Instructions for Pulmonary Procedures at Memorial Hospital

This information will help you get ready for your pulmonary procedure at Memorial Hospital, the main hospital at MSK.

About your pulmonary procedure

Your healthcare provider will give you information and talk with you about what to expect during your procedure. They will also tell you where your procedure will be done. They will check off the correct box below to help you remember.

Your procedure will be done at one of these locations in Memorial Hospital:

• Endoscopy suite
  1275 York Ave. (between East 67th and East 68th streets)
  New York, NY 10065
  Take the B elevator to the 2nd floor. Turn right and enter the Surgery and Procedural Center through the glass doors.
• Operating room
  1275 York Ave. (between East 67th and East 68th streets)
  New York, NY 10065
  Take the B elevator to the Presurgical Center (PSC) on the 6th floor.

Visit www.msk.org/parking for parking information and directions to all MSK locations.

What to do before your pulmonary procedure

Talk with a nurse and plan your care

Before your procedure, you’ll talk with a nurse to plan your care during your procedure. The way you talk with the nurse depends on where your procedure will be done. Your healthcare provider will tell you what to expect.

Presurgical testing (PST)

Your healthcare provider will tell you if you need presurgical testing (PST) before your procedure. PST is a regular physical exam. It can also include other medical tests that will give your care team important information about your health. PST helps your care team find out if you’re healthy enough to have the procedure.

If you need PST, you will be scheduled for an appointment within 30 days (1 month) of your procedure. The date, time, and location will be printed on the appointment reminder from your healthcare provider’s office. You can eat and take your usual medications the day of your appointment.

It’s helpful to bring these things to your PST appointment:

• A list of all the medications you’re taking, including prescription and over-the-counter medications, patches, and creams.
• Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
• The names and telephone numbers of your healthcare providers.

During your PST appointment, you’ll meet with a nurse practitioner (NP). They work closely with anesthesiology staff (specialized healthcare providers who will give you anesthesia during your procedure). Your NP will review your medical and surgical history with you. You may also have medical tests to help plan your procedure, such as:

• An electrocardiogram (EKG) to check your heart rhythm.
• A chest X-ray.
• Blood tests.

Your NP may recommend you see other healthcare providers. They will also talk with you about which medications to take the morning of your procedure.

Ask about your medicines

You may need to stop taking some of your usual medicines before your procedure. Talk with your healthcare provider about which medicines are safe for you to stop taking.

We’ve included some common examples below, but there are others. Make sure your care team knows all the prescription and over-the-counter medicines you take. A prescription medicine is one you can only get with a prescription from a healthcare provider. An over-the-counter medicine is one you can buy without a prescription.

‌ It is very important to take your medicines the right way in the days leading up to your procedure. If you don’t, we may need to cancel your procedure.
 

Blood thinners

Blood thinners are medications that affect the way your blood clots. If you take blood thinners, ask the healthcare provider performing your procedure what to do. They may recommend you stop taking the medication. This will depend on the type of procedure you’re having and the reason you’re taking blood thinners.

Examples of common blood thinners are listed below. There are others, so be sure your care team knows all the medicine you take. Do not stop taking your blood thinner without talking with a member of your care team.

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs, such as ibuprofen (Advil^® and Motrin^®) and naproxen (Aleve^®), can cause bleeding. Stop taking them 2 days before your procedure. If your healthcare provider gives you other instructions, follow those instead.

To learn more, read How To Check if a Medicine or Supplement Has Aspirin, Other NSAIDs, Vitamin E, or Fish Oil.

Medications for diabetes

Before your procedure, talk with the healthcare provider who prescribes your insulin or other medications for diabetes. They may need to change the dose of medications you take for diabetes. Ask them what you should do the morning of your procedure.

Your care team will check your blood sugar levels during your procedure.

Diuretics (water pills)

A diuretic is a medicine that helps control fluid buildup in your body.

If you take a diuretic, ask the healthcare provider doing your procedure what to do before your procedure. You may need to stop taking it the day of your procedure.

Examples of common diuretics are listed below. There are others, so be sure your care team knows all the medicines you take.

Arrange for someone to take you home

You must have a responsible care partner take you home after your procedure. A responsible care partner is someone who can help you get home safely. They should be able to contact your care team if they have any concerns. Make sure to plan this before the day of your procedure.

If you don’t have a responsible care partner to take you home, call one of the agencies below. They’ll send someone to go home with you. There’s a charge for this service, and you’ll need to provide transportation. It’s OK to use a taxi or car service, but you still need a responsible care partner with you.

Tell us if you’re sick

If you get sick (including having a fever, cold, sore throat, or flu) before your procedure, call the healthcare provider who scheduled your procedure. You can reach them Monday through Friday, from 9 a.m. to 5 p.m.

After 5 p.m., during the weekend, and on holidays, call 212-639-2000. Ask for the fellow on call (covering) for the Pulmonary Service.

What to do the day before your pulmonary procedure

Note the time of your procedure

A staff member will call you after 2 p.m. the day before your procedure. If your procedure is scheduled for a Monday, they’ll call you on the Friday before. If you do not get a call by 7 p.m., call 212-639-5014.

The staff member will tell you what time to arrive for your procedure. They’ll also remind you where to go.

Instructions for eating

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Stop eating at midnight (12 a.m.) the night before your surgery. This includes hard candy and gum.

If your healthcare provider told you to stop eating earlier than midnight, follow their instructions. Some people need to fast (not eat) for longer before their surgery.

What to do the day of your pulmonary procedure

Instructions for drinking

Between midnight (12 a.m.) and 2 hours before your arrival time, only drink the liquids on the list below. Do not eat or drink anything else. Stop drinking 2 hours before your arrival time.

• Water.
• Clear apple juice, clear grape juice, or clear cranberry juice.
• Gatorade or Powerade.
• Black coffee or plain tea. It’s OK to add sugar. Do not add anything else.
  • Do not add any amount of any type of milk or creamer. This includes plant-based milks and creamers.
  • Do not add honey.
  • Do not add flavored syrup.

If you have diabetes, pay attention to the amount of sugar in these drinks. It will be easier to control your blood sugar levels if you include sugar-free, low-sugar, or no added sugar versions of these drinks.

It’s helpful to stay hydrated before surgery, so drink if you are thirsty. Do not drink more than you need. You will get intravenous (IV) fluids during your surgery.

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Stop drinking 2 hours before your arrival time. This includes water.

Things to remember

• Follow your healthcare provider’s instructions for taking your medications the morning of your procedure. It’s OK to take them with a few small sips of water.
• Wear loose, comfortable clothing.
• If you wear contact lenses, wear your glasses instead, if you can. If you don’t have glasses, bring a case for your contacts.
• Do not put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
• Take off any jewelry, including body piercings.
• Leave valuable items, such as credit cards and jewelry, at home.
• When it’s time for your procedure, you’ll need to remove your hearing aid(s), dentures, prosthetic device(s), wig, and religious articles.

What to bring

• A list of all the medications you take at home, including patches and creams.
• Your rescue inhaler (such as albuterol for asthma), if you have one, or any other medications for breathing.
• Your cell phone and charger.
• Only the money you may want for small purchases, such as a newspaper.
• A case for your personal items, if you have one. This includes glasses or contacts, hearing aid(s), dentures, prosthetic device(s), wig, or religious articles.
• Your Health Care Proxy form and other advance directives, if you have filled them out.
• Your breathing device for sleep apnea (such as your CPAP machine), if you use one. If you can’t bring it, we will give you one to use while you’re in the hospital.
• If you have an implanted pacemaker or automatic implantable cardioverter-defibrillator (AICD), bring your wallet card with you.

Where to go

When you get to the hospital, take:

• The B elevator to the 2nd floor (if your procedure will be in the endoscopy suite). Turn right and enter the Surgery and Procedural Center through the glass doors.
• The B elevator to the Presurgical Center (PSC) on the 6th floor (if your procedure will be in the operating room).

What to expect when you arrive at the hospital

Many doctors, nurses, and other staff members will ask you to state and spell your name and date of birth. This is for your safety. People with the same or similar names may be having procedures on the same day.

When it’s time to change for your procedure, you’ll get a hospital gown and nonskid socks to wear. You’ll be asked to remove your glasses or contacts, hearing aid(s), dentures, prosthetic device(s), wig, or religious articles, if you have any.

Meet with a nurse

You’ll meet with a nurse before your procedure. Tell them the dose of any medications you took after midnight (12 a.m.) and the time you took them. Make sure to include prescription and over-the-counter medications, patches, and creams.

Your nurse may place an intravenous (IV) line in one of your veins, usually in your arm or hand. If your nurse does not place the IV, your anesthesiologist will do it in the procedure room.

The IV will be used to give you anesthesia (medication to make you sleep) during your procedure. You may also get fluids through the IV before your procedure.

Meet with an anesthesiologist

You will also meet with an anesthesiologist (A-nes-THEE-zee-AH-loh-jist). An anesthesiologist is a doctor with special training in anesthesia. They will give you anesthesia during your procedure. They will also:

• Review your medical history with you.
• Ask if you’ve had any problems with anesthesia in the past. This includes nausea (feeling like you’re going to throw up) or pain.
• Talk with you about your comfort and safety during your procedure.
• Talk with you about the kind of anesthesia you’ll get.
• Answer questions you have about anesthesia.

Meet with your doctor

You’ll talk with your doctor before your procedure. They will explain the procedure and answer your questions.

What to expect during your pulmonary procedure

When it’s time for your procedure, you’ll go into the procedure room and be helped onto an exam table. Your healthcare provider will set up equipment to monitor your heart rate, breathing, and blood pressure. You’ll also get oxygen through a thin tube that rests below your nose.

Once you’re comfortable, the anesthesiologist will give you anesthesia through your IV line and you’ll fall asleep.

What to expect after your pulmonary procedure

In the post-anesthesia care unit (PACU)

When you wake up after your procedure, you’ll be in the Post-Anesthesia Care Unit (PACU).

A nurse will keep track of your body temperature, pulse, blood pressure, and oxygen levels. You may also have a chest X-ray to make sure your lung was not damaged. This type of injury is rare.

Your doctor will talk with you and the person taking you home about how your procedure went. If they feel you need to stay overnight for more care, you’ll be admitted to the hospital.

If you stopped taking any medications before your procedure, ask your doctor when you can start taking them again.

Before you leave, your nurse will explain your discharge instructions to you and the person taking you home.

Contact information

If you have any questions or concerns, call the healthcare provider who did your procedure. You can reach them Monday through Friday, from 9 a.m. to 5 p.m. If you don’t know their phone number, call 212-639-LUNG (212-639-5864).

After 5 p.m., during the weekend, and on holidays, call 212-639-2000. Ask for the fellow on call (covering) for the Pulmonary Service.