry towel.
7. Do not apply lotions or powders.
8. Wear freshly laundered clothes after bathing.
ADDITIONAL INFORMATION
• Do not use regular soap in addition to CHG.
• Underarm deodorant may be used.
• Avoid shaving any part of your body for 4 days prior to surgery. Patients may shave
their face during the 4 days prior to surgery but should not shave the morning of
surgery.
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DAY OF SURGERY
BRING THE FOLLOWING ITEMS WITH YOU
 Photo ID
 Insurance cards or forms
 Any co-payments needed for the admission process
 Do not wear contact lenses to The NeuroSpine Center on the day of surgery
 A list of all medications you currently take and any inhalers you currently use
 A driver who will be asked to remain in the building while you are in surgery
 Wear loose, comfortable clothing and simple shoes to make getting dressed easier
after your surgery
WHEN YOU ARRIVE
Once you have registered, a nurse will escort you into the preoperative area, where your
pulse, temperature, respiration, and blood pressure will be taken. You will be asked to
change into a gown provided by The NeuroSpine Center. Your clothes will be placed in a
secured locker until you are ready to be discharged. For those patients receiving
anesthesia and sedation, an I.V. will be started.
Your anesthesiologist, surgeon and operating nurse will visit you in the pre-op area and will
re-verify information and answer any questions you may have about your surgery. Your
surgeon will ask you to assist with identifying and marking the location of your surgery.
RECOVERY
After surgery you will be taken directly to the recovery room where you will again be
monitored by nurses. The length of time you remain in recovery depends on several
factors including the type of procedure, your pain level and your ability to tolerate fluids.
Estimated recovery time is 1-2.5 hours.
You will be given something to drink and a snack during the recovery phase. Once you are
fully recovered the nurse will review and give you discharge instructions.
Rarely, patients may need to be admitted to the hospital for specific medical reasons. If
this need arises, be assured that this decision will be made in conjunction with anesthesia
personnel and your surgeon. If this decision needs to be made you would be transferred
by Manheim Township Ambulance Service to Lancaster General Hospital.
SURVEY AND FOLLOW-UP
You will be asked to complete a patient satisfaction survey on the care you received during
your stay. Your comments are very important to us and will help us improve our services
and provide the finest care possible.
A member of the Surgical Center staff will call you the day after your surgery to check on
how you are doing.
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FINANCIAL INFORMATION
FINANCIAL BREAKDOWN
The NeuroSpine Center takes great pride in assuring that every patient receives the highest
level of service. This also applies to the way our Business Office handles your account. To
help you understand the various issues related to payment of your surgery we have
prepared the following:
• The “total” cost of your surgery may be comprised of a number of charges and bills.
Your surgeon will generate a bill for his professional services in addition to The
NeuroSpine Center generating a bill for their “facility”, which includes some of the
following items:
• Use of the operating room and surgical equipment
• All supplies and medications used during your surgery
• Provision of nursing personnel for your care
• The administration of anesthetic agents are provided and/or supervised by an
anesthesiologist; a separate bill will be generated by the anesthesia company for
their services. Any pre-surgical testing or specimens obtained during the procedure
will also be billed separately to your insurance plan by the facility providing those
services.
• We will submit a claim, on your behalf, to the insurance company for our facility fee.
You will be financially responsible for any deductible, co-pay and/or co-insurance, as
determined by your individual plan coverage.
• If you do not have insurance, payment will be required on or before your service
date. We will estimate the cost prior to your procedure for our facility fee only. Our
Business Office will contact you to discuss a payment method; we accept cash,
check, VISA, Discover or MasterCard.
QUESTIONS
Should you have any questions regarding your financial responsibilities with The
NeuroSpine Center, you may call our Billing Coordinator at (717) 581-4804
OWNERSHIP DISCLOSURE
You are being referred to The NeuroSpine Center for a procedure that the surgeon has
recommended. You have a right to know that the surgeon has an ownership interest in The
NeuroSpine Center.
The physician is confident that you will receive prompt, courteous and professional care at
The NeuroSpine Center. However, you are free to have your procedure performed at a
facility of your choice. At your request, we would be happy to supply you with the names
of other ambulatory care centers in our area.
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AFTER YOUR DISCHARGE
You will be given specific written instructions regarding your care upon discharge from The
NeuroSpine Center. It is very important that your escort is present during the post
operative instructions, as you may experience difficulty remembering said instructions due
to the anesthesia. Our recommendations include:
• Have an adult stay with you for at least 24 hours directly following your surgery.
• Rest and relax - Follow your surgeon’s recommendations for resuming your normal
activities.
• Eat a light meal when you feel hungry - heavy meals may cause nausea.
• Follow your surgeon’s instructions for resuming any medications as well as pain
medication that may have been prescribed. You will receive instructions specific to
your surgical procedure and anesthesia in general at the time of discharge.
• Please be aware of restrictions and/or limitations when taking narcotic medication.
• Do not drive, drink alcoholic beverages or operate heavy machinery for at least 24
hours directly following your surgery (or as directed by your surgeon).
• It is natural to experience some discomfort in the area of the operation. You may
also experience some drowsiness or dizziness for the first 24 hours directly following
your surgery.
• Please contact your surgeon’s office at Lancaster NeuroScience & Spine Associates
at (717) 569-5331 immediately if you experience any problems following your
surgery.
NEUROSURGEONS
Eddy Garrido, MD, FACS, FRCS (C)
• University of Santo Domingo Medical School
• Neurological Surgery Residency: Tufts New England
Medical Center
• Pediatric Neurosurgery Fellowship: The Hospital for Sick
Children, Toronto, Ontario
Co-Chairman, Gamma Knife Center, Lancaster General Hospital
Joined the practice in 1981
Keith R. Kuhlengel, MD, FACS
• Washington University School of Medicine
• Neurological Surgery Residency: Washington University
Barnes Hospital
• Fellowship in Neurobiology of Spinal Cord Injury:
Washington University Barnes Hospital
Chief of Neurosurgery, Lancaster General Hospital
Joined the practice in 1995
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NEUROSURGEONS
Christopher D. Kager, MD, FACS
• University of Pennsylvania School of Medicine
• Neurological Surgery Residency: University of Cincinnati
Medical Center
• Fellowship in Spinal Surgery: The Cleveland Clinic Foundation
Joined the practice in 2001
William T. Monacci, MD, FACS
• Uniformed Services University, Health Sciences
School of Medicine
• Neurological Surgery Residency: Walter Reed Army
Medical Center
• Research Fellowship: National Institute of Health
• Cranial Base and Micro-Neurosurgery Fellowship:
George Washington University Hospital
Joined the practice in 2006
James C. Thurmond, MD
• Indiana University School of Medicine
• Neurological Surgery Residency: University of
Medicine and Dentistry, New Jersey
• Endovascular Fellowship Year: University of Medicine
and Dentistry, New Jersey
Joined the practice in 2009
Kristine Dziurzynski, MD
• University of South Alabama
• Neurosurgical Residency: University of Wisconsin
Hospitals and Clinics, Wisconsin
• General Surgery Residency: University of South
Alabama, Alabama
• Skull Base Fellowship: Oregon Health Sciences
University, Oregon
Joined the practice in 2013
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ADDITIONAL NOTES
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The NeuroSpine Center
)
72
(Rt
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nP
ike
Ore
go
Sheetz
Eden Road
Drive
Crooked Oak
Lititz Pike (Rte. 501)
Eden Road Medical Center • 730 Eden Road, 2nd Floor
Lancaster, PA 17601 • (717) 509-6510
Eden Resort/
Best Western
Rte. 30 By-
Pass
Directions
The NeuroSpine Center is located on the second floor of the Eden Road Medical
Center, adjacent to Lancaster NeuroScience & Spine Associates’ Main Office. In
addition to the NeuroSpine Center, the building is home to the MRI Group, Eden
Physical Therapy, and The Lancaster Family Allergy Group.
From Route 30, take exit for Oregon Pike north. Drive one-tenth of a mile north
on Oregon Pike to the intersection at Eden Road. Go right onto Eden Road (at
Sheetz), past the Best Western Hotel/Eden Resort. Drive a half-mile to entrance
of the NeuroSpine Center (just past Crooked Oak Drive) on right.
The NeuroSpine Center is in partnership with Lancaster General Hospital.
1671 CROOKED OAK DRIVE, LANCASTER, PA 17601
717.569.5331 • TOLL FREE IN PA 800.628.2080
FAX 717.569.4210
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