Be sure to let the surgeon, the anesthesiologist and your primary physician know about the vitamins and medications you're taking. Patients should be especially aware of potential risks associated with these medications:
Blood-thinning medications can interfere with the blood's ability to clot, which raises the risk of uncontrolled bleeding. Most patients are well aware that they are taking prescription blood thinners such as warfarin (Coumadin) or clopidogrel (Plavix). But people often forget about aspirin when it is only one ingredient of an over-the-counter compound. Nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) and naproxen (Aleve) can significantly prolong the time for blood to clot. Even herbal preparations and food supplements such as gingko biloba, fish oil, vitamin E, feverfew and garlic capsules have blood-thinning effects.
- Diabetes medications need adjustment on the day of surgery, if not a day or two beforehand. Ask your doctor to provide very specific instructions. Whether you are taking pills or insulin or a combination of both, dosage will need to be reduced. If you take metformin (Glucophage), your doctor may stop this a couple of days before surgery or certain X-ray procedures.
- Herbal preparations, although considered "natural" products by many people, can cause complications by interfering with anesthesia or cardiovascular function. According to the American Society of Anesthesiologists (ASA), St. John's wort can intensify or prolong the effects of some narcotic drugs and anesthetics. Ginseng can trigger hypertension and rapid heartbeat. The ASA cautions patients to discontinue herbal medications at least one to three weeks before surgery.
Don't overlook any medications or supplements, including antibiotics prescribed by a dentist or even herbal teas. When you go for your preoperative evaluation, bring a list of all medications, or put them all in a bag and bring them along. If you realize you've forgotten something, call your doctor right away. Waiting to share this information until the day before or the day of surgery may delay the procedure or cause complications during your surgery or recovery.
It's also important to let your doctors know if you've ever had a bad reaction to certain medications. This may be a true drug allergy such as a rash or hives, or it may simply be that a certain drug made you feel nauseated or uncomfortable. Often, your doctors will be able to choose alternative medications that avoid allergic reactions or other serious side effects.