Preparing for Shoulder Replacement: Imaging, Blood Work, Fasting and the Medicine Pause

The first thing many people notice is the toothbrush. Standing at the sink the week before surgery, they try brushing with the other hand and realize how much of daily life quietly runs through one shoulder. Buttons, seat belts, the top shelf, the dog’s leash. Preparing for shoulder replacement surgery is partly about scans and lab slips, and partly about rehearsing this smaller, slower version of ordinary life before it arrives.

Most people come to the operation after years of a joint that grinds, aches at night and refuses to lift a kettle. The surgery itself is well established. What surprises people is how much of the outcome is shaped in the weeks before the anesthesiologist says hello: whether the skin is clear, the blood sugar steady, the medicine list honest, the stomach empty at the right hour.

This explainer walks through what the pre-operative team is checking and why, so the questions you bring to your care team are sharper and the surprises are fewer.

What actually happens during a shoulder replacement, in plain language

The shoulder is a ball-and-socket joint. The ball is the top of the upper arm bone, called the humeral head, and the socket is a shallow dish on the shoulder blade called the glenoid. Arthroplasty, the medical word for joint replacement, means resurfacing or replacing those worn parts with metal and medical-grade plastic components.

Surgeons broadly use two designs. In an anatomic total shoulder replacement, a metal ball replaces the humeral head and a plastic liner covers the glenoid, keeping the joint’s natural arrangement. In a reverse shoulder replacement, the positions are swapped: the ball is fixed to the shoulder blade and the socket sits on the arm bone. That reversal lets the large deltoid muscle on the outside of the shoulder lift the arm when the rotator cuff, the group of four small muscles that normally centers the ball, is torn beyond repair. A partial replacement, or hemiarthroplasty, replaces only the ball.

The operation is done under general anesthesia, often combined with a nerve block, an injection of local anesthetic near the nerves in the neck that numbs the arm for hours afterward. Through an incision at the front of the shoulder, the surgeon moves muscles aside, removes damaged bone and cartilage, shapes the bone to accept the components and fixes them in place, sometimes with bone cement. Mayo Clinic describes the procedure as typically taking a couple of hours, followed by a short hospital stay or, for some people, same-day discharge.

Knowing which design your surgeon plans matters for preparation, because the movements you are asked to avoid afterward differ between anatomic and reverse replacements. Ask early, and ask why.

Who is usually offered shoulder replacement, and who is asked to wait

The most common reason is osteoarthritis, the wear-and-tear loss of cartilage that leaves bone rubbing on bone. Rheumatoid arthritis, avascular necrosis (bone that has lost its blood supply), badly healed fractures and long-standing massive rotator cuff tears with arthritis, a combination called cuff tear arthropathy, are the other usual paths to the operating room. Surgeons generally consider replacement when pain interferes with sleep and daily tasks and when injections, physical therapy and activity changes have stopped helping, as MedlinePlus and Mayo Clinic both note.

Some people are asked to wait, and the reasons are usually about safety rather than eligibility. An active infection anywhere in the body, including a dental abscess or an open skin sore near the shoulder, raises the risk of bacteria settling on a new implant, so surgery is typically postponed until it is treated. Poorly controlled diabetes, recent heart trouble, untreated sleep apnea or heavy smoking may lead the team to delay while those risks are addressed. Severe nerve damage around the shoulder, or a deltoid muscle that does not work, can make a reverse replacement unlikely to help, because that muscle does the lifting afterward.

Younger, very active people are sometimes counseled to wait because implants have a finite life and heavy loading wears them faster. This is a judgment call for the surgeon, weighing today’s pain against the possibility of a second operation years later.

None of this is a verdict. It is a conversation about timing, and the decision rests with you and the treating team together.

Preparing for shoulder replacement surgery: why the pre-op visit is the real starting line

Somewhere between the decision and the operation sits a pre-operative assessment, sometimes called a pre-admission clinic. The NHS describes it as the appointment where the team checks your general health, confirms the tests you need and explains what to do in the days before surgery. It is easy to treat as paperwork. It is better treated as the moment the surgery becomes a plan.

Expect a detailed history: past operations, reactions to anesthesia, bleeding problems, blood clots, heart or lung disease, diabetes, and whether you snore or stop breathing in your sleep. Expect a full medicine reconciliation, meaning a line-by-line review of every prescription, over-the-counter tablet, inhaler, patch, herbal remedy and supplement. Bring the actual containers or a photograph of each label. Memory is unreliable under stress, and a forgotten blood thinner or supplement can change the plan.

The anesthesia team, or a nurse on their behalf, will usually look at your airway, your teeth and your neck movement, and ask about loose or capped teeth. They will explain the nerve block and general anesthesia and ask about any previous nausea after surgery.

Preparing for shoulder replacement surgery also means practical planning that starts here: who drives you home, who stays the first night, whether stairs at home are a problem, and how you will manage a sling for several weeks. Write down what you are told. People routinely leave this visit with instructions they cannot recall the next morning.

Which imaging do you need before shoulder replacement?

Plain X-rays come first and are usually already in hand by the time surgery is discussed. They show how much cartilage is lost, whether the humeral head has migrated upward (a sign the rotator cuff has failed) and how worn the glenoid socket has become. Several views are taken so the surgeon can see the joint from the front and from the side, in the axillary view taken with the arm raised.

Many surgeons then order a CT scan, a computed tomography study that stacks many X-ray slices into a three-dimensional picture of the bone. CT matters in the shoulder because the glenoid is small, shallow and often eroded unevenly in arthritis. Knowing the exact shape and angle of that socket helps the surgeon choose the implant size and position and decide whether extra support, such as a bone graft or an augmented component, is needed. Some teams use the CT to build a patient-specific plan or a printed guide before the operation.

MRI, magnetic resonance imaging, uses magnets rather than radiation and shows soft tissue. It is more likely to be ordered when the state of the rotator cuff tendons is unclear, because the answer can tip the choice between an anatomic and a reverse design. If the cuff is already known to be torn on earlier scans, MRI may be unnecessary.

Tell the team about any metal in your body, pacemakers or claustrophobia before MRI, and about kidney problems before any scan with contrast dye. Bring older imaging if you have it; comparing pictures over time is often more informative than a single new scan.

What blood work and heart tests are done before surgery?

The blood tests before a joint replacement are less about the shoulder than about how your body will handle anesthesia, blood loss and healing. A full blood count checks for anemia, since low red blood cells before surgery mean less reserve if you lose blood, and checks platelets, the cells that plug bleeding. Kidney function and electrolytes, the salts in your blood, tell the anesthesiologist how your body clears drugs and fluids. A clotting screen may be added if you take anticoagulants or have a bleeding history.

If you have diabetes, expect an HbA1c, a measure of average blood sugar over roughly the previous three months. High readings are linked with slower wound healing and more infections after joint surgery, which is why many teams set a threshold and may delay the operation to improve control first. The exact target is a decision for your surgical and diabetes team, not a fixed rule.

A blood group and antibody screen is often taken so that matched blood is available if needed, even though transfusion after shoulder replacement is uncommon. Some centers swab the nose for Staphylococcus aureus, including the resistant form known as MRSA, because carriers can be treated before surgery to lower infection risk.

An electrocardiogram, the tracing of the heart’s electrical rhythm, is routine for older adults and anyone with heart disease, high blood pressure or diabetes. A chest X-ray, lung function tests or an echocardiogram (an ultrasound of the heart) are reserved for people whose history suggests they are needed. Abnormal results do not automatically cancel surgery; they may simply change the anesthetic plan or prompt a specialist opinion first.

Fasting before shoulder surgery: the rules and the reasons behind them

An empty stomach is one of the few pre-operative steps entirely in your hands, and it is not a formality. Under general anesthesia the reflexes that normally keep stomach contents out of the lungs are switched off. If food or liquid comes back up, it can be inhaled, an event called aspiration, which can cause serious pneumonia. Fasting reduces that risk by reducing what is in the stomach.

Guidance from the NHS describes the typical pattern: no food for about six hours before the anesthetic, and clear fluids allowed until about two hours before. Clear fluids means water, diluted squash, black tea or coffee without milk. Milk counts as food because it curdles and empties slowly; so do chewing gum, sweets and most sports drinks with pulp or protein. Your own instructions may differ, and the printed sheet from your team overrides anything general.

The mistake people make is over-fasting. Going without any liquid from midnight for an afternoon operation leaves you dehydrated, headachy and more prone to nausea and low blood pressure when the anesthetic starts. Many anesthesia teams now actively encourage clear fluids up to the permitted cutoff for exactly this reason.

The other mistake is silence. If you slip and eat a biscuit at breakfast, say so at check-in. The team may delay your slot rather than cancel, and an honest answer is far safer than a quiet one.

Usual medicines are often taken on the morning of surgery with a small sip of water unless you have been told otherwise; that instruction comes from the pre-op team, not from this article.

Blood thinners before shoulder surgery: how the medicine pause works

Anticoagulants, medicines that slow blood clotting, present a genuine balancing act. Continue them and the surgeon faces more bleeding into the joint and the wound; stop them and the condition they treat, such as an irregular heart rhythm or a previous clot, becomes riskier for a few days. Neither choice is free, which is why the pause is planned by the prescribing clinician, sometimes with a cardiologist or hematologist, and never improvised.

The timing depends on the drug’s mechanism. Warfarin works by blocking vitamin K, so its effect wears off slowly over days and is usually stopped earlier, with a clotting blood test on the morning of surgery to confirm it has cleared. The newer direct oral anticoagulants act on a single clotting protein and leave the body faster, so they are typically held for a shorter window that also depends on kidney function. Antiplatelet drugs, which make platelets less sticky, are handled differently again; aspirin prescribed after a heart stent is often continued through surgery because stopping it carries its own hazards, while other antiplatelets may be paused.

People at very high clot risk may be offered bridging: short-acting injectable anticoagulant given during the gap so they are never fully unprotected. Others are told to simply stop and restart. After the operation, most joint replacement patients receive some form of clot prevention anyway, whether an injection, a tablet or compression stockings, since immobility raises the risk of deep vein thrombosis.

The practical rule is simple. Never stop or alter a blood thinner because a leaflet, a friend or a search result said so. Ask your prescriber for written instructions with the exact last dose date, and bring that paper to the hospital.

What about diabetes medicines, supplements and everyday pills?

Blood thinners get the attention, but the medicine review at the pre-op visit reaches much further, and the reasoning is worth understanding even though the decisions belong to your prescriber.

Diabetes medicines are adjusted around fasting. If you cannot eat, a normal dose of insulin or a sugar-lowering tablet can drive blood glucose too low. One class, the SGLT2 inhibitors, which make the kidneys pass sugar in the urine, is usually paused for a few days before surgery because fasting while taking them can trigger a dangerous acid build-up in the blood. Your diabetes team will usually give a written day-by-day plan.

Non-steroidal anti-inflammatory drugs, the family that includes ibuprofen and naproxen, reduce platelet stickiness and may be stopped in the days before surgery to limit bleeding; acetaminophen is often the suggested substitute for pain in the meantime, if your clinician agrees. Blood pressure medicines are largely continued, though certain classes that widen blood vessels are sometimes held on the morning of surgery to avoid a drop in pressure under anesthesia.

Herbal remedies and supplements deserve a candid conversation. Fish oil, high-dose vitamin E, garlic and ginkgo extracts can add to bleeding tendency; St John’s wort can interfere with anesthetic drugs. Because they are sold as food supplements, people often leave them off medicine lists. Put them on.

Steroid tablets taken long term are a special case: the body’s own stress hormone response may be blunted, and the anesthesiologist may give extra steroid during surgery. Hormonal contraception and hormone therapy are sometimes reviewed because of clot risk. Every one of these is a conversation, not a self-directed change.

Skin, teeth, smoking and the other infection work in the weeks before

Infection around an artificial joint is uncommon, but when it happens it can mean prolonged antibiotics or further surgery, so the weeks before the operation are spent quietly closing doors that bacteria could walk through.

Skin comes first. Cuts, scratches, eczema flares, acne or rashes on the shoulder, arm or chest should be reported, since an incision through inflamed skin carries more risk; surgery may be postponed until the skin is calm. Many teams ask you to wash with an antiseptic soap for several days beforehand and to avoid shaving the area yourself, because tiny razor nicks are entry points. Any hair removal is done in the hospital with clippers.

Teeth are next. Dental infections release bacteria into the blood, and those bacteria can lodge on a new implant. If you are overdue for dental care or have a sore tooth, sort it out well before surgery, and ask your surgeon whether they want dental work avoided in the weeks immediately after the operation.

Smoking affects every part of healing. Nicotine narrows blood vessels and carbon monoxide starves tissue of oxygen, so wounds close more slowly and bone integrates with the implant less reliably; anesthesia is also harder on smokers’ lungs. MedlinePlus advises quitting as far ahead of surgery as possible, noting that even stopping a few weeks before lowers complications. Vaping is not a neutral substitute, since it still delivers nicotine.

Finally, nutrition. Protein supports wound repair, and unintentional weight loss or a low albumin level on blood tests may prompt a dietitian referral. This is not the moment for a crash diet.

A shoulder replacement pre-op checklist for your home, and what to bring to the hospital

For several weeks after surgery your operated arm will be in a sling, and you will be told not to push, pull or reach with it. The kitchen, bathroom and bedroom need rearranging for one-handed life before you leave for the hospital, not after.

Move daily items to counter height so nothing requires reaching up or bending low. Pre-cook and freeze meals in single portions with lids you can open with one hand. Loosen or remove jar lids in advance. A long-handled sponge and a pump bottle of soap make showering possible; a shower chair adds safety, and a handheld showerhead lets you rinse without lifting the arm. Practise wiping after the toilet with your non-dominant hand if the dominant shoulder is being replaced; a bottom-wiping aid or a bidet attachment removes the twisting that the shoulder cannot yet do.

Sleep is a common struggle, because lying flat pulls on the shoulder. Many people rest in a recliner or prop themselves upright with a wedge and pillows for the first weeks. Set that up beforehand.

Clothing should be loose, front-opening and a size up on top: button or zip shirts, wide-neck tops, slip-on shoes, elastic waistbands. A bra with a front fastening or a soft camisole is easier than a back clasp.

What to bring to shoulder surgery is a shorter list than people expect: your written medicine list and blood-thinner instructions, a photo ID and insurance details, glasses or hearing aids in a labeled case, your inhalers or sleep apnea machine if you use one, a phone charger, and one comfortable outfit to wear home. Leave jewelry, nail polish and valuables at home. Arrange a driver; you cannot drive yourself after anesthesia or while wearing a sling.

The typical countdown: what happens when before shoulder replacement

The order of events varies between hospitals, but the shape is broadly the same. The table below summarizes the usual sequence; treat it as a map, not a schedule, and let your own team’s paperwork be the timetable.

Stage	What usually happens	Why it matters
Decision visit	Surgeon confirms diagnosis on X-ray, discusses anatomic versus reverse design, orders CT or MRI if needed	Implant choice shapes the movements you must avoid afterward
Weeks before	Pre-op assessment, blood tests, ECG, medicine review, dental check, smoking cessation, home set-up	Fixable risks (anemia, high blood sugar, skin problems) are found while there is time to act
Days before	Planned medicine pauses begin per prescriber; antiseptic washes may start; confirm transport and helper	Bleeding and clot risk are balanced deliberately, not by chance
Night before	Last meal by the time stated; remove jewelry and nail polish; pack bag	An empty stomach lowers aspiration risk under anesthesia
Morning of surgery	Clear fluids until the stated cutoff; take only the medicines you were told to take; arrive at the given time	Hydration reduces nausea and low blood pressure at induction

Two points deserve emphasis. First, the medicine pause is the step most often mis-timed, because instructions from a cardiologist, a surgeon and a pharmacist can arrive separately. If you have more than one set of instructions and they disagree, phone the pre-op clinic before the surgery date rather than guessing. Second, illness in the final week changes things. A cold, a fever, a urinary infection or a flare of a skin condition should be reported; the team may prefer to reschedule rather than operate on an unwell body, and that is caution, not a setback.

What the first days and weeks after shoulder replacement usually look like

Waking up, the arm will feel heavy and strangely absent. That is the nerve block, which typically numbs the shoulder and arm for many hours; the team will usually start scheduled pain relief before it wears off so there is no cliff edge. Mayo Clinic notes that people either go home the same day or stay one to two nights depending on health and support at home.

The sling stays on for several weeks, removed for washing, dressing and the gentle exercises a physical therapist teaches before discharge. Those early exercises are mostly pendulum swings and elbow, wrist and hand movements to prevent stiffness elsewhere. The rules differ by implant: after an anatomic replacement the repaired tendon at the front of the shoulder is protected by avoiding outward rotation, while after a reverse replacement the usual warning is against reaching behind the back and pushing up from a chair. Your surgeon’s protocol governs.

Wound care is simple: keep the dressing dry and intact until the follow-up visit, watch for redness spreading beyond the edges, and expect some bruising down the arm as blood tracks under the skin. Swelling in the hand is common and eases with elevation and finger movement.

Formal physical therapy generally ramps up over the following weeks, moving from assisted range of motion to active movement and, later, strengthening. MedlinePlus and Johns Hopkins describe recovery as a process of months rather than weeks, with the most noticeable gains in the first few months and continued improvement beyond that. Driving usually waits until the sling is off and the arm can be controlled safely, a call for your surgeon. Desk work often resumes sooner than manual work; both depend on the individual plan.

What people often get wrong about preparing for shoulder replacement surgery

Ask people what they wish they had known before shoulder surgery and the answers cluster into a handful of myths worth correcting.

“There is a fastest way to recover.” There is not, in the sense people mean. Healing of bone to implant and tendon to bone runs on biology’s clock, and pushing range of motion or strength ahead of the protocol risks loosening or tearing what the surgeon repaired. The fastest realistic recovery is the one with no setbacks: following the sling rules, doing the prescribed exercises daily, sleeping upright if that is what works, eating enough protein and not smoking.

“Fasting means nothing from midnight.” Long dry fasts are outdated. Clear fluids up to the stated cutoff are encouraged in most modern guidance, including the NHS anesthesia advice, and arriving dehydrated makes the anesthetic harder, not safer.

“I should stop all my medicines to be safe.” Stopping heart or blood pressure medicines without instruction can be more dangerous than the surgery. Only the medicines you are specifically told to hold should be held.

“You can never use the arm properly again.” Most people return to everyday tasks, gardening, swimming and gentle sports. Surgeons do commonly advise against repetitive heavy lifting, contact sports and high-impact loading for the life of the implant, and after a reverse replacement some movements remain restricted. The list is individual and should come from your surgeon, not from forums.

“Preparation is the hospital’s job.” The team runs the tests. You run the home set-up, the smoking plan, the honest medicine list and the fasting clock. Those are not small contributions.

Questions to ask your care team before shoulder replacement

A good pre-operative conversation leaves you able to explain your own plan to a relative. These questions tend to draw out the answers that matter.

• Which design are you planning, anatomic or reverse, and what specifically about my joint led to that choice?
• What imaging have you used for planning, and do you need anything further before the date?
• Which of my medicines and supplements should I stop, when exactly should I take the last dose, and who is responsible for telling me when to restart?
• Do I take my morning medicines on the day of surgery, and with how much water?
• What are my fasting times for food and for clear fluids, and what counts as clear?
• Will I have a nerve block, how long is it expected to last, and what should I do for pain when it wears off?
• Am I likely to go home the same day, and what would keep me in overnight?
• Which movements are forbidden with this implant, and for how long?
• When does physical therapy start, how often, and will I have written exercises?
• How will I shower, dress and sleep in the first weeks, and is there equipment you recommend I arrange in advance?
• When can I expect to drive, return to my kind of work, and resume the activities that matter most to me?
• What signs should make me call, and which number do I call outside office hours?
• Is there anything about my blood tests, heart tracing or blood sugar that you want improved before we go ahead?

Write the answers down, or bring someone who will. Ask for the protocol on paper. Teams expect these questions, and the ones they answer most carefully are usually the ones that prevent the phone call at two in the morning.

When to call your doctor before or after shoulder replacement

Before the operation, contact the pre-op team promptly if you develop a fever, a cough with green or bloody sputum, a urinary infection, vomiting or diarrhea, a new rash or broken skin on the shoulder or arm, a dental abscess, or chest pain, breathlessness or a fainting episode. Also call if you have accidentally taken a medicine you were told to stop, missed a planned dose of one you were told to continue, or ate or drank after the fasting cutoff. None of these are embarrassing; all of them change the plan, and knowing in advance lets the team reschedule safely rather than cancel at the door.

After the operation, some signs need same-day medical attention rather than waiting for the follow-up visit:

• Fever, or shaking chills.
• Redness spreading outward from the incision, increasing warmth, thick or foul-smelling drainage, or a wound that opens.
• Pain that escalates rather than settling, or pain that the prescribed relief no longer touches.
• New numbness, tingling or weakness in the hand or fingers that was not present when you left the hospital, or fingers that turn pale, blue or cold.
• Calf pain, swelling or tenderness in either leg, which can signal a deep vein clot.
• A feeling that the shoulder has slipped, popped or come out of place, or a sudden loss of movement.

Call emergency services immediately for chest pain, sudden shortness of breath, coughing up blood, or one-sided weakness, facial droop or confusion. Breathlessness with chest pain after joint surgery can indicate a clot that has traveled to the lungs and is treated as an emergency.

Every threshold above is a reason to make contact, not a diagnosis. Your surgical team decides what the sign means and what happens next.

Frequently asked questions

What is on a typical shoulder replacement pre op checklist?

A typical shoulder replacement pre op checklist covers a pre-operative assessment visit, X-rays and often a CT scan, blood tests and an ECG, a full review of medicines and supplements with written pause instructions, a dental check, antiseptic skin washes if requested, fasting times, transport and a helper for the first night, and home changes for one-handed living such as front-opening clothes, a shower chair and meals prepared in advance.

What are the rules for fasting before shoulder surgery?

Most fasting instructions follow the pattern the NHS describes: no food for about six hours before the anesthetic and clear fluids such as water or black tea allowed until about two hours before. Milk, chewing gum and sweets count as food. Your hospital’s printed instructions take priority over any general guidance, and if you accidentally eat or drink after the cutoff, tell the team at check-in so they can adjust safely.

Do I have to stop blood thinners before shoulder surgery?

Blood thinners before shoulder surgery are usually paused, but the timing depends on which drug you take, your kidney function and why you take it, so the decision belongs to your prescribing clinician, often alongside the surgeon or a cardiologist. Some people at high clot risk receive short-acting injections during the gap. Never stop, skip or change a blood thinner on your own; ask for the last dose date in writing and bring it with you.

What should I bring to shoulder surgery?

Bring your complete medicine list including supplements, any written medicine pause instructions, photo ID and insurance details, glasses or hearing aids in a labeled case, inhalers or a sleep apnea machine if you use them, a phone charger and loose, front-opening clothes to go home in. Leave jewelry, nail polish and valuables at home. You will need someone to drive you home, since driving after anesthesia or in a sling is not safe.

What do people wish they knew before shoulder surgery?

The most common reflections are practical: sleeping flat is difficult so many people rest in a recliner for the first weeks, showering and wiping after the toilet need to be rehearsed one-handed before surgery, front-opening clothes matter more than expected, and the nerve block wears off hours later so pain relief should already be on board. People also say they underestimated how many months of physical therapy the recovery involves.

What is the fastest way to recover from shoulder replacement surgery?

There is no shortcut that beats biology, since bone must bond to the implant and repaired tendons must heal on their own timescale. The most reliable route to a smooth recovery is avoiding setbacks: wearing the sling as instructed, doing the prescribed exercises daily, respecting the movement restrictions for your implant type, eating enough protein, not smoking and keeping blood sugar controlled. Pushing range of motion early risks damaging the repair.

What can you never do again after shoulder replacement?

Surgeons commonly advise against repetitive heavy overhead lifting, contact sports and high-impact activities that load the joint, because implants wear and can loosen under heavy use. After a reverse replacement, some movements such as reaching behind the back may remain restricted. Most people return to daily tasks, swimming, cycling, golf and gardening. The exact list is individual and should come from your own surgeon rather than general sources.

How do you wipe your bottom after shoulder surgery?

If the operated side is your dominant arm, practise wiping with the other hand before surgery, because the operated arm cannot twist or reach behind you for several weeks. A long-handled bottom-wiping aid, flushable moist wipes or an inexpensive bidet attachment for the toilet all remove the need to reach. Loose elastic-waist trousers make the whole process easier. Occupational therapists can suggest equipment during the pre-op visit.

Will my blood tests or ECG stop the surgery from happening?

Usually not. Abnormal pre-operative results more often change the anesthetic plan or prompt a specialist review than cancel the operation. Anemia may be treated beforehand, high blood sugar may lead to a short delay while control improves, and an unexpected heart finding may lead to an echocardiogram or cardiology opinion. The purpose of testing is to find fixable risks while there is still time to fix them.

Should I stop supplements and herbal remedies before shoulder replacement?

Tell your pre-op team about every supplement and herbal product, because several affect surgery even though they are sold as food supplements. Fish oil, high-dose vitamin E, garlic and ginkgo extracts can increase bleeding tendency, and St John’s wort can interact with anesthetic drugs. The team will tell you which to hold and when. Do not restart anything after surgery until you have checked, since some interact with clot-prevention medicines.

References

• MedlinePlus: Shoulder replacement
• NHS: Having an operation (surgery), preparation
• NHS: Anaesthesia
• MedlinePlus: Smoking and surgery

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.