The preparation for major orthopaedic surgery (such as hip and knee replacement or foot and ankle surgery) may require careful thought and planning around any home modifications needed for the postoperative period. Patients undergoing major surgery should also not be burdened with having to run errands during their early postoperative rehabilitation.
The following is a guide to some of the preparations patients may wish to make prior to surgery.
In the weeks leading up to surgery you may consider the following:
Improve your general fitness
- Consider working with a physiotherapist or performing exercises to build up muscle strength.
- Good joint and muscle control leading into an operation improves postoperative strength and outcomes.
- Consider upper body strengthening to help with postoperative crutch or frame use if required.
- Practice with crutches under physiotherapy supervision may make the transition to discharge postoperatively much quicker.
- Cease smoking.
- Ensure you have an adequate supply of your normal medications, possibly using a pillbox for planning postoperative needs.
- Ensure you have an up-to-date list of your medications with you.
- Do not consume alcohol or recreational drugs at least 24 hours prior to an anaesthetic
- Blood thinning medications should be ceased a week prior to surgery unless you have been instructed to continue for medical reasons. These include:
- Aspirin and Assasantin
- Warfarin
- Plavix / Clopidogrel
- Pradaxa
- Xarelto
- Fish Oil
- If you develop any illnesses, you must contact Dr. Mackie’s office to determine if elective surgery should be postponed until you are healthier.
- If you have any scratches, marks, potential infections on the limb being operated upon you must contact Dr. Mackie’s office to determine if it is safe to proceed.
Prepare your home environment
- Look for hazards around your house that may result in tripping or may restrict your mobility.
- Loose rugs or cords can be moved.
- Set up extra lights or lamps in dimly lit areas.
- Consider whether rail supports are needed for steps.
- Ensure you will be able to safely get into and out of a shower.
- A shower stool or seat is commonly required if having major joint replacements (rental can be arranged at the hospital).
- Have a slip-resistant mat or surface ready on the bathroom (and possibly shower) floor.
- Ensure toiletries, spare toilet paper etc. are easily accessible for your return home.
- If you wish to keep an eye on your wound – have a hand mirror accessible.
- Replace important batteries or check appliances you may not be able to easily access during recovery.
- If you use glasses or contacts then ensure easy access to a spare pair.
- Prepare books, reading material, DVDs etc. to keep you occupied during recovery.
- Consider whether a temporary bedroom should be set-up in a more accessible room.
Prepare your food stocks
- Bring important or required groceries, utensils etc. into easily accessible cupboards.
- Consider preparing frozen foods or easily prepared foods for the postoperative period.
- Plan to have simple non-perishable groceries waiting for you at home when your return.
Prepare to reduce required errands in the postoperative period
- Plan for mail cessation or redirection if required.
- Liaise with family or contacts who may assist you with transportation.
- Don’t refuse offers of postoperative support / food etc.
- Lay out clothing which will be easy to get on or off after your planned procedure.
- Consider bill payments.
- Complete a list of required phone numbers or references.
Prepare hospital admission paperwork and admission
- Ensure the necessary paperwork from your booking pack has been returned to the hospital.
- You may wish to use the private hospital on-line registration options, reducing the need to complete paper-based information if it is already known to the hospital.
- Check your paperwork as to when to arrive at the hospital.
- You should check with the anaesthetist or Dr Mackie’s rooms when to fast (no food or fluids, no chewing gum, no smoking).
- Most patients are asked to fast from midnight for morning operations or 07:00am for afternoon operations.
- Some anaesthetists may permit drinking clear fluid (water) up until 2 hours prior to surgery.
- You may take your normal medications (other than blood thinners) with a tiny sip of water, unless otherwise instructed by the anaesthetist.
- Bring all of your hospital paperwork and Dr. Mackie’s booking pack to the hospital.
- Bring your X-Rays and other scans.
- Bring reading material.
- If having major joint replacement surgery you may have been provided with an antiseptic wash to shower with prior to coming to hospital.
- Remove jewellery, watches, false nails, contact lenses.
- Avoid perfumes, after-shave, face creams, body oils.
- You may wear dentures or glasses to the operating theatre and they will be returned to you in the recovery room.
- Don’t bring valuables into the hospital.
- Wear loose and comfortable clothing and wear soft soled, flat, non-slip shoes.
- Ensure you bring changes of clothes, underwear, toiletries, books.
- Telephone the office if you have any questions!
Finally, once you are in the hospital, you will have an admission check-in at the main reception desk and then be directed to the Day of Surgery Admission area for nursing check-in. There you will be readied for surgery (a further antiseptic wash / shower for patients undergoing joint replacement). If not seen by the anaesthetist at a previous outpatient consultation they will see you on the day of presentation. Dr Mackie will briefly check in on you and mark the relevant operating site with a texta-marker (to avoid mistaken site operations). The order of operating lists is determined by patient medical factors and then by planning processes for use of equipment or resources. Some patients have to wait until later in the operating session for their surgery. Dr. Mackie does not have long elective operating sessions into evenings, thus reducing potential waiting times for surgery.
After surgery you may be spoken to within the recovery room, but many patients have little recall of such discussions due to anaesthetic effects. Day-case surgery patients will be provided with postoperative instructions by nursing staff and provided with paperwork to assist in postoperative care and review consultation planning. The details of your operation will be discussed at the postoperative visit (at the rooms after day-case surgery or in hospital for patients staying more than 1 night).
