WHAT CAN I EXPECT IN HOSPITAL?
On your arrival at the hospital, you will be greeted by the nursing staff who will take a brief nursing and medical history from you as well as recording your blood pressure, pulse, temperature and weight. An ECG and blood test is sometimes also required. You should have taken all of your normal medications on the day of surgery unless otherwise instructed. Insulin dependent diabetics should ask for special instructions.
If you were previously taking Warfarin (a strong blood thinner) Dr Bray will have asked you to stop taking it 5 days preoperatively and a blood test will be done on admission to confirm clotting has returned to normal. Clopidogrel (Plavix or Iscover) needs to be stopped 10 days prior to the procedure.
On the morning of admission you are required to have a Chlorhexidine antiseptic wash. Please purchase the Chlorhexidine from your local pharmacy.
On the ward, nurses will prepare you for theatre. You will continue to fast (i.e. no eating or drinking) and you will be required to have your legs and groin areas shaved and dressed in the appropriate theatre attire provided. Ensure that you have brought your stockings with you as in some cases these are applied in theatre.
Your anaesthetist will visit you prior to your operation to obtain a relevant medical history and carry out a medical examination to ensure your fitness for the surgical procedure. Dr. Bray will also see you in the anaesthetic area prior to surgery, at which time he will mark out the veins on your legs with a marking pen. If all the troublesome veins are not marked, please advise Dr. Bray at that time. This ensures that the varicose veins are readily identified and removed during the operation. In some cases Dr Bray will have arranged for an ultrasound the day prior to surgery to mark a deep vein using ultrasound. This is so that a small incision can be made directly above the varicose vein rather than “searching” for it with a larger incision. If your legs are marked you will need to ensure these marks do not come off in the shower and remark them with a permanent marker if fading. The nurse admitting you can do this for you if need be.
At the appropriate time you will be transferred to the Operating Theatre on a trolley by a nurse and an orderly where you will then be cared for by the theatre staff.
IN THE OPERATING THEATRE
The actual operation takes 45 to 60 minutes for each leg. You will be asleep during the procedure as a general anaesthetic is preferable, but if there are contra-indications for this, or you prefer, a spinal anaesthetic can be given. You should discuss this with the anaesthetist during the pre-operative assessment.
AFTER THE OPERATION
You will wake in the recovery ward where you will be closely supervised by nursing staff. Your legs will be bandaged quite firmly, and this may feel uncomfortable but it should not be painful. Some discomfort can be relieved by upward, downward and circular movements of the feet and toes. These movements create a pumping action in the calf muscle which assists in clearing blood from the leg, thus reducing the ache. The foot end of the bed will be elevated to assist in the drainage of blood from your limbs. If your discomfort is not alleviated by these routine measures the bandages can be loosened or the nursing staff will administer medication to relieve this.
BACK IN YOUR WARD
When you return to your bed you may notice the foot of the bed elevated. It will remain in that position until you are discharged. Staff will encourage you to continue the foot movements mentioned previously. If the bandages are uncomfortable, it is important that the nursing staff are informed so they can be loosened. Your comfort is our primary concern.
Intravenous fluids will be given to you through a vein in your hand or arm. This may continue until the next morning if you are feeling nauseated and unable to drink and eat normally, otherwise it will be removed that evening. Normally you can have a light meal in the evening after your operation.
A nurse will assist you to wash and help you into your own bed clothes during which time you should remain in bed. After 4 hours you will be encouraged to go for a short walk to pump the blood through the deep veins of the leg to reduce the risk of clots developing in the deep veins of the legs. You will also be given an injection of heparin which is a blood thinner in the evening for the same reason. If you wish to go to the toilet, please seek the nurse’s assistance as your legs will be sore and the anaesthetic and pain medications can make you quite unsteady.
That evening if the legs are aching unduly in any area, it is important that you notify your nurse. It may be relieved by re-bandaging your legs as the bandage may be pressing on a tender area. If this is not effective, the nurse will be able to give you medication to relieve pain and help you sleep.
Return to Varicose Veins – Surgery information.