This information is provided by Jai as an outline for patients embarking on the surgical journey. Please keep in mind that this material is a reference guide only and your preparation and recovery may differ from that described. Preparing mentally and physically for surgery is an important step toward a successful result.
Understanding the process and your role within the team will help you recover more quickly and you will have a lower chance of having problems.
Before Surgery
Investigations and Appointments in the Lead Up to Surgery
Before surgery, Jai and members of his team will assess your risk profile. Based on this you may require further tests and investigations before proceeding. If there are any conditions that could interfere with the anaesthetic, the surgery or the outcomes, these will be dealt with. Routine tests, such as blood tests and x-rays, are usually performed before any major surgery (eg, joint replacement). In addition to this you will usually undergo a pre-operative assessment at the hospital and an appointment with Jai’s anaesthetist and/or general physician.
Blood-Thinning Medications
Common blood-thinning medications such as warfarin and clopidogrel are often stopped prior to major elective surgery (eg, joint replacement) to decrease the expected blood loss. The decision to cease these will be made by Jai’s team in the lead up to surgery. You should inform Jai’s rooms if you are on blood- thinning medications so that a plan can be customised for your specific needs.
Fasting
It is not safe to have food within 6 hours of an operation. Current ANZCA guidelines for adults state a light meal (toast, cereal, etc) can be consumed no less that 6 hours before surgery. The hospital will contact you on the business day before surgery to confirm your specific fasting time and fluid restrictions.
Medications
Some medications interact with other medications prescribed doing surgery such as antibiotics and pain relief. Other medications can increase the expected blood loss or interfere with wound healing. Discuss any medications you are taking with your doctors to see which ones you should stop taking before surgery. If you have any concerns please contact Jai’s rooms or your anaesthetist.
Skin
All surgery requires a cut (or cuts) through the skin. Any breach in the skin has a small risk of infection until the wound has healed. Some skin conditions or ulcerations around the surgical site can increase the risk of infection. If you have any open or inflamed wounds on your operative limb, please call Jai’s rooms to inform them. In some surgeries (especially joint replacement), we need all skin breaches healed before proceeding to surgery.
Smoking
Smoking interferes with wound and bone healing. Cutting down will reduce your surgical risks and likely improve your outcome.
Weight
Being underweight can affect your body’s response to the anaesthetic, wound healing and the stress of surgery. Similarly, if you are overweight, losing weight before surgery will help decrease the stress placed on your body during the procedure and reduce the force through your joints during your rehabilitation. Patients with a higher than normal BMI have an increased risk of complications including infection, wound breakdown, implant failure and revision surgery.
After Surgery
Infections
Report any suspected infections to your GP or to Jai. Alternatively, you can call the hospital directly on (02) 49696799 and inform the Hospital in Charge who will direct your enquiry.
Pain Relief
Take your pain medicine as directed. The focus should be on being proactive rather than reactive to pain. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait until your pain is severe before taking your medication, you will have more difficulty controlling the pain.
Swelling
Keep the extremity elevated and use ice indirectly (do not apply ice directly to the skin). Place ice no longer than 20 minutes at a time. Keeping the “toes higher than the nose” will aid in returning fluid to the heart and help decrease swelling and pain.
Daily Activities
You may require prolonged bed rest or limb elevation after your surgery. Arrange for someone to help out with everyday tasks like cooking, shopping and laundry. Put items that you use often within easy reach before surgery so you won’t have to reach and bend as often. Remove all loose carpets and tape down electrical cords to avoid falls. Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.
Driving
A safe return to driving after surgery is not governed by legislation but more by common sense. A safe return to driving depends largely on the procedure you have had, your individual driving ability and your recommended rehabilitation. You can refer to the section of Jai’s website regarding Driving After Orthopaedic Surgery.
Work
Confirm with Jai and your employer how long you plan to take off work. After a procedure, a minimum of 2 weeks off work can be expected to recover from the anaesthetic and to protect the wounds. This time can be truncated in some situations if light or “home-based” duties are an option. Longer periods may be expected if your work site has potential hazards, or if your employer requires “a full work clearance” before returning to full duties. It is important that you discuss this with your employer prior to surgery to avoid disappointment. Jai’s team will email you a medical certificate on the day of your surgery. Workers compensations patients will be given formal Workcover certificates during their admission which will ensure you are covered for at least 2 calendar months.
Do you still have a question about your recovery that has not been covered?
Jai is continually updating and improving the information made available to his patients. If you feel that specific information may benefit future patients please email us on office@theorthoclinic.com.au.