Pre-op physical in Anaheim

1. Your surgeon's form sets the agenda. The provider works from the clearance form and test order your surgeon's office gave you.
2. Health history. Expect questions about current conditions, past surgeries, any trouble with anesthesia, allergies, and how active you are day to day.
3. Medication review. Prescriptions, over-the-counter medicines, vitamins and supplements all get reviewed, because some affect bleeding or anesthesia.
4. Exam. Vital signs, including blood pressure, and a physical exam.
5. Tests on your order. Blood work, a urine test or a chest x-ray, if your surgeon's order lists them.
6. Paperwork. The provider fills in the parts of the form the exam and results support. Ask at check-in how the finished form and results will reach your surgeon's office.

If the exam or a result needs a closer look, the provider may recommend follow-up with your regular doctor or a specialist first, and your surgeon may decide to wait.

There is no single standard panel. A review in American Family Physician says the decision to test should rest on your history and exam, your surgical risk and clinical judgment, rather than one routine set of tests for everyone. It says routine chest x-rays are not indicated for healthy people without symptoms, and that healthy patients having cataract surgery do not need pre-op testing. Your surgeon's order is what counts, so bring it.

The clinic posts these lab and x-ray services, but it has not posted exactly what a pre-op visit includes. With your surgeon's order in hand, call (714) 400-2959 to confirm the clinic can complete every item and when sent-out results should be back.

• The surgeon's clearance form, with your procedure, surgery date and the office's contact or fax number filled in.
• Any lab, x-ray or EKG order from the surgeon or anesthesia team.
• A complete medication list: prescriptions, over-the-counter medicines, vitamins, herbs and supplements, with doses. The American College of Surgeons offers a printable list on its site.
• Recent records, such as test results and specialist notes (for example, from a cardiologist), plus a list of past surgeries and any anesthesia problems.
• Medicine allergies and what reaction you had.
• Photo ID, and your insurance card if you plan to use insurance.

Your surgeon's office sets the window, so ask them before you come in. For hospitals in Medicare, a federal rule (42 CFR 482.22) generally requires the history and physical to be done no more than 30 days before admission or registration, or within 24 hours after. An exam done ahead of time must be updated within 24 hours of admission and before surgery. Outpatient surgery centers write their own timing policy under a separate rule (42 CFR 416.52), so their number of days can differ.

Once you have a surgery date, plan the visit inside that window with enough days left for sent-out lab results and any follow-up the provider suggests.

Do not stop or change a prescribed medicine on your own. This page does not give dosing advice. MedlinePlus's question list for hip and knee replacement patients includes asking your surgeon about aspirin, ibuprofen and other arthritis drugs; vitamins, herbs and supplements; blood thinners such as warfarin or clopidogrel; and which medicines to take on the day of surgery.

The American College of Surgeons notes that some supplements, including ginkgo, vitamin E, fish oil, garlic, ginger and St. John's wort, can affect clotting or interact with other drugs. It also says diabetes medicines are usually adjusted because you will not be eating before surgery, and that dental, skin and other low-risk procedures likely will not require you to stop your medicines. Bring these questions to the pre-op visit, and get the final answer from your surgeon and the doctor who prescribes the medicine.

The clinic has not posted a pre-op price. Its posted self-pay office visit is $185 for the visit with a provider, and labs and x-rays are billed on top of that, so a self-pay total depends on what your surgeon ordered. Ask the front desk to price your surgeon's test list before anything is drawn. If you have insurance, check pre-op coverage with your plan. See self-pay visits for what the flat fee covers, and call to confirm current prices.

Ready to come in? Save your spot for a pre-op physical; pre-op requests are confirmed by the front desk after you pick a time. Need a work, school or sports exam instead? See physicals.

Chest pain, fainting or sudden trouble breathing before surgery needs 911 or an emergency room, not a clearance visit.