Mr Adrian Ling, Vascular and Endovascular Surgeon, Melbourne.

Where does Mr Ling perform his procedures?

Mr Ling operates at Epworth Richmond (Endovascular and major and minor surgical procedures) Northpark Private (minor surgical procedures), and Warringal Private (endovascular procedures). In some cases you may require a 'hybrid' procedure that combines endovascular treatment with open surgery. In this case, your procedure will be done in a state-of-the-art Hybrid Operating Theatre at Epworth Richmond. Varicose vein procedures can either be performed as an inpatient in a private hospital, or as an outpatient in his main clinic in North Carlton.

What should I bring with me to the hospital?

Please bring with you:
1) Your current medication list including their dosages. If you do not have a list you can obtain one from your GP or pharmacist. You can also bring in your actual medications if you do not have a list.
2) Personal belongings - toiletries, night gown, slippers, hearing aids, orthodontics, physical mobility aids, CPAP machine etc.
3) Please organise for someone to drive you home upon discharge, as you cannot drive for at least 24 hours after sedation or general anaesthesia. If you live alone please arrange to stay with someone on discharge.

I have private insurance. Will I be out of pocket for my operation?

Mr Ling is a 'known gap provider'. The expenses NOT covered by insurance include:

1. Your excess - this is what you agreed to with your insurance fund when you started your policy. Note that some funds do not charge an excess for day stay procedures - Mr Ling's varicose vein procedures are day stay - please clarify this with your fund.
2. Mr Ling's gap fee - some procedures will have a gap fee. Informed consent will always be provided to you prior to your procedure.
3. The anaesthetist's gap fee - some anaesthetists may charge a gap fee. Their contact details are provided to you so you are fully informed prior to your procedure.

Do I have to fill in pre-admission paperwork?

Yes. When you see Mr Ling and a procedure is confirmed, you will receive a confirmation letter that details your admission details, fasting instructions and your anaesthetist's contact details. Please submit your paperwork at your earliest convenience.
Pre-admission paperwork can either be filled in:

1. By hand - the admission booklet will be provided to you at your consultation. Please fill this in and send it in the reply-paid envelope to the hospital.
2. By online submission - see above.

When do I stop eating and drinking prior to a procedure?

Procedures done in the clinic (varicose veins) do not require fasting. If you are having a procedure in hospital, it usually requires an anaesthetic. This includes sedation (twilight anaesthetic) and general anaesthetics. During your pre-operative consultation, Mr Ling and/or his staff will inform you whether you need to fast, as well as the time to fast from. This will be also clearly stated on your operation confirmation letter. ​ As a general rule:

• FOOD: You cannot eat any food for 6 hours prior to an anaesthetic (sedation or general anaesthetic).
• DRINK: However, you can have clear fluids until 2 hours prior to an anaesthetic. Clear fluids includes water, juice, cordial, soft drinks, black tea or black coffee - not milk. The time that you can have clear fluids up until is stated on your operation confirmation letter.

Which medications should I stop taking?

This information is usually discussed during your consultation with Mr Ling when your procedure is confirmed. ​ Specific medications to clarify if not already discussed:

1. Aspirin - do not stop taking this
2. Clopidogrel (Iscover, Plavix) - clarify with Mr Ling
3. Other blood thinners - eg Warfarin/Coumadin/Marevan, Apixaban (Eliquis), Dabigatran (Pradaxa), Rivaroxaban (Xarelto) - clarify with Mr Ling
4. Diabetic medications
   • Please inform the nurse on admission that you are diabetic so he/she can check your blood sugar levels.
   • Diabetic tablets - you can continue this on the day prior to surgery. You can omit taking these tablets on the morning of surgery irrespective of whether you are on the morning or afternoon list.
   • Insulin - this requires individualised advice. Please contact Mr Ling if not already discussed.
   • You can recommence all diabetic medications when you are able to eat and drink normally.

Can a relative or friend accompany me prior to the procedure?

Yes. Your relative can accompany you and even wait by your side in the 'holding bay'. They will have to leave you once you are being taken in to the operating theatre. The nurse will be able to tell them which ward you will be going to if applicable, to meet you afterwards.

When will I be discharged?

Mr Ling will tell you at your pre-operative consultation whether or not you will be staying in hospital after your procedure and for how long. This is subject to change based on extenuating circumstances. If you are having a day procedure such as varicose veins, generally you are observed for 2-3 hours after your procedure prior to discharge. You or the nurse can call your relative or friend from recovery to let them know an approximate time to pick you up.

Can I have a private room?

Unfortunately this is not a decision made by Mr Ling. Requests can be put into the nurse in charge of the ward. Often there are medical reasons for single rooms eg infection control, noise from medical equipment etc

Where can I find out information about the hospital eg parking, visiting hours etc?

Go to the "contact page" on this website and there will be a link to the relevant information.

Can I continue taking my blood thinners?

You can continue the following medications, even on the day of your procedure. This applies to any venous or arterial procedure performed by Mr Ling:

• Aspirin/Cardiprin/Cartia/Aspro/Disprin/Solprin/Asasantin

I'm a diabetic - should I take my medications?

The management of your diabetic medications will be influenced by whether you are on a morning or afternoon list, what sort of medications you take (insulin, oral medications) and whether you are having a minor or major operation. You may be directed by either Mr Ling or the anaesthetist who will be looking after you. Sometimes for complex diabetic medications Mr Ling will ask your usual endocrinologist to instruct you about what to take and what not to take. If you do not have one, he will ask a physician to be involved. Please bring your usual diabetic medications with you to the hospital. It is very important to notify the hospital nurses on admission if you are diabetic. They will check your blood sugar on arrival. ****IMPORTANT**** You MUST notify Mr Ling if you are taking any of the following diabetic medications as they must NOT be taken for 48 hours prior to fasting.

1. Dapagliflozin (Forxig)
2. Empagliflozi + Metformin (Jardiamet, Synjardy)
3. Empagliflozin (Jardiance)
4. Empaglifozin + Linagliptin (Glyxambi)
5. Danagliflozin + Metformin (Xigduo)
6. Dapagliflozin + Saxagliptin (Qtern)