Surgery Expectations (Page 2)
Discharge Day — Recovery
What can I expect the first few days after discharge?
Expect a time of transition. You may feel overwhelmed the first day or two after discharge and may even feel you’ve made a mistake coming home so soon.This may occur even after discharge from a rehab or sub-acute floor. Be patient, and give yourself some time to adjust. Many patients report that after the first day or two of practical problem solving and establishing a routine, they experience a change in their progress and notice a definite upward trend in their recuperation. If, on the other hand, you are experiencing pain or discomfort or have concerns about your condition, please consult your physician.
In addition, during this phase of discharge, usually within the first 24-72 hours, you will receive a telephone check-up from your case manager. You will be asked several questions to establish your progress and whether your post-discharge home or outpatient therapies have been started. This phone call also allows you to ask any questions or voice concerns regarding your home situation so they can be addressed.
Do I need someone to stay full-time with me when I go home?
It is our recommendation that someone be with you the first 24-72 hours after discharge. Many patients do live alone and we realize this is not always possible. But if you have a relative or a friend who offers to stay with you, take this offer for your own ease of mind. Many times patients have family members or friends who stay with them all day in the hospital. While this is certainly welcomed, it is often more helpful that this person be available after you leave the hospital. If you do live alone and either are discharged from rehab or from the orthopaedic floor with no help available at home, perhaps a friend or neighbor can call you daily to check on your progress. In addition, if home care has been arranged, these visits usually can be arranged so that someone is checking on you daily. The case manager will be discussing options available for your particular circumstances, and together you will develop a discharge plan, which will address your particular situation.
When can I go up and down stairs?
Stair climbing will be practiced in the physical therapy program before you leave the hospital. Most patients can climb stairs before leaving the hospital. If you live in a 2-story home and have practiced stair climbing, stairs can be done one to two times a day after discharge, depending upon your comfort level and provided that your physician has approved this activity.
Will I need pain medicine after I’m discharged from the hospital?
Most patients do require a short-term course of pain medicine. Renewals on these prescriptions can be obtained by calling your surgeon’s office. Expect to be on some type of pain medication for several weeks after discharge. Most patients take these medications especially at night or before therapy sessions.
How long will I need to use my walker or crutches?
Walkers and/or crutches are usually used the first 6 weeks after surgery. You will then be allowed to use a cane, which again will be used for approximately 6 weeks. After that time, most patients do not need any support for walking.
When can I go outside?
Consult your physician for a recommended time to engage in outdoor activities. Comfort and safety should be the primary guidelines for doing this. It is suggested to start with short trips at first, perhaps to therapy (if nearby) or your local supermarket or church, for example. Gradually increase the number and length of outside activities as you feel more comfortable.
When can I drive?
Driving routinely is not permitted before 6 weeks from the time of your surgery. However, some physicians may allow the patient to drive earlier if they feel the patient can do so safely. The type of surgery, side of surgery (left vs. right leg), and the patient’s overall general condition plays a part in this decision.
If you feel you will need to drive earlier than the 6-week routine prescribed, you should discuss this with your surgeon and obtain his/her approval. Consult your physician for further details.
When will I be able to return to work?
This varies with each patient. In general, patients usually do not return to work until after their first check-up at 6 weeks from surgery. Some patients do return to work earlier if they can do so safely. This should be discussed with your physician so that the best decision for your individual situation is made.
When will I be able to participate in sports activities?
Depending upon what activity you want to participate in will determine when you can safely start these activities again. Swimming, walking distances (hiking), bicycle riding, golfing, and other low impact sports activities can likely be tried after a few weeks. Returning to high impact activities such as jogging, tennis, or aerobics exercises will probably not be recommended for quite some time. Your return to any of these activities should be discussed with your surgeon.
When will I be able to have sexual intercourse after my surgery?
In most cases, sexual activities can be resumed when the patient feels comfortable enough to do so. If the patient has been cautioned to maintain certain position restrictions, these restrictions should be followed in this instance also. In general, most patients resume their normal sexual activities between 4-6 weeks following surgery.
Hopefully this website has answered some of your questions about joint replacement surgery and provided you with a better understanding of what to expect during the surgical experience. Your orthopaedic specialist will be happy to answer any additional questions so that you’ll feel comfortable and confident with your upcoming surgery. As individuals vary, please discuss your specific instructions with your orthopaedic specialist.
Life After Total Joint Replacement
The vast majority of individuals who have joint replacement surgery experience a dramatic reduction in joint pain and a significant improvement in their ability to participate in the activities of daily living. Your physician will recommend the most appropriate level of activity following joint replacement surgery.
It is important to understand that there are risks associated with any major surgical procedure and total joint replacement is no exception. Although the occurrence of complications is low in number, each patient needs to be informed of these possible risks prior to surgery. In all cases, discussion between the patient and the treating physician is imperative so that the patient is aware of potential complications and how to minimize them.
This information has been provided with permission by the authors:
David Hungerford, MD
Lynne Jones, PhD
Pat Pietryak, RN
Johns Hopkins University and Health System Baltimore, MD