Pre-op Class

I went to my class yesterday. I learned a lot. Somethings I already knew, but we learned some new things too!

The class was taught by a RN, OT, PT, and Caseworker.

The nurse talked first. She talked about what a knee replacement is (she also talked about hip replacement). There were about 15 people who were going to have a joint replaced. She gave us a brochure about it as well.

She talked about benefits of replacements, how the joints works, why the joint gets bad, what happens before surgery, what the prosthesis looks like, preparing your house, arranging for help, seeing your DR, seeing dentist, preparing for surgery, risks and complications, the procedure itself, in the recovery room, in the hospital room, rehabilitation.

She gave us a special cleaner we are suppose to use to cleanse the joint area the night before surgery and the morning before surgery. She also gave us pre-admission paper work to fill out.

The important highlights:

1. put a drain tube in knee to monitor blood lose (since cutting bone you will loose blood) they can recycle the blood and give it back to you
2. come in 3-5 in AM to draw blood every morning (takes 2 hours to get results and the DR wants to see the results when he comes in for rounds)
3. My DR does rounds at 6-630
4. If blood count to low may need transfusion
5. no taking vitamin E or fish oil (causes bleeding)
6. anesthesiologist will call night before surgery to tell me what his instructions are
7. will have to take preventative antibiotics before seeing dentist and procedures
8. report 2 hours before surgery to hospital
9. surgery takes 1 1/2 hours
10. recover in "pacu"
11. wheel you over in bed to your room
12. private rooms (futon for my support people)
13. blood clot prevention - 1. use medication - shots in fat - have to give them to your self at home :( 2. mechanicals to squeeze legs 3. get up and active
14. do lung and PT exercises
15. no food restrictions after surgery
16. ****the success of a knee replacement is not what the DR does in the Operating Room but what YOU do in recovery!!!
17. CONTROL THE PAIN SO YOU CAN MOVE!!!! - different kinds of pain control methods - 1. spinal can leave it in 12-24 hours and give direct medication that way, shunt directly feneral nerve block (biggest nerve in leg) 48 hours, patient controlled meds, eventually pills
18. all ligaments want to heal stiff so you HAVE to work them
19. ALL THE WAY STRAIGHT - the knee so you can walk without limping...(so nice...it will be to walk normally for the first time in over 16 years!!!)
20. got to get it bending too
21. Hospital stay 3-4 days

The the OT (occupational therapist) talked to us. She was really cool.

Here are the highlights of what she talked about:

1. OT/PT come in together the first time the morning after the surgery
2. they do it together because you are getting out of the bed for the first time and it is not pretty (nausea, vomiting, dizziness, etc)
3. get a baseline of what you use to be able to do
4. what house is like
5. talked about the equipment to get - shower chair (I have) - reach-er (I'm getting) - sock aids to get socks on and off (I have people :))
6. bring comfy clothes so OT can teach you how to put them on - no pants with zippers...you only have 2 hands! :) you have to use those to help you stand up
7. OT does shower training
8. stair training
9. ***bring your sense of humor because you'll need it :)

Physical therapist talked next

1. give exercises to do at home
2. ***get in the mind set NOW - HARD WORK - NO LYING AROUND!!!
3. knee will be doing something ALL the time - exercising or using the CPM (continuous passive motion) machine picture of the machine http://www.accesshealth.com.au/sample/185/188/M_CPM_phoenix_2_299_x_250_2555.jpg
4. will be in the CPM 6-8 hours a day
5. normal range of motion 120-130 (need at least 90 to live normally)
6. TAKE YOUR PAIN MEDICATION - DON'T SKIM!!!!!!
7. will have home health PT at home
8. GET range of motion EARLY!!!
9. Work REALLY REALLY hard from the beginning

The case worker talked last

1. discharge plan
2. home health therapy
3. visitors ANY TIME!!!
4. surgery day not counted in post op days
5. 5 wishes (see post about this)

All in all it was a great class. Honora came with me. It was great for her to get all the information as well! 1 week now!!!