Adolescent Idiopathic Scoliosis Roadmap

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Preoperative visit

I will:

• Have blood tests.
• Have X-rays taken.
• Meet with Anesthesia and the Center for Preoperative Assessment and Planning (CPAP).
• Learn how to get ready for surgery.
• Learn what to expect while in the hospital.
• Be given written instructions to take home.
• Meet with your care team who will explain the operation.  

Two weeks before surgery

I will: 

• Stop taking NSAID medications (ibuprofen, aspirin, naproxen, ketorolac).

Five days before surgery

I will: 

• Use mupirocin ointment if prescribed.
• Take bowel medications if indicated by surgery team.

Three days before surgery

I will: 

• Wash body from chin to toe with the antibacterial Hibiclens soap, making sure to clean your back well. You will continue to bathe with this soap until your surgery.

One day before surgery

I will:

• Receive a phone call from my care team about when to arrive for surgery and when to stop eating and drinking.
• Stop eating and drinking as instructed (midnight if not instructed).
• Take a shower with antibacterial Hibiclens soap and wear freshly washed clothes to sleep.
• Wash sheets on bed so they are clean for your arrival home at discharge.

Day of surgery

I will:

• Take a shower with antibacterial Hibiclens soap.
• Take medications as directed by CPAP with a small sip of water.
• Have nothing to eat or drink after midnight or as instructed.

At the hospital, my care team will:

• Help me get ready for surgery (change into a hospital gown, clean back with antibacterial soap, start IV and antibiotics, etc.)

After surgery, I will:

• Be transferred to recovery room and then an inpatient room on the 10th floor.
• Tell your nurse if you have pain greater than 4/10 on the pain scale.
• Eat ice chips and take sips of clears.

One day after surgery

I will:

• Use your Incentive Spirometer every hour while awake and during respiratory treatments.
• Do arm and leg exercises with physical therapy, sit on the side of the bed with physical therapy in the morning, and sit in a chair in the afternoon with physical therapy.
• Maintain spine precautions.
• Take oral pain medications after pain PCA is removed; tell my nurse if my pain is greater than 4/10.
• Drink more clear liquids advancing to regular as my stomach tolerates.
• Take prescribed bowel medications.

Two days after surgery

I will:

• Use your Incentive Spirometer every hour while awake and respiratory treatments.
• Have the urine tube in your bladder removed.
• Get up and walk to the bathroom or use a urinal. 
• Eat a regular diet and drink plenty of liquids.
• Sit up in a chair for all meals.
• Participate in exercises with physical therapy.
• Walk to the door of my room in the morning with physical therapy.
• Walk to the hallway in the afternoon with physical therapy.
• Tell my nurse if my pain is greater than 4/10.
• Tell nurse or doctor if I start to pass flatus.
• Plan to go home tomorrow.

Three days after surgery

I will:

• Continue the same as yesterday (get up and walk, do breathing exercises, eat and drink, etc.).
• Tell nurse if your pain reaches 4/10 on the pain scale.
• Have drains removed (if present).
• Have standing x-rays taken.
• Have a suppository if you have not had a bowel movement.
• Review written discharge instructions with your nurse.
• Pick up discharge prescriptions (pain medication and stool softeners) in pharmacy at St. Louis Children’s Hospital.
• Leave hospital with filled prescriptions and follow-up appointment time.
• Go home when your care team feels you're ready; usually after lunch.