Before Surgery

Pre-anesthesia Testing Clinic (PATC)
Before you have anesthesia for surgery at City of Hope, your surgeon or doctor will schedule an appointment for you at the Pre-anesthesia Testing Clinic.  This is a service provided by the Department of Anesthesiology.  The clinic is located on the second floor of Helford Clinical Research Hospital at City of Hope. 
Making your operation safer
The primary goal of the PATC is patient safety, that is, to minimize anesthetic risk by assuring that any issues relating to a patient’s coexisting conditions are addressed. Optimizing your health before surgery not only maximizes your safety, but also reduces your time to surgical therapy. 
The PATC visit gives you an opportunity to ask questions, and it helps our anesthesiologists create the ideal anesthetic plan for you.  After your PATC visit, you should know what to expect both in the time leading up to your surgery and during your recovery. 

If you are scheduled for a PATC visit, you will undergo a history and physical examination by the PATC provider, an advanced practice nurse, with special emphasis on aspects of your health that are pertinent to the administration of anesthesia.  The decision to obtain further tests will be based on your individual health, relative to your upcoming surgical procedure.  Preparing a patient for surgery often requires collaboration between a primary care physician, anesthesiologist, surgeon and specialty consultants such as cardiologists or pulmonologists.
Ensuring successful outcomes for our patients is a team effort
At City of Hope, we have a variety of consulting specialists available for our patients.  For those who require further testing, we coordinate this aspect of your care during the PATC appointment. 
To expedite the PATC visit, many patients find it helpful to have completed the PATC Intake form prior to arrival. The form is also available in Spanish. The PATC intake questionnaire reviews past medical/surgical history, current medications and allergies, and it asks questions pertinent to potential medical issues that may not have been previously evaluated.  

As part of your PATC visit, we will perform a pre-anesthetic medical evaluation and give you instructions about when to stop taking certain medications and when to stop eating and drinking before surgery. It is important to coordinate medication changes with your primary doctor, your surgeon and your anesthesiologist.   For example, it is important to inform the PATC if you are taking blood thinners (Plavix, Aspirin, Coumadin, or Lovenox), antibiotics, and diabetes or heart medications.  Some of these medications may need to be continued through surgery, while others may need to be stopped several days in advance.
If you have a pacemaker or a Automatic Implantable Cardioverter Defibrillator (AICD) you will need to bring your device identification card and the details of its latest checkup so that the appropriate evaluation may occur.  These devices are managed differently depending upon the medical reason for the device and type of surgery. 

Frequently asked questions about the PATC

What can I expect during my appointment at the PATC?

During your appointment, the PATC staff will:
  • Take your medical history
  • Perform a physical examination
  • Review pertinent tests ordered by your doctors
  • Discuss what medications you should or should not take before your surgery
  • Order any additional tests that may be necessary to make sure it is safe to proceed with surgery
  • Perform an EKG and, possibly, basic blood work
If I need additional testing, can this be done the same day as my visit to the PATC?
All blood testing can be done the same day.  However, if a consultation with another specialist is needed, this may need to be scheduled another day, when there is an available appointment.
Will you have enough information to know if I am ready for surgery?
In most cases, if your medical records are complete and up to date, your visit will supply your PATC provider with enough information to know if you are ready for surgery. 
However, sometimes a previously unknown underlying problem might be identified that needs to be addressed before surgery.  When this occurs, arrangements will be made for further evaluation.
Will my surgery be delayed or postponed for any reason?
Generally, your surgery will not be delayed.  However, even a simple problem like a common cold can make surgery less safe.  Other times, tests may show that an existing medical condition such as high blood pressure or diabetes is less than optimally controlled.

If you have a condition in need of further optimization, your PATC provider may send you to your primary care doctor or the appropriate consulting specialist to start treatment to improve your health and reevaluate your condition before surgery.  The PATC clinic will inform you and your surgeon about any conditions that require further attention before surgery.
What do I need to bring to my visit to the PATC?
It is important to get as complete a picture of your medical history as possible.  Therefore, in order to save you time during your visit, please bring all the information you have about the following:
  • All your relevant medical records  and details of your past medical history
  • All of your medications or a clear, printed list with their complete names, dosages and how often you take them
  • A list of the operations you have had, including the hospitals at which they took place
  • The name and phone number of your family doctor and any other doctors who take care of you regularly (like your heart doctor or your lung doctor)
  • Copies of the reports of any recent tests that you may have had, particularly stress tests, echocardiograms, cardiac catheterizations or lung function tests.  If you do not have the results of any of these tests, information regarding when and where they were performed would be helpful, including any phone numbers to which you may have access
  • If you have a pacemaker, Automatic Implantable Cardioverter Defibrillator (AICD)  or coronary stent, the card that goes with that device
  • Any recent laboratory studies you may have had outside of City of Hope
  • Preoperative Medical Questionnaire (to be completed before your clinic visit)