Your Hospital Stay
On the day of your surgery, report to Whitingham Pavilion and take the elevator to second floor to Day Surgery. A staff member will greet you and explain to you the pre-operative procedure and what you and your family/significant others can expect for the rest of the day. Other members of the healthcare team, including an anesthesiologist and physician assistant, will be interviewing you as well.
You will be asked to sign authorization and consent forms. A registered nurse will review your medical and surgical information and medications, and ask you to sign that you have not had anything to eat or drink since midnight.
Your surgeon will meet with you briefly to answer any last-minute questions and confirm with you the surgical procedure to be performed. A registered nurse from the operating room will greet and interview you before taking you into the operating room.
Anesthesia
You will meet your anesthesiologist prior to surgery. The anesthesiologist will review your history and discuss options for anesthesia along with your plan of care. There are two major options for anesthesia for joint replacement surgery:
General Anesthesia
The anesthesiologist induces a full unconsciousness (you will be completely asleep) using a combination of intravenous and inhaled medications. The anesthesiologist maintains a correct depth of anesthesia during the entire procedure. When the surgery is over, you will awaken and have complete sensation that will most likely require pain medication. Nausea, vomiting and sleepiness can be common side effects of general anesthesia. If necessary, you will be given medication for the nausea and vomiting. It is important to note that every person reacts differently to general anesthesia.
Regional Anesthesia
Regional anesthesia results in the elimination of pain and feeling in a given region or area of your body (e.g., legs), usually by injection of a local anesthetic to numb or block a group of nerves. In addition, you will be given sedative medication to induce a mild sleep. Your anesthesiologist will discuss the anesthetic options with you during the preoperative visit. Certain medical conditions may affect the possibility of choosing one type or the other. If you have ever had a poor reaction to anesthesia, inform your anesthesiologist. Together, you can decide on the best anesthetic for you.
As you prepare for surgery, please feel free to call the Surgical Nurse Coordinator at 203.276.7975 if you are unsure about anything, or have any questions or concerns. We are happy to be a resource for you in the pre-operative phase.
Pain Management
Managing your pain is crucial to your recovery. Our goal in managing your pain is for you to be able to move easily, get in and out of bed, participate in therapy and rest comfortably. Our healthcare team will work with you to keep you as comfortable as possible following surgery. Your job is to communicate to us how you are feeling, so that adjustments can be made if needed.
Pain Control Options
Our protocol for pain management includes a combination of medications and therapies that give you the best results. These include narcotics given through your IV line or injected under the skin, long-acting narcotic pills that give 12 hour relief, quick-acting narcotic pills which are available as needed, non-narcotic medications such as Tylenol or Celebrex, ice/cold pack application after physical therapy or whenever desired, and relaxation techniques. We have various medications available to use, should one type not work well for you.
Should you have a significant pain history, or you feel you are not getting adequate pain relief, we have a pain management specialist nurse available to work with you.
Taking Your Pain Medication
You will want to take pain medication regularly for awhile, and especially before doing any significant moving, such as getting out of bed or participating in therapy. Help your nurse plan ahead to have the best pain control. Remember that it works best, and less medication is needed, if you do not let the pain become severe before taking the medication. Ask for pain medicine as soon as you are aware that your pain level is rising.
Again, ask sooner rather than later for best results! The nurse will help you identify the level of your pain by using a Pain Scale.
Don't Be Afraid…It is important to talk honestly and openly about your pain and its treatment so that you can receive the proper care.
Pain Management Following Discharge
When you are discharged you will receive a prescription for pain pills. Pain should decrease over the next few weeks as you heal, so less medication is required and your pain may be controlled using an over-the-counter medication such as Tylenol, ibuprofen, or naproxen.
Preventing Complications
Lungs-- In order to keep your lungs clear of congestion, you will be instructed to practice coughing and deep breathing. You will be given a device called an incentive spirometer. Taking deep breaths on the mouthpiece will inflate your lungs and provide the needed activity to prevent pulmonary complications. You should do this 10 times every hour while you are awake in bed.
Blood Clots--Your decreased mobility following surgery and normal postoperative swelling put you at risk for blood clot formation in your legs. Many steps will be taken to prevent this from happening:
- Early ambulation: Every effort will be made to get you up and moving as soon as possible. In most cases, you will be encouraged to dangle your legs or stand the evening of surgery.
- Neurovascular Issues: Sensation, motion and circulation in your feet will be checked frequently. You should report any numbness, tingling or difficulty moving your toes, or any burning or discomfort in your heels immediately.
Bowel Function--Your bowel activity may be slow to return to normal due to anesthesia or pain medication. To prevent distension in your abdomen, you will be started on liquids and slowly progressed to solid food. If you have not moved your bowels by the second day after surgery, you should ask for a laxative or suppository. You should move your bowels no later than the third day after surgery.
Rehabilitation
Surgery to replace a damaged hip or knee offers many people the opportunity to regain lost function and return to activities of daily living without pain. Surgery is the first step to your recovery. Active participation in the therapy program, beginning immediately following your surgery through your hospitalization and outpatient therapy, will be the key to a successful outcome.
During your hospital stay you will work with a physical and occupational therapist daily to develop a therapy plan that will assist you in accomplishing your goals for function and independence. You will be given a therapy program schedule the day following your surgery that will include both individual and group sessions overseen by the physical therapy staff.
For more information or to make an appointment please call
1-877-233-WELL (9355).