Submitted By Reconstructive Orthopaedics of Central Florida
While surgery is often not the initial goal when seeking treatment for joint pain, it is sometimes the best resolution.
Additionally, things like traumatic fractures, tears, and other injuries result in your physician ordering surgery to best address your pain, discomfort, or decreased functionality. Whether the surgery is orthopaedic in nature or is in some other realm of your health care journey, there are some steps you can take as a patient to help increase the likelihood of positive outcomes.
Every practice is different, but it remains that your healthcare providers chose their profession with the idea and hope that he or she could help people live their best lives. Having a patient who is on the same team and who wants to be proactively involved in healing and rehabilitation makes for a powerful force.
Remember that it is up to you to make the decisions for your body. Ask questions and include your Primary Care Physician in decisions you make, as well as talking to spouses, children, parents, or friends – lean on your circle because they know YOU and your life. You know your pain and limitations and you can discuss that with your physician for best understandings of what will and can happen to you with or without surgery. Then weigh your pros and cons so that you can make a decision YOU feel good about. Some trauma situations may reduce the time you have to make the decisions, but it is important to be committed to being informed.
Make sure you talk to your physician about realistic expectations for mobility after your procedure. Find out if and when you will be able to walk – will you need a cane, walker, or wheelchair? Will you be able to lift things or will you have limitations? Can you drive? Shower? Will you need to go to a rehabilitation facility for inpatient recovery or will you go home? If you go home will you need a nurse or a physical or occupational therapist to come to the house to help you? Will you go to a local physical therapy provider for exercises instead?
Your friends and family may very well be part of your circle of healing for after care. You may need help getting to doctors’ appointments, physical therapy, the pharmacy, and more. You may need food for meals delivered or help with pets.
Your insurance, if you are using it for the surgery, is also part of your rehabilitation – many companies have certain providers from whom they want you to get your care – from labs, to wheelchairs, to physical therapy, to having a nurse come by the house. It’s a good idea to find out what you might need ahead of time and then, before the surgery happens, call them and find out who the providers are for the services you will need so that you can select which vendor you will seek for the services you need. If you know ahead of time, you can let the staff at the surgeon’s office know and, in general, they should be able to get orders to the provider you have selected before or near the time of your surgery so there are no gaps between surgery and discharge. This includes Home Health Care (nurses at home), inpatient recovery at a (rehabilitative facility), physical therapy, and more. In fact, if you choose your preferred inpatient recovery facility and you tell the surgeon and the hospital staff prior to surgery, many facilities will allow virtual tours of the facility prior to admission so you know were you are going and can have an enhanced comfort level about your upcoming stay.
If your surgery is a planned surgery the hospital or surgical center will most likely have a preadmission appointment where some lab work is done, paperwork is reviewed, insurance is verified, and other information that only the facility where the surgery will be done can provide. For most facilities, the actual time of your surgery is not decided until late in the afternoon on the last business day before your surgery. This is because the day is not planned until all the surgeries are booked and then the directors and managers of the operating rooms look at all the cases and organize them in a fashion that is efficient and safe for physicians, patients, nurses, and all the other staff involved in ensuring your surgery is a success. It’s similar to the guest seating at a wedding reception- once they see the total number of RSVPs, they can assign seats (times).
You will be asked to be NPO (nothing to eat or drink) the night before -we know that can be hard, but it is for your protection. Some prescriptions are not compatible with invasive surgery so you may also be asked to curb or stop certain medications for several days before your surgery – this is another important reason to share the names of all medications you take with your surgeon and the staff at the surgeon’s office. Additionally, some medications may be prescribed to help manage your postoperative pain. These are short term tools and do not eliminate pain – the goal is to control the pain. It is also worth noting that the prescriptions will only be for a few days. Pain management after that time frame will be between you and your physician. Most offices ask that you allow for up to 2 business days for refills- whether for your regular medicine or surgery related pharmaceuticals it’s always good to b aware of how many you have in a bottle, how many refills (if any) you have, and whether or not weekends or holidays are coming up that may hinder your ability to get a refill on something you deem as urgent.
One postoperative concern is DVT (Deep Vein Thrombosis) which is a blood clot located in a deep vein, usually a leg or an arm. Check for unexpected swelling, pain, tenderness, and/or redness of the skin. Being over 55, having a major trauma, having cancer, family/personal history of blood clots, estrogen medications, and obesity all place you at greater risk for blood clots. If you have a personal history with DVT, you absolutely should discuss this with your surgeon prior to scheduling surgery.
While all surgeries are different, from an orthopaedic stance, the general postoperative guidelines for things to reach out to the office that happen while you are recovering include fevers over 101, increased redness, swelling, or pain in the incision area, a discharge with an offensive odor, re-opening of the incision that may or may not also have fresh bleeding, inability to tolerate pain even with medication, nausea, rash, or itching, you have fallen, or you have unexplained calf pain. If you have shortness of breath or chest pain you should call 911 instead of your doctor’s office, especially if it is after hours. Minutes can make a difference.
For orthopaedic surgeries we try to schedule a postoperative follow up at about two weeks after your surgery. X-Rays may be done and, if you are in a rehabilitative facility, the X-Rays will be done there, and you and the facility’s transportation service will bring the disc of the images to the appointment.
Hand washing is vitally important to keep the risk of secondary infections lower. You should know that smoking is not healthy on a good day but can drastically delay and in some cases prevent proper healing. Sutures and staples usually stay in for about two weeks. The incision should be kept clean and dry – do not use ointments like Neosporin or any other topical ointments – they are contraindicated for surgical wounds.
Lastly, most surgeries include what is often referred to as ‘global care’ which means that for 90 days after the date of your surgery you and your surgeon’s office will work together to ensure your recovery. Things like X-Rays, lab work, injections, and castings or splints may have a cost associated with them, but the communication between you, the physician, and the physicians clinical and office staff are included in the cost of the surgery. Your post-operative visits during that time frame, for all basic post-operative care, have a zero-dollar charge. We are in this together. We are in the business of fixing and repairing – our goal is your best-case scenario.
Reconstructive Orthopedics of Central Florida Today at (352) 456-0220.