Day of surgery
What to expect, before, during, and after.
A general guide to help you prepare. Your care team will give you instructions specific to your procedure — this page covers the basics that apply to most surgeries.
The week before
You'll receive a call from the surgical scheduling team with your arrival time and any final instructions.
- Confirm your ride home — you cannot drive yourself after anesthesia
- Stop eating and drinking at the time specified by your pre-op instructions
- Fill any prescriptions in advance so they're ready when you get home
- Arrange for help at home for the first few days if needed
The morning of
Arrive at the time you were given — this is earlier than your actual procedure time, to allow for check-in and prep.
- Wear loose, comfortable clothing that accommodates a brace or sling
- Leave jewelry and valuables at home
- Bring your photo ID, insurance card, and a list of current medications
- You'll meet with your anesthesia team before heading back
In recovery
Most patients spend one to two hours in the recovery area before discharge, depending on the procedure and anesthesia used.
- A nurse will review your discharge instructions with you and your ride
- You'll receive written instructions covering pain management, wound care, and activity restrictions
- Your first follow-up appointment will be scheduled before you leave
The first 48 hours at home
Rest and ice are the priority in the first two days.
- Keep the surgical site elevated and iced as directed
- Take pain medication as prescribed, ahead of pain becoming severe
- Watch for signs that need a call to the office: fever, increasing redness, or unusual drainage
Follow-up & rehab
Your recovery plan continues well past the day of surgery.
- Your first post-op visit is typically scheduled 1–2 weeks out
- Physical therapy will begin on the timeline specific to your procedure — see the Rehab Protocols page
- Questions between visits can go to the office directly — see Contact
Before your surgery
Prior to surgery: helpful items
A few logistics worth handling early, so nothing is a surprise as your surgery date approaches.
When & where
You'll get a phone call after 12 PM the day before surgery with your arrival time, location, and other day-of details. If your surgery falls on a Monday, that call comes the Friday before; if it falls the day after a holiday, you'll be called 2 days prior.
Pre-surgical testing
Some patients are required to complete certain tests before surgery. We'll let you know if you need any of the following:
- EKG (completed within 6 months of the surgery date)
- Blood work (completed within 30 days prior to surgery)
- PCP clearance note
- MRSA swab (must be done at an MGB test site)
Pre-procedure evaluation (Patient Gateway)
All surgical patients are required to submit an electronic Pre-Procedure Evaluation (PPE). If you don't already have a Patient Gateway account:
- Go to massgeneral.org and, under "Get Started," select Partners Patient Gateway
- Select Enroll, or sign in if you're already registered
- Complete the registration process
Expect a call from the medical team a week or two before your surgery date to review your health history.
Physical therapy
Call to schedule your physical therapy before your surgery — don't wait until afterward. You're responsible for finding a PT location that works for you and is accepted by your insurance; once you let us know where you're going, we'll send them the order. ACL reconstruction patients should begin PT within 5 days of surgery; most other knee and shoulder surgeries can begin 1–2 weeks after.
Braces, slings & CPM machines
If you didn't receive your brace or sling in the office, one will be provided after surgery, or ordered for you if a custom brace is needed. If you were told you need a continuous passive motion (CPM) machine, an outside company will contact you directly. ACL patients typically don't need a CPM if starting physical therapy 3–5 days after surgery, unless Dr. Nascimento tells you otherwise or you request one.
Disability paperwork & work notes
If you need paperwork for your employer about your surgery, please send us the following in writing — by fax (617-643-0808), dropped off at the office, or as a Patient Gateway message attachment to Erin McGovern, PA-C or Dr. Nascimento:
- The official disability forms
- Any job-specific forms your employer needs completed
- The date you plan to stop work (usually the surgery date) and your expected return-to-work date
- Where you'd like the completed forms sent
Please allow 3–5 days for completion. Forms are returned by fax, Patient Gateway message, mail, or available for pickup in the office.
School notes
Requests can be submitted by fax (617-643-0808) or Patient Gateway message to Erin McGovern, PA-C. Please include your name, where you'd like the note sent (mailing address, fax, or email — or note that you'll pick it up in person), and what the note needs to include.
Preventing infection before surgery
Before some surgeries, we test for Staphylococcus aureus ("staph") with a quick nasal swab. About 1 in 3 people carry staph without knowing it, and having it raises the risk of infection after surgery — if you test positive, we'll prescribe medication to reduce that risk. The full instructions, including the bathing and medication schedule, are in the handout below.
Cold therapy after surgery
For some procedures, Dr. Nascimento prescribes a NICE1 cold-and-compression therapy device to help with pain and swelling during recovery. A representative from CoreVerity will call to schedule an in-home setup visit, typically 2–5 days before your surgery date. If your insurance doesn't fully cover the device, any out-of-pocket cost will be communicated to you before delivery — CoreVerity handles the insurance approval process directly. Please direct any questions about the device itself to CoreVerity at 617-906-8787, not the surgery center or our office.
Pain control — EXPAREL
For some shoulder procedures, Dr. Nascimento uses EXPAREL, a long-acting, non-opioid local anesthetic injected at the site of surgery to help manage pain in the days immediately afterward. It's designed to reduce or delay the need for opioid pain medication during the period when pain relief matters most. For full details, including indication and safety information, visit exparel.com/patient or call 1-855-793-9727.
Pain control — On-Q Pump
For certain procedures, Dr. Nascimento may send you home with an ON-Q* pump — a small, portable device connected to a thin catheter placed near the surgical site during your procedure. It delivers a steady, low-dose flow of local anesthetic directly to the area for several days after surgery, which can reduce pain and lower how much opioid medication you need during early recovery. The pump requires no batteries or programming by the patient, and is removed once the medication is fully delivered (typically within 2–5 days). For more information, visit mypainpump.com.
Preparing for surgery
Eating & drinking before your surgery
If you take a GLP-1 medication
If you take — or have taken within the last 4 weeks — a GLP-1 medication (examples: Trulicity, Ozempic, Zepbound, or Mounjaro), you must follow a clear liquid diet the day before surgery, regardless of your surgery time. If these guidelines aren't followed, your surgery may need to be rescheduled.
- Begin a clear liquid diet at 7:00 AM the day before surgery — you may have breakfast, but must finish eating by 7:00 AM
- Four hours before surgery, take nothing by mouth except medications you were instructed to take, with a sip of water
If you are not on a GLP-1
Follow the standard fasting guidelines below.
- No solid food after midnight the night before surgery
- From midnight until 4 hours before surgery, clear liquids are encouraged (see list below)
- For the 4 hours immediately before surgery, nothing by mouth except medications you were instructed to take, with a sip of water
- You may brush your teeth — please spit the water out
Clear liquids permitted
- Water
- Apple juice (not cider)
- Cranberry juice
- Clear sodas — ginger ale, lemon-lime, cola (caffeinated or decaf)
- Carbohydrate/sugar-based sports drinks (e.g., Gatorade, Pedialyte)
- Black coffee or clear tea — sweetener okay, no milk or creamer
- Fat-free broth
- Gelatin dessert (Jell-O)
Laboratory work
After your phone appointment with the Pre-Admission Testing Unit, someone from the anesthesia team reviews your electronic record. The anesthesia team will often order additional labs or an EKG prior to your surgery date — this is common practice and shouldn't cause concern. This requires a separate trip to the hospital, since results are needed several days in advance of surgery, so please have any labs or an EKG done as soon as possible.
Weekend lab hours: the Pretest Lab is closed on weekends — report to the main laboratory instead (Saturday 7:00 AM–3:30 PM, Sunday 7:00 AM–2:00 PM). EKGs cannot be done on weekends and must be scheduled Monday–Friday.
What to bring & wear
Bring
- Cell phone
- Glasses
- Any equipment given to you to use after your procedure
Leave at home
- Valuables of any kind
- Wallet, keys, ID, insurance cards
- Jewelry — wedding bands on the operative side, necklaces, earrings, piercings, watches
Wear
- Loose-fitting clothes, such as sweatpants
- Pants and tops that will slide easily over a cast or brace
Avoid wearing
- Skinny jeans (won't fit over a cast or brace)
- Tight-fitting clothing
- Long-sleeve shirts (won't fit over a cast or brace)
- Belts
After your procedure
Post Surgery Instructions
Download the written instructions that apply to your procedure. Always follow the version your care team gives you directly, as your plan may be adjusted for your specific case.
Shoulder
Knee
Other procedures
Questions before your procedure?
Reach out to the office directly — we're glad to walk through anything on this page in more detail.