How to Prepare for Surgery

• A list of your medications or your current medications in their original container. Plan to have a family member take them home after the medication names and doses have been checked by your nurse or pharmacist.
• Driver’s license
• Insurance card
• Copy of Living Will and/or Health Care Power of Attorney
• Credit card or money for insurance co-payment
• Glasses, contacts, hearing aids, dentures, and cases
• Personal care items
• CPAP or BiPAP
• Walker
• Pair of non-skid shoes that are not tight, as you may have some swelling.
• Two sets of loose fitting clothes ie. shirt and pants or shorts. If you wish to wear a robe, bring one that opens along the entire front and is calf length.
• Books or magazines
• Tablet or laptop computer

Anesthesia includes the administration of medications to control pain and level of consciousness during surgery. There are various types that may be used alone or together. The goal is to provide the greatest comfort level with the least amount of side effects.

General Anesthesia: General anesthesia is a medication-induced deep unconscious state for surgery. A breathing tube may be placed to support your breathing during general anesthesia.

Regional Anesthesia: Regional anesthesia involves the use of anesthetics and/or pain medication to block the feeling in a certain region of the body, such as the lower body or just a single leg. IV sedation is also given with regional anesthesia.

An anesthesiologist will meet with you before surgery to discuss your anesthesia options.

• If you have a two-story home, prepare a room on the first floor with supplies you will need during the day.
• Make certain you have secure handrails along stairways and in the bathroom. Consider installing grab bars.
• Remove anything in your walking path that may cause you to trip or fall, like throw rugs, cords or furniture. Arrange furniture so pathways are not cluttered.
• Have a telephone within easy reach.
• Chairs with arm rests provide more support when sitting and more leverage when getting in and out of the chair.
• Use a cushion to raise the seat of a low chair.
• Make sure you have ample lighting to prevent falls.
• Run errands and grocery shop before surgery.
• Stock up on food that is easy to prepare and store it at waist to shoulder level to avoid bending and reaching.
• Make sure your pets can be out of your way when you return home.
• Install skid resistant strips or a rubber mat in the bathtub or shower.

• Check with your surgeon about special equipment you may need after surgery, such as a walker, cane, or bedside commode.
• Check with your insurance plan to find out which items will be covered. Some equipment may need your doctor’s authorization.
• If you already have a walker, plan to bring it to the hospital with you.

• Make arrangements to have a friend or family member stay with you for up to 2 weeks after your surgery or until you are safe with your daily routine.
• Arrange for someone to take you to and from your therapy and follow-up doctor’s appointments.
• If you decide to continue your therapy in a rehabilitation facility, tour and choose two facilities before you have your surgery. Be prepared to share the names of the facilities with your case manager.

Smoking
FMC is tobacco and smoke-free. The use of tobacco products, including cigarettes, E-cigarrettes, cigars, chewing tobacco and pipes is not allowed inside or outside any FMC buildings, properties or parking structures. If you are a smoker or tobacco user, it is important to quit at least a few days before surgery. Smoking constricts blood vessels, which can slow healing and increase the chance of infection and pneumonia. Quitting smoking before surgery will decrease the risk of these complications. Talk with your doctor before surgery about smoking cessation and alternatives to smoking or tobacco products. FMC supports your efforts to quit smoking. Ask a staff member for more information, or call the Ohio Tobacco Quit Line at 800-QUIT NOW.

Blood Donation
In rare cases, loss of blood during surgery may require a transfusion during your hospital stay. All blood and blood products used by FMC are obtained from the American Red Cross. The donors are strictly screened and the blood is tested for a number of infections, as well as compatibility with the recipient. You may refuse to receive a blood or blood product transfusion. Please tell the nursing and anesthesia staff if this is your wish.

Operative Site
Be careful with site of your operation (knee, hip or shoulder). If there is a scratch, cut, scab, or even a pimple, your surgery may be cancelled due to the possibility of infection at the site.

As with any surgery, there are risks of complications. Potential complications include:

Blood Clots
Surgery and a lack of activity put you at risk for blood clots in the veins in your legs. Measures are taken to reduce the risk of blood clots. These include early activity and therapy, ankle pump exercises, elastic stockings, calf pumps, and a blood thinner medication. Even with preventive measures, it is still possible for blood clots to form. Tell the staff if you have swelling, redness, pain, warmth, or tenderness in your calf or lower leg.

Pneumonia
Pneumonia is also a risk after surgery. You will be taught deep breathing and coughing exercises to help keep your lungs clear and prevent pneumonia. Being active after your surgery will also help prevent pneumonia. Smoking increases the risk of pneumonia. If you are a current smoker, you should consider smoking cessation.

Infection
Infection is a risk with any surgery. Every precaution is taken to reduce the risk of infection. You will be given an IV (intravenous) antibiotic before and after surgery. All total joint replacements are done using special equipment that keeps the surgical area sterile during the procedure. You will also be given instructions for preventing infections. Being overweight, a smoker, or having diabetes can increase your risk of getting an infection. Ask your doctor or nurse for help in managing these risk factors.

Nerve Damage
Nerves around the surgical area may be damaged during surgery. Generally, the symptoms of nerve damage will improve or resolve over time.

Implant Loosening
Over time, your implant knee may loosen from the surrounding bone. Surgery may be performed to replace the implant.

Implant Wear
A small amount of wear is common with all joint replacements. If this wear is severe, surgery may be needed to replace the implant.

Implant Breakage
While very rare, the metal or plastic components of the knee implant may break. A knee revision surgery would be needed to resolve this.

Loss of Limb
Loss of limb is a rare possibility.

Death
As with any surgery, death is a potential but rare outcome.

FMC supports and complies with our patient’s advance directives for medical care. In order to comply with your wishes, we will ask you about a living will or other advance directives. If you have already executed advance directives, please bring copies to the hospital. If you would like information about living wills and other advance directives, please talk with your nurse.