Before Surgery

We are pleased that you have chosen the Rubin Institute for your surgical care. There are a lot of things to take care of before your surgery, so we have developed a detailed “Count Down to Your Surgery Checklist” to assist you.

• Scheduling Your Surgery
• Checking Your Insurance Benefits
• Required Preoperative Examination Testing and Additional Medical Clearance
• Blood Transfusions and Donations
• Guardianship/Legal Representative
• Presurgical Visit at the ICLL
• Keep Your Contact Information Up-To-Date
• Fasting and Avoiding Certain Medications before Surgery
• Pre-Schedule Physical Therapy
• Prehabilitation Stretches to Help You Prepare for Limb Lengthening Surgery Success
• Other Pre-Surgery Considerations

Scheduling Your Surgery

If your surgery date was not scheduled during your clinic visit, please call your doctor’s secretary or surgical scheduler to arrange a surgery date. The surgeons’ secretaries and/or surgical scheduler can be reached by accessing the main menu at 410-601-BONE (2663) or 1-844-LBH-RIAO (524-7426). Please note that the exact time of surgery might not be determined until a few days before the procedure, (or possibly the day before in some cases), so that the schedule can be adjusted for emergency cases. Please call the secretary a few days before the surgery to obtain the time of surgery.

Checking Your Insurance Benefits

Please call your insurance carrier to check your benefits for surgery and physical therapy. Note that physical therapy is essential for the surgery to be successful. Do not assume that you are automatically covered for the extensive physical therapy that may be required, as that often is not the case. If you do not have adequate physical therapy benefits, it might be better to delay elective surgery until the matter can be resolved. Here is a helpful insurance benefits worksheet to assist you in determining your benefits. The ICLL will work on obtaining medical insurance authorization for the surgery; it is generally obtained one to two weeks before surgery.

Required Preoperative Examination Testing and Additional Medical Clearance

It is your responsibility to make sure that your preoperative clearance medical examination and tests are completed before your surgery date. (Please note that the presurgical visit at the ICLL is different from the preoperative examination which cannot be done at the ICLL.) To ensure your preoperative exam and tests go smoothly, please see our Preoperative Medical Exams & Tests page.

Blood Transfusions and Donations

If you might require a blood transfusion during or after surgery, the secretary will inform you of this when s/he schedules your surgery. You will need to have blood drawn at Sinai Hospital’s Preoperative Anesthesia Services (PASS) Department between two and seven days before surgery. This blood test is not a blood donation and is necessary even if you donated your own blood or someone donated blood for you. Our laboratory must verify your blood is compatible with the donated blood or the blood from the blood bank. If you want to donate your own blood or want to arrange for a friend or family member to donate blood on your behalf, please see our Blood Donation page.

Guardianship/Legal Representative

A parent or legal guardian must accompany all children (younger than 18 years) for the entire presurgical visit and on the surgery date. A legal representative must accompany all patients who lack the capacity to make health care decisions or who are unable to articulate their wishes.

Presurgical Visit at the ICLL

You may be asked to visit the ICLL for a presurgical visit during the week before your surgery. Remember, the presurgical visit is not the same as the preoperative examination with your primary care physician or pediatrician. During the presurgical visit, you will discuss your surgery with your healthcare team and you will sign various forms. We have developed a list of questions you may want to ask your doctor. The doctor may decide that you need new X-rays and clinical photographs during this visit. Additionally, you might need to go to another area of the hospital to have blood drawn. If applicable, external fixator classes for adults and older children may be held during this visit. Please note that the presurgical visit might last for several hours, so please plan accordingly.

Keep Your Contact Information Up-To-Date

Our office needs to know how to contact you in the weeks before your surgery because we need to be able to alert you if there are scheduling changes. Please be sure to respond to all phone calls from our office. If we are unable to contact you, your surgery might be cancelled.

Fasting and Avoiding Certain Medications before Surgery

It is critical that your stomach is empty for surgery, so you will need to fast for a specific amount of time prior to surgery. Please follow our “Fasting Requirements Before Surgery” handout to ensure your surgery is not cancelled or delayed. It is also important that you continue taking some medication and stop taking other medications before surgery; please see our “Patient Medications Prior to Surgery” handout for guidance.

Pre-Schedule Physical Therapy

As soon as your surgery date is set, please call 410-601-0935 or email RIAOPediatricTherapy@lifebridgehealth.org to schedule physical therapy sessions if you will be doing your physical therapy at the Rubin Institute. Patients who do not schedule physical therapy ahead of time are not guaranteed consistent therapists or times. Remember to contact your insurance company to check your coverage for physical therapy; often the required number of sessions exceeds what is covered by insurance.

Other Pre-Surgery Considerations

• Check with your local pharmacist to find out whether s/he will accept prescriptions for pain medications and antibiotics from a Maryland doctor. Ask if there are any restrictions or special forms to fill out.
• If you are planning to use family or short-term disability leave, please provide us with the paperwork during the month before surgery.
• If you need us to fill out forms for school or work, please fax them or bring them with you.
• If you will be receiving an external fixator, you will likely need to make adjustments to your clothing.
• As soon as your surgery date is set, we recommend you make reservations for low-cost housing or other accommodations and think through transportation arrangements.
• If your surgeon asks you to get X-rays before surgery, here is a helpful page of some of the X-ray positions our doctors need that are not as commonly done at other institutions.
• There are steps that you can take to help children and their siblings prepare for surgery; see our Help Children Cope with Surgery & Treatment page.
• If your child is having surgery, familiarize yourself with the visiting policy for the Pediatric Unit.
• You may find it helpful to connect with other patients and their families in the ICLL Families Facebook Group.