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Before Surgery

How do I get to CSA Surgical Center?
It's very important you obtain directions to our facility prior to your surgery date; those are details you don't want to worry about last minute. We are conveniently located off Hwy 63 at the AC Exit in Columbia, Missouri. Our address is:

CSA Surgical Center
3220 Bluff Creek Dr. Ste 104
Columbia, MO 65201
Specific directions can be found on our website on our contact page.

Will someone from CSA Surgical Center contact me before my surgery?
Yes. You may receive a couple of calls from our facility.

• A nurse from the healthcare team will contact you to conduct a routine health assessment and provide basic instructions for surgery. Please plan about 10-15 minutes for this call. This is the time to ask any questions you might have about your procedure.
• A biller from the business office will contact you to address financial matters regarding your procedure – insurance coverage, co-payments and deductibles. (This call applies only to the facility fee for surgery.)

I have already provided my health history information to my surgeon's office. Why do I have to review my health history with a nurse at the surgery center?

• The surgery center will receive all of your medical history information from the surgeon's office before they call you to review your health history.
• During this call, we will ask some additional specific questions that better assist our anesthesia provider in planning your anesthesia care.
• Your safety is our top priority, so we want to make sure all of the information we have on file is up to date, accurate and complete. This will also give you the opportunity to remember health information that you might have forgotten during your visit with the surgeon.

Are there any tests required before surgery?

• Any tests needed before your surgery will be determined and ordered by your surgeon and/or anesthesia provider.
• Should you require such testing, you will be contacted before the date of surgery. We would like to complete any testing as soon as possible in order to review and prevent any delays.
• Be sure to have your doctor's office send all necessary paperwork regarding pre-operative tests and blood work to the facility.

What should I do if I notice a change in my physical condition leading up to my surgery?

• Call your surgeon's office if there are any changes to your well-being prior to your procedure. Colds, fevers, additional pain, etc. should all be reported to your surgeon's office right away.
• With advanced notice, we can try to avoid any delays to your scheduled procedure.

Who administers anesthesia?

• Anesthetics are administered by contracted anesthesia providers which include anesthesiologists and Certified Registered Nurse Anesthetists (CRNA).
• The contracted anesthesia service has been chosen to provide services at the facility based upon their proven reputation for high quality patient outcomes.

Will I get to speak with the person doing my anesthesia before my surgery?

• Yes. Before surgery, you and your anesthesia provider will discuss your medial history and review the anesthesia plan; this is when you'll be able to voice all of your questions and concerns.
• Make sure to communicate any anesthesia concerns you have during your pre-op call with the facility nurse.

What, if anything, am I allowed to eat or drink before my surgery

• We generally ask that you avoid all food and beverages – even water, mints, chewing gum and tobacco products – from midnight on before your surgery. Otherwise, your procedure may need to be postponed.
• This may not always be the case, so more specific directions may be given during your pre-operative phone call.

Are there certain medications I should avoid?

• Your doctor or nurse will give your specific directions regarding your medications during a pre-operative phone call.
• During the call, do not forget to mention the use of blood thinners (i.e. Plavix, Aspirin, Coumadin, etc.) or any blood pressure/heart medications (metoprolol, Lisinopril, hydrochlorothiazide, Benicar, Cardizem, etc.) or any diabetic medications (metformin, insulin, etc.)

Do I need a ride to and from my surgery?

• Yes, you will. Due to anesthesia you will not be permitted to drive for 24 hours after your surgery.
• If your procedure requires anesthesia and you do not have a ride home or a responsible adult to care for you after surgery, your procedure will be canceled.

Is it safe to have surgery if I believe I may be pregnant?

• Surgical procedures, anesthesia and other medications can be very harmful to a developing baby. If you believe there is a chance you are pregnant, please notify your doctor, nurse and the facility prior to your surgery date.
• We will complete a pregnancy test before surgery if you are of childbearing age.

Do I need to shower before surgery?

• Yes, please! Showering will help prevent surgical site infections.
• You may shower the night before and the morning of your surgery, but avoid aggressively scrubbing the area of the surgical site.
• Wash your hair with shampoo first.
• Using a clean washcloth for both showers, wash your body with a liquid antibacterial soap.
• Do not shave near the surgical site unless specifically instructed to do so.
• Once you have rinsed thoroughly, use a clean towel after each shower.
• Do not use lotions, powders or perfumes after showering. You may apply a deodorant/antiperspirant unless instructed not to do so.

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Day of Surgery

What should I wear to the surgery center?
On the day of your surgery, be sure to wear loose-fitting clothing, making it easy to dress and undress yourself.

Is it ok to wear makeup and nail polish?
No. Please do not apply makeup the day of your surgery and remove nail polish prior to your arrival.

Why is handwashing so important?

• Hand washing is one of the best ways to prevent the spread or transfer of germs and infection.
• The day of surgery do not hesitate to ask friends, loved ones- and even those caring for you at the facility- if they have washed their hands or used alcohol foam prior to entering your room. You should also take care to wash your hands throughout this process.

May I smoke the day of my surgery?
No. We strongly recommend you avoid smoking the day of your surgery and for as long as possible leading up to the day of your surgery. Not only could it create complications with your anesthesia, but you could also experience a greater risk of nausea while recovering.

What items should I bring with me on the date of my surgery?

• Photo ID and insurance cards; we are required to verify these during check-in at the facility. Without them, your procedure will be canceled or postponed until you can provide.
• A current list of home medications and any supplements you are taking.
• Any and all medications needed during your stay (i.e. inhalers).
• Payment for your procedure (deductible, co-payment, etc.)
• Wear eyeglasses and bring a case to store them in while you are in surgery; do not wear your contact lenses.
• Bring socks with you if you would like to wear socks in the recovery area.
• CPAP machine if you usually require one for sleep.
• Advanced directive if you wish to have on file at the facility. If you would like to learn more about advanced directives, visit the CaringInfo web site or click here to download a PDF form.
• Do not bring any valuables like loose money, rings and other jewelry.
• If you are having anesthesia, make sure you arrive with a responsible adult who will take you home.

When should I arrive?
You will be given specific instructions with regard to your arrival time the day before your scheduled procedure. If your procedure requires anesthesia, your arrival time usually be about 1 hour before your scheduled procedure.

• If you have not received a call with an arrival time by 2:30pm the day before your surgery, please call 573-777-3377 and ask to speak to a nurse.

Why can't I know my arrival time sooner than the day before surgery?
The surgery schedule may change several times leading up to the day before your procedure, so it is very common place to provide an arrival time the day before surgery to avoid multiple calls and confusion.

• If you require special accommodations due to transportation, please discuss with the nurse during your pre-operative call. We will do our best to accommodate your needs.

How early will I have to arrive for surgery?
You will arrive about 1 hour before your scheduled surgery time if your procedure requires anesthesia.

• The registration process will take around 10-15 minutes
• The process to prepare you for surgery will take around 45 minutes.

What should I do when I get to CSA Surgical Center?
When you enter the facility, you will be greeted at check-in. Admission and verification will take around 10-15 minutes. We will have several documents to review with you at check-in and do not want you to feel rushed during this process. We have built the time needed for registration into your arrival time. Please remember to bring:

• Photo ID
• Insurance card(s)
• Payment for your deductible or co-pay
• A list of your current medications and supplements.

What will happen after check in?
After checking in, a nurse will take you through a 30-45 minute pre-operative assessment that includes:

• Confirming your information
• Meeting with an anesthesiologist
• Meeting with your surgeon
• Meeting with your OR nurse
• Taking your vital signs
• Starting an IV (if necessary)
• Performing any additional tests required on the day of surgery

Once you are ready, your friends and family will be able to join you in this private room until it is time for your procedure.

What will I do with my personal belongings?

• After changing, your belongings will be safely stored in the pre-operative area and will travel with you throughout your stay at the facility in the undercarriage of your transport cart. Remember to leave anything of value at home!
• We will ask that your cell phone and electronics are given to a family member before you go into surgery.

How do I ensure I receive the correct procedure on the correct surgical site?

• There are no greater goals for CSA Surgical Center than to keep you safe and get you the care you need. We follow rigorous national guidelines and protocols (National Patient Safety Goals) with regard to both.
• Before surgery, you will meet with your doctor to confirm the procedure and its correct surgical site. When applicable, the surgeon will write his initials on your skin near the surgical site with a specialized skin marker
• For your safety, you will be asked multiple times by the members of your health care  team to confirm your name, date of birth, planned procedure and which side if applicable

What is your part in ensuring your safety?

• Please be patient and understanding when you are asked numerous times to confirm the same information. This process is all part of a proven safety initiative and you should find comfort in knowing your healthcare team is committed to your care and outcomes.
• Speak up. Do not hesitate to voice any concerns and ask questions throughout this process.

Should I take my normal home medications the day of my surgery?
There are certain medications we will not want you to take and certain medications we will want you to take.

• Your doctor or nurse will give your specific directions regarding your medications during a pre-operative phone call.
• During the call, do not forget to mention the use of blood thinners (i.e. Plavix, Aspirin, Coumadin, etc.) or any blood pressure/heart medications (metoprolol, Lisinopril, hydrochlorothiazide, Benicar, Cardizem, etc.) or any diabetic medications (metformin, insulin, etc.)

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After Surgery

When can I see my family and friends after surgery?

• A nurse will be closely monitoring your vital signs after your procedure. As soon as you are waking up and able to move around, we will ask your family or friends to come see you.
• Up to 2 guests are welcomed in the recovery area at the same time

How soon can I leave?
We understand that you will be ready to return to the comfort of your own home to recover soon after surgery; but you will need to meet a few criteria before you will be discharged to home:

• Your vital signs have returned to normal
• Any pain you are having is controlled and tolerable
• You are able to drink fluids without difficulty
• You have been up and walked without difficulty
• Some procedures will require urinating before you are discharged to home

Do I need a ride to and from my surgery?

• Yes, you will. Due to anesthesia you will not be permitted to drive for 24 hours after your surgery.
• If your procedure requires anesthesia and you do not have a ride home or a responsible adult to care for you after surgery, your procedure will be canceled.

What should I do when I get home?

• You should not make plans to do anything after your surgery except to go home and rest
• Your recovery nurse will discuss specific home care instructions with you and the responsible party who is taking you home.
• Remember to avoid driving for at least 24 hours after surgery
• Plan to have someone stay with you for the first 24 hours after your procedure

What if I'm not well enough to go home the same day?

• On rare occasions, your physician or anesthesiologist may decide you need additional post-operative care. In that case, you will be admitted to a nearby hospital.

What should I do if I am not feeling well at home?
Your recovery nurse will discuss warning signs with you prior to discharge. If you exhibit any of these symptoms or severe pain not controlled by your prescribed pain control regimen, you should:

• Use the quick guide on the back of your discharge folder to contact your surgeon immediately
• Head straight to the nearest emergency room, or
• Call 911

How soon will I be permitted to eat something?

• You will probably receive crackers in the recovery area.
• You recovery nurse will review specific instructions for you to follow with regard to your immediate diet.
• Plan to drink lots of fluids (no alcohol) and initially maintain a very light post-operative diet.
• Some commonly recommended foods for the immediate post-operative period include soups, potatoes, pasta, applesauce and rice.
• Some common foods to avoid include milk products, spicy, greasy, fatty, fried food and  citrus juices

How will I avoid infection at the surgical site?
Your recovery nurse will review specific instructions to care for your surgical site.

Remember to follow our protocol for bathing and cleaning your surgical site:

• Showering will help prevent surgical site infections. You may shower the night before and the morning of your surgery, but avoid aggressively scrubbing the area of the surgical site.
• Wash your hair with shampoo first.
• Using a clean washcloth for both showers, wash your body with a liquid antibacterial soap.
• Do not shave near the surgical site unless specifically instructed to do so.
• Once you have rinsed thoroughly, use a clean towel after each shower.
• Hand washing is one of the best ways to prevent the spread or transfer of germs and infection.
• The day of surgery do not hesitate to ask friends, loved ones- and even those caring for you at the facility- if they have washed their hands or used alcohol foam prior to entering your room. You should also take care to wash your hands throughout this process.

When should I begin taking my normal medications?
In most cases, you will be instructed to continue with your usual medications after surgery. Should temporary changes to your medication routine be needed, our staff will notify you before leaving.

How will I manage my pain?

• You may experience pain after your procedure. Your surgeon will speak with you before your procedure about what to expect and, if necessary, how your pain will be managed. From the time you are admitted, to our post-operative call at home after you are discharged, we will be asking you describe your pain level and working to make sure your pain is well controlled.
• You will be asked to rate your pain on a scale of 0-10, 0 being no pain and 10 being the worst pain imaginable
• Follow directions for pain medication closely and remember that most of them will take at least 20-30 minutes to begin working effectively. Therefore, consider taking the next dose before the pain becomes unbearable.

What should I expect during my follow up call after surgery?

• Your nurse will ask a series of very specific questions to assess your recovery
• Your nurse will review your discharge instructions as needed
• This is a time intended to allow you to ask any questions you might have about your recovery process
• If we are unable to reach you, we will continue calling throughout the day and following days making a minimum of 3 attempts
• If you are experiencing an urgent issue, do not wait for us to call you. Please follow up with your surgeon's office as instructed.

Is my physician employed by this facility?

• No. Your physician, along with the other medical service providers, including anesthesia, radiology or pathology specialists, who use this facility are independent professional providers. Because these individuals are not employed by our facility, we are not responsible or liable for their acts or omissions.

Why do you need to call me the day after surgery?

• You will receive a call from a nurse at the facility the day after your surgery (on Monday if your surgery was on a Friday.) This call is intended to check on how you are recovering, answer or clarify any instructions you received the day before.