total hip joint replacement education manual

A partner for lifelong health

Total Hip Joint Replacement Education Manual

Please bring this booklet with you to:⚫ Everyofficevisitwithyourdoctor

⚫ Yourjointreplacementclass

⚫ Thehospitalwhenyouareadmitted

⚫ Everyfollow-upvisitwithyourdoctor

⚫ Yourphysicaltherapyappointments

2|LMHHealthandOrthoKansasTotalHipReplacementEducationManual

3 Appointments for your total hip joint replacement surgery

4 Your questions

5-7 Phone numbers and LMH Health maps

8 Our commitment to you

9 Notes

10-16 Preparing for surgery (what you need to do)

17 Notes

18-23 Surgery and hospitalization

24-27 Recovery after discharge

28-30 Frequently asked questions

31 Notes

Contents

LMHHealthandOrthoKansasTotalHipReplacementEducationManual|3

Appointments for Your Total Hip Joint Replacement Surgery

Medical clearance:

Date:��

Time:��

Doctor:��

Other necessary clearances:

��

��

Pre-admission phone call:

Date:��

Time:��

Joint replacement class:

Date:��

Time:��

ClasswilltakeplaceatLMHHealth.Reporttothemainlobbyonthewestsidenearadmissions.Bringalistofyourmedications,allergiesandquestions,aswellasthisbookandyourcompassionatecoach.

Surgery:

Date:��

Time:��

Post-operative surgeon office visit:

Date:��

Time:��

Doctor:��


Questions


LMHHealthsurgerydepartment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785-505-6480OrthoKansas. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785-843-9125Surgerypre-admissionnurse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785-505-6268OrthoKansasschedulers:(foranindividualscheduler’sphonenumber,seetheirbusinesscard). . . . . . . . . 785-843-9125OrthoKansasnursenavigator. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 785-838-7815Primarycarephysician. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ��

Important Phone Numbers and Maps

Patient Parking

4 T H ST R E E T

3 R D ST R E E T3 R D ST R E E T

2 n d ST R E E T2 n d ST R E E T

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AR

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AS

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4th Street Health Plaza

Lawrence Memorial Hospital

Lawrence Health Plaza

EMERGENCY

225 Maine

CO

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TR

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ON

EN

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AR

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316 Maine

320 Maine

ReservedParking

for 320 Maine

ReservedParking

for 316 Maine

C

A

B

D

E


First floor

Patient Rooms 201-214



2 North

2 East

Lawrence GI Consultants 215

Lawrence Urology Specialists 205

Cardiopulmonary Services 2030• Anticoagulation Clinic• Echocardiology Services• Pulmonary Function Lab• EKG

Lawrence General Surgery 202Spencer Harrison, MD

Lawrence Pain Specialists 201

LMH Health System Pharmacy

Therapy& Wellness

Treatment & Procedure

Center

ICU Patient Rooms229-238


Chaplain

Chapel

Compliance Management

Cardiovascular Specialists of Lawrence 2050

Lawrence Pulmonary Specialists 2001Vascular Surgery Associates


LMH

Palliative Support Services 210

EMERGENCY


Volunteer ServicesRisk Management/Medical Sta� O�ceLab

Endoscopy Center


Ko�ee Korner

Gift Shop

SpecialProcedures

Imaging

Surgery

ExecutiveO�ces

Admissions/Patient Registration

Cotton O’Neil Clinic 110

Oncology/Hematology Center 105

Precision Cancer Care 120Radiation Oncology

Hospital Patient Accounts

D

Nursing Administration


Pain Management

DaVita Dialysis 100

Elevators to Lower Level and Floors 2 & 3

Elevators to 4th Floor

Workplace Wellness 1020Information Technology 1010

Mario’s Closet

WellCare Clinic 1015

Second floor



Quest Diagnostics 3000

Total Family Care 3200Lawrence Endocrinology 3201Plastic Surgery Specialists of Lawrence 3202Lawrence Neurology Specialists 3203Lawrence Spine Care 3204

Cardiac & Pulmonary Rehabilitation 310Diabetes Education

Rooftop Garden

Lawrence OB/GYN Specialists 300

Care Coordination/Social Services


Patient Rooms 317-321 Patient Rooms 338-348


Pediatric Rooms 322-328 Family Birthing Center

Maternity Preadmission Clinic

Perfect Fit

Patient Rooms

370-387

3 West

3 North


LMH

Lower level

Third floor

Fourth floor

DiningCourt

Community Outreach & Engagement

MedicalRecords(HIMS)

Education/Learning ServicesConference Room A

Conference Room D North

Conference Room D South

Human Resources Auditorium

CafeteriaDining

Facilities Management

Environmental Services

ReceivingLoading Dock

Materials Management/

Purchasing

SterileProcessing

Biomedical


4 North

Rehabilitation Rooms 418-426

Transitional Care Unit Rooms 401-417


Our Commitment to You

ThankyoufortrustingLMHHealthandOrthoKansaswithyourorthopedicsurgeryexperience.We

arecommittedtobeingyourpartnerforlifelonghealthandassureyouthatourexperiencedteamof

physicians,nurses,therapistsandotherhealthcareprofessionalsarededicatedtoprovidingexcellent

orthopediccare.

Wewantyoutohaveapositiveexperiencefromthemomentyouscheduleyoursurgerythroughyour

recoveryprocess.Ourgoalistoassistyouingettingbacktoyournormalactivitylevelasquicklyas

possible.Wewanttoinvolveyouinyourtreatmenteachstepoftheway.

Theinformationinthisbookcanhelpyouunderstandthejointreplacementprocessandmakethe

preparationandrecoveryforyourupcomingsurgeryeasier.Anytimeyouhavequestions,pleaseask

yourdoctor,nursesoranyoneinvolvedinyourcare.

WethankyouforchoosingLMHHealthandOrthoKansas.Wevalueyourtrustinusandarecommitted

tohelpingyouachieveaspeedyrecovery

Introduction to a new lifeJointreplacementisanelectiveoperation,meaningthatitisachoiceyoumakeafterconsultingwith

yourorthopedicsurgeon.Thedecisiontoproceedcanbedifficulttomakeandshouldnotbetaken

lightly.Jointreplacementisconsideredamajoroperation,andrecoverycanbepainfulandchallenging.

Thegoalsofthissurgeryincluderelieffrompain,improvedmobilityandrestoredfunction–allof

whichcanprovideyouwithanewoutlookonlife.

Theinformationinthisbookcanguideyouthroughtheprocessbyexplaininggeneralandspecific

medicalandsurgicalrisks,andbyansweringquestionsrelatedtopre-andpost-operativecareandthe

healingprocess.

Youareapartnerinthisprocesswithyourcareteam.Youplayalargeroleinshapingtheoutcome

ofyoursurgery.Supportfromyourfamilyandfriendsisalsoimportant.Eachsurgicalexperienceis

unique.Ourmainfocusisyoursafetyandwell-being.Pleasedonothesitatetoaskquestions.

Individualshavethecapacitytohealthemselvestoonedegreeoranother.Thisvariesanddependson

multiplefactorssuchasnutrition,weight,exerciseandleveloffitness,smokinganduseofalcoholas

wellasoverallgeneralhealth.

Attitudeiseverything!Themostimportantfactorsinasuccessfulrecoveryareyouroverallattitude,

motivationandefforts.Apositive,can-doattitudeandwillingnesstoworkhardwillgreatlyincrease

yourpotentialforasuccessfuljointreplacementandrenewedoutlookonlife.

Thank you for choosingLMH Health and OrthoKansasas your healthcare providers.


Notes


Preparing for Surgery

Verify insurance benefits and coverageItisimportanttoverifybenefitsandcoverageandobtainauthorizationwhennecessarypriortoyour

surgery.Youwillreceivestatementsforchargesfrommultipleentitiesincluding,butnotlimitedto:

LMHPhysicianBilling,LMHHealth,radiologyandanesthesia.

OrthoKansaswillprovideyouwithawrittenestimateofthechargesthatourofficewillsubmitto

yourinsuranceifyouhaveanon-Medicareinsuranceplan.Thesechargesincludeallcareprovided

byOrthoKansasdoctorsandphysicianassistantsforwhatisknownastheglobalperiod.Thisperiod

startsonthedayofyoursurgeryandcontinuesfor90daysafteryoursurgery.Youwillberequested

topayanyout-of-pocketcostspriortoschedulingyoursurgery.Ourfinancialcounselorwillreview

thesecostswithyou.

IfyouhaveMedicarewithasupplementalplan,youwillnotneedtomeetwiththeOrthoKansas

financialcounselor.However,ifyouhaveMedicarewithnosupplementalplan,youwillberequested

topayanyexpectedout-of-pocketexpensespriortoschedulingsurgery.Ifyouhavequestions,you

cancontacttheOrthoKansasfinancialcounselorat785-838-7854.


Obtain medical clearance for your surgeryYouwillneedtohaveacompletephysicalexam

conductedbyyourprimarycarephysician

approximatelyonemonthbeforeyoursurgery

toassessyourgeneralhealthandruleoutany

conditionsthatcouldinterferewithyoursurgery.

Youalsomayberequiredtoobtainclearance

fromanyspecialistyouseesuchasacardiologist

(heartdoctor)orpulmonologist(lungdoctor).

Itisimportanttohavetheseexamsandall

testingdoneinatimelymannertoavoidlast-

minutedelaysorcancellations.Severaltests,

includingabloodtest,anelectrocardiogram

(EKG)andaurinetestwillbeperformedto

helpyourphysiciandetermineyourabilityto

undergosurgerysafely.Youshouldreviewyour

medicationswithyourphysiciantodetermineif

thereareanythatyouwillneedtostoptaking

priortosurgery.

Thefollowingmedicationsshouldbestopped

seven dayspriortosurgery.Theseareknown

asanti-inflammatories.Ifyoufeelthatstopping

thesewillcauseundueincreasedpain,pleasetalk

withyoursurgeon.

⚫ Celebrex

⚫ Voltaren(diclofenac)

⚫ Mobic(meloxicam)

⚫ Relafen(nabumetone)

⚫ Aleve(naproxen)

⚫ Naproxyn,Motrin/Advil(ibuprofen)

⚫ Feldene(piroxicam)

⚫ Clinoril(sulindac)

⚫ Lodine(etodolac)

⚫ Toradol(ketorolactromethamine)

⚫ Indocin(indomethacin)

Ifyoutakemedicationssuchasaspirin,Coumadin

(warfarin),Jantoven,Plavix,Effient,Brilinta,

Pradaxa,Xarelto,Eliquis,anyanti-coagulantor

anti-plateletmedication,youneedtocheckwith

yourprimaryphysicianorcardiologistabout

whentostopthismedicationpriortosurgery.

Thiswillberesumedaftersurgerywhenyour

surgeondecidesitissafetodoso.

Ifyoutakemedicationsthatsuppressyour

immunesystemsuchas:Humira, Remicade, Enbrel, Methotrexate,orOtezla,youmayneed

todiscontinueuseweekspriortosurgery.Your

surgeonwilldiscussthiswithyouandyour

prescribingprovider.

MedicationsforweightlosssuchasPhentermine

andContraveneedtobestoppedtwoweeks

priortosurgery.Pleasediscusswithyour

prescribingprovider.

PleasenotifytheOrthoKansasnursenavigatorof

anymedicationchangespriortosurgery.


Additional activitiesYouwillmeetandvisitwiththenursenavigator

whenyouscheduleyoursurgery.Heorshewill

helpguideyouthroughthisprocess.

Identifysomeoneasyourcompassionatecoach.

Thismaybeafamilymemberorclosefriendwho

willbeavailablebeforeandaftersurgerytohelp

youprepareforandrecoverfromyoursurgery.

Heorsheshouldattendthejointreplacement

classwithyouandattendatleastonephysical

therapysessionwithyouduringyourstayat

LMHHealth.Thispersonwillhelpwithyour

day-to-dayneedsandprogressafterdischarge

fromthehospitalandwilllikelyberequiredto

transportyoutofollow-updoctorvisitsandto

therapyappointments.Itisbestifthisperson

canstaywithyouforthefirstoneortwoweeks

aftersurgery.

Attendjointreplacementclasswithyour

compassionatecoach.Don’tforgettobring

thisbook!

Stopsmokingpriortosurgery.Youwillnotbe

abletosmokewhileatthehospital.Smoking

reducescirculationtotissueandmakeshealing

moredifficult.Itreducesthesizeofbloodvessels

anddecreasestheamountofoxygencirculated

intheblood.Itcanincreasetheriskofbloodclots

whichisoneofthebiggestpost-operativerisks

associatedwithtotaljointreplacementsurgery.

Bloodclotscanleadtoheartorlungdamage

andincreasetheriskofstroke.Ifyouwanthelp

withsmokingcessation,pleaseaskusabout

availableresources.

Preventinfections,especiallyintheteeth,skin

andurinarytract.Reportanysymptomstoyour

primaryphysician.Althoughrare,aninfection

canoccuraroundyourreplacedjointifbacteriais

allowedintothebloodstream.Toreducetherisk:

⚫ Haveacompletedentalexamnocloserthan

twoweekspriortoyoursurgerydatetobe

suretherearenopotentialproblems.

⚫ Avoidtreatmentofsignificantdentaldiseases

foratleastamonthpriortosurgery.Wealso

recommendavoidinganyelectivedentalwork

forthreemonthsaftersurgery.

⚫ Notifyyourprimaryphysicianifyoudevelop

anyurinarysymptomssuchasburningwith

urination,achangeinurinaryfrequencyor

bloodinurine.

⚫ Notifyyourprimaryphysicianifyoudevelop

anyskininfectionsorirritationonyour

operativeleg,orifyoudevelopchronic

swellingofthatleg.

ConsidercompletingaLivingWillandDurable

PowerofAttorney.Thisissimplyaprecaution.

Ifalreadydone,besuretotakeacopytothe

medicalrecordsdepartmentonthelowerlevel

ofLMHHealthorbringitwithyouthedayof

surgery.

Contactyourpreferredphysicaltherapylocation

andletthemknowyourdateofsurgeryand

whattypeofsurgeryyouwillhave.Ifyouintend

togotooutpatienttherapyimmediatelyafter

discharge,plantostartthisthreeorfourdays

aftersurgery.Ifyouwillbehavinghomehealth

therapy,plantostartoutpatienttherapy15-20

daysaftersurgery.


Notes

Joint replacement classReviewthisbookpriortothedateofyourjoint

replacementclass,andbringitwithyoutoyour

scheduledclass.Usethespaceonthispageto

writedownanyquestionsthatcometomindand

wewilladdresstheminclass.

RepresentativesfromseveralLMHHealth

departmentswillbeapartoftheclass

experience.Theseincludesocialwork,pharmacy,

physicaltherapy,nursing,andothers.Itisvery

importantforyourcompassionatecoachto

attendthisclasswithyou.Theclasswilltake

approximatelytwototwoandahalfhours.

Bringyourmedicationlisttoreviewwitha

pharmacyrepresentative.Yourlistshouldinclude

allknownallergiesandintolerances.


Pre-op instructionsArepresentativefromtheLMHHealthsurgerydepartmentwillcontactyoubytelephonepriortoyour

surgerydate.Youwillbegivenfinalpre-opinstructionsregardingwhentostoptakingmedications

thedaybeforesurgery.Youwillbeinstructednot to take anything by mouth after midnight the night before surgery.Thisincludesfluids,gum,candy,tobaccoandalcohol.Youalsowillbeinstructedwhat

timetoarriveatthehospitalthedayofsurgery.Inrareinstances,yourarrivaltimemayneedtobe

changedduetoachangeinthesurgeryschedule.Ifthishappens,youwillbenotifiedofyournewtime.

Itisimportanttobecarefulwithyourlegsinthedayspriortosurgery.Cuts,scrapesandscratcheson

youroperativelegcouldposeaninfectionrisksopleasenotifyyoursurgeonifthisoccurs.Youmaybe

askedtogotothesurgeon’sofficetohavethisevaluated.

Avoidusingnailpolishonyourfingernailsandtoenailsunlessitisclearpolish.

Practiceorreviewbreathingexercises.Theseexerciseswillbeimportantaftersurgerytokeepyour

lungsclearandreduceyourriskofinfection.Youwillreceiveanincentivespirometeraftersurgeryfor

useinthehospitalandathome,butpracticingdeepbreathingandforcedcoughingbeforesurgerywill

behelpful.Practicinginadvancewithoutthespirometerwillstrengthenthemusclesofyourabdomen

andchest.

For deep breathing:⚫ Breatheinthroughyournoseasdeeplyasyoucan.

⚫ Holdyourbreathfor5-10seconds.

⚫ Breatheoutasifyouwereblowingoutacandle.Trytobreatheoutfor10-20seconds.

⚫ Takeabreakbetweenbreathsthenrepeatthisexercise5-10times.

Coughing:⚫ Takeinaslow,deepbreaththroughyournose,fillinglungscompletely.

⚫ Breatheoutthroughyourmouthandconcentrateonemptyingyourlungscompletely.

⚫ Repeatbreathingin,butthistimeholdyourbreathandthencoughhard.Whenyoucough,focuson

emptyingyourlungs.

⚫ Repeatthesesteps3-5times.


Preparing your homeTherearemanythingsyoucandobeforesurgery

toprepareyourselfandyourhomeforasafe

recovery.

Safety⚫ Putitemsyouuseoftenoncountersorshelves

thatareeasytoreach.

⚫ Makesurestairrailingsaresecure.

⚫ Beawareofallfloorhazardssuchaspets,

powercordsandunevensurfaces.

⚫ Removeallthrowrugsfromyourwalkingor

standingpath.

⚫ Installnightlightsinbathrooms,bedroomsand

hallways.

⚫ Haveanon-slipmatinyourshower.

⚫ Havesupportlinedup,especiallyifyoulive

alone.Ifyouhaveconcernsaboutreturning

homeafterdischarge,pleasediscussthese

withthenursenavigator.

Comfort⚫ Shopahead.Freezemealsforuseafter

surgery.Considerstockinguponfoodsand

beveragesthatwillbeeasytoeatordrink

whenyourappetiteispoor,oryouhavenausea

orbowelproblems.

⚫ Checkchairandbedheightbysittingonthem.

Yourhipsshouldbehigherthanyourknees

whenseated.

⚫ Checktoiletheight.Addaseatriserifitistoo

low.

⚫ Arrangeforcareofpetsandcollectionofmail.

⚫ Cleanyourhouse.

⚫ Dolaundryandputitaway.

⚫ Putcleanlinensonyourbedandinthe

bathroom.

⚫ Haveyardworkdoneasneeded.

What to bring to the hospital⚫ Personalhygieneitems(toothbrush,

toothpaste,deodorant,batteryoperated

razor,comb,etc.)

⚫ Loose-fittingclothes(sweats,shorts,t-shirts,

bathrobe)

⚫ Slipperswithnon-sticksoles,flatshoes

ortennisshoes

⚫ Walkerorcrutchesifavailable,or

borrow/purchaseaftersurgery

⚫ Casesforglasses,dentures,hearingaids

andextrabatteries

⚫ CopyofyourAdvanceDirectives(ifyou

haveone)

⚫ Thishandbook

⚫ YourphotoIDandinsurancecard

⚫ AformofpaymentforMedstoBeds

shouldyoudecidetousethisservice

What to leave at home⚫ Homemedications,exceptinhalers(checkwith

thehospitalpharmacistformoreinformation)

⚫ Valuablesincludingmoneyandjewelry

Stop smoking⚫ Decidetoquit.

⚫ Choosethedate.

⚫ Talkwithyourprimarydoctoraboutsmoking

cessationresourcesandmedications.

⚫ Limittheareawhereyousmoke;don’t

smokeathome.

⚫ Throwawaycigarettesandashtrays.

⚫ Don’tputyourselfinsituationswhere

otherssmoke.

⚫ Rewardyourselfforeachdaywithout

cigarettes.

⚫ Staypositive.

⚫ Takeitonedayatatime.Youmightslip,but

ifyoudo,getbacktoyourdecisiontoquit.


Further preparationHandicap parking placard Youmaywanttoobtainahandicapparkingpermitforthemonthsfollowingsurgery.Thiswill

allowyoueasieraccesstoyourdoctor’soffice,therapyclinicsandshopping.Callyoursurgeon’s

nurseorclinicalassistanttorequestanapplication.Oncecompleted,takeittoyourlocalcounty

treasurer’soffice.

Therapy preparationItisimportanttobeasflexibleandasstrongaspossiblebeforehavinghipsurgery.Manypatientswith

arthritistendtolimithowmuchtheyusetheirpainfulleg.Withlessuse,musclesbecomeweakerwhich

leadstoaslowerandmorechallengingrecovery.Startingatherapy/exerciseprogrambeforesurgery

canmakeyourrecoveryfasterandeasier.Exercisesareincludedwiththishandbookthatalsocanbe

usedafteryoursurgery.Starttheexerciseswithbothlegsaboutsixweeksbeforesurgery.Performthe

exercisestwiceadayfor15-20minutesforbestresults.Ifyouareable,youshouldalsoperformlight

enduranceactivitiestobenefityourheartandlungs.Trywalkingorcyclingfor10-15minuteseachday.

Poolexerciseisagoodalternativeifwalkingorcyclingistoopainful.

Tohelpyourphysicaltherapistbetterprepareyoutoreturnhomeaftersurgery,pleaseanswerthe

questionsbelowpriortoyoursurgery.

1. Doyouhavemainflooraccesstoyourbed,bathandtoilet?

2. Whichsideofthebeddoyougetinandoutof?

3. Whatistheheightofthetopofyourbedmattressfromthefloor?

4. Whatisyourtub/showerdesign?

5. Haveyoubeenfittocrutchesorawalker?

6. Howmanystairsdoyouhavetoclimbtogetintoyourhouse?

7. Doyouhaverailingsonyourstairs?Onwhichsidearetherailings?


Notes


Surgery and Hospitalization

The day of surgeryRemembernottoeatordrinkanythingafter

midnight.

ArriveattheLMHHealtheasthospitalentrance

(MaineStreet)promptlyatyourdesignatedtime.

Ifthereisachangetoyourarrivaltimeyouwill

benotifiedbyamemberofthehospitalstaff.If

youhaveanylast-minuteissuesthatwillprevent

youfromarrivingatyourscheduledtime,please

contactthesurgerydepartmentat785-505-

6482.

Anursewillcompleteyouradmissionactivities

andanyadditionalnecessarypreparation.The

nursewillaskyouwhich,ifany,medicationsyou

tooktodayandthelasttimeyouateordrank

anything.

Youwillchangeintoahospitalgown.Special

supportstockings(TEDhose)andcompression

deviceswillbeappliedonyourlowerlegstohelp

preventbloodclots.Arepresentativefromthe

laboratorywilldrawyourbloodtocheckyour

bloodtype.Shouldyouneedabloodtransfusion,

compatiblebloodwillbeavailable.

Youwillbeaskedtosignasurgicalconsentwhich

detailsyoursurgicalprocedure.

AnIVwillbestartedforadministrationoffluids

andmedications.Youwillreceiveatleastthree

dosesofantibioticsthroughyourIV.Besureto

mentionanyallergiestomedications.Ifyouhave

allergies,aspecialbraceletwillbeplacedonyour

armtoalertstaff.

Ananesthesiologistwillvisitwithyoupriorto

goingtotheoperatingroom.Heorshewill

considerwhichtypeofanesthesiawillbebest

foryou,takingintoaccountyourhealthhistory

andpreferences.Therearetwomaintypesof

anesthesiathatareused:

⚫ Generalanesthesiaproducestemporary

unconsciousness.

⚫ Spinalanesthesiainvolvestheinjectionofa

localanestheticprovidingnumbness,lossof

pain,orlossofsensationtothebody.Youalso

willreceiveadoseofmedicationthroughyour

IVthatwillrelaxyouandcreatewhatisknown

asconscioussedation


Yoursurgeonwilltalkwithyoubeforeyou

aretakentotheoperatingroomtoreviewthe

plannedsurgery.Thesurgeonwillsignthe

correctsurgicalhippriortosurgery.Thisisto

ensureaccuracy.

Whenyougototheoperatingroom,yourfamily

willbedirectedtothesurgerywaitingroom.

Theywillbegiveninstructionsonhowto

checkyourprogressandknowwhensurgeryis

complete.

Somepeopleexperienceanxietypriorto

surgery.Weencourageyoutoaskquestionsand

communicatewiththesurgerystaffifyouhave

concerns.

Therewillbemanypeopleintheoperatingroom.

Thesurgicalteamincludesananesthesiologist,

yoursurgeonandhisorherphysicianassistant,

nurses,andotherprofessionals.Theywillbe

movingaroundtheroombeforesurgerymaking

sureeverythingisreadyforyourprocedure.

Onceyouentertheoperatingroomandare

situatedontheoperatingtable,youwillbe

askedyournameandwhatsurgeryyouare

havingdone.

Youwillhavemonitoringdevicessuchasablood

pressurecuffandaheartmonitorplacedon

you.Theanesthesiologistusestheseandother

devicestomonitoryourconditionthroughout

thesurgery.Heorshewillmanageyourvital

signssuchasheartrateandrhythm,blood

pressure,temperatureandbreathing.Heorshe

alsowillmonitoryourIVfluidandneedforblood

replacementifnecessary.Medicationwillbe

giventohelpyoufeelmorecomfortable.

Onceyouareasleep,aurinarycathetermaybe

placedtohelpdrainyourbladder.

Theentiresurgerytakesapproximatelyoneand

ahalftotwohours.Oncecomplete,yoursurgeon

willvisitwithyourfamily.

After surgery – Post Anesthesia Care UnitFollowingsurgery,youwillbemovedtothe

PostAnesthesiaCareUnit.Youwillbemonitored

byphysiciansandnursesforanadditionalone

totwohours.Yourvitalsignsandpainlevelwill

bemonitored.

Dependingonthetypeofanesthesiaused,

youmayexperiencenausea,drymouth,chills

orothersymptoms.

MedicationwillbegivenbymouthorbyIV

tohelpcontrolyourpainandothersymptoms

asneeded.

Yourhipwillbecoveredwithadressing.Ifyou

haveacoldtherapymachine,thepadwillbe

placedoveryouroperativehip.Youalsowill

havecompressiondevicesaroundbothlower

legsthatworkbysqueezingthecalvestohelp

preventbloodclots.

Whenyouareawake,yourvitalsignsare

stableandyourpainiscontrolled,youwillbe

transportedupstairstoyourroomon3West.

Continued on page 20


Pain controlMostoftheworstdiscomfortwilloccur12-24

hoursaftersurgery.Paincontrolisatoppriority

foryournursesandphysician.Youwillfrequently

beaskedquestionsthathelpstaffmonitorand

treatyourpain.Weencourageyoutoletthe

staffknowifyouarehavingpainoritisnot

well-controlledatanytime.AtLMHHealthwe

useanassessmentmethodcalledtheClinically

AlignedPainAssessment.Thismethodinvolves

aconversationthatfocusesonthequalityofpain

andhowitaffectsyourabilitytocomfortably

performdailyactivities,ambulate,orcomplete

testsandtherapies.Youwillbeasked:

InregardtoCOMFORT,isyourpain…

⚫ Tolerable

⚫ Tolerablewithdiscomfort

⚫ Comfortablymanageable

⚫ Littleornopain

InregardtoFUNCTIONING,wouldyousay…

⚫ Ican’tdoanythingbecauseofthepain.

⚫ PainkeepsmefromdoingMOSTof

whatIneedtodo.

⚫ Icandomostthings,butpaingetsin

thewaysome.

⚫ IcandoeverythingthatIneedtodo.

InregardtoCHANGEINPAIN,isyourpain…

⚫ Gettingworse

⚫ Aboutthesame

⚫ Gettingbetter

InregardtoSLEEP,areyou…

⚫ Awakewithpainmostofthenight

⚫ Awakewithoccasionalpain

⚫ Sleepingnormally

Itislikelyyouwillcontinuetoneedpain

medicationonceyouhavebeendischarged

fromthehospital.Youwillbegivenawritten

prescriptionforthispriortoleavingthehospital.

Youmaychoosetohaveitfilledatthehospital’s

pharmacythroughtheMedstoBedsprogram

beforedischarge.Narcoticmedicationsmust

betakenasprescribedastheycanhaveserious

consequencesifnotusedcorrectly.Yoursurgeon

willmanageyourpainmedicationfollowing

dischargesoyouwillneedtocontacthisorher

officetorequestrefills.Youwillwanttoplan

aheadwhenyouarerunninglowonmedication

sinceyoursurgeonisofteninsurgeryand

outoftheoffice.Allowtwobusinessdaysfor

refillstobewritten.You must pick up a written prescription in the office to take to your pharmacy.Theofficestaffisunabletophoneor

faxtheprescriptioninforyou.Afriendorrelative

onyourHIPAAlistmaypickupthewritten

prescriptionforyouifneeded.

3 WestYourstayon3Westisdesignedtogetyou

startedontheroadtorecoveryfromyour

hipsurgery.

Anytimethereisashiftchange,thenurseswill

cometoyourbedsideanddiscussyourplan

ofcarewhichincludesyourhealthcareneeds

andtreatmentgoals.Yourinputinthisprocess

isencouraged.Youandyourcompassionate

coachmayusethistimetoaskquestionsorraise

concernswithyournurses.Youareapartnerin

thisprocessandshouldunderstandyourplanof

care.Pleasebeawarethatyoumaybeawakened

duringthenightforthenursetomonitoryour

condition.Thestaffwillmakeeveryattempt

toperformthesenecessaryinterruptionsinan

efficientmanner.

Yoursafetyisofthehighestconcerntothestaff.

Youwillwearabraceletthatwillbescanned

priortoreceivinganymedicationtobesureyou

Surgery and Hospitalization continued from page 19


receivetherightmedication.Anadditionalred

braceletindicatesanyallergiestomedications

orproductsthatcontainlatexoradhesives.You

alsomayhaveonayellowbraceletthatindicates

youmightbeaFallRisk,meaningyourriskof

fallingisgreaterduetomedications,equipment

orhealthconditions.Pleaseuseyourcalllightto

letthestaffknowifyouneedassistanceorhave

otherneeds.

Yournursewillcheckyourvitalsignsand

conditionfrequently.Besuretolethimor

herknowifyouhavequestionsorconcerns.

Yourcompassionatecoachalsocanbe

helpfulincommunicatingwiththestaffsince

themedicationstocontrolpainmaymake

youdrowsy.Thosemedications,alongwith

anesthesia,cancausenauseaand/orvomiting.

Yournursecangiveyoumedicationforthisif

needed.Anothercommonproblemaftersurgery

isconstipation,forwhichmedicationwillbe

prescribed.

Onceyourpainiswell-controlledwithoral

medicationsandyouaretoleratingoralfluids,

yourIVwillbediscontinued.Initially,youwillbe

givenclearliquidstodrink,andyourdietwill

beadvancedastolerated.Youmaynothave

muchappetiteaftersurgery,butyouwillbe

encouragedtoeatanddrink.Goodnutritionis

importantforgoodhealing.MealtimesatLMH

Healthareflexibleandarepresentativefrom

diningserviceswillcometoyourroomtotake

yourorderoffofamenuwhichcorrespondswith

thedietyourphysicianhasordered.

Anincentivespirometerwillbeatyourbedside.

Youwillbeencouragedtouseitfrequently,much

likeyourpre-operativebreathingexercises.Thisis

tohelpdecreaseyourriskofpneumonia.

Youwillbeencouragedtodofootandankle

movementssoonaftersurgeryandthroughout

yourhospitalstay.ContinuetowearyourTED

hose(compressionstockings)untilyourfirst

post-opappointmentatyoursurgeon’soffice.

Besurethatyouhavetheseonwhenyouare

dischargedfromthehospital.Theyhelpminimize

theriskofbloodclotsandreduceswelling.

Youwillbeencouragedtouseacommodeor

standtourinate.Ifyouareunabletourinate,a

cathetermaybeplacedtemporarilytoempty

yourbladder.Difficultyinurinatingisnot

uncommonaftersurgery.Ifyouhaveaurinary

catheterinplacefromsurgery,itwillprobablybe

removedthemorningaftersurgery.

Thecoldtherapywraponyourhipwillstayin

place,aswillthecompressiondeviceforyour

lowerlegs.Thegoalistominimizeswellingas

muchaspossiblearoundthehip,whichhelps

reducepain.

Intheeveningonthesamedayasyoursurgery,

youwilllikelybeassistedtositontheedge

ofyourbed,andpossiblytostandattheside

ofyourbed.Youalsomaybeginwalkingwith

assistancethedayofsurgery.Thismayseemlike

adifficulttask,butitisthefirststeptowardyour

recovery.

Weencourageyoutohavevisitorsduringyour

hospitalstay,butkeepinmindthatyoualsoneed

timetorest.Youmayneedyourcompassionate

coachtolimithowmanypeoplevisitatatime,

andremindvisitorshowlongtheymaystay.3

WesthasadesignatedQuiet Timefrom3:30 to 5:00 p.m.Thisisagoodtimetorestandrecover

fromtheday.Thestaffwilltrynottodisturb

youduringthistime,butyouareencouragedto

notifythemusingthecalllightifneeded.

Planningforyourdischargewillbeginafter

surgery.AteamofprofessionalsfromLMH

Healthwillworkwithyouandyourphysician(s)

todeterminethetimingandconditionsofyour

dischargefrom3West.Theteamincludes

physicalandoccupationaltherapists,social

workers,nurses,andpharmacystaff.Some

patientsareabletoleavethehospitalafterone

ortwodays,butsomestayuntilthethirdday

aftersurgery.Priortosurgery,youmaywantto

considerwhatyouroptionsareafterdischarge.

3 West continued on page 22


3 West continued from page 21

Surgery and Hospitalization

Themajorityofpeoplegohomewithacaregiver,

butsomepeoplemayneedtotransfertoarehab

orskilledfacility.LMHHealthhassuchafacility

onthe4thfloorandthereareotheroptionsin

thecommunity.Asocialworkercanhelpyou

exploreyouroptions.Socialworkwillvisitwith

youandyourcareteamtohelpmakewhatever

arrangementsareneeded.Donothesitatetoask

forinformation.

After surgery, while you are in the hospitalYourgoalforthesedaysistopreparephysically

andmentallytoleavethehospitalandcontinue

yourrehabilitation.

Laboratorypersonnelwilldrawyourblood

themorningaftersurgerytocheckyourblood

counts.Resultsofthesetestswillletyourdoctor

knowifyoumayhaveaninfectionorifyou

havebecomeanemic.Anemiaishavingalow

redbloodcellcountwhichcancausefatigue,

weaknessandpaleskin.Itisnotuncommonfor

thistooccuraftertotaljointreplacementsurgery.

Ifyourredbloodcellcountgoestoolow,your

doctormayorderabloodtransfusion.Redblood

cellscarryoxygentovitalorgansincludingthe

brain,soit’simportanttomakesureyoumaintain

ahealthylevel.

Yoursurgeonand/orphysicianassistant

willcheckonyoudaily,usuallyearlyinthe

morning.Thisisagoodtimetoaskquestions

orcommunicateconcernswithyourphysician.

Askyournursewhattimeyoucanexpectyour

surgeonorphysicianassistantifyouwantto

arrangetohaveyourcompassionatecoach

presentduringthesevisits.

Youwillbeencouragedtochangefromahospital

gownintoyourown,loose-fittingclothes.You

mayweartheseforthedurationofyourstay.

Itwillbemorecomfortabletobeinyourown

clothes,especiallywhenworkingwithphysical

therapyoutsideofyourroom.Youwillcontinue

towearyourTEDhoseatalltimesexceptwhile

bathing.

Ourgoalisthatyouambulateshortlyafteryou

arrivetoyourroomon3Westaftersurgery.

Youwillbeencouragedtositinachairforyour

mealsratherthanstayinginbed.Youalsowill

beencouragedtogetuptousethebathroom

orcommodeforyourtoiletingneeds.Astaff

memberwillassistyouwithyourdailyhygiene.

Atsomepoint,onceyouareable,youwillbe

encouragedtotakeashower.Instructionsabout

howtokeepyourwounddrywillbeprovided.

Alwaysrequestassistancewhengettingoutof

bed.Astaffmemberwillneedtobepresentto

helpwithtransferstoachairortoescortyouto

thebathroom.Youwillbeunstableonyourfeet

andatahigherriskforfalls,especiallyinthefirst

severaldaysaftersurgery.

Medicationwillbegiventoyoutopreventblood

clots.Thismedicationwillbegiveneitherorally

orbyinjection,dependingonyourphysician’s

preferencesandyourhealthhistory.Thiswillbe

continuedafterdischargeandyouwillbegiven

instructionsfortakingthismedicationathome.

Physicaltherapywillbeginrightaway.Therapy

staffwillworkwithyouonyourhipexercisesand

transfersfromthebedtochair.Theyalsowill

helpyoulearntouseyourwalkerorcrutches.

Yourweight-bearingstatus(howmuchweight

youcanputonyouroperativeleg)dependson

thetypeofincisionyoursurgeonused(anterior

oranteriorlateral)aswellasotherfactors.Your

compassionatecoachisencouragedtobe

presentforatleastonetherapysessiontolearn

yourroutinesoheorshecanassistyouathome.


Youwillbeexpectedtoexerciseatleasttwice

adayathome.Thegoalistograduallyimprove

thedistanceyouareabletowalk.Thismayseem

likeanimpossibletaskinthedaysimmediately

followingsurgery,butiskeyforasuccessful

recovery.Youmayhaveanoccupational

therapistworkwithyouonactivitiesofdaily

livingifyouneedassistancewithtaskssuchas

dressing,bathingandusingadaptiveequipment.

Therapystaffalsowillmakesureyourassistive

devicessuchasawalker,caneandcrutchesfit

appropriately.Theywillaskquestionsaboutyour

homeenvironmenttolearnaboutanyphysical

challengesyoumightfacesuchasstairsinside

andoutsidethehouse.

Youwillbeinstructedonwhattypeofdressings

youwillneedtopurchase,aswellashowoften

youwillneedtochangeyourdressing.Your

compassionatecoachwillneedtobeinstructed

onthisaswell.

Discharge from LMH HealthYourdischargefromLMHHealthwilloccurwhen

yourhealthcareteamdeterminesitissafeforyou

toleave3West.Dependingonyourcontinuing

careneeds,youroptionsafterdischargeinclude:

⚫ Homewithcompassionatecoach

⚫ Homewithoutpatienttherapy

⚫ Homewithhomecarenurseand/ortherapy

⚫ Transfertoskilledorrehabfacility

Mostpeoplegodirectlyhomeafterleaving3

Westaslongastheyhavetheabilitytowalk

safelywithawalker,transferinandoutofbed

safelyandindependently,andnavigatestairs.

TherearequalifyingfactorssetbyMedicareand

otherinsurancesthathavetobemetinorder

foranypatienttobetransferredtoaskilledor

rehabfacility.Asocialworkerwillexplainthese

qualifyingfactorstoyou.

Ifyouplantohavehomehealththerapy,post-

dischargetherapyorderswillbesenttothe

homehealthagencyofyourchoice.Otherwise,

theorderswillbesenttotheoutpatientphysical

therapylocationofyourchoice.Ifyouknowprior

tosurgerythatyourplanistogotoanoutpatient

therapyfacility,youwillwanttocontactthem

afewweeksbeforesurgerytosetyourfirst

appointments.Theseshouldbescheduledfor

twoorsixweeksaftersurgery,dependingon

thetypeofincisionyouhave.Thesefacilities

canbeverybusyandtheremaybeawaitbefore

youcangetintoseeatherapist.Planningahead

mayhelpyouavoiddelaysinreceivingtherapy

aftersurgery.Thetypeoftherapyyouwillhave

inthefirstsixweeksaftersurgerywilldepend

againonyourphysicianandthetypeofincision

youhave.Duringthefirstseveralweeks,youmay

onlyneedformaltherapyassistancewithwalking,

gaitandbalance.

Priortodischarge,yournursewillreviewwritten

careinstructionswithyouandgiveyouacopy

totakehome.Theseinstructionswillinclude

informationaboutwoundcare,dressingchanges

andhowtoprotectyourincisionduringashower.

Yoursurgeonwillgiveyouaprescriptionfor

painmedicationandpossiblyabloodthinner.

LMHHealthhasapharmacyconvenientlylocated

onsite.WiththeMedstoBedsprogram,you

areabletohaveyourprescription(s)filledatthe

hospitalpharmacyanddelivereddirectlytoyour

roompriortodischarge.Yourcompassionate

coachwillneedtoarrangetohaveyourwallet

availablesoyoucanpayforyourmedication.

Thebenefitsofthisprogramareexplainedinthe

FrequentlyAskedQuestionssectionofthisbook.

Besuretotakeyourassistivedevicesand

equipmentwithyouwhenyouleave.These

includeyourwalkerorcrutches,TEDhose,

incentivespirometerandcoldtherapymachine.

Don’tforgetthisbook!

Ifgoinghome,youwillneedtoarrangefor

someonetopickyouup.Ifyouaretransferring

toaskilledorrehabfacility,transportationwill

bearranged.Yourdischargewillusuallytake

placebetween11a.m.and3p.m.


Recovery After Discharge

Complications after joint replacement surgeryTwomaincomplicationsfollowingtotaljoint

replacementsurgeryareinfectionaroundthe

newjointandbloodclots,oftenreferredtoas

DVT(deepveinthrombosis).

Infection:Signsofinfectioninclude:

⚫ Feverwithtemperaturegreaterthan101

degrees

⚫ Chillsorshaking

⚫ Increasedredness,swellingorpainaroundthe

incision

⚫ Changeincolor,amountorodorofdrainage

⚫ Increasedjointpain

Youshouldnotifyyoursurgeonifyoudevelop

anyofthesesignsofinfection.

Blood clots:Signsofabloodclotinclude:

⚫ Increasedpain,tenderness,warmthorredness

intheleg(notdirectlyaroundthehip)

⚫ Swellingortightnessinthecalforankle

Notifyyoursurgeonimmediatelyifyoudevelop

anyofthesesymptoms.Anultrasoundmaybe

donetoevaluateforbloodclots.Ifclotsdevelop,

medicationcanbeusedtotreatthem.

Anundiagnosedbloodclotinthelegcantravel

tothelungsandbecomeapulmonaryembolism.

Signsofthisinclude:

⚫ Suddendifficultybreathing,rapidbreathingor

feelingshortofbreath

⚫ Chestorbackpain

⚫ Coughingupblood

⚫ Sweating

⚫ Changeinmentalstatus(confusion)

Notifyyoursurgeonorgotothenearest

EmergencyRoomimmediatelyasthisisa

medicalemergency.Apulmonaryembolismc

anbefatalifnottreatedquickly.


RecoveryThenextseveralweekswillbeveryimportant

inthesuccessfulrecoveryfromyourtotalhip

replacement.Theseweekscanbedifficultdue

tothechallengesofadaptingtobeingathome

andworkingthroughphysicaltherapy.Yourgoal

willbetoregainuseofyourhipandreturntoan

activelifestylethatyoumayhavebeenmissing

priortosurgery.Berealisticaboutyourgoals

afterrecovery.Ifyoucoulddocertainactivities

priortothehipbecomingarthriticandpainful,

thereisagoodchanceyoucangetbacktothose

activitiesaslongastheydonotputtoomuch

stressonyournewjoint.Butifyouwerelimited

byotherhealthconditionspriortosurgery,you

maycontinuetohavethesesameissues,but

withoutthehipproblem.

Physical therapyYouwillcontinuewithphysicaltherapyeitherat

homewithahomehealthphysicaltherapistorat

anoutpatientfacility.Thearrangementsforthis

willbemadepriortoyouleavingthehospital.

Youshouldexpecttoworkwithatherapistabout

threetimesaweekafterthefirsttwoweeks

followingsurgeryifyouhaveananteriorincision.

Ifyouhaveananteriorlateralincision,youwill

likelynotbeginformaltherapyuntilaboutsix

weeksaftersurgery.Yourphysician’spreference

willdeterminehowsoonyoubeginformal

therapy.Eitherway,youwillbetaughtahome

exerciseprogramwithexercisesthatyouwillbe

expectedtoperformtwiceaday.Yourtherapist

willhelpsetgoalsforfunctionandactivity.The

therapistwilltakeintoconsiderationyourlevelof

activitypriortosurgeryandyourgoalsforafter

surgerywhenworkingwithyoutoadvanceyour

progress.Youwillcontinuewiththerapyuntil

yourgoalshavebeenmetoryoudemonstrate

theabilitytoworkonyourown.Insomecases,

yourinsurancewillhavealimitofhowmany

therapysessionstheywillcoveraftersurgery.

Incision careKeepyourincisioncoveredanddryuntilyou

seeyoursurgeonatyourpost-opappointment.

Beforeleavingthehospitalyouwillbetaught

howtochangeyourdressing.Mostpatients

willgohomewithanAquaceldressing.This

ischangedeverysevendaysunlessthere

arecircumstancesthatmakeitnecessaryto

changeitsooner.Somepatientsgohomewitha

Tegadermdressing.Tegadermdressingsshould

bechangedeveryotherdayunlessyouare

instructedtodootherwise.Ifyouhaveincreased

drainage,youmayneedtochangethedressing

moreoften.IftheTegadermdressinggetswet,

youwillneedtoremoveitandreplaceitwitha

dryone.Bothtypescanbepurchasedatlocal

pharmacies,includingtheLMHHealthPharmacy.

Besureyourhandsarecleanbeforechanging

yourdressing.Whilethedressingisoff,checkfor

anychangesintheappearanceoftheincision.

Ifthereareanysignsofinfection,notifyyour

surgeon.Donotapplyanylotions,ointmentsor

creamsonordirectlyaroundyourincision.You

willbegivenadditionalwoundcareinstructions

atyourfirstpost-opappointmentwhenyouhave

yourstaplesorsuturesremoved.

ShoweringPriortoyourfirstpost-operativeappointment

withyoursurgeon,youmayshoweraslong

asyouprotectyourincisionfromgettingwet.

Tegadermdressingswillkeepmoistureout,

butitisalwaysgoodtoreinforcethis.Aquacel

dressingsarewaterproof.Besuretheyareintact

andnomoisturegetsinsidethedressing.Donot

soakinatuborsimilaruntilyouaretoldyouare

clearedtodoso.Itmaybemanyweeksafter

surgerybeforeyouwillbeallowedtosoakyour

hipinatuborpool.Youwillreceiveinstructions

regardingshoweringandbathingwhenyou

haveyourstaplesorsuturesremovedatyour

appointmentwithyoursurgeon.



SwellingSwellingiscommonaftertotaljointreplacement,

generallyonlyintheoperativeleg.Areasmost

likelytobecomeswollenarethefoot,ankle,hip

andthigh.Useofcompressionstockings(TED

hose)canhelpavoidthis.Continuetousecold

therapy.Thiswillalsohelpreducetheamountof

swellinginyourhip.Swellinginthehipcanmake

therapymoredifficult.Donotallowyourlegsto

hanglowerthanyourwaistforextendedperiods

oftime.Movingaroundfrequentlywillalsohelp

reduceswellingbyincreasingbloodflowtothe

legs.

Bruising or redness on operative legYoumaynoticebruisinganywhereontheleg

fromyourhipdowntoyourfeet.Thisisnot

uncommonafterhipreplacement.Gravityand

bloodflowcancausebruisingalldownthe

operativeleg.Bruisingaroundthereplacedhipis

verycommon.

DietSomelossofappetiteiscommonforseveral

weeksaftersurgery.Abalanceddietisimportant

topromotepropertissuehealingandrestore

musclestrength.Besureyouconsumeplentyof

proteinasthisisespeciallyimportantinhealing.

Asyoubegintobemoreactive,yourappetite

shouldimprove.Besureyouaredrinkingplenty

offluids.Hydrationwillhelpavoidconstipation

whichiscommonaftersurgery.Constipationcan

occurbecauseofdecreasedactivityandnarcotic

painmedicationuse.

Pain controlContinuetotakeyourpainmedication(s)as

neededandasprescribedtokeepyourpain

undercontrolforthefirstfewweeks.Keepin

mindthatrecoveryfromhipreplacementsurgery

ispainful,andmedicationmaynoteliminate

allofyourpain.Donotexceedrecommended

orprescribeddosesofyourmedication.Some

medications,iftakentoooftenorintoohigha

dose,cancauseover-sedationorotherwiseput

yourhealthatrisk.Donotexceed3,000mgof

Tylenolina24-hourperiod.Ifyouareprescribed

apainmedicationthatcontainsTylenol,youneed

tostaywithinthatdosinglimit.Refillrequests

mustbecalledintoyoursurgeon’sofficeand

youwillneedtopickupthewrittenprescription

there.Overtime,yoursurgeonwillencourageyou

tobackoffofstrongnarcoticpainmedication

andbeginusingover-the-countermedications.

Mostpeopleareabletoreduceoreliminatethe

needforprescriptionpainmedicationwithinfour

tosixweeksaftersurgery.Ifyouhavequestions

aboutwhatover-the-countermedicationsyou

cantake,contactyoursurgeon’soffice.

Besidesmedication,thereareotherwaysto

helpminimizethepainanddiscomfortfrom

yoursurgery.Continuetousecoldtherapy

overthehiptohelpreduceswelling.Youalso

shouldelevatethelegwhenlyingorsittingto

aidinreducingswelling.Youshouldgetup,walk

andchangeposition.Althoughyourexercises

andtherapycanbepainful,theyalsocanaid

inreducingswellingbyincreasingcirculation.

Expectyournewhiptofeelstiffaftersittingor

lyingforextendedperiodsoftime.Youwillbe

encouragedtomovearoundfrequentlytoavoid

this.

Sleeping positionIntheweeksfollowingsurgery,youmayhave

toadjustyournormalsleepingposition.Youwill

notbeabletolieonthesidewherethehipwas

replacedforseveralweeks.Youwillneedtoplace

Recovery After Discharge

Continued from page 25


apillowbetweenyourlegsbothforcomfortand

toavoidoverextendingtheoperativehipifyou

sleepontheoppositeside.

TravelingDonottravelalongdistance(overonehour)by

vehicleorairplaneuntilclearedbyyoursurgeon.

Thisrestrictionusuallylastssixtoeightweeks

aftersurgery.Failuretofollowthisrestriction

increasesyourriskforbloodclots.Ifyouare

travelingbycar,besuretostopeveryhourto

getoutandstretchyourlegs,otherwiseyou

canbecomestiffandsore.Iftravelingbyairplane,

trytostandandstretchperiodicallyaswellas

dosomelowerlegstretchesorexerciseswhile

seated.

Yournewjointwilllikelyactivatethemetal

detectorsthatareusedinsecuritychecksat

airportsandinsomebuildings.Youwillreceive

acardatyoursurgeon’sofficethatyoucancarry

inyourwallettoshowtosecuritypersonnel.

Accommodationswillbemadetoscreenyoufor

clearance.

Dental workForaperiodofatleasttwoyearsafteryourtotal

jointreplacement,youwillberequiredtotake

asingledoseofantibioticspriortoalldental

procedures.Theseincludecleanings,periodontal

procedures,fillings,etc.Yoursurgeon’sofficewill

prescribetheappropriatemedicationforyouto

take.Youneedtowaitthreemonthsaftersurgery

beforehavinganydentalworkdone.Although

theriskisverysmall,yoursurgeonwantsto

minimizetheriskofanyinfectioninyournewhip

asaresultofbacteriafromyourmouth.

Activity after hip replacementExerciseisthekeytosuccessfulrecovery

followingjointreplacementsurgery.Oncecleared

byyoursurgeonintheweeksaftersurgery,you

shouldbeabletoresumemostnormalactivities.

Atfirst,someactivitiesmaybealittlepainful,but

overtimeyouwillfindyourselfparticipatingmore

intheactivitiesyouenjoy.

Startbackintoactivitygradually.Slowlyincrease

youractivityinyourhomebywalkingaround

thehouseandresuminghouseholdchores.

Eventually,youshouldbeabletoreturnto

walkingoutsideorgoingtoagym.Besureto

usecautiontoavoidfallsandinjuries.Swimming

isanexcellentformofexercisethathelps

strengthenyourlegswhileyouarerecovering.

Otheractivitiesthatyoumightconsiderinclude

golf,lighthiking,recreationalbikingonimproved

surfaces,dancing,bowling,gardeningandpickle

ball.Plantoexerciseatleastthreetofourtimes

eachweekfor20to30minutesatatime.

Donotrunorparticipateinhigh-impactactivities.

Avoidactivitiesthatrequirealotofstops,starts,

turnsandtwistingmotions.Donotparticipatein

contactsportsthatincreaseriskofinjurytoyour

hip.Specificactivitiestoavoidincludevigorous

hiking,jogging,snowskiing,tennis,football,

basketball,baseball,highimpactaerobicsand

racquetball,tonameseveral.Youshouldalso

avoidclimbingladdersthattakeyoumorethana

fewfeetofftheground.Theseactivitiesincrease

riskofinjuryorearlywearingoftheartificialjoint.

Sexual activityItisnotuncommonforyouoryourpartnerto

experienceanxietyaboutengaginginsexual

activityaftertotaljointreplacement.Thepainful

jointmayhavelimitedyourabilitytoenjoy

sexualactivitypriortosurgery.Thejointsurgery

willalleviateasignificantamountofthatpain

andjointstiffnessandallowyoutoresumethis

activitymorecomfortably.Itisgenerallysafe

toresumesexualactivityaboutsixweeksafter

surgery.Youshouldavoidexcessivebendingof

thehipandexcessiveabduction(spreading)of

thelegsduringtherecoveryperiod.Youshould

beabletoresumeamoreactivesexlifeover

time.Ifyouhavequestions,youcanalwayscheck

withyoursurgeon,nurseorphysicaltherapist.


Frequently Asked Questions

What is osteoarthritis and why does it make my hip hurt?Osteoarthritisisthemostcommonformof

arthritis.Itiscausedbythewearingdownofjoint

cartilage,thetough,smoothtissuethatcovers

theendsofboneswherejointsarelocated.Joint

cartilagecushionsthebonesduringmovement

andallowsmotionwithminimalfriction.Asthe

cartilagewearsdownovertimeitexposesthe

endsoftheboneswhichleadstopainfulbone-

on-bonecontact,swellingandlossofmotionin

thejoint.

What is a total hip replacement?Animplantwillreplacethewornendofthefemur

andasmoothcupisinsertedintothesocketin

thepelviswheretheimplantsits.Theheadofthe

femurisreplacedwithametalorceramicball

andametalstemwhichfitsintoacanalcreated

inthefemur.Theexistingsocketissmoothedout

andametalandplasticcupisplacedinsideto

createanew,smoothcushionandafunctional

joint.Totalhipreplacementsurgerywillreduceor

eliminatepain.

How long and where will my scar be?Dependingonyoursurgeon’spreference,your

scarwilleitherbelocatedjustinfrontofyour

hiporofftothesideofyourhip.Surgicalscars

willvaryinlength,butyoursurgeonmakesitas

smallaspossible.Itwillstartjustaboveyourhip

andextenddowntojustbelowthehip.Astime

goesby,thisscarwillfadeandbecomemuch

lessnoticeable.Somepeoplenoticenumbness

aroundthescarwhichmaydecreaseovertime,

ormaybepermanent.

What is the recovery time after my hip surgery?Everyonehealsfromsurgeryatadifferentpace.

Peoplehavedifferentlevelsofpaintolerance

anddifferentlevelsofmotivation,andbothare

factorsthataffecthowsoonanindividualis


abletoworktowardrecovery.Youshouldplan

touseanassistivedevicesuchasawalker,cane

orcrutchesforamonthortwoaftersurgery.

Physicaltherapywillhelpyougetbacknormal

useofyourhip.Bythreemonthsaftersurgery

mostpeoplehaveregainedfulluseofthehipand

areabletoresumemostnormalactivities.

How long will I be on pain medication, and why do I have to pick up a written prescription from my surgeon’s office?Mostpeopleareabletodecreaseoreliminate

theuseofnarcoticpainmedicationfourto

sixweeksaftersurgery.Refillswillbeatthe

discretionofyoursurgeonandbasedonyour

progresswiththerapyandthelengthoftime

thathaspassedsincesurgery.Thestrong

narcoticpainmedicationthatyoureceivedat

thehospitalwillgraduallybereplacedwith

lowerdosepainmedications,andeventually

youwillbeencouragedtouseonlyover-the-

countermedicationssuchasTylenoland/or

anti-inflammatories.Narcoticpainmedications

arerigidlycontrolledbytheDrugEnforcement

Agencyandpertheirguidelines,onlywritten,

signedprescriptionscanbeacceptedatthe

pharmacy.TheDEAmonitorsallcontrolled

substanceprescriptionswrittenbydoctorsas

wellasprescriptionsfilledbyindividuals.

How long will my new hip last and can a second replacement be done?Allimplantshavealimitedlifedependingonan

individual’sage,weight,activitylevelandmedical

condition(s).Theimplantisamedicaldeviceand

issubjecttowearthatmayleadtomechanical

failureovertime.Thereisnoguaranteethat

yourimplantwilllastforanyspecifiedlengthof

time.However,mosttotalhipimplantslastat

least15to20years.Animplantcanbereplaced,

althoughthesurgeryismorecomplicated.

How often will I need to see the surgeon after surgery?Youwillhaveaseriesofappointmentsduring

thethreemonthsaftersurgery.Expecttosee

yoursurgeontwoweeksaftersurgeryandagain

atdifferentintervalsduringthattimeperiod.

Youalsowillfollowupwithyoursurgeonatthe

one-yearanniversaryofyoursurgery.Afterthat,

expecttofollowupannuallyoreverythreetofive

yearsaftersurgery,dependingonyourphysician,

tobesureeverythingisgoingwell.

When will I be able to return to work after surgery?Thatanswerdependsalotonwhattypeofwork

youdo.Ifyouworkatasedentaryjob,youmay

bereadytoreturntoworkinfourtosixweeks,

althoughtheremaybelimitationsinplaceand

youmayonlybeabletoworkparttimeforafew

weeks.Ifyouhaveajobthatismorephysically

demanding,itmaybeuptothreemonthsbefore

youcanreturntofullduty.

Can I drink alcohol during my recovery?Aslongasyouaretakingnarcoticpain

medication,youshouldavoidanyalcohol

consumption.Bothhaveasedatingeffect

andcansuppressthecentralnervoussystem.

Alcoholalsocandecreaseyourabilityto

walksafelyandincreaseyourriskoffalling.

Youshouldavoidalcoholifyoutakecertain

prescriptionmedicationssuchasWarfarin.

Checkwithyourprimarycaredoctorifyou

havequestionsaboutthis.

Is it normal to feel depressed after surgery?Itisnotuncommontohavenewsymptomsof

depression(orworseningsymptomsifyouhadit

priortosurgery)afterjointreplacementsurgery.

Thismaybeduetoavarietyoffactorssuchas

limitedmobility,discomfort,temporarylossof

independence,lackofsleep,feelinghomebound

andmedicationsideeffects.Thesefeelings



useitaslongasyoufeelitiseffectiveforyou.It

ismosteffectiveifyouuseitatleastthreetimes

adayfor10-15minutesatatime.Youshould

expecttouseitforatleastseveralweeksafter

surgerytohelpkeepswellingundercontroland

minimizepain.Ifyoudonotwanttopurchasethe

coldtherapymachine,youcanpurchaseormake

yourowncoldpacks.

Who do I call after surgery if I have questions?Contactyourdoctor’snurseorclinicalassistant

atOrthoKansasifyouhavequestionsor

concerns.Therealsoareclinicalcarecoordinators

atOrthoKansasavailabletodiscussyour

concerns.Ifyoubelieveyouarehavingamedical

emergency,however,youshouldcontact911or

godirectlytotheEmergencyRoom.

What are the benefits of using Meds to Beds?

⚫ Yourprescriptionsareconvenientlydelivered

toyou.

⚫ Youcanavoidanadditionalstopatthe

pharmacyonyourwayhome.

⚫ Apharmacistorpharmacyinternwillmeet

withyoupersonallytoprovideon-on-one

dischargemedicationeducationandanswer

medicationquestionstoyoursatisfaction.

⚫ Remainingrefillswillbetransferredtoyour

pharmacyofchoiceandmedicationchanges

willbecommunicatedtoyourpharmacist.

⚫ Anupdatedmedicationlistwillbesenttoyour

primarycareprovider.

Frequently Asked Questions

shoulddiminishasyoubegintoresumeregular

activities.Ifthesymptomspersist,checkwith

yourprimarycarephysician.

Is it normal to have insomnia after surgery and what can I do about it?Insomniaisverycommonaftertotaljoint

replacementsurgery.Patientsoftenreportthis

asoneoftheirchiefcomplaintsduringtheir

recovery.Thiscanresultfrompain,toomuch

daynapping,anxietyoranynumberofother

reasons.Yoursurgeonwillnotprescribesleep

medicationforyoubecausethesedatingeffect

ofthatwithyournarcoticpainmedicationcanbe

adangerouscombination.Therearenaturalover-

the-counteroptionssuchasmelatoninthatyou

mightconsidertrying.

Is it normal for my leg with the joint replacement to feel longer now?Inmostcases,thelengthofyourlegwillnot

bedifferentaftersurgery.However,insome

casesleglengthcanbeslightlyaltered.Itmay

feelawkwardatfirst,butmostpeoplebecome

accustomedtothedifference.Inrareinstances,a

shoeliftmaybenecessaryontheoppositeleg.

How do I get the cold therapy unit and how long will I need it?Whenyouschedulesurgeryyouwillbegiven

informationaboutwhotocontactandhowto

makearrangementstohavethecoldtherapy

machineavailablepriortosurgery.Youwillhave

thisinplaceimmediatelyaftersurgeryandwill

Continued from page 29


Notes


©2020TheLawrenceMemorialHospitalDBALMHHealth.Allrightsreserved.LMHHealthprovidescarethatissensitivetocultural,racial,religiousandotherdifferencesanddoesnotdiscriminateonthebasis

ofrace,religion,age,ethnicity,culture,language,socio-economicstatus,sex,sexualorientation,genderidentityorexpression,nationalorigin,physicalormentaldisability,orsourceofpayment,norinrelationtoemploymentpractices.

8/2020

total hip joint replacement education manual

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