
Sir na Vascular Center
* Sirona is the Celtic Goddess of Health
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(415) 464-5400
"Everything about you depends on circulation." (Jack LaLanne)
Preparing for surgery.
Having surgery is stressful. Preparing yourself ahead of time can help reduce anxiety and set the stage for a positive experience. Please review the following instructions, and call us for any questions or concerns. We are here to help you.
1-2 weeks before

Make an appointment with your PMD for a history and physical.

Clarify with your surgeon the instructions for your medications. If you are on a blood thinner like plavix, aggrenox or warfarin, we will give you instructions on when to stop it. If you are taking aspirin, please continue this medication; do not stop it. If you are on a medication for diabetes (such as insulin, metformin, glyburide, januvia), you will be given instructions for modifying or holding your medication while you are fasting for the procedure. If you are a brittle diabetic or have an insulin pump, please discuss this with your endocrinologist. If you are on metformin (glucophage) and are undergoing an angiogram, you will be not taking this medication for several days following the procedure.

​Discontinue any herbal medications or supplements that are not absolutely essential.

If you are over 60, you will need to have an EKG and labs within a week of the surgery date.

Our office will be obtaining the insurance authorization for the surgical procedure. If there are issues with this, you will be advised in advance of the surgery date.


Discuss the surgery with your family, so that they have enough time to ask questions and arrange their schedules to provide assistance for you after surgery.

Make arrangements for your ride the day of surgery. You will not be permitted to drive yourself home.

Provide us with a cell phone number or a contact number where you will be the day prior to your surgery.
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If your alcohol consumption is greater than 3 drinks a night, if you consider yourself to have an alcohol addiction, or if you have ever suffered from alcohol withdrawal, please discuss this with your surgeon.

If you do not speak English, please try to arrange for someone to be with you who can translate for you. We also have a language line in the hospital to assist with translation.

Talk with your employer about your time off work. The number of days off work is not always predictable, and depends on the type of work you do and the type of surgery you are having. There may also be activity restrictions following surgery (like no heavy lifting). Discuss these issues with your surgeon. In general, for varicose vein surgery, people are off work for 2-3 days and have no specific activity restrictions afterwards.

If you are going to be staying in the hospital after surgery, make arrangements for your dependents (who will be taking care of the dog? etc)

If you have pre-existing disabilities and are undergoing a major surgery, you may benefit from a few days or weeks in a rehab center after the hospitalization. There is no need for you to arrange this ahead of time; there will be case managers in the hospital to help with this.

If you are traveling from a distance and need to make hotel arrangements for family, the hospital has contracts with local establishments and can help with this.
The day before

You will be given instructions about fasting prior to surgery. In general, you will need to have an empty stomach (no food, no liquids) for 8 hours prior to the procedure. This is to reduce risk of stomach contents refluxing into your lungs during anesthesia. You are permitted to take your medications with a sip of water.

If you are having a procedure at the hospital, pack a small overnight bag. It should have the following items:
- a list of your medications and doses
- a list of your important phone numbers
- a copy of your advanced directive, if you have one
- toothbrush and paste
- eyeglasses or contacts and contact solution and case (if applicable)
- dentures/case/cream (if applicable)
- ​hearing aids/case (if applicable)
- inhalers (if applicable)
- ​any special wound care items (if applicable)
- insulin pump, TENS unit (if applicable)
- CPAP machine (if applicable)
- consider: books, crosswords, music, earplugs, slippers, eyemask, neck pillow

Do not bring:
- any jewelry or unnecessary valuables
- cigarettes or candles or anything flammable. The hospital has a strict no smoking policy. We can assist you with nicotine patches or gum.
- Illegal drugs or weapons.


If you are having an abdominal surgery (open aneurysm repair), you may be given special instructions:
Liquid diet the day before (soups, shakes, jello, juice, milk)
Bowel prep starting early afternoon the day prior to surgery. Moviprep is available in the pharmacy. Follow the directions on the bottle. The goal is to decompress your bowels so that visualization is better during surgery and also so that you are not constipated after surgery. Do not wait until late in the day to begin this. The bowel prep may take several hours, and you will want to be near a bathroom while you do it.


Typically, you will receive a call from the anesthesiologist the day prior to surgery. He or she will review any anesthetic concerns you may have and will review the instructions for the following day.
The day of

Give yourself plenty of time to get to the hospital. You will be asked to be there 1 to 2 hours prior to the surgery time.

If you are going to the Marin General Hospital, you will check in in Admitting. This is on the second floor in the back of the building. There is free parking.

Unless otherwise instructed, take your normal morning blood pressure medication with a sip of water.

Relax. You are in good hands.