Getting fitter - please try to carry out regular walking for at least 30 minutes on alernative days for one month before surgery in order to improve your cardiovascular fitnesss for surgery and reduce risk in the recovery period 

Loosing weight - please try to exercise and diet with less carbohydrate/fatty foods if your BMI is over 30 in order to reduce risk and complications

Smoking - try to give up smoking 6 weeks before surgery with the help of nicotine gum or a vapour cigarette in order to give your lungs time to recover and any cough to resolve. This will help to reduce infection, complications and improve wound healling

Aspirin, clodigrel and statins - these medications can help reduce the risk of heart attack and stroke after major surgery if you have cardiovascular or heart disease. Aspiring and clopidogrel needs to be stopped 5 days before most small operations*

Warfarin - if you take warfarin this will need to be stopped 5 days before surgery and replaced with aspirin or clexane heparin injections for the operative period*

Warfarin substitutes - these drugs need to be stopped 2 days before surgery, such as apixaban, rivaroxaban and dabigatran. Mr Howard will advise on when to restart.

History of DVT -  If you or a first degree relative has a history of deep vein thrombosis (DVT) or pulmonary embolus (PE) then you will need a clexane heparin injection before surgery and you will be taught to self inject* for 14 days after surgery to prevent DVT.

If you take hormone medications for contraception or HRT then these need to be stopped one week before and one month after surgery to reduce the risk of DVT.

All patients (unless contraindicated) need to wear antiembolism stockings for one month after a general anaesthetic and carry out daily short walks for 2 weeks to prevent DVT

Day of surgery - please shower or bath in antiseptic soap on the morning of surgery, please don't shave as it is cleaner to do this in the operating theatre just before the incision is made. Please don't eat food or drink milk products for 6 hours before a general anaesthetic and 2 hours before a local anaesthetic operation. Water can be drunk up until 2 hours before any operation. Please bring in a list of your medications and allergies. You may not be the first patient on the operating list as diabetic and latex allergy patients need to go first for medical reasons.

(*) - your doctor or Mr Howard will advise