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During Your Hospital Stay | Joint Camp | Your Role Before Surgery | Before & After Surgery
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Surgery

During Your Hospital Stay

After surgery, you'll be sent to the PACU (postanesthesia care unit). When you are fully awake, you'll be moved to your room. You can expect to feel some pain at first. To gain the best pain relief, answer honestly when you are asked how much you hurt. Soon, health care providers will help you get up and moving. You'll also be shown how to clear your lungs.

In the PACU

When you wake up, you'll be on your back or side in the PACU. The nurses will give you medications to ease your pain. You may have a catheter (small tube) in your bladder. There may also be a drain in your low back. To help reduce the risk of blood clots, you might be wearing compression boots or special stockings.

In Your Hospital Room

You'll be moved to your room when you are alert and your blood pressure and pulse are stable. An IV and the catheter are likely to still be in place. Health care providers will check on you often. The nurses will work closely with you to control your pain. Once you are in your room, family and friends will be able to visit you.

Controlling Pain

At first, you may be given pain medications by IV or injection. Expect to feel some pain, even with the medications. This is normal. But if the medication does not reduce your pain, be sure to tell the nurse.

PCA Puts You in Control

With PCA (patient-controlled analgesia), pain medication is sent through an IV line at the push of a button. To provide a steady level of pain relief, only you should push the button. For your safety, the pumps have special features to limit the amount of medication you receive.

Getting Up and Moving

You may begin to walk within hours after surgery. This reduces some risks of surgery, such as blood clots. With an IV and a PCA pump in place, walking may be a little tricky. But don't worry. A health care provider will help you.

Clearing Your Lungs

Fluid can collect in the lungs after any surgery. To clear your lungs and prevent pneumonia, breathe deeply and cough. You should do this often?at least a few times each hour. A respiratory therapist or nurse may show you how to use an incentive spirometer. This machine can help you breathe in and out the right way.
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Joint Camp

A program is available for patients having total knee and total hip replacements. This program is available only at Avera McKennan Hospital and emphasizes education and wellness. The surgeons of Orthopedic Institute in connection with Avera McKennan Hospital have developed the Total Joint Center, also referred to as Joint Camp.

Surgeries are scheduled for Mondays and Tuesdays, with patients typically being discharged to their own homes, not another facility or step-down unit, on Thursdays and Fridays. Therapy is delivered in a group setting on the unit, which facilitates camaraderie among the patients. In addition to the therapists working with the patients, each patient has a coach who helps with the recovery. Coaches may be a family member, friend or volunteer. Patients stay in a designated wing of the hospital on the orthopedic unit.

Emphasis on patient education occurs before and after surgery. Patients are given a notebook before surgery and are expected to attend a class. Pre-op education prepares the patient for the surgery, hospitalization, rehabilitation and return to functional activities. Every day at Joint Camp patients receive newsletters with updates on what to expect. Prior to going home, patients are giving videos and handouts explaining what to expect in the days ahead.

Surgeons and staff of Joint Camp believe that patients requiring total joint replacements are often in good overall health. Therefore, there is a wellness approach in the care that is provided. Patients are expected to dress in their own clothes, (loose-fitting) not hospital gowns. Lunches are eaten in the dining area with other campers and coaches.

If you are interested in Joint Camp, visit with your surgeon at Orthopedic Institute to determine if this experience is right for you.
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Your Role Before Surgery

If you decide to have surgery, you can help make it a success. Be sure you know what to expect, and be prepared. Plan ahead for your surgery. Have realistic expectations about what surgery can do for you. And follow all of your surgeon's instructions.

Planning Ahead

Having surgery can be stressful. But if you plan ahead, you can make your recovery easier. Talk to your surgeon about how much time you'll need to be away from work. You may not be able to drive or do certain other activities for a few weeks after surgery. Make sure family or friends can help you with errands and household chores. Planning ahead may include rearranging items you use often. This helps you reach them easily once you're home after surgery.

Having Realistic Expectations

What is a good surgical result for you? This surgery can help relieve neck and arm symptoms. But symptoms may not go away completely. Having realistic expectations may be the key to success. Before you have cervical disk surgery, learn what this procedure can and can't do for your problem. Discuss your expectations with your surgeon.

If You Need a Bone Graft

Depending on the type of surgery, you may need a bone graft. The graft is a piece of bone that can be obtained from a bone bank (allograft) or from a bone in your own body (autograft), for example, your pelvic (hip) bone. Your surgeon will discuss these options with you.

Fitting a Brace

Depending on your problem, your surgeon may recommend a rigid brace, a soft cervical collar, or no brace at all. A brace can help protect your cervical spine while it's healing by limiting its motion. The brace may be fitted before surgery or right afterward.
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Before & After Surgery

To prepare for surgery:

• You may be told to stop taking certain medications, including herbal supplements and nonsteroidal anti-inflammatories such as ibuprofen.

• Your surgeon may instruct you to stop smoking.

• You will be told not to eat or drink anything after midnight the night before surgery.

• You will be asked to sign a surgery consent form.

• Your healthcare provider will discuss your options for anesthesia (medication to keep you asleep during surgery).

Risks and Complications

Your surgeon will discuss possible risks and complications of surgery, which include:

• Problems with swallowing

• Persistent hoarseness

• Side effects from anesthesia

• Failure of the graft to fuse

• Shifting or displacement of bone graft

• Damage to nearby structures

• Bleeding and possible need for transfusion

• Infection

• Spinal cord or nerve damage

BREATHING TIPS:

• You will have a breathing tool to assist with lung expansion

• Cough and deep breathe

• NO SMOKING

• Increase activity as soon as possible

What to expect after surgery

• Expect some pain

• Have realistic expectations - you will have ups and downs

• Be patient and persistent - rebuild strength gradually

• Be prepared for some emotional changes

• Develop a positive mental attitude

• Nurses will explain wound/incision care

Watch for:

• Increased temperature

• Increased redness

• Increased drainage

Activity Guidelines

When Sitting:

• Sit with good posture

• Keep feet flat on floor

• Sit for short periods of time

Excercising:

• Talk to your physician about resuming exercise

• Walk! Walk! Walk!

• Wear good, supportive, flat-soled shoes

Sleeping:

• Rest when fatigued

• DO NOT spend all of your time in bed

• May be "stiff" when first up - slowly stretch
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This content is not intended as a substitute for professional medical care. Only your doctor can diagnose and treat a medical problem.

NO PHYSICIAN REFERRAL IS NEEDED UNLESS REQUIRED BY YOUR INSURANCE

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