WHAT TO EXPECT

Initial Consultation

This will be when and where you will meet Dr.Wong in his office. Please plan to arrive 30 minutes prior to your scheduled appointment to ensure plenty of time to register and fill out your paperwork. You will need to have your insurance information, copay if necessary, any previous X-rays, CT scans, MRIs, and EMG / nerve conduction studies (if they have been previously performed). Please also bring any medical records that you feel are pertinent. Please feel free to download and print your intake forms (from this website) to bring with you to your first visit. You will find them under the tab labeled “patient information”.

You will be taken into an exam room where your vitals will be checked and other questions will be asked of you by our staff. Dr.Wong spends quality time with each and every patient and occasionally he must spend more time with a patient which places him behind schedule. If this occurs, please be patient as Dr.Wong will not rush through your visit and will spend as much time as necessary to answer your questions.

During this visit it may be necessary to undergo an X-ray examination. This is performed on-site by Dr.Wong, who is licensed by the Radiologic Health Branch of California. You will be asked to wear a protective lead apron that will be provided to you. If your physical examination and condition warrants, Dr.Wong may also recommend that you receive a steroid injection, a splint, or even a cast. Regardless of the method of treatment, you will be fully informed of the risks, benefits, alternatives, complications, and efficacy of any proposed treatment. You may further read about these treatment options located under the “patient information” tab on this website.

If your condition requires follow-up, an appointment will be made for you on your way out. Should Dr.Wong recommend surgery, and should you agree after having all of your questions answered, you will undergo a brief history and extended physical examination of your heart, lungs, and neck. You will meet our surgery scheduler and will be given all of the information needed to prepare you for surgery.

Pre-operative Visit

If you and Dr.Wong decide that surgery is necessary AND, that it will be performed WITHIN the next 30 days, then an extended physical examination will be completed during the same visit. All paperwork will be completed at this time and (within the next few days) you will be sent to the hospital / surgery center for the “pre-op visit”. Here you will be asked many of the same questions, and depending on your age, gender, condition, and overall health you may receive:

  • A chest X-ray
  • General X-rays of your extremities
  • Blood work
  • EKG
  • A pregnancy test
  • Other examinations deemed necessary for your safety

If you elect to have your surgery AFTER 30 days, then you may be asked to schedule a return visit to complete all of the paperwork and items listed above.

Day of Surgery

At Home If your surgery is elective in nature and you have no open wounds, bandage, splint, or cast in place then you will likely be instructed to bathe the night before with a special soap known to help eliminate common bacteria responsible for surgical infections. You will also be expected to have nothing to eat OR drink after midnight (termed N.P.O) before your scheduled surgery. We understand that this is unpleasant and difficult however, this is in place for your safety so that we minimize the risk of lung complications which can result in pneumonia, prolonged intubation in the ICU, and even rarely it can result in brain injury and / or death. So as you can see it is very important to follow this order. One exception exists and depending on your co-existing medical conditions you may be instructed to take certain medications (heart, seizure, etc..) with a small sip of water in the morning.

Pre-operative Holding Area This is where your day at the hospital will begin. Your nurse will verify your identity and ask you to wash your hands and arms with the same special soap. An IV will then be inserted in your arm on the side opposite to your surgery. Dr.Wong will meet you to answer any questions that you and your family may have. He will verify the correct procedure and the site of operation. He will then mark your skin with his initials using a marker that is semi-permanent. The purpose of this is to make sure the operation occurs at the correct site. You will be interviewed by the anesthesiologist who will also verify all of your information. Through your IV you will now receive medicine to help you relax. Once all of the above is complete you will be taken into the operating room. Your family and friends will now be waiting for you in the waiting room. It is likely that you will not remember much from this point forward as you will have been given medication that has a powerful amnestic effect.

If we have decided to perform your surgery under a “regional block”, meaning your arm is asleep, this will be administered either here in the pre-operative holding area or in the operating room. This will be decided upon by your anesthesiologist.

Operating Room The operating room is very bright and cold. We will do our best to keep you warm. Once in the operating room you will be asked to move from the gurney to the very narrow operating table. You will be secured to this table with a “seat belt” to keep you safe. The anesthesiologist will be at the top of the table near your head. Antibiotics will be administered at this time. There will be bright lights above you and as many as six or seven staff members in the room. Depending upon the nature of your procedure you will be provided sedation or general anesthesia. A tourniquet will be placed on your arm. Your arm will then be washed and drapes will be placed over your arm and body. These drapes will block you from viewing the operation. After the procedure is complete you will be transferred back to the gurney and will be transported to the recovery room. If you are placed under general anesthesia, you will require a tube be placed into your trachea or pharynx (throat) for us to breathe for you. This is for your safety. It is very common after this type of anesthesia to experience a “sore or itchy throat” (similar to when you come down with a cold and sore throat) in the next 12 to 24 hours. Occasionally it is a coincidence and you are “catching” a cold, but most likely it is due to the “breathing tube” and it will pass. You may use an over-the-counter throat spray like Chloraseptic® for relief following the manufacturer’s directions.

Recovery Room The recovery room or PACU (*P*ost *A*nesthesia *C*are *U*nit) is where you will wake up. It is likely you will be in this area for 30 minutes up to a few hours depending upon your condition. The nurses will continuously monitor your blood pressure, pain level, and the amount of oxygen in your body. If you experience pain or nausea you will be given appropriate medications. Once you have met the criteria for being discharged home, you and your “ride” home (family or friends) will be given specific instructions for your care. Likely, you will also be given a prescription for pain medication and perhaps an antibiotic. You will be transported to your vehicle via wheelchair.

If we previously planned to keep you in the hospital overnight, or should your pain or nausea not be controlled, you will be transferred / admitted to the hospital.

Post-Operative Care

Upon being discharged from the hospital you will have entered into the “post-operative” period. It is important for you to follow all of the instructions provided to you by Dr.Wong. You will be sent home with detailed instructions. These instructions will serve as a reference for you should any questions arise. If your questions or concerns are not answered by this guide, then please call the office (661-664-2200) to reach Dr.Wong or one of his partners on-call.

After surgery it is highly recommended that you rest. You should take the prescribed medications as directed. It is recommended that pain medication be taken around the clock as prescribed for the first 3 days, whether you are having severe pain or not. This is recommended so that you may “stay ahead” of the pain as trying to play “catch up” is difficult and often not successful. You will over the long term us less medication if you follow this recommendation. The only exception is if you become too sedated and then narcotic pain medication should be held and Dr.Wong expects to be contacted immediately. After 3 days, you may begin to wean yourself as per your tolerance to the pain. If an antibiotic has been prescribed for you, you **MUST* take and FINISH* the entire prescription. That said, if you experience nausea, vomiting, a rash, shortness of breath, or any other worrisome side effect, then you MUST STOP the medication and call Dr.Wong immediately. (661-664-2200)

Call 911 or proceed to the nearest Emergency Room for any true emergency. DO NOT waste time calling Dr.Wong.

Two types of pain are experienced after surgery. Sharp pain is created by your injury and by the operation itself. This sharp pain will respond to pain medications. Throbbing pain, or pain that feels like there is a heart beat in your arm or hand, is caused by swelling. Swelling does not reliably respond to pain medication and is best treated by elevation of the affected arm and hand above the level of your heart. You may have to keep your arm completely elevated, like raising your hand in elementary school, for up to an hour. If after this time you are not better, then you are advised to call Dr.Wong.

Likely, after surgery you will have a splint and a big, bulky dressing on your hand and arm. Unless specifically ordered by Dr.Wong, these dressings must stay on until you are seen back in the office (usually 10 to 12 days later). This means you must keep the dressings clean, dry, and intact. You must cover them when you shower or bathe.

Leading up to surgery you will have had nothing to eat or drink for at least eight hours prior to your operation. This often means you believe you will be extremely hungry after your procedure. It is recommended that you resume your diet slowly, beginning with bland, light meals and then progressing slowly to your regular diet as tolerated. It is important to drink plenty of water in the days before and after your surgery. By doing so, you will likely tolerate the operation better and hopefully it will help prevent post-operative constipation.

Again, if you have any questions or concerns, you are encouraged to call Dr.Wong sooner rather than later.