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Blog mainpage / Surgery / Getting ready for your surgery: Questions your doctor might want to ask you 

08 February 2022

Getting ready for your surgery: Questions your doctor might want to ask you 

Medicine list

Your doctor and medical team would like to know about your past medical history, and they may want to know what medications you are currently taking.  

Here is a handy tool to help you prepare for your meeting with your clinical team, remember to fill it in and take it with you to your meeting. 

Medicine

I take…    (Name of medicine, Dose, Times a day) 

  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 

I take over the counter medicine such as: 

I take…    (Name of medicine, Dose, Times a day) 

  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 

I use prescriptions, crème, patches etc.  such as: 

Name of your product, Dose, Times a day 

  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ___________________________________________________________  

I take over the counter crème, patches etc. such as: 

Name of your product, Dose, Times a day 

  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ___________________________________________________________ 

I take dietary supplements such as: 

Vitamins 

Name of your product, Dose, Times a day 

  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ___________________________________________________________  

Herbs 

Name of your product, Dose, Times a day 

  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • __________________________________________________________ 

Minerals 

Name of your product, Dose, Times a day 

  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • __________________________________________________________ 

Herbal remedies  

Name of your product, Dose, Times a day 

  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • ____________________________________________________________ 
  • __________________________________________________________ 

I use recreational drugs: 

Dose, Times a day 

__________________________________________________________ 

Pacemaker or other heart device 

____________________________________________________________ 

Sleep apnea 

____________________________________________________________ 

Problems with anesthesia before 

____________________________________________________________ 

Allergies / Allergic to medications, materials etc. 

____________________________________________________________ 

_________________________________________________________ 

___________________________________________________________ 

I drink alcohol _____________ times a week 

Alcohol might affect your surgery and recovery. Pause drinking alcohol before your surgery and during your recovery. If you find this difficult, or if you´re experiencing withdrawal symptoms, talk to your medical team. If you can´t stop drinking, tell your doctor. 

This is a personal question, but be honest when your doctor asks, then they will be able to help you. Your medical information is confidential.  

I smoke ___________________ times a day 

I use an electronic smoking device _____________ times a day 

Stop smoking just before your surgery. This will help you during the operation. Tell your medical team and they will help you. Smoking can cause breathing problems during surgery, so it is a good idea to quit before your surgery.  

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