Physical exams before surgery?

… he put a swab down the side of my groin.

That sounds odd. Whatever would a doctor swab for in that location on the body?

Checking for MRSA. Prior to my pre-surgical exam I did a lot of research of what to expect. The common areas to swab for MRSA are up your nose, your groin, and rectum (at least that's what I read a few years ago). I was soooo nervous going into my exam thinking the nurse was going to expose me and swab me in those 3 locations. Then after my exam, I was soooo disappointed that she didn't swab me in any of those locations.

My exam was pretty much exactly as @Rubnlickmi described it. Pretty routine and boring.

Prior to an exploratory surgery at an outpatient surgery center in 2013 I didn’t have anything except what happened the morning of surgery. The nurse who started my IV took a little extra blood, checked to make sure I didn’t have a fever, and the anesthesiologist listened to my lungs and looked in my throat.

Prior to having my gallbladder removed in 2015 I had to go to the hospital a couple of days before for a pre-surgery appointment and had labs drawn and met with someone from anesthesia, but she just made a bunch of notes and the anesthesiologist actually listened to my lungs the day of surgery and then grilled me on my previous answers anyway. Given that I was relatively healthy with no major history at that point the pre-appointment kind of seemed like a waste of time for everyone involved (and it was clear the medical staff felt that way while I was there!)

Checking for MRSA. The common areas to swab for MRSA are up your nose, your groin, and rectum (at least that's what I read a few years ago).

OK, now the follow-up question inevitably is: what is MRSA??

OK, now the follow-up question inevitably is: what is MRSA??

https://www.cdc.gov/mrsa/index.html

Methicillin-resistant Staphylococcus aureus (MRSA) is a staph infection that is difficult to treat because of resistance to some antibiotics. Staph infections—including those caused by MRSA—can spread in hospitals, other healthcare facilities, and in the community where you live, work, and go to school.

MRSA is especially bad due to it's resistance to antibiotics - many people end up being treated with amputations to prevent spreading to other parts of the body. It's a big deal in hospitals - esp. Operating Rooms where exposure is much more likely (blood and guts stuff!).

https://www.mrsasurvivors.org/survivor-stories/

MRSA. It was probably a halfhearted swab but yeah.

A lot of blood samples and checks before hospitalisation. EKG etc.

In hospital talk with anesthesiologist.

The times I have had surgery, they always required a chest x-ray. My recent heart surgery required a negative COVID test, a respirogram, an echocardiogram, and a host of blood tests along with the chest x-ray. Spent half a day in the hospital's outpatient clinic.

When i was in OR during training-rotations, we always did a history- brief clinical exam-lab review in pre-operative area.. Anesthesia did their on evaluation.. We had some elective procedure cancellations in pre-operative area due to abnormal labs, any or ongoing infections and some due to abnormal EKG-rhythm..

Some needed admission to hospital due to new diagnosed condition like New onset atrial fibrillation with EKG changes.

There was a quick listen to my heart and lungs before my appendix removal and then a long wait.

I've had 2 surgeries in the last two years, one out patient and one required hospitalization. Both required that I be cleared by my primary care provider. The out patient surgery clearance was the typical screening plus an EKG. It was hand surgery but under general anesthesia.

Clearance for the other was much more thorough and required full labs, EKG and chest x-ray.

Both surgeries required the pre-op physical be completed no more than 30 days prior to the operation

About a year and a half ago, my wife had hip surgery and was required to have a physical even though she had just had her yearly PCP exam a month earlier, with an ekg. The surgery center insisted that they do the exam because they wanted to do a “thorough” exam. We called on speakerphone to inquire about what ”thorough” meant and was told to expect 90 minutes duration. They wanted to examine all extremities carefully, walking, moving, blood work, ekg, breast exam, etc. Well, we were coming out of Covid lockdowns and they hadn’t made any money the previous year so this was a way that they could make some bucks because they were still not busy. As you know, doctors get paid for every thing that they do, so even though she had a breast exam a month earlier, the insurance company would have paid for another. We discussed it and then she said that either our MD does the exam or I will find another MD to do the hip replacement. Within seconds…okay, that will be fine…. Gotta love how money drives just about everything!

I had laparoscopic hernia repair this past august. It was done outpatient and all went fine. Had it done on a Monday, so the Friday before I had to report to the same hospital for a “pre-surgery clearance” as they called it. Consisted of complete blood and urinalysis, MRSA (nose swab) and COVID tests, EKG, heart untrasound and a meeting and very brief “listen to the heart and lungs” with the cardiologist. The whole thing took about 3 hours, most of which consisted of waiting between tests. honestly, given how “hands off” physical exams seem lately, this felt really comprehensive and I was glad to have it done.

Bloodwork, urine and maybe an EKG depending on your medical history. Not usually more than that.

I did not have anything special when I had to get my leg fixed after an accident : X rays mostly.

My only other surgery was appendectomy, something like 40 years ago, and I got abdominal palpation + digital rectal exam twice : once by our GP, then by somebody (the surgeon I presume) at the hospital.

I had a fairly thorough physical before my appendectomy a few years ago, but it had to be done quickly due to the nature of the surgery.

In 2010 I had a surgery that was considered elective, and I had to get a physical from my regular doctor first. From what I recall, it was a pretty standard physical, no more invasive than a regular one, and no EKG. The one thing I do remember from it is that when he looked down my throat, he said, “Throat looks good, there shouldn't be a problem if they have to intubate you." At the time I didn't know that was common with general anesthesia so I was a little surprised.

I had retina surgery about three years ago. The physical exam was brief and took place about three weeks before the surgery. I walked through the door and I guess that was part one. They took my blood pressure and pulse, listened to my lungs and heart, an EKG then sent me on my way. About 15 minutes in total. All pre covid-19.

I have had two total knee replacement procedures—each knee done separately three years apart. The hospital where the procedures were performed requires all the pre-op testing to be done at the hospital a week or more prior to the procedure. It was a pretty long day with xrays, bloodwork, meeting with a PA to review history and medications, and then an exam by an internal medicine doc, who would be responsible for all non-surgical care in the hospital. At the end of the day, I met with the surgeon and his PA.

On the day of the procedure, the only exam was a quick heart and lung listen by the anesthesiologist.

I’m not a doctor, but I do know you need a medical clearance before you can have surgery.

I’m not a doctor, but I do know you need a medical clearance before you can have surgery.

That doesn't necessarily mean you will need or get a physical exam before surgery.

A few years ago, I was only given an abdominal scan and a very brief manual palpation of my abdomen before being operated on for appendicitis. There was also bloodwork of course.

The only one I recall was before appendectomy, and the physician did what had already been done by our family doctor: abdominal examination and digital rectal exam. I suppose this was confirmation before sending to surgery.

Or do you also could X-ray and other examinations for a broken limb?

I had a pre-surgery physical done at 8 years old on a Friday back in September of 2008 for a left undescended testicle. It was done by my Pediatrician. The nurse had me undress down to my underwear and wait for the doctor before leaving the exam room. I did as I was told and stripped down to my briefs. I remember my briefs being a blueish gray color. After, the doctor entered the exam room he did a basic physical exam paying close attention to my heart and lungs. The exam ended with the genital exam. I was laying on my back with my briefs were pulled all the way down off my right ankle. They were left around my left ankle with my legs spread wide. It was the most thorough genital exam I've gotten in my entire life. When the exam was over I could fix my briefs and pull them back up and get dressed. The doctor wished both my mom and me good luck on the surgery.

In my experience, they would do a complete history, and very basic physical, focusing primarily in the area being operated on.

Isn’t a major objective of the preop physical a risk assessment as to how well you can tolerate the surgery and anesthesia? Heart and lung health, meds review (things like blood thinners that would cause more bleeding). Age, medical conditions, extent of the surgery are factored in to what needs to be checked. For my 2 hour ankle replacement it was basic heart and lungs. For my wife’s muscle flap surgery performed by a plastic surgeon - scheduled for 10 hours, but took 13 - it was very extensive, including a CT scan, echocardiogram, referrals to an ENT and neurosurgeon. They even provided a score for the probability of a cardiac event during surgery and recovery.

A few weeks before surgery, I was called in for a pre-op exam.

Blood pressure, ecg, and chest and lung exam.

Once I needed an enema for the rectal exam.

It all depends on the surgery that is required.

I had surgery a few months ago, I had to go to regular doctor for EKG, and general exam. Then they scheduled chest early and blood and urine test. Pretty basic

My pre-op physical wasn't much, but was done through my PCP, except for the EKG and blood work. That was done right after the surgeons visit. As we have a large building with many specialties and associated services under one roof (cardiology, bone doctors, radiology, blood work, hematology(?), "eyes, ear, throat", ect.).

The other questions and check up was finished, not really much, by my PCP. Though she answered my questions and better interpreted what was wrong with me than the surgeon did.

Had major surgery 26 years ago and at that time I did not have a regular family doc. So at the surgeon's office after going over the surgery I needed, he had his intern (surgery was to be done at a large teaching hospital) do an exam on me. It was basic but included heart, lungs, reflexes and a couple of other typical items. Surgery was scheduled for three weeks from then and a few days prior I had an EKG and blood work. Hospital stay was for five days and then discharge. Since then I have had two same day surgeries on my knees, but by then I had a PCP and no prior exam was needed.

Several years ago 1997 I had my gal bladder removed. My PCP sent me to a surgeon. His nurse let me back to exam room and I told her my PCP suspected problems with my gal bladder. She said "ok, so I need you to undress down to your underwear and he'll be right in" . Then she leaf. When the doctor came in to meet me I was already in just underwear. We talked about me symptoms and then he asked me to lay down on the exam table. Felt my abs. and then took hold of my brief and said raise up a bit and he pulled my underwear all the way down to my ankles but not off. He did more pressing in the ab area. Then he moved down to my feet and started feeling my pulse in my ankles. All the time my underwear was still down all the way. I laid there basically naked for a short time while we talked. In was only about 45 seconds of talking but mean while I laying there naked with my underwear still at my feet. When he finish he told me I could get dressed. Had the g. b. removed and that fixed me. After me surgery was over and before I dress (was still in nothing but gown) the nurse asked me I needed to see if I could pee.......... if not she said, then she might have to put a catheter in. For better or worse I was able to pee so that didn't have to happen

When I had minor surgery on my arm a couple of years ago the pre op phone call was just a call then I had to go to a walk through place for a Covid test. That was a couple of days before.

On the day someone came to look in my mouth and check my airway. Another doctor then came and listened to my hear and lungs then did a quick abdominal exam. I didn’t have to have any blood tests and the urine pregnancy test was only done once they realised I wasn’t joking about being trans