What VCRs and Outdated Surgery Instructions Have in Common

By Mario Leyba, MD

It seemed innocent enough. A pre-surgery instruction sheet handed to a Goldfinch patient several weeks ago, in advance of a procedure we eventually helped the patient to successfully navigate.

If you’ve had surgery yourself—or seen a loved one go through it—you’ve probably seen something just like the pre-surgery instruction sheet pictured.

More than 10,000 pre-surgical instruction sheets just like this will be handed to patients in the United States today. The problem?

This instruction sheet is as outdated as a VCR*, and substantially more dangerous.

(*a video cassette recorder, for those not old enough to remember, and for those who’ve chosen to forget the 80s and 90s).

So what exactly is outdated about this list:

  • Recommendation for bowel prep (e.g., magnesium citrate, etc)

No longer recommended prior to most surgeries as it leaves the patient in a dehydrated, weakened state heading into the trauma of a surgical procedure.

  • Recommendation for no food or drink starting the night before surgery

No longer recommended prior to surgery and hasn’t been supported by the clinical guidelines and medical professional societies for 20 years, as this also leaves the patient in a dehydrated, insulin-resistant, weakened state heading into the trauma of a surgical procedure.

  • No suggestion of pain management using multiple non-narcotic pain meds beginning prior to surgery (referred to as “multimodal analgesia”)

The “multimodal” approach before and after surgery has been shown to dramatically reduce the need for addictive opioid painkillers and speed recovery.

With this outdated pre-surgery instruction sheet, the patient was on a collision course with a 1980’s version of surgery, complete with a heavy dose of addictive opioid painkillers and a longer-than-necessary recovery from surgery. That is, until her Goldfinch Nurse Navigator was able to intervene and advocate on her behalf.

Surgery is more invasive than most realize, especially in the less obvious ways beyond the size of the incision. Is bowel prep, starving for 16+ hours and a large opioid prescription invasive to someone’s life? Yes. Yes. And yes.

According to the most recent Goldfinch Health data, these decisions often prolong a patient’s return to activities of normal life by 34 days on average and greatly increase the likelihood that surgery will become a gateway to long-term opioid addiction.

It doesn’t have to be this way. And people don’t have to go through fighting for a better approach on their own. No matter how nostalgic you might be for the 1980s, let’s leave 1980’s surgery (and VCRs) where they belong.

Protect your people. Protect your plans with Goldfinch Health –  a Better Approach to Surgery and Recovery.

Learn more by watching THIS VIDEO where Amanda shares her Goldfinch patient experience.

About the author:

Dr. Leyba is a board-certified surgeon and Chief Medical Officer of Goldfinch Health. He performs a wide variety of surgical procedures, including robotic-assisted and minimally-invasive surgery. He specializes in complex robotic surgical procedures and has done many of the first robotic procedures in New Mexico. Dr. Leyba has utilized Enhanced Recovery After Surgery (ERAS) protocols since 2016 to dramatically speed patient recovery time after surgery and protect patients against opioid addiction that can result from surgery.

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