What to expect when you are having surgery
The decision to have elective Joint replacement surgery is an important step to help improve your mobility and quality of life. At Silver Cross Hospital, we will help you start arrangements prior to surgery, support you through the surgery and recovery in the hospital, and help make sure your discharge plans meet your needs.
When you make the decision to have surgery, start planning for someone to help you after surgery as it is important that you have assistance when you get home.
What to bring:
- Pre Surgical Discharge Questionnaire
- Home medication list
- Equipment if available
- Loose-fitting clothing
- Safe footwear
Your case management team of registered nurses and social workers will help you with your surgical plans such as:
- Coordination of Care
- Discharge Planning
- Arrangements for home care services like medical equipment of skilled nursing care
- Verify Insurance benefits
- Provide patient education
- Address emotional/psychological needs
- Assist with Durable Power of Attorney and Living Will development
Please bring a copy of your Durable Power of Attorney forms, Living Wills, and Do Not Resuscitate forms with you on your day of surgery. If you provide these forms to registration or nursing, they can be scanned into our system for future visits.
After having a hip or knee replacement surgery we want to ensure that you have safe discharge from the hospital. The case management team will work with you to identify your specific needs and have a safe discharge plan in place for you, such as obtaining equipment and or services for after discharge. Equipment needs may include:
- Rolling walker
- 3 in 1 commode
- Home Health RN/Physical Therapy
In most cases, case management can help set up equipment for you, but some insurance companies require authorization and this may take some time to get arranged. If you do not have the equipment, your surgeon’s office may be able to provide them to you before surgery. Some patients may choose to order on Amazon or obtain through township offices that rent equipment. Lockport, Frankfort, and Orland Townships are great resources for residents. Good Will stores often have like new equipment available to purchase. These items in most cases are used only for short periods of time. You may also want to borrow a cane or crutches if you have stairs.
Hip Kits are available in Walgreens in Pavilion A for about $50 and include all of the equipment the Occupational Therapist will review. Often it is cheaper to order what you need individually from Amazon or borrow from friends and family.
3 in 1 commodes are covered under most insurances, but the raised toilet seats are not. If you do not have room in your bathroom and do not want a commode to use outside of your bathroom, you may want to look at medical supply stores or Walgreens, Meijer, CVS, etc. that offer medical equipment for this item prior to surgery. They come in different heights and shapes.
Length of Stay
Orthopedic surgeries are generally only 1-2 night stays and some patients may even go home the same day. Your surgeon should let you know how long they expect you to be in the hospital. Do not be surprised if you are placed in observation or outpatient status.
Many joint replacements are Observation admissions, meaning only 1 overnight stay, so plan to have help at home and arrange your living area if you anticipate difficulty managing your home and stairs. Your physician will determine your admission status prior to your surgery. Commercial insurance will provide authorization for your procedure which determines your admission status.
If you have questions for the case management team prior to surgery please feel free to reach out to them at 815-300-7115.
Inpatient Room Views
Managing your pain
Oral pain medications will be started immediately after surgery to help manage your pain. These medications are usually ordered to be given as needed between every 4-6 hours, so please let the nurse know when you are getting uncomfortable. Ensuring your pain is controlled is an important element of healing and will allow for your participation in physical and occupational therapy sessions. The nursing staff works closely with the physical and occupational therapists to ensure that pain medications are given before your therapy sessions to maximize your ability to participate. IV pain medications may also be ordered for breakthrough pain relief when taking oral pain medications.
You may have a patient-controlled analgesia (PCA) pain pump after surgery. This is a pain pump that delivers pain medication through your IV on demand and is controlled by you.
Application of cold therapy is necessary for reduction pain and swelling at the incision site. In the hospital ice packs are provided and the staff will assist with application and filling of the ice packs.
Your surgical dressing is changed after surgery as directed by your surgeon. The nursing staff frequently checks your surgical dressing to ensure its integrity and will reinforce the dressing as needed.
Some surgeons utilize a Prevena Wound Vacuum over the surgical incision site. This is a portable disposable system that utilizes negative pressure to protect your incision. If your surgeon does apply this device you will receive teaching on it prior to leaving the hospital.
Sequential Compression Devices (SCD) and TED (anti-embolism) hose help prevent post-operative blood clots. SCDS should be worn while you are in bed at the hospital. TED hose should be worn at all times but can be removed when bathing. It is best if you apply the TED hose first thing in the morning.
As additional protection from infection, you will usually receive two doses of antibiotics after surgery.
The doctor will prescribe you a blood thinner to take at home for or a designated amount of time after surgery. Blood thinners are given for the prevention of blood clots.
Nausea can be a side effect of pain medications and or anesthesia. The doctor will prescribe anti-nausea medications to be given as needed if you are experiencing nausea.
Constipation can occur from decreased activity and is also a side effect of some pain medications. It is important that pain medications are taken as needed to manage your surgical pain so your doctor may prescribe stool softeners such as Colace or Milk of Magnesia to be taken.
Please bring a list of home medications with you the day of surgery. The nursing staff will review all of your home medications and your doctor will decide if your medications can be taken while you are in the hospital. You do not need to bring your own medications in from home as the pharmacy will distribute medications to you while you are in the hospital.
As soon as you are awake and alert you will be offered clear liquids. Begin to drink liquids slowly to ensure you are not nauseated. Your doctor will advance your diet tolerated after surgery.
After surgery you will have your blood checked daily to monitor for post-surgical blood loss.
This lab test will help the doctor decide if you need to have a blood transfusion.
Being in an unfamiliar room, using pain medications, and having surgery can put you at risk for falls. Your safety is important to us and ask that you call a staff member for help before getting up. To help us meet your needs, we may use a bed alarm or a chair alarm to alert the staff to come help you if you forget to call and begin to get up without assistance.
In order to help prevent infection prior to surgery please DO NOT SHAVE your legs. You will also receive a special (CHG) bath to help kill microbes on your skin when you arrive on your surgery day.
In order to help prevent infection, remember to wash your hands before and after touching your incision site or doing any dressing changes. Ask anyone helping to care for you, to wash their hands before providing care as well.
Monitor your incision site for redness, increased swelling, increase in temperature, or drainage at the incision site. If you have any of these symptoms