Before Anesthesia/Sedation

Non-Diabetic Surgical Instructions

IDENTIFICATION MAY BE REQUIRED AT THIS APPOINTMENT FOR PRESCRIPTION PURPOSES

  1. You must not eat or drink anything, not even water, 8 hours before surgery. This includes no gum/candy and no smoking. There are two exceptions:
    1. If we prescribed you an antibiotic, please take as directed with a small sip of WATER only
    2. If you are taking medications prescribed by your doctor, please take them as per usual with a small sip of WATER (unless instructed differently by your doctor).
  2. Your judgement and reflexes may be impaired following sedation or anaesthetic. Although you may feel fully alert, you must make arrangements for an adult to take you home by car or by taxi following surgery and to be with you for the remainder of the day. Public transport is not permitted. If the responsible adult is not with you when you arrive, your appointment will be rescheduled. Please have your driver remain in the office while you are undergoing treatment.
  3. Please remove all dental wax/elastics from your braces before the procedure.
  4. You must not operate a vehicle, power tools, or any machinery for 24 hours following sedation or anaesthetic. Avoid tasks requiring co-ordination or judgement during this time. You are advised to avoid alcohol, sedatives, or tranquillizers until the following day. If in doubt, ask your surgeon.
  5. Do not smoke cigarettes on the day of the procedure. Do not drink alcohol the day before the procedure. Do not use marijuana before the procedure.
  6. Please do not wear contact lenses on the day of surgery.
  7. Please wear an open neck, short sleeve shirt.
  8. No NAIL POLISH, make-up or jewellery.
  9. You must be 100% positive that you are NOT pregnant for the procedure. If there is any possibility that you are pregnant, we will not be able to perform the sedation.
  10. If you have asthma, please bring your puffers to the procedure.
  11. If your health changes, or you develop a cold, flu or any chest disease during the week before surgery, please notify us immediately.
  12. If for any reason, you are unable to keep your appointment, please notify us immediately. The Surgeon has a limited number of surgical appointments available and one is now reserved for you. As a courtesy to patients who are waiting for surgery, changes to the surgical appointments must be made at least one week in advance (416.461.0424)

Diabetic Surgical Instructions

IDENTIFICATION MAY BE REQUIRED AT THIS APPOINTMENT FOR PRESCRIPTION PURPOSES

  1. You must not eat or drink anything, not even water, 12 hours before surgery. This includes no gum/candy and no smoking. There are two exceptions:
    1. If we prescribed you an antibiotic, please take as directed with a small sip of WATER only
    2. If you are taking medications prescribed by your doctor, please take them as per usual with a small sip of WATER (unless instructed differently by your doctor).
  2. Your judgement and reflexes may be impaired following sedation or anaesthetic. Although you may feel fully alert, you must make arrangements for an adult to take you home by car or by taxi following surgery and to be with you for the remainder of the day. Public transport is not permitted. If the responsible adult is not with you when you arrive, your appointment will be rescheduled. Please have your driver remain in the office while you are undergoing treatment.
  3. Please remove all dental wax/elastics from your braces before the procedure.
  4. You must not operate a vehicle, power tools, or any machinery for 24 hours following sedation or anaesthetic. Avoid tasks requiring co-ordination or judgement during this time. You are advised to avoid alcohol, sedatives, or tranquillizers until the following day. If in doubt, ask your surgeon.
  5. Do not smoke cigarettes on the day of the procedure. Do not drink alcohol the day before the procedure. Do not use marijuana before the procedure.
  6. Please do not wear contact lenses on the day of surgery.
  7. Please wear an open neck, short sleeve shirt.
  8. No NAIL POLISH, make-up or jewellery.
  9. You must be 100% positive that you are NOT pregnant for the procedure. If there is any possibility that you are pregnant, we will not be able to perform the sedation.
  10. If you have asthma, please bring your puffers to the procedure.
  11. If your health changes, or you develop a cold, flu or any chest disease during the week before surgery, please notify us immediately.
  12. You must bring ALL your insulin preparations to the office on the day of surgery.
  13. You must have the first appointment in the morning.
  14. Wake up 2.5 hours before the procedure and check your blood glucose. Follow instructions 15 D and 15 E.
  15. If you are on Insulin Formulations:
    1. Glargine Insulin Users:
      1. Reduce dose of glargine (Lantus) based on waking blood glucose. Consider a 20% decrease for evening before the procedure.
    2. NPH Insulin Users:
      1. Normal evening NPH.
      2. Reduce NPH by 1⁄2 in the morning. (Or reduce morning and evening dose by 20-25%).
    3. Humalog, Novolog, or Regular Insulin Users:
      1. Take No Humalog, Novolog or Regular Insulin the morning of the procedure.
    4. If low blood sugar the morning of the procedure:
      1. Take sips of non-caffeinated clear liquids (apple juice) until 2 hours before procedure.
    5. If high blood sugar the morning of the procedure:
      1. A dose of short-acting insulin may be given if blood glucose is > 12mmol/L.
  16. If you are on an Insulin Pump:
    1. Little reduction to the overnight basal levels (depending on typical morning blood glucose)
    2. Maintain basal rates during the procedure or reduction of basal rates by 20% before, during, and after the procedure
    3. Return to typical basal rates after the procedure (dependent on blood glucose and your ability to eat and drink)
  17. If you are taking Diabetic medication pills by mouth (no insulin injections):
    1. Do not take your morning dose.
    2. Resume usual dosing after the procedure with eating.
      1. After the procedure check blood glucose before taking the next 3 scheduled doses of your medication to ensure your blood sugar levels are not too low.

If for any reason, you are unable to keep your appointment, please notify us immediately. The Surgeon has a limited number of surgical appointments available and one is now reserved for you. As a courtesy to patients who are waiting for surgery, changes to the surgical appointments must be made at least one week in advance (416.461.0424)

If you were prescribed a narcotic medication, please remember they are to be used for break-through pain only and pain uncontrolled by over-the-counter medications. Return all unused medication to your pharmacy after 10 days.

It is our desire that your recovery be as smooth and pleasant as possible. Following these instructions will assist you, but if you have questions about your progress, please call the office during office hours at 416.461.0424. If there is an after hours concern please do not hesitate to call Dr. Kaplan on his personal mobile at 647.539.6565.

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