Patient Information
BEFORE SURGERY
A surgical consultation will assess to see if you are a good candidate for surgery. The risks and benefits of surgery will be discussed with you. Once you have agreed to proceed, you will be asked to complete the necessary paperwork, including the consent form and the hospital’s health questionnaire.
If your imaging (e.g. x-ray, CT, MRI) was not performed at the hospital, Dr. Chang will not be able to access your images. Please call the imaging centre where you had your investigations and they will provide you with a secure, personalized link so Dr. Chang can access the images. Alternatively, they may provide a CD disc. Please bring this to your initial consultation with Dr. Chang.
Please also bring a valid OHIP health card. If your OHIP card has expired, please renew your OHIP card before your appointment with Dr. Chang. This can be done online (free of charge) at https://www.ontario.ca/page/health-card-renewal
Once you have made the decision to go ahead with your surgery, Preeya (Dr. Chang’s secretary) will call you to arrange a date for your surgery. Unfortunately, a surgery date will not able to be offered on the same day of your office visit.
Depending on your type of surgery and your medical history, you may also be booked for a pre-admission visit to be completed before your scheduled surgery date.
If you need to cancel or reschedule your surgery date, please call the office as soon as possible.
At this visit, you will be assessed by a pre-admission nurse and meet one of the anaesthesiologists. They will discuss the anaesthetic plan with you. Depending on your surgery, the anesthesiologist may discuss nerve blocks as part of your anaesthetic plan for sustained pain relief after surgery.
At this visit, you may also have to undergo any necessary pre-operative bloodwork or investigations. You may also meet with a medicine specialist to assess your fitness to proceed with surgery. They may also make recommendations around medications you are currently taking. For example, you may be asked to hold certain medications prior to your surgery (e.g. blood thinners, immunosuppressants, Ozempic).
Please bring an up-to-date list of your medications with you to your pre-admission visit.
The pre-assessment clinic will give you instructions about which regular medications you should continue before surgery. Most of your regular home medications should be continued before and after surgery. Some medications, such as blood thinners or immunosuppressants, may need to be stopped prior to surgery.
DAY OF SURGERY
Please follow the pre-operative instructions you received from Preeya or your pre-admission clinic. Avoid eating or drinking after midnight the night before your surgery. If you have received instructions to continue any regular medications, you may have these with sips of water in the morning.
On the day of your surgery, please arrive at your scheduled time. Ensure you check whether your surgery will be at Cortellucci Vaughan Hospital or Mackenzie Richmond Hill Hospital.
Cortellucci Vaughan Hospital
3200 Major Mackenzie Dr West
Vaughan, ON L6A 4Z3
Mackenzie Richmond Hill Hospital
10 Trench Street
Richmond Hill, ON L4C 4Z3
Please bring an up-to-date list of your current medications.
If you already own a sling, please bring this with you on the day of surgery (if indicated). If you do not have a sling, the hospital will provide one post-operatively, but the hospital will send you an invoice.
If you have sleep apnea, please bring your CPAP machine with you.
If the plan is for overnight admission, please ensure you bring any personal belongings you may require during your admission.
Please check-in at patient registration where you will receive your patient ID wrist band. You will be brought to the day surgery unit where you will be provided with a patient dressing gown. A nurse will review your medical information and you will also meet your anesthesiologist to review your anaesthetic plan. Dr. Chang will see you before your surgery to confirm the procedure and mark the surgical site. Depending on the anaesthetic plan, you may be brought to the “block room” for your nerve block.
A nerve block is a method of regional anaesthesia to provide sustained, tartgeted pain relief during and after surgery. It works by infiltrating local anaesthetic (numbing medication) around some of the nerves that relay pain signals from the site of surgery.
The nerve block will be performed by your anaesthesiologist, and is typically performed under ultrasound guidance before your surgery.
This can last anywhere from 4 - 24 hours. Your arm may feel numb and heavy.
Your anesthesiologist will discuss the benefits and risks of performing the nerve block and together you will decide if it is right for you. The risk of nerve damage is extremely rare, with reports of 1 in 15,000-30,000 cases.
AFTER SURGERY
After your surgery is complete, you will be transferred to the PACU for routine monitoring post-surgery and x-rays (if applicable). You can expect to stay in the PACU for 60-90 minutes before being transferred to the day surgery unit. You will be able to be picked up in the day surgery unit by your family member or designated accompanying person.
The vast majority of patients will be able to go home on the day of surgery. If you require hospital admission overnight, you will be transferred directly to your room on the surgical floor from the PACU where your family can wait for you.
In addition to visiting you in the PACU, Dr. Chang will speak to your designated contact person after the surgery is complete.
Depending on the type of surgery, a physiotherapist may visit you after surgery to teach you exercises that you can start at home. At your first post-operative visit, Dr. Chang will review your personal physiotherapy rehab protocol with you.
The day surgery nurses will review the post-operative medications you have been prescribed. If you have had a nerve block, it is recommended you start taking the pain medications before the nerve block has completely worn off.
Please refer to your post-operative instructions for specific information about your dressings.
Please keep the clear, water-resistant adhesive dressings on until you see Dr. Chang for your first follow-up appointment. You may shower with the water-resistant dressings on, but do not bathe or submerge the incisions until they have completely healed.
If you have a bulky dressing, the tensor bandage and cotton can be removed two days after your surgery, but do not remove the clear, water resistant adhesive dressings.
Please refer to your post-operative instructions for specific information about your sling.
Typically, your sling should stay on 24 hours a day apart from hygiene and the exercises the physiotherapist showed you after your surgery.
If your sling was only required for the nerve block, then this can be discontinued once the nerve block has worn off.
Please refer to your post-operative instructions for specific information about your splint. It is important to keep your plaster splint as dry as possible.
If you would like to shower, you may cover the splint with a plastic bag and completely seal it with tape.
Your first post-operative follow-up appointment will usually occur approximately 2 weeks after your surgery. A this visit, your wound will be assessed, and your sutures/staples will be removed. If applicable, an x-ray will also be performed.
All follow-up appointments will be located at the Orthopaedic Fracture Clinic at Mackenzie Richmond Hill Hospital. Preeya will arrange your appointment date and time before your surgery takes place.