Before Your Surgery
You will receive a call from the pre-surgical unit two business days before your surgery. The nurses will review your medications, provide any instructions and confirm your procedure and arrival time.
You will first arrive at the surgery registration area. Staff will provide you with an identification wristband and an explanation of what to expect in the surgical area. They will ask you a number of questions and initiate the paperwork needed for your procedure.
An escort will walk you to the Ambulatory Surgery Unit. While you wait to be taken to the operating room, your nurse or anesthesiologist will start intravenous fluids. Both will ask you a few more questions in preparation for your surgery. Your anesthesiologist will help you decide which type of anesthesia is best for you. If not already completed, you will be asked to sign a consent form.
Once in the operating room, you will be prepped for surgery. The skin will be cleansed with an antimicrobial agent. All body areas will be draped except the part that will be operated on. Your anesthesiologist will be at your side throughout the surgery. Your surgeon will guide the team though the operation. Depending on the length and complexity of your surgery, a number of other team members will be present. The team may include nurses, surgical residents, physician assistants, surgical technicians and patient aides.
Once the surgery is complete, you will be taken to the Post Anesthesia Care Unit (PACU). You will be continuously monitored by a nurse until you are fully awake and alert. Your nurse will explain the equipment and any additional clothing, dressings or tubes that were placed on you. You also will be instructed in your level of activity and any exercises that you need to perform during this period. You are kept in this area until you are considered stable enough to be moved to an inpatient unit or discharged to go home.
When you are discharged from the hospital, your care team will provide information on what to do and not to do while you recover. These considerations include:
Be aware of any exercise restrictions ordered by your surgeon, which will be written on your discharge instructions.
Follow your exercise program as outlined by the physical and/or occupational therapist. They will assess your abilities to perform what you learned in the hospital and help improve performance and set goals to gain more independence.
It's important to continue the exercise programs given to you as part of your daily routine. Your endurance will continue to improve. Continue to use any of the home aids and devices to protect and reduce stress on the surgical areas.
Your physician will advise when it is safe for you to drive.
As a passenger, the following tips will make your trip a safe and enjoyable one:
- Have the driver park the car a few feet from the curb so that you enter and exit the car from street level rather than the curb.
- Have the seat pushed back before getting into the car.
- Use a firm cushion to raise the seat height.
- Sit down first, then bring legs in pivoting to face forward.
- Use your seat belt.
- Your physical therapist will advise you of any special precautions you need to use as a passenger.
Hygiene and Wound Care
Your surgeon will write any water-related restrictions in your discharge summary. Depending on your surgery, a shower may be a safer option than a bath.
Showering is easier and safer when you use the following items:
- A rubber mat or other type of non slip surface.
- Grab bars
- Long handled sponge
- Hand held shower hose
- Your occupational therapist will advise you which of the above items are necessary.
Know the appearance of your wound. Your surgeon will write orders regarding the cleaning and bandaging of your wound before you leave the hospital. Your nurse will instruct you on wound care and may require a return demonstration from you.
Report the following signs and symptoms to your surgeon:
- Drainage or odor from the incision
- Increased swelling or pain in the surgical area
- Increased redness
- Numbness or tingling
Follow-up appointment with your doctor help monitor your wound healing and overall recovery progress.
Your surgeon will provide prescriptions for your pain medicine based on your pain management during the procedure. Take the medicine as directed. Taking more than the prescribed dose can be dangerous.
Some pain medications can cause constipation. Eat high-fiber foods, fresh fruits and vegetables and drink at least eight glasses of fluid each day. Unless instructed otherwise, take a laxative, when necessary to relieve constipation. Your surgeon may also prescribe a stool softener to aid your bowel function.
Depending on the type of surgery, it may be necessary to take a medicine to prevent blood clots.
Your nurse or case manager can answer any questions about your medication.
Resume your normal diet. Eat plenty of foods high in protein to help with healing.
A nutritionist is available to visit you in the hospital. Feel free to ask questions about your diet.
Notify your doctor if any infection occurs. Antibiotic treatment may be necessary.
Infection can occur in the bladder, respiratory tract, ear, teeth, gums, or other area that comes in contact with the blood stream.
Depending on the type of surgery, antibiotics may be required before certain tests or procedures.
Normal sexual activity is possible upon discharge although some modifications may be necessary. Your surgeon will advise you of any restrictions.
The sensitivity of metal detectors can vary. If your surgery results in a prosthesis, it may cause the alarm to sound. Tell the security officer that you have a prosthesis. A hand-held wand will be passed over the prosthesis to confirm its presence.
A rehabilitation team may include physical, occupational, speech, activity and recreational therapists. Rehabilitation can occur at any point of your care. You are able to see therapists as an inpatient, as an outpatient or in your home. Your physician will determine which therapist you see and for how long.
Following surgery, you will be evaluated and treated by a physical therapist. This may start as soon as the day of surgery. A physical therapist will assist you with getting out of bed and on moving safely in following the recommendations of your orthopaedic surgeon. He or she will teach you how to increase your mobility. You may require an assistive device to walk safely such as a cane, walker or crutch. Your therapist can make this recommendation based on your strength, coordination and ability to follow instructions. Upon discharge, you and your caregiver will be educated on the device to ensure confidence and understanding of your home program.
An occupational therapist will evaluate your level of functional independence and work with you to develop goals for therapy. Following surgery, a person's ability to take care of their daily living tasks can be impaired due to pain, restrictions of movement or weakness. An occupational therapist can help you perform daily living tasks safely through training in the use of adaptive equipment. You will also go through a strengthening program and learn special techniques that conserve energy. Occupational therapy will enable you to return home safely and with confidence following your orthopaedic surgery.
Home care services are made up of skilled nursing, physical therapy, occupational therapy, social work and home health aides. Depending on your specific needs, we will work with you to coordinate these types of services at discharge.
- Skilled nursing services include instruction in medication regime, assessment of pain control, assessment of wound healing, wound packing and dressing changes, staple removal and diet instruction.
- Physical therapy helps you continue with an exercise program and gait training plan that has been established in the hospital.
- Occupational therapy focuses on assessing your functional mobility and evaluating the activities of daily living.
- Social workers act as a resource in financial areas.
- Home health aides can arrange to assist with personal care.
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