SURGICAL HANDBOOK

Table of Contents

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From Your Surgeon

Dear Valued Patient,

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Thank you for entrusting me with your care. Providing high quality, evidence-based, compassionate care is of the utmost importance to me and my team. Please use this handbook as a guide for your upcoming surgery, I believe you will find this helpful as you start your recovery. Our team is there to support you during the recovery process. If you have any questions or concerns, please do not hesitate to call (630) 646 – 7000 or contact us via Epic MyChart.

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Sincerely

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Kushal Patel, MD. FAAOS.

Hand, Wrist, & Elbow Surgery

Important Contact Information

Keep this information close as you might need these numbers during recovery.

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*In cases of emergencies go to Edward Hospital Emergency Room or the local ER.

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Surgical Team

Kushal Patel, MD. FAAOS.

Kushal Patel, MD is a board-certified Orthopaedic Surgeon who is fellowship trained in Hand, Wrist, and Elbow Surgery. He is a fellow of the American Academy of Orthopedic Surgeons and an active member of American Society for Surgery of the Hand.

Dr. Patel graduated from Washington University in St. Louis with college honors. He proceeded to University of Illinois where he earned his Doctorate in Medicine. During medical school, Dr. Patel was selected to be the Morgan & Madison McClellan Fellow at the Institute for Global Orthopaedics & Traumatology (IGOT) at University of California San Francisco Medical Center. During his year at IGOT, he worked to improve access to orthopedic care in low-income countries through research, training, and capacity building. He worked abroad in Ghana and helped facilitate the accreditation of the first orthopedic residency program in Ghana.

After medical school, Dr. Patel returned to Chicago to complete his orthopaedic surgery residency training at the University of Illinois Hospital, one of the oldest orthopedic residency training programs in the country. During his residency, he was chosen by residents and faculty to be Chief Academic Resident. He won numerous awards including the Outstanding Performance in Hand Surgery and ASSH Adrian E. Flatt Resident Scholarship for his research as a resident. Dr. Patel was involved with American Academy of Orthopedic Surgeons (AAOS) and was the Chair of Resident Assembly Education Committee as well as a AAOS Resident Assembly Executive Board Member. He also travelled as a delegate of AAOS to Washington D.C. to meet with Illinois congressional/senate leaders to work on improving access and cost of care for Americans.

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Dr. Patel underwent additional subspecialty training in Hand, Wrist and Elbow Surgery at Harvard University’s Massachusetts General Hospital, Brigham & Women’s Hospital, and Boston Children’s Hospital. Under the tutelage of world leaders in hand, wrist, and elbow surgery, Dr. Patel mastered treatment of complex conditions and injuries. He is a fellow of American Academy of Orthopedic Surgeon, has subspecialty certification in the surgery of the hand, and is a Castle Connolly Top Doctor. Dr. Patel’s surgical philosophy entails providing compassionate evidence-based treatment to help patient’s recover from simple to complex problems and injuries.

Ellen Kohlmann, PA-C

Ellen completed a Bachelor's Degree in Kinesiology at the University of Illinois in Urbana-Champaign in 2017. She then went on to earn a Master's Degree to become a Physician Assistant at Rosalind Franklin University. She graduated in 2019 and has been working as a PA in orthopedics since then, subspecializing in hand, wrist and elbow surgery.  Ellen sees patients in outpatient clinic and also assists in surgery with Dr. Kushal Patel. She is able to assess, diagnose and treat patients as well as refer to surgery when needed.  She enjoys treating patients for both acute and chronic conditions as well as aiding with postoperative care. Ellen takes the time to thoroughly discuss and educate her patients on their diagnosis and treatment options, which provides them confidence in her recommendations. She is always transparent about potential risks, benefits and realistic expectations regarding surgery. Ellen works as part of a team with Dr. Patel and together they will provide you with excellent care. 

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Medical Assistants

Our group of talented medical assistants are the backbone of our team. They each have extensive background in patient care and prioritize strong interpersonal connections. They play a vital role in all daily operations to allow for a personalized and tailored patient experience.

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Surgery Schedulers

The surgery scheduling team is composed of thoughtful, highly organized, and efficient individuals who are committed to the care of our patients. A surgery scheduler will communicate with you directly after the pre-surgical clinical appointment to review and outline the details of surgery to help guide you through each step of the process. They will be readily available to answer further questions that may arise leading up to the day of surgery. You will typically get a phone call within a week of your appointment.

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Elmhurst Outpatient Surgery Center (EOSC)

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2025 America’s Best Ambulatory Surgery Centers

Elmhurst Surgery Center was included on the Newsweek and Statista “America’s Best Ambulatory Surgery Centers” award list for multiple years in a row.

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1200 S. York, Road Suite 1400 Elmhurst, IL 60126

• Complimentary valet parking is available at the main entrance of the Center for Health. If you prefer to self-park, please follow the signs for the North Entrance and park in the Purple Parking Lot in any of the spaces labeled Visitor Parking.
• Patients who self-park should enter via the North Entrance door. Upon entering the building, follow the signs directing you to Surgery Registration. You will be required to sign-in upon your arrival.

Edward Hospital

• Please park in the South Parking Lot at Edward Hospital. You may proceed into the hospital, take D elevators to the second floor for check in with Surgery.
• If you have not received a call by 4pm the day before surgery, or have additional questions please call: 630-646-7000.

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801 S. Washington Street Naperville, IL 60540

Medications/Supplements to Hold

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Please get the okay from your prescribing physician to stop blood thinners:

Diet Instructions Before Surgery (Sedation/General Anesthesia)

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DO:

• Drink 12 oz of Gatorade/Powerade (any flavor Except Red) 12 hours prior AND 4 hours prior to your scheduled surgery time.
• Patients with Diabetes, please use low-sugar Gatorade or Powerade.
•  Take 1000mg of Tylenol (Acetaminophen) with your Gatorade 4 hours prior to your scheduled surgery time.

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DO NOT:

•  No foods after 11pm prior to the day of surgery.
•  No other fluids 12 hours prior to the day of surgery (except Gatorade/Powerade)

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Diet Instructions Before Surgery (Local Anesthesia Only)

• Okay to eat/drink before surgery, but avoid heavy meals

Pre-Surgical Skin Preparation

• Please remove false nails and trim nails short
• Please clean underneath nails to get rid of any dirt/grime
• If you work with oil/grease please ensure that you use soaps with pumice, walnut shell, or synthetic scrubbers to rid the oil/grease off your hands (ie. Fast Orange Pumice Hand Cleaner)
• Please ensure that any rings on operative hand can be removed prior to surgery
• Please remove any piercings prior to surgery

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Pain Management

A multimodal pain protocol will be used to minimize your pain after surgery. Various pain medication in addition to non-pharmacologic interventions will be utilized to decrease pain at varying locations in the pain pathway. This allows the patient to benefit from several different medications that synergically work together, mitigate side effects of certain drug classes, and decrease the amount of use of opiates post-operatively.

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Please have the following over the counter medications available to be used for after surgery:

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• Acetaminophen Arthritis 650 mg

(Tylenol Arthritis 650 mg)

• Ibuprofen 200 mg (Advil, Motrin)
• Disregard if you are not able to take NSAIDs

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Depending on the surgery, you may be prescribed one of the following opioid medications for you to be taken in addition to the over-the-counter medications that was recommended above:

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• Tramadol
• Oxycodone

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*** Please refer to post-operative guidelines for your surgery for additional instructions/details. ***

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Anesthesia

An anesthetic plan will be discussed with you prior to surgery typically at the time of surgery scheduling. Depending on the planned surgery, you maybe put to sleep utilizing either a general anesthetic, sedative (aka sedation/twilight), or be awake.

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General Anesthesia

General anesthesia is a pharmacologically induced, reversible loss of consciousness, resulting in an inability to feel pain and loss of reflexes (including airway reflexes). This is different from conscious sedation and monitored anesthesia care because of the need for airway manipulation secondary to potentially inadequate patient ventilation given the depth of anesthesia. General anesthesia involves airway manipulation with the use of an endotracheal tube, laryngeal mask airway (LMA), or supraglottic airway device.

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Sedation/Monitored Anesthesia Care (MAC)

MAC anesthesia (aka twilight/sedation) is accomplished by giving you medications that help you relax to minimize any discomfort during surgery. It is combined with a peripheral nerve block or local anesthetic depending on the type of surgery. MAC allows you to breath on your own thus avoiding the need for a breathing tube. It also results in less nausea and grogginess after surgery.

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Anesthesia

Peripheral Nerve Block (Regional Block)

A long-acting local anesthetic is injected around the bundle of nerves that are responsible for sensation to the the hand and arm in the axilla (armpit) or near the clavicle (collar bone). The nerve block will minimize/prevent pain signals from reaching your brain. It also blocks the ability for the brain to control the muscles of the hand and arm and thus a sling will be provided after surgery to help carry the arm. This procedure is performed prior to surgery by your anesthesiologist. An ultrasound is used for real-time visualization of the nerves and needle while the anesthetic is being injected. Your anesthesiologist will determine the optimal type of nerve block to be performed prior to surgery. Nerve blocks are performed in conjunction with sedation/MAC or general anesthesia. The nerve block can last up to 24-30 hours. A sling should be utilized while the block is in effect.

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Local Anesthetic

A long-acting local anesthetic is injected into the soft tissue in the area that surgery will be performed. The local anesthetic effect typically lasts about 6-8 hours.

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Therapy Locations

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Checklist: Before Surgery

2 Weeks Before Surgery

• Medical Clearances (if needed)
• Know which medications to hold and when
• Medical Leave / Short Term Disability Paperwork
• Schedule Therapy
• Make sure you have a post-op appointment scheduled

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Week of Surgery

• Pick up pain medications and wound care supplies

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Day Before Surgery

• Surgery Time / Arrival Time if you have not received a phone call by 3 pm day before surgery with your surgical time and arrival time, please call the surgery scheduling number

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Checklist: Day of Surgery

Please bring:

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• A legal picture identification
• Insurance card
• Credit Card/ Co Payment (if applicable)
• Medication list
• Surgical Folder/Packet
• Something to read (book, magazine)

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Please do not bring:

• Jewelry – remove any rings/piercings
• Valuables
• Remove contacts and wear eyeglasses (for sedation/general anesthesia, okay to wear contacts for local cases)

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Notes

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Date of Surgery:

Location of Surgery:

Therapy Location/Start:

Date/Time of 1^st Post-Op Visit:

Location of 1^st Post-Op:

Contact Us

(630) 646-7000

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(630) 548-1563

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