SAME DAY TOTAL HIP REPLACEMENT POST-OP
INSTRUCTIONS
INSTRUCTIONS
Printable Same Day Total Hip Replacement Information and Instructions click HERE
AFTER SURGERY:
Post Anaesthetic Care Unit (PACU)
When you wake from surgery you will be in the PACU. You will be monitored here closely (pulse, blood pressure, oxygen level, breathing, pain control and dressing/wound status).
Surgical Day Care Unit after surgery
You will be discharged from hospital to your home when you can
IMPORTANT INFORMATION I SHOULD KNOW ABOUT:
All surgeries come with some risk of complications. The good news is that many of these can be prevented by managing your pain as directed and getting up and moving on the same day as your surgery. Even when we do everything right, complications can still happen. Knowing what signs and symptoms to watch for helps us catch and treat problems early which keeps your recovery on track.
HIP PAIN
Pain is personal and individual. The amount of pain you feel may not be the same as others feel, even for those who have had the same surgery. It is not possible to be pain free after surgery, but it is important you have effective pain relief. Our goal is to help you be comfortable enough to participate in the healing process. Your pain should be controlled enough so you can rest comfortably and participate in deep breathing, coughing, turning, getting out of bed and walking.
What are my options for managing pain?
Pain is managed best when treated early and continuously. Pain is very individual. Both medicine and non-medicine methods can be used to prevent and manage pain.
You will be given pain medications by mouth before surgery. During surgery you will likely have a spinal anaesthetic and an injection of pain medications around the hip. In the PACU you will be given more pain medications by IV and or mouth. In the surgical day unit, we will focus on more medications by mouth in preparation for going home.
Common pain medications:
There are many pain medications available to treat different types and levels of pain. The more common ones are:
Acetaminophen (Tylenol) is used alone for mild pain and with other medicines for moderate to severe pain. It is often the first step in the ladder of pain management. You will be given Tylenol just before surgery and should continue this every 6 hours while awake for a couple of weeks. Tylenol can affect the liver if taken in high doses over long periods of time so read the bottle before taking. Let your doctor know if you have liver problems.
NSAIDS (Advil, Motrin, Aleve) are also used as one of the first steps of the ladder in managing pain and can be used with other pain medicine for moderate to severe pain. Like Tylenol, NSAIDs can reduce the amount of opioids needed. You will be give a prescription for an NSAID for about 2 weeks post surgery. Never take more than one type of NSAID at a time. They may affect the kidneys and stomach and increase the risk of stomach and gut bleeding. Talk to your doctor to see if there is a reason why you should not take an NSAID.
Opioids (Codeine, oxycodone, hydromorphone) also called narctoics or pain killers are used for moderate to severe pain. They are often used in addition to Tylenol and NSAIDs. You will be given a prescription for either Hydromorphone (Dilaudid) or Oxycodone to take by mouth every four hours if needed.
Many people are afraid that if they take opioids they may become addicted. The chance of addiction is very low. Taking opioids for pain relief is not an addiction. People addicted to opioids crave the opioid and use it regularly for reasons other than pain relief.
Side Effects
You may have side effects from any of these medicines. Side effects usually can be controlled or resolved over time.
Physical techniques such as positioning, movement, splinting and cold packs.
Relaxation can increase your comfort by calming your mind and muscles.
Meditation, relaxation, distraction with breathing and imagery techniques. There are lots of great apps for this.
Focussing your attention on something other than the pain can make you less aware of the pain. Distraction may work well while you are waiting for the pain medicine to take effect.
Cold Packs help reduce swelling, relax muscles, and slow nerve transmission. This may make pain more tolerable. Apply for 20-30 minutes at a time, four to five times per day after your hip surgery.
Cold Compression units Your surgeon may have given you a prescription for a cold/compression device. This is a therapy involving continuous circulation of cold water, sometimes with compression. This therapy can help reduce pain, swelling, tissue damage, and muscle spasms. A prescription is needed to obtain this device. Specific information on how to use this device is given at the time it is purchased.
Pain is personal. Do what works best for you to decrease the intensity of your pain and help you achieve your goal.
BLOOD CLOTS
After your surgery, there is a small chance of developing a blood clot. This is a thick, jelly like, accumulation of blood. The body normally makes clots to help stop bleeding. After surgery, clots can form in the legs, stopping the normal flow of blood back to the heart. This is called a deep vein thrombosis or DVT. A thrombus is the medical term for a blood clot. They are more common in the leg and pelvis.
Signs and symptoms include:
Signs and symptoms include:
Your surgeon has prescribed a blood thinner. This is a pill that you will take by mouth each morning for 35 days. This helps to prevent clots from forming.
Tell your surgeon if you already are taking a blood thinner or have a bleeding disorder.
Call your surgeon if you have:
WOUND (INCISION) Infection and Care
Antibiotics will be given to you before and after your surgery through your intravenous to help reduce the chance of infection.
The original dressing worn home is waterproof and may be worn in the shower. The SDC unit nurse will provide you with a second dressing to take home.
• Drainage, redness, swelling, a foul odor or your incision is opening up
• Elevated temperature greater than 38.5 degrees Celsius on 2 consecutive measurements, 30 minutes apart
AFTER SURGERY:
Post Anaesthetic Care Unit (PACU)
When you wake from surgery you will be in the PACU. You will be monitored here closely (pulse, blood pressure, oxygen level, breathing, pain control and dressing/wound status).
- You will have an intravenous (IV) and may receive oxygen.
- There will be a dressing on your wound.
- Tell the nurse if you have any of the following: unrelieved pain, nausea and/or vomiting, itchiness, difficulty urinating.
- You will stay in the PACU until you are ready to go to the Surgical Day Care Unit (where you arrived).
Surgical Day Care Unit after surgery
- You will remain here until ready for discharge.
- You will be given fluid to drink
- You will get pain medications and also antibiotics prior to leaving
- Cooling device or Ice over the dressing can be helpful
- The physiotherapist will see you and teach/review how to get out of bed, walk with crutches/walker and use stairs (if you have stairs at home).
You will be discharged from hospital to your home when you can
- Independently transfer from bed to chair, walk and use stairs (if needed) with crutches or walker
- Understand your pain management plan and the pain medications you can take
- Your designated care giver understands your care needs for when you are at home.
- You are satisfied with your pain control and the pain does not prevent you from moving or walking.
IMPORTANT INFORMATION I SHOULD KNOW ABOUT:
All surgeries come with some risk of complications. The good news is that many of these can be prevented by managing your pain as directed and getting up and moving on the same day as your surgery. Even when we do everything right, complications can still happen. Knowing what signs and symptoms to watch for helps us catch and treat problems early which keeps your recovery on track.
HIP PAIN
Pain is personal and individual. The amount of pain you feel may not be the same as others feel, even for those who have had the same surgery. It is not possible to be pain free after surgery, but it is important you have effective pain relief. Our goal is to help you be comfortable enough to participate in the healing process. Your pain should be controlled enough so you can rest comfortably and participate in deep breathing, coughing, turning, getting out of bed and walking.
What are my options for managing pain?
Pain is managed best when treated early and continuously. Pain is very individual. Both medicine and non-medicine methods can be used to prevent and manage pain.
You will be given pain medications by mouth before surgery. During surgery you will likely have a spinal anaesthetic and an injection of pain medications around the hip. In the PACU you will be given more pain medications by IV and or mouth. In the surgical day unit, we will focus on more medications by mouth in preparation for going home.
Common pain medications:
There are many pain medications available to treat different types and levels of pain. The more common ones are:
- Acetaminophen (Tylenol)
- Non-steroidal anti-inflammatory drugs (NSAID’s)
- Opioids
- Other medications (local anaesthetics, anticonvulsants)
Acetaminophen (Tylenol) is used alone for mild pain and with other medicines for moderate to severe pain. It is often the first step in the ladder of pain management. You will be given Tylenol just before surgery and should continue this every 6 hours while awake for a couple of weeks. Tylenol can affect the liver if taken in high doses over long periods of time so read the bottle before taking. Let your doctor know if you have liver problems.
NSAIDS (Advil, Motrin, Aleve) are also used as one of the first steps of the ladder in managing pain and can be used with other pain medicine for moderate to severe pain. Like Tylenol, NSAIDs can reduce the amount of opioids needed. You will be give a prescription for an NSAID for about 2 weeks post surgery. Never take more than one type of NSAID at a time. They may affect the kidneys and stomach and increase the risk of stomach and gut bleeding. Talk to your doctor to see if there is a reason why you should not take an NSAID.
Opioids (Codeine, oxycodone, hydromorphone) also called narctoics or pain killers are used for moderate to severe pain. They are often used in addition to Tylenol and NSAIDs. You will be given a prescription for either Hydromorphone (Dilaudid) or Oxycodone to take by mouth every four hours if needed.
Many people are afraid that if they take opioids they may become addicted. The chance of addiction is very low. Taking opioids for pain relief is not an addiction. People addicted to opioids crave the opioid and use it regularly for reasons other than pain relief.
Side Effects
You may have side effects from any of these medicines. Side effects usually can be controlled or resolved over time.
- Nausea You may experience nausea when starting to take stronger pain medicine such as opioids. This may go away after a few days; however you may need to take antinausea medicine. Try flat gingerale or dry crackers. Also, Ginger Gravol, non-drowsy. This may help.
- Drowsy You may feel sleepy. This is a common effect of strong pain medicaine. At the same time, pain uses up a lot of energy. Once your pain is managed, your body will be able to rest and you may feel sleepy for a few days. Before standing up from lying down, take a minute to make sure you aren't dizzy.
- Constipation from opioids is common. Prevention is the best approach. Take plenty of water, raw fruits, vegetables and exercise (move around). You may also need to take a laxative such as a combination of a stool softener such as Magnalax and stimulant laxative (ask the pharmacist).
Physical techniques such as positioning, movement, splinting and cold packs.
Relaxation can increase your comfort by calming your mind and muscles.
Meditation, relaxation, distraction with breathing and imagery techniques. There are lots of great apps for this.
- Get into a comfortable position. Breathe in slowly.
- Breathe out slowly and feel yourself begin to relax. Feel the tension leave your body.
- Breathe in and out, slowly and regularly, at whatever rate is comfortable for you.
Focussing your attention on something other than the pain can make you less aware of the pain. Distraction may work well while you are waiting for the pain medicine to take effect.
- Concentrate on your breathing as described in the relaxation exercise above.
- Close your eyes and focus on an object or a quiet place.
Cold Packs help reduce swelling, relax muscles, and slow nerve transmission. This may make pain more tolerable. Apply for 20-30 minutes at a time, four to five times per day after your hip surgery.
Cold Compression units Your surgeon may have given you a prescription for a cold/compression device. This is a therapy involving continuous circulation of cold water, sometimes with compression. This therapy can help reduce pain, swelling, tissue damage, and muscle spasms. A prescription is needed to obtain this device. Specific information on how to use this device is given at the time it is purchased.
Pain is personal. Do what works best for you to decrease the intensity of your pain and help you achieve your goal.
BLOOD CLOTS
After your surgery, there is a small chance of developing a blood clot. This is a thick, jelly like, accumulation of blood. The body normally makes clots to help stop bleeding. After surgery, clots can form in the legs, stopping the normal flow of blood back to the heart. This is called a deep vein thrombosis or DVT. A thrombus is the medical term for a blood clot. They are more common in the leg and pelvis.
Signs and symptoms include:
- Pain or tenderness in the leg
- Skin is warm to touch
- Swelling of the leg
- Redness of the skin
Signs and symptoms include:
- Shortness of breath
- Pain in the chest
- Feeling faint
- Coughing up blood
- Heart palpitations
Your surgeon has prescribed a blood thinner. This is a pill that you will take by mouth each morning for 35 days. This helps to prevent clots from forming.
Tell your surgeon if you already are taking a blood thinner or have a bleeding disorder.
Call your surgeon if you have:
- Increased bleeding at the surgical wound.
- Other bleeding; nosebleed, blood in the urine, feces (bowel movement), mouth, vagina, anus or gums.
WOUND (INCISION) Infection and Care
Antibiotics will be given to you before and after your surgery through your intravenous to help reduce the chance of infection.
The original dressing worn home is waterproof and may be worn in the shower. The SDC unit nurse will provide you with a second dressing to take home.
- The day after surgery, remove the elastic bandage and the thick bulky dressing underneath. Leave on the smaller dressing.
- You may keep and put back on the elastic wrap to help control swelling and for gentle pressure
- Change the dressing in 5-7 days or if it is leaking or no longer completely sealed.
- Wash hands well.
- Gently loosen the dressing all around the edges until sticky part is off and gently remove dressing and discard.
- Ensure skin is dry
- Seal edges all the way around to prevent water from getting in during your shower.
- Remove the second dressing after 5 days or leave on until follow-up appointment
• Drainage, redness, swelling, a foul odor or your incision is opening up
• Elevated temperature greater than 38.5 degrees Celsius on 2 consecutive measurements, 30 minutes apart