Medical Clearance (Pre-Op)

Medical clearance, also known as a preoperative evaluation, involves a series of tests and examinations performed before surgery to assess your overall health. This process is essential to determine whether you are medically fit to undergo surgery and general anesthesia.

If you have an upcoming procedure, your surgeon may request a pre-surgical clearance from your primary care provider before proceeding with treatment.

At Internal Medicine & Primary Care of Sebastian (IMPCS), we streamline the pre-op process by ensuring you are fully prepared and cleared for your procedure.

We handle all necessary tests, complete surgeon-required evaluations, and ensure all forms are signed and submitted promptly.

Why is medical clearance before surgery important?

Medical clearance is a critical part of the surgical process. It’s a vital step designed to reduce the risk of complications during and after your procedure.

The primary goal of a pre-surgical clearance is to identify any health issues that could affect the success of your surgery or increase your risk for complications. This evaluation ensures that you’re in the best possible condition to safely undergo surgery and have a healthy recovery.

During the clearance process, your primary care provider will assess your overall health, review your medical history, and determine if your body is ready to handle anesthesia and the physical stress of surgery.

A clearance letter from your provider informs your surgeon that you’ve been properly evaluated and are medically fit for surgery. It also gives the anesthesiologist valuable insights into your health, helping them tailor anesthesia plans to your specific needs.

In some cases, this evaluation may uncover conditions that need to be addressed before proceeding with surgery. This may include things like uncontrolled blood pressure, blood sugar concerns, or medication adjustments. Taking care of these issues beforehand helps ensure your procedure is as safe and successful as possible.

What is involved in pre-op testing?

At Internal Medicine & Primary Care of Sebastian, pre-op evaluations are customized to your age, medical history, the type of surgery being planned, and any specific input or requirements from your surgeon.

Here is a breakdown of the key components involved in the pre-surgical clearance process.

Physical Examination

Your pre-op evaluation begins with a thorough physical exam, which helps establish a clear picture of your current health status and identifies any red flags before surgery.

This includes monitoring your vital signs:

  • Blood pressure
  • Heart rate (pulse)
  • Body temperature
  • Respiratory rate (breathing pattern)

Our provider will listen carefully to your heart and lungs to detect any abnormal breathing sounds or signs of fluid buildup that could indicate underlying issues.

We also conduct a thorough examination to check for any visible signs of infection, inflammation, swelling, or pain that may delay or complicate your surgery. This full-body assessment provides valuable insights into your overall health and helps guide any further testing that may be needed before your procedure.

Past Medical History Review

A thorough review of your medical history helps ensure that any condition, whether previously diagnosed or not, is taken into account before your surgery. This process allows us to recognize potential red flags that could interfere with your procedure, recovery, or how your body responds to anesthesia.

Here is what we focus on:

  • Medical Conditions: We evaluate your pre-existing health conditions, such as diabetes, high blood pressure, asthma, kidney or liver problems, sleep apnea, and more. These conditions can:
    • Increase the risk of infections
    • Affect your recovery process
    • Impact how your body processes anesthesia
    • Cause cardiac or respiratory complications during surgery

Depending on the condition, we may need to adjust your medications or take precautions to ensure the success and safety of surgery.

  • History of Surgeries: We review past surgeries to understand how your body responded previously. Our team will discuss the types of surgeries you have had, how you recovered, and whether there were any complications. This helps us anticipate the likelihood of similar issues occurring again and prepare accordingly.
  • Hospitalizations & ER Visits: Information about any past hospital stays or emergency room visits, whether due to injuries, infections, chest pain, or unknown symptoms, can reveal underlying issues that need to be addressed beforehand. By reviewing these events, we get a more complete picture of your health and can investigate any unresolved concerns before you undergo the procedure.
  • Family Medical History: We may also ask about health issues in your immediate family, such as heart conditions, blood clotting disorders, or allergic reactions to any medications. This helps identify genetic risks that might not yet be diagnosed in you but could still impact your safety during surgery.

Understanding your medical background in detail enables us to take proactive decisions to minimize the likelihood of complications and ensure the safest possible outcome from your surgery.

Medication & Supplement Review

Our provider will review your current medications, including prescription drugs, over-the-counter medications, supplements, and vitamins you are taking. 

  • Blood-thinning medications, such as aspirin, warfarin, or clopidogrel (Plavix), can significantly increase the risk of bleeding during and after surgery. These may need to be stopped several days prior to surgery or replaced with short-acting alternatives under medical supervision.
  • Diabetes medications like insulin or metformin may require adjustments before surgery. Blood sugar control during surgery is critical. Insulin may need dose adjustments to prevent hypoglycemia (dangerously low blood sugar) while fasting. Metformin, in particular, may be paused before certain procedures to reduce the risk of lactic acidosis, a rare but serious complication that can affect the kidneys.
  • Steroids or immunosuppressants can impair your ability to heal after surgery and increase your risk of infection. If you are on these medications, our team will coordinate closely with your specialist to determine how best to manage them.
  • Certain herbal supplements can interact with anesthesia, affect blood clotting, or impact liver enzymes that metabolize medications. These will often need to be discontinued at least 1–2 weeks prior to surgery.

If medication changes are required, our team will:

  • Create a clear and safe substitution plan, when necessary
  • Provide detailed instructions on when to stop and restart each medication
  • Coordinate with your surgeon or specialists for high-risk medications
  • Monitor and support your health during the medication adjustment period

Basic Diagnostic Tests

Sometimes, your body may not show obvious symptoms of an underlying issue, but internal issues can still pose serious risks during surgery. That is why we perform some basic diagnostic tests to get a snapshot of your overall health and help identify any hidden conditions that could interfere with surgery or recovery.

Here are some common tests that may be ordered as part of your preoperative evaluation.

  • Complete Blood Count (CBC): This test measures your red and white blood cells, hemoglobin levels, and platelets. It helps identify conditions like anemia, infections, or low platelet counts, which could increase bleeding risks. If any abnormalities are found, treatment may be needed before surgery can proceed safely.
  • Comprehensive Metabolic Panel (CMP): This test evaluates your electrolyte balance, kidney and liver function, and blood glucose levels. Abnormalities could indicate uncontrolled diabetes, kidney disease, liver dysfunction, or dehydration, all of which could complicate your recovery after the procedure. 
  • Prothrombin Time (PT/INR): This test measures how quickly your blood clots. Abnormal clotting can increase your risk of excessive bleeding during surgery. It is especially important if you take blood-thinning medications (like warfarin or aspirin) or have liver disease. 
  • Urinalysis: This simple urine test can reveal signs of a urinary tract infection, kidney issues, or other systemic conditions. For example, large amounts of protein in the urine may indicate early kidney disease, and the presence of bacteria or white blood cells may signal an infection that needs to be treated before the surgical procedure.
  • Electrocardiogram (EKG/ECG): An EKG checks the electrical activity of your heart and helps detect irregular heart rhythms (arrhythmias) or other cardiac concerns. This test is commonly recommended for patients with a history of heart disease or those at elevated cardiovascular risk. It provides important information about how well your heart is functioning and helps determine whether it can safely handle the stress of surgery.
  • Chest X-Ray: This imaging test may be recommended if you have a history of lung disease, chronic smoking, or recent respiratory infections. It provides insight into your lung health and signs of fluid buildup or infection, which could affect your ability to tolerate anesthesia or breathe normally after surgery.

Please note that not all patients will need every test listed. Our healthcare provider will determine which tests are necessary based on your medical history, age, and the type of surgery you are having.

How do we help you prepare for surgery after pre-op testing?

Once your pre-operative testing is complete, our team takes several steps to help ensure you are fully prepared, physically and medically, for your upcoming procedure.

Pre-op evaluations are usually scheduled a few weeks to a month before surgery, allowing us time to identify and manage any potential issues well in advance. This proactive approach helps reduce surgical risks, improves recovery, and gives both you and your surgical team peace of mind. 

Here is what happens after your evaluation.

If Everything Looks Good - If your test results come back normal and you are deemed fit for surgery:

  • We will provide your medical clearance in the form of a signed document, sent directly to your surgeon.
  • All required test results, forms, and notes are completed and forwarded as needed.
  • You will receive detailed pre-surgical instructions, including fasting guidelines, medication schedules, and what to expect on surgery day.

If an Issue is Found - If the testing results reveal any concerns that could impact your safety or surgical outcome, we will act quickly and efficiently to address it:

  • We provide treatment for issues like anemia, infections, or electrolyte imbalances to get your levels stabilized before surgery.
  • If you have high blood pressure, uncontrolled diabetes, or a heart or lung condition, medication adjustments are made, and follow-up checks are planned until your condition is under control.
  • If your medications need to be paused or switched before surgery, we will give you a clear schedule and plan, so you know exactly what to take, stop, or resume, and when. 
  • In certain cases, we may refer you to a cardiologist, pulmonologist, or another specialist for additional evaluation. We help coordinate these referrals promptly to keep your surgery timeline on track.

Throughout this process, we remain in close communication with your surgeon and any specialists involved in your care. Our priority is to make sure every aspect of your health is addressed so you can safely proceed with surgery.

Medical Clearance for Surgery in Sebastian, FL

At IMPCS, we provide essential medical clearance for surgery to ensure you're healthy and ready for your procedure. Our team, led by Dr. Edeck Pierre, is committed to making your surgical journey as smooth and safe as possible.

To schedule a consultation, please call (772) 783-2436 or book an appointment online today.

If you experience symptoms requiring immediate attention, we also provide acute care appointments within 48 hours to ensure you receive prompt evaluation and treatment.

7955 Bay St Suite 2
Sebastian, FL 32958

Monday - Friday | 9:00 AM - 5:00 PM
Saturday | Available by Appointment

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Internal Medicine and Primary Care of Sebastian
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