What to Expect
After surgery you will be brought to your private room on the second floor, the Medical-Surgical Unit, at Southwest Health. There you will be greeted by your registered nurse and certified nursing assistant. What you should expect:
- Your private room will include a recliner and a walker or crutches. The walker is provided for use during your stay and is in addition to the one you’ll need when you return home.
- You will have an ice pack or ice wrap on your new joint. Ice helps decrease inflammation (swelling) which decreases pain. Keeping ice on your incision is very important.
- There will be a dressing over the incision. Dr Lindsey will remove the dressing at your follow up appointment. If you have a large amount of drainage, this may be changed during your hospital stay by Dr. Lindsey.
- You will have stockings on your legs as well as leg pumps. The stockings help decrease the leg swelling and add compression to your wound. The leg pumps continually squeeze your calves to promote circulation. In combination, these will help prevent blood clots.
- When lying in bed, try to pump your foot up and down to promote circulation. Doing this can help increase circulation and prevent blood clots.
- You will have an IV in your arm (the one started in OR); you will get fluids through this IV as well as medications as needed.
- You may have oxygen going through your nose the first night. Your vital signs will be checked every 4 hours for the first 24 hours after your frequent surgical vital signs are completed. Your blood pressure, heart rate, respiratory count, and temperature as well as your oxygen saturation.
- After surgery it is not unusual to have pain. Our goal is to help manage your pain and keep your pain at an acceptable level. While we will not be able to eliminate your pain completely; we want to control your pain well enough that you can participate in your care.
- You will be asked to rate your pain on a 0-10 scale, where 0 is no pain and 10 is the worst pain ever. If you pain is a “5” of above, your nurse will evaluate your pain management to help make you feel more comfortable. It is important to discuss with your nurse if your pain medication is not working so changes can be made that will help make you feel better.
- There are many types of pain medications. There may be one medication or a combination of medications used to control your pain. Communication with your nurse and Dr Lindsey will help keep your pain manageable.
- The sooner you are active the better it is for your recovery and for your pain control! Physical Therapy (PT) will visit you the day of surgery and assist you to move from the bed to the chair. PT will work with you twice a day.
- Raising your incision higher than your heart helps improve healing and reduces swelling. It also helps reduce pain. Be sure not to place a pillow directly under your knee; this can obstruct blood flow and increases the risk of a blood clot; pillows should be placed under your ankle. Your nurse will help adjust your position.
- Hourly Rounding will be completed while you are at the hospital. You should see a RN or CNA at least every hour during the day every two hours at night (we will not wake you up for Hourly Rounding). During Hourly Rounding your nurse/CNA should ask you if you have any pain, if you need to use the bathroom, if you are comfortable in your current position, or if you need anything else.
- At shift changes, your nurses will be in your room discussing how you are doing, including your pain control, your incision/dressing, your ambulation progression, and other pertinent information regarding your care. Please feel free to ask questions, add comments, etc.
- There will be a white board in your room where your Team will write their names (Dr Lindsey, your RN and CNA), the next time you may have pain medication, what PT plans are, and other important information.
- Infection prevention is very important! All staff when entering and leaving your room will wash their hands, either with an alcohol based gel or with soap and water. You will have the opportunity to wash your hands or have washcloths at your bedside. You and your family/visitors should wash hands frequently.
- Since your dressing is waterproof, you will be able to shower before you leave the hospital. Until you shower your RN or CNA will help you wash up; you will brush teeth and do your hair. Feel free to bring your toothbrush and hair care products with you.
Rehab During Your Hospital Stay
The afternoon following surgery, a physical therapist will get you up and out of bed. You will be able to put weight through your surgical leg and will start with the use of a walker for mobility.
The first day after surgery the physical therapists will see you in the morning and the afternoon to work on getting you up and walking with a walker. During this time , they will also be performing exercises to assist with strengthening and improving range of motion.
The occupational therapist will also come to see you the first day after surgery. She will focus on dressing, bathing, toileting, and preparing you for your return home. They may also need to train you on how to apply TED stockings on your legs. They may recommend equipment that you may need or adaptations that may be necessary for your prior living environment.
The second and third day following surgery, the physical therapists will continue to see you two times a day to focus on walking stairs (if necessary for you to return home) and exercises focusing on strengthening and range of motion. During this time, the therapists will also be working with your coach to provide instructions for your return home. The therapists will ask that you try to do more each day and increase your walking distance.
Occupational therapy will continue to see you during your stay if they feel it is necessary. They will continue to work on dressing, toileting, getting in and out of the shower, and any further adaptations that may be necessary for you to return to your prior living environment.
Throughout your stay, the therapists will be working with your coach, social worker, and physician to ensure that you will be discharged from the hospital to a safe environment that will allow you to continue to heal and improve. Our goal is for each patient to return home, but it may require that you go to a facility for a short period of time for further therapy and care, or stay at the hospital for a couple of extra days for therapy.
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