Understand the Procedure

The more you know about your procedure, the better you will be able to handle the challenges and changes that surgery will make in your life. Do not ever hesitate to ask questions, voice concerns, or tell your healthcare provider when you do not understand.

Attend the Total Joint Class to learn what to expect before, during, and after surgery. Ask about the process of being admitted to the hospital, scheduled surgery, the type of anesthesia you might need, the type of implant if needed, the length of stay in the hospital, rehabilitation, and pain management.

Before your surgery, many healthcare professionals will be asking about your medical history, insurance coverage, and legal arrangements. You may feel that you are answering the same questions over and over again, but this is necessary to meet quality assurance regulations and medical insurance guidelines.

To reduce frustration and speed the process, have everything written down, and be sure to include the following information:

A designated person (family member or friend), who will be your primary contact to receive information from the doctor and then give it to other family members and friends.
A list of all the healthcare providers you currently see and the reasons for seeing them. Provide names, addresses, and phone numbers if possible.
A list of medical conditions, previous operations, and an up-to-date list of all the medications you're currently taking, including the dosage and the frequency.
Include vitamin and mineral supplements or other over-the-counter medications you take regularly. Your physician may advise you to stop taking certain medications or supplements before your surgery.
A list of any allergies or adverse reactions to drugs or anesthesia in the past. Provide the name of the drug, the reason for taking it, and a description of the reaction and when this happened.
Any dietary restrictions or other medical conditions you have, such as diabetes, asthma, HIV, or hepatitis.
A list of your insurance coverage, including the name of the insurance company, the plan or group number and contact information. Be sure to bring your insurance card with you.
Information about any legal arrangements you have made, such as a living will or durable power of attorney. Bring a copy of the documents with you to the hospital.

Physical Preparation

Physical preparations affect both the outcome of the surgery and your recovery time. Preparations may include:

Quit smoking. Smoking changes blood flow patterns, delays healing and slows recovery.
Don't drink any alcohol for at least 48 hours before surgery.
If you use any other types of controlled substances, tell your doctor. Narcotics and other drugs can have an impact on your surgery.
If you have any active infections (dental, sinus, bladder or other) these must be addressed prior to the time of surgery.
If any dental work is planned have this completed prior to your scheduled surgery. Note that most surgeons have a time period after surgery that they recommend this is not done. Please verify this with your surgeon.
Make sure that you are well hydrated, this will help with your general health and how you will respond to medications.
Eat well. If you are overweight, your doctor may recommend a weight loss program.
Ask your doctor for any pre-surgical exercises that will benefit the surgery outcome.

Medical Preparations

Several healthcare professionals will be involved in your surgery. Ensure that each professional has the information necessary for proper decision making.

Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery. This examination will assess your health and your risk for anesthesia complications. The results of this examination should be forwarded to your orthopedic surgeon with a surgical clearance.

If you will be donating your own blood for the surgery, donation times should be scheduled at least one week apart, beginning about six weeks and ending approximately five days before your surgery. During this time, you should be especially careful to eat properly and take a daily iron supplement.

Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and answer any last minute questions.

You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray.

Tell your surgeon of any medical conditions you have and all the medications you are taking. You may need to stop taking certain medications or your surgeon may recommend substitute medications until your surgery. Medications such as corticosteroids, insulin or anticoagulants will need to be managed before and after surgery.

For total joint surgery, any dental work such as extractions or periodontal treatments, need to be scheduled well in advance of your surgery. Do not schedule any dental work, including routine cleanings, for several weeks after your surgery.

Notify your doctor if you come down with a fever, a cold or any other illness in the week before the surgery.

The Day Before Surgery

The 24 hours before surgery will be busy. This checklist will help to make sure you do not forget anything.

Take a shower or bath the night before and morning of your surgery. Dry with a clean towel and put on clean clothes. This will help reduce the risk of infection.
Do not shave the area of the surgery. If this is necessary, the doctor will take care of it.
Do not wear any make-up, lipstick, nail polish, or eye contacts.
Do not eat or drink anything after the designated time before surgery. This will help prevent any nausea from the anesthesia.
Leave valuables at home.
Tell the nurse if you wear dentures or prosthetic device.
If hospitalization is required, do bring a hospital bag. Some of the items you should include are:
- a pair of comfortable, sturdy bedroom slippers with non-skid soles
- a knee-length robe or gown
- a lightweight camisole or cotton shirt to wear under your hospital gown
- something to read
- copies of your insurance cards, advance medical directives, and medical history
- any medications you regularly take
- personal care items such as a hair brush, toothbrush, denture case, eyeglass case, and contact lens case
- leave your cash, credit cards and jewelry at home
- a loose-fitting sweat suit or jogging suit and comfortable shoes to wear home
If you have not asked others for help yet, do so now.

Plan for Your Homecoming

Planning ahead helps minimize stress and optimize your outcome. Consider the following suggestions in your planning process:

Arrange for someone to take you home and to stay with you after your surgery.
If you do the cooking, make double batches of everything for a week or two before your surgery or stock up on ready-made foods. Freeze half, and you'll have ready-made meals when you get home.
Place items you use regularly at arm level so you do not have to reach up or bend down.
You may need to rearrange furniture or temporarily change rooms so you can maneuver through your home.
Remove any throw or area rugs and secure electrical cords that could cause you to slip.
You may need to consider modifying the bathroom to include a shower chair, gripping bar, or raised toilet.
Shop for things that will make your life easier after surgery, such as a long-handled sponge, a grabbing tool, a footstool, and a big-pocket shirt or soft shoulder bag for carrying things around.
Set up a "recovery center" where you will spend most of your time. Things like the phone, television remote control, radio, facial tissues, wastebasket, pitcher and glass, reading materials and medications should all be within reach.