Before you come in — the pre-admission clinic
Most patients attend a pre-admission clinic appointment before surgery, at one of:
- RPA — Royal Prince Alfred Medical Centre, Level 2, corner of Carillon Avenue and Missenden Road, Newtown
- IRO — Institute of Rheumatology and Orthopaedics, Level 6, Queen Elizabeth II Building, 59 Missenden Road, Camperdown
The purpose is to make sure it is safe to proceed with surgery and anaesthetic, and to tell you what to expect on the day. You may meet the anaesthetist and clinic nurse, and have basic tests — an ECG (heart tracing), blood tests, and sometimes a chest X-ray. Allow one to two hours.
Blood thinners: if you take medicines such as aspirin, warfarin or apixaban, these need to be stopped before surgery — but only on your team’s instructions. Wait to be told when.
The team you will meet
A lot of people will introduce themselves. Broadly:
- The medical team — your consultant surgeons (orthopaedic and, for many operations, plastic), surgical fellows, registrars, resident medical officers and interns. Someone from the team will see you every day. Although the team is large, the consultant surgeon ultimately makes the decisions about your care. If you or your family want a proper sit-down conversation, ask — a time can be arranged.
- Nursing staff — registered nurses provide your daily care around the clock; the Nursing Unit Manager runs the ward; and your Clinical Nurse Consultant (CNC) coordinates your care before and after surgery. The CNC is your key contact — their number is given to you directly.
- Physiotherapist — you will usually be seen on the day of your operation or the day after. Getting up and moving early is genuinely important: walking re-expands the lungs and helps prevent chest complications like pneumonia after an anaesthetic. You will start with a frame or other aid and progress from there; after discharge, physiotherapy continues at a rehabilitation hospital or an outpatient clinic, whichever suits your needs.
- Psychologist — a sarcoma diagnosis is overwhelming, and a range of emotions is completely natural. The psycho-oncology service offers a safe space to work through stress, low mood, body-image changes and grief — in person or by video or phone, before or after surgery, and support may also be available for your loved ones.
- Social worker — practical and emotional support: financial assistance, transport, accommodation, carer support and community services. Ask any member of the team to connect you.
- Depending on your needs, you may also see an occupational therapist, dietitian, pharmacist, Aboriginal liaison officer, speech therapist or interpreter. RPA takes your cultural and religious needs into consideration wherever possible — let your nurse know what matters to you.
What to bring
Comfortable and boring is the rule: toiletries and pyjamas, phone and charger, headphones, a book or magazines, an eye mask and ear plugs, photos if they help, and a small amount of money for a newspaper or café. Your valuables can be locked away during surgery, but you are responsible for what you bring — leave anything of value or sentimental importance at home.
The common wards for this surgery are Q7E (elective orthopaedics, IRO), 8W1 (orthopaedics and trauma, RPA) and 6E3 (plastic surgery, RPA); children are cared for on the children’s ward, and some patients spend time in intensive care after larger operations — planned, not alarming. Guest Wi-Fi is available (network SLHD-Guest, sessions up to 12 hours).
Parking, travel and accommodation
Concession parking is available for eligible patients and carers — including those attending for ongoing cancer treatment — and for holders of a Pension, Health Care, Gold Veterans or Mobility Parking card. Have the Concession Parking form signed by clinical staff and present it with your ID at the RPA Security Office, Level 5, Main Hospital Entrance (phone 9515 8409).
If you live more than 100 km from Sydney, you are entitled to claim a subsidy towards travel and accommodation through IPTAAS — the Isolated Patients Travel and Accommodation Assistance Scheme (iptaas.health.nsw.gov.au). The social work team and your CNC can help you apply, while you are an inpatient or at clinic appointments.
Accommodation for you or your relatives can be arranged nearby — speak to your CNC, or call the RPA Accommodation Officer on 0407 672 351.
Eating well
Cancer and its treatment place extra demands on the body. Eating well before, during and after treatment gives you more energy, helps wounds heal and tissues rebuild, supports your immune system, and can shorten hospital stays. During treatment you may need to be flexible — the foods you can manage may not match your normal diet, and that is fine. Check with your doctors before drinking alcohol during treatment, as it can interact with some medicines. The Cancer Council’s Nutrition for People Living with Cancer booklet (linked below) is excellent, and the ward dietitian can help with specifics.
The RPA Virtual Hospital — help, day or night
The Virtual Sarcoma & Tumour Advice and Support Service is a 24/7 clinical contact point for all patients of the RPA sarcoma unit or the Chris O’Brien Lifehouse sarcoma service — and for their carers and families.
Call 1800 463 918, any time, about symptom management, pain, chemotherapy or radiotherapy concerns, or anything before or after your operation. If you need a healthcare interpreter, let them know.
Not for emergencies — in an emergency call 000 or go to your nearest emergency department.