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Brenton R. Jennewine, M.D.
Orthopedic Surgeon, Shoulder & Elbow Specialist
Before Your Surgery
Thank you for choosing myself and the Memorial Hospital of Converse County family for your care! My mission is to improve your quality of life and give you more enjoyment out of the things you love to do. I know there can be a lot of moving parts in the days leading to surgery, which can lead to many questions. Please take the time to review this information before your surgery, as it can be a valuable resource to answer most questions prior to surgery.
Contact my office if you have any questions or concerns after reading this information. This information is composed of the following sections:
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Overview and general information
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Pre-operative steps and instructions
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Timeline before your surgery
Overview and General Information
Surgery location:
As an employee at Memorial Hospital of Converse County, I operate at both Summit Medical Center in Casper, WY and Memorial Hospital of Converse County in Douglas, WY. When you schedule your surgery, we will confirm with you regarding which hospital your surgery will take place.
Outpatient surgery vs inpatient surgery:
Most of my surgeries are outpatient procedures, where patients may go home the same day as your surgery if you meet certain criteria after surgery in the recovery unit (PACU). Depending on the type of operation you undergo, medical history, and recovery after surgery, we may have you stay overnight if needed. If we expect you may need to stay overnight after surgery, I typically will discuss this with patients at the time you schedule your surgery. Additionally, if you are traveling in from out of town and need to stay overnight for safety reasons, we can make arrangements.
Surgery time and when to arrive:
The surgical facility (MHCC or SMC) will call you the day before your surgery to let you know your arrival time the day of surgery. If for some reason you need to cancel your surgery on the morning of your procedure, place call directly to the facility using the numbers below:
Summit Medical Center: 307-232-6600
Memorial Hospital of Converse County: 307-358-2122
Pre-operative Steps and Instructions
Insurance & Worker’s Compensation Approval:
After your surgery has been scheduled, our office will work on obtaining insurance or worker's compensation (if workplace injury) approval. If there are any issues obtaining this approval, then we will notify you promptly.
Medical Clearance and Pre-Admission Testing:
Depending on the planned surgery, your age, and medical history, you may need to undergo Pre-Admission Testing at the hospital you are scheduled for surgery. The Pre-Admission Testing office from that hospital should reach out to you for scheduling this visit, where pre-operative labs, testing (EKG), and/or imaging may occur (X-ray). You may also need to obtain medical clearance from the following:
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Your primary care provider
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Cardiologist: if you see a cardiologist or the Pre-Admission Testing office requires clearance from a cardiologist
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Hematology: if you see a hematologist routinely and are on a blood thinner, have a bleeding or clotting disorder, or if you have a personal history of a blood clot (Deep Vein Thrombosis or Pulmonary Embolus)
Preventing Surgical Infections
Preventing or minimizing the risk of an infection after all surgeries is critical. We take many steps before, during, and after surgery to minimize your risk of this complication. There are certain steps that I ask all my patients to take before surgery.
All Surgeries: Pre-operative Scrub
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Wash with chlorhexidine solution (2 times per day for 2 days before surgery) OR chlorhexidine wipes if provided by the hospital
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Chlorhexadine Gluconate (Hibiclens, Betasept) is an anti-septic soap that is available online or over-the counter at your pharmacy. Please use this product twice daily, for two days before surgery.
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To use: Wash with normal soap and rinse with water well. Then, while in the shower, put some solution on a clean cloth or sponge. Wash from neck down, avoiding your private areas, and rinse well. Do not apply lotions, powders, or perfumes to the body areas that have been cleaned with the product.
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Shoulder Surgeries: Pre-operative Scrub
Due to the unique bacteria that live in the skin around your shoulder, an extra step is essential to decrease your risk of infection following any surgery around your shoulder
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Wash with chlorhexidine solution (2 times per day for 2 days before surgery) OR chlorhexidine wipes if provided by the hospital
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Please follow the directions as above
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Apply 10% Benzoyl Peroxide solution (once daily for 3 days before surgery)
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Benzoyl Peroxide is an anti-septic that can decrease the unique bacteria living around your shoulder and has been shown to decrease your risk of developing an infection after shoulder surgery. This product is also available online or over the counter at your pharmacy.
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To use: After washing with normal soap and then with the chlorhexidine solution, please apply this solution once daily as per the instructions on the packaging.
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Shaving and hair removal products
Do not use any hair removal products or shave the general area where your surgery will take place. We will trim your hair at the surgery site on the day of surgery.
Medications to STOP taking before surgery
Please stop the following medications prior to surgery, unless directed to continue by the provider who gave you clearance for surgery (primary care, cardiologist, hematologist, etc.).
Biologic Rheumatology Drugs: if you take one of these drugs for Rheumatoid Arthritis, Lupus, Psoriatic arthritis, etc. Please contact our office and/or your rheumatologist for specific recommendations when to stop taking these drugs and when you may resume them after surgery.
Oral steroids: discuss with your rheumatologist regarding decreasing your dose or stopping oral steroids approximately 4 weeks ahead of surgery.
Aspirin and Plavix: stop 7 days prior to surgery
Blood thinners (Eliquis, Xarelto, Warfarin, etc): Stop 3-7 days prior to surgery as instructed by your provider who gave clearance.
Anti-inflammatory medications (ibuprofen, Advil, Aleve, Motrin, Mobic, Naproxen, Celebrex, etc.): stop 7 days prior to surgery
Herbal supplements (Fish oil, Vitamin E, Vitamin K, glucosamine, chondroitin, ginkgo biloba): stop 7 days prior to surgery
GLP-1 drugs for weight loss: Stop 7 days prior to surgery.
Timeline Before Your Surgery
4 Weeks Before
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Stop rheumatoid medications / oral steroids (after discussing with your rheumatologist/prescribing provider)
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Stop smoking
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Verify that your pre-admission testing appointment has been scheduled (must be within 30 days of surgery)
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Obtain any medical clearances needed
1 Week Before
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Stop blood thinners, anti-inflammatory medications, aspirin, Plavix, and herbal supplements
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Stop GLP-1 weight loss drugs
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Order or pick-up Chlorhexidine solution (Hibiclens) unless hospital has provided Chlorhexidine solution or wipes
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Shoulder surgery patient: Order or pick-up benzoyl peroxide from drug or grocery store
3 Days Before
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Shoulder surgery patients only: start using benzoyl peroxide wash in the shower once per day
2 Days Before
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All patients: start washing with Chlorhexidine Solution (Hibiclens) or wipes
1 Day Before
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Do not eat or drink anything starting at 12:00 midnight before your surgery. Your surgery will be cancelled if you eat or drink anything
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The hospital should call to notify you what time to arrive on the day of your surgery
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I will call patients the day before surgery to review any last-minute questions.
Day of Surgery
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Check-in at the hospital at your expected arrival time
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Take any medications you were instructed to take during your pre-admission testing appointment. This is generally limited to blood pressure medications you normally take in the morning. Do not take any blood thinners.
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Do not wear any make-up or nail polish
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Do not bring valuables, including jewelry
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Wear glasses if you normally wear contacts
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Bring to the hospital: Drivers’ license, insurance information, comfortable clothes if going home, or overnight bag if you are staying. If you are staying overnight and you have sleep apnea, make sure you bring your CPAP machine.