Hospital Discharge – Planning for Home
Your surgeon will talk to you about the actual date of your discharge.  The date will depend on your medical and physical condition as well as any special discharge needs.  Once your doctor decides on a date, members of your healthcare team will be notified.

You must arrange for a family member or trusted friend to escort you home once your discharge date is decided.  If you cannot arrange for this service, you should speak with your patient representative about making special arrangements to get you home safely.

When you review your discharge instructions, make sure both you and your family member or friend completely understand the directions.  Ask questions and take notes.   Be sure to have your doctor or nurse repeat anything you don’t understand about the treatment plan you will use when you leave the hospital.

Remember your pain and blood thinner medications have already been sent to your home from H.O.M.E. pharmacy and are there waiting for you. You should be able to move smoothly from the hospital to home. You probably just have to schedule your next post-surgery follow-up visit, and then you can be on your way.

Preparing To Leave the Hospital - Ask Questions and Take Notes
Before you leave the hospital, be sure you gather all the important information you can:

Confirm how to take the medications you have waiting at home Know what signs to look for regarding an infection Know if and when to change your bandage Know when to schedule a follow-up appointment For example, when will your bandages/stitches be removed? Know if, and when, you can shower Obtain answers to any other questions you might have.  Remember, as the patient, you have the right to ask as many questions as you need.  Your doctor will answer all of your questions.

Write down as much information as possible, so you can have a reference when you get home

Your post-surgery medications – pain medicine and blood thinners - have already been shipped to your home by H.O.M.E. Program. No stopping at the pharmacy on the way home - just straight home so you can continue healing. You should be able to move smoothly through the discharge process. Hospital Tip: Remember to turn off your telephone and TV service in your room before you are discharged. Also, remember to check that you have not left any of your personal items behind.

A safe recovery at home –

Pain management
Following your joint replacement surgery you probably feel pain or discomfort for the first few weeks at home. You will be given a prescription-strength painkiller to help get, and keep, any pain under control.  Take your pain medicine as prescribed, and as needed!

You should not be afraid of taking your pain medications. Keeping your pain under control will not only make you feel more comfortable it will help you:

• Regain your strength
• Move more easily so you can participate more fully in your physical therapy.
• Keep you moving to help avoid other health problems

Learn More: CLICK HERE TO LEARN MORE ABOUT PAIN MANAGEMENT

How to avoid complications –

Infection
Sometimes an infection may develop after joint replacement surgery.  It may occur deep in your wound and can spread to your new joint.  Bacteria entering the bloodstream are the most common cause of infection after joint-replacement surgery. 

These bacteria can come from a dental procedure, urinary tract infection or skin infection, and can lodge around your artificial joint to cause an infection. Make sure you discuss any medical or dental procedures with your physician. If appropriate, you should get a prescription for an antibiotic before any major dental work, or any surgical procedure, that could allow bacteria to enter your bloodstream. Be sure to take your medications exactly as directed by your physician.

Any swelling around your new joint should slowly decrease over the weeks following surgery. You must follow your doctor’s instructions regarding wearing your compression stockings. If you notice increased swelling, redness, or wound bleeding, call your surgeon immediately.

Blood Clots
Your risk of developing a deep vein thrombosis (DVT) and/or pulmonary embolism (PE) is greatest during the first several weeks of your recovery. 

You must follow your surgeon’s instructions faithfully during this critical period of time, including taking your prescribed blood thinning (anticoagulant) medicine and keeping as active as you can.

Learn More: CLICK HERE TO LEARN MORE ABOUT DVT/BLOOD CLOTS

Stability
As in the hospital, night time bathroom trips can be dangerous. Sleeping pills and pain medications may cause unexpected balance problems. Blood loss from surgery can also make you woozy when first standing up.

Helpful hints include: Stand still at the bedside for a moment before walking; be careful getting up! Use your eyeglasses and turn on a light Be sure scatter rugs have been removed, so you don’t slip Be aware that emptying your bladder can drop blood pressure and cause fainting. Men are much safer sitting down.   Be careful getting up! If something is confusing or does not seem right, call the doctor's office for advice; their staff often knows the answer.

Help at home
Arrangements for a visiting nurse and/or home physical therapist will be made at the time of your discharge from the hospital if needed.  Their role is to help you transition into the home environment and monitor your progress.

Some things to help you cope after total joint replacement surgery:

Try to arrange for someone to visit you at home to help you for up to 6 weeks. You may need help putting on the elastic stockings, cooking, doing laundry, cleaning, and getting around town. You may be qualified to receive personal care services from a home health aid if you do not have family members who can provide all the help you need. Ice may reduce pain and swelling during the first few weeks after surgery—you should check with your surgeon. Many patients may shower when they get home. You should double check with your surgeon if and when your incision can get wet.

Set up an At-Home Comfort Station Before surgery, gather everyday items you may need post-surgery and place them near the area where you will be spending most of your time when you get home: Some items to include: Remote control Radio Telephone Tissues and wastebasket Books, magazines

 

Recovery Journal: Get a notebook and set up a Recovery Journal to help you keep track of your meds, your questions, and your daily progress.  It’s also a useful way to monitor your pain progress, and keep a schedule of your daily medicines. Bring it along on your next scheduled visit with your surgeon.  It will be very helpful to have this information handy when discussing your recovery progress.

Rehabilitation  
Rehabilitation is one of the most critical parts of your recovery.  The results of your surgery, including the level of activity you will be capable of in the future, are highly dependent on a successful rehabilitation process.

You will most probably be sitting and standing on the day after your surgery. Your rehabilitation following joint replacement will start soon after your surgery.  A successful rehabilitation program consists of both physical and occupational therapy. 

The primary objectives of your rehabilitation are designed to help you – Stretch and strengthen your muscles Restore motion in your new joint Increase movement in your new joint Resume comfortable walking and return to your normal activities

 

A successful rehab program depends on your doing your part.  Sticking to your physical therapy and exercise schedule is essential to a successful outcome for your joint replacement.

Physical Therapy
Physicians generally recommend that you focus on your therapy program and avoid strenuous activities that may irritate your new joint for several weeks following surgery. The goal is to restore your motion and improve your strength.

Walking longer distances slowly and progressively each day is helpful. Riding a stationary bicycle may also help restore motion.  Only your doctor and therapist will know for sure!

Arrangements for a visiting nurse and home physical therapist will be made at the time of discharge from the hospital. Their role is to help you with your transition into the home environment and monitor your progress.

Your assigned physical therapist will develop a series of exercises designed to help:

• Restore your range of motion (ROM) – that is, the amount you can move
  • Most of your ROM will be regained within the first few weeks after surgery 
• Regain your strength
  • It is critical to actively participate in your exercise program so that tissue surrounding your new joint will not become too tight and permanently limit your motion
• Give you back your independence
  • Set your therapy goals and work towards them, a successful therapy depends on you
  • Each exercise you successfully perform is getting you back in step with an active lifestyle

Occupational Therapy
Even everyday activities as simple as bathing and dressing can be a challenge after surgery.  The goal of occupational therapy is to be certain you can resume performing daily activities safely when you return home.

To help you avoid overworking your new joint, the occupational therapist will order special equipment for you as needed.  These may include:

• Bath chair
• Commode
• Reacher
• Walker
• Cane

Remember, you might have difficulty performing routine tasks during your rehabilitation. Your occupational therapist will show you different ways of putting on your pants, socks, pantyhose, and shoes. You will also learn tips on how to make your bathroom, and other living areas safer and easier to use.

Most people find it helpful to continue their physical therapy after leaving the hospital.  Check with your surgeon about when you can start an at-home therapy and/or outpatient regimen.

 

Exercising your New Joint Following total joint replacement, patients are encouraged to resume an active lifestyle.  However, how you treat your new joint may influence its longevity.  Therefore, it is important to know which activities are permissible. Some helpful tips include: When you are ready to resume activities: Try to choose those that are easy on your new joint Try to avoid activities that add too much strain Remember that your former activities may require some modification Avoid activities that produce high impact loads such as running, and jumping Avoid heavy lifting, high heels, twisting If you experience a sudden sharp, or severe pain in your new joint, contact your surgeon immediately