Home the same day?

[KBSunny]

I'm scheduled for my first TKR in October. My orthopedic surgeon suggests going home the same day I have my surgery. He is quite progressive and has a great reputation. But . . . Has anyone done this? I'm young-ish and healthy. My mom will be staying with me, but I'm pretty freaked out about possible complications the first night. Should I ask to be in rehab for a night?

 

[SusieShoes]

KBSunny! We at BoneSmart are happy you found us before surgery. The reading material on this site and the community on this forum can help you prepare for a less stressful recovery (because fewer surprises).

Many members have gone home the same day of surgery and done very well at home. Home is actually the ideal place to recover because your chance of picking up an infection is far less. But I agree it can be scary. Being in rehab for just one night would be pretty much the same as being in the hospital overnight. Talk about your concerns with your surgeon and see if he or she will allow you to stay a night. If you go home, though, you will do just fine.

Here's some reading material that will answer some of your questions and reassure you.

New BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?

Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:

Stories of amazing knee recoveries

There's also a section on planning your pain control you might want to visit: Plan Against Pain

If you have any questions, fire away! We're here to help.

 

[birdwatchr]

@KBSunny
I was offered same day surgery and I jumped at the chance to avoid being in the hospital. I had used the surgery center twice before, so I was familiar with them.

I do better at home alone with things like this. I could get up and move whenever I wanted to, not have to wait for someone to come get me. I could take my medicine as needed without having to wait for someone to "find the time" to bring them. I could get my ice packs whenever I wanted them, etc, etc. I slept when I wanted/needed to, ate if I wanted, it was all basically on MY schedule, not someone else's.

I also had surgery on a Friday, but it was a holiday weekend, so someone actually was there, but for the most part I was left alone. Didn't need someone to wait hand and foot on me, but he did set up a small table, etc so I could have everything nearby. You will most likely do fine. My doctor feels people who have outpatient TKR do much better than those who stay in the hospital a few days. But some people are more comfortable staying in the hospital. If your doctor feels you are healthy enough for outpatient, I think you should consider it. But ultimately, the decision would be yours. You have to feel comfortable with the idea.

 

[Jaycey]

I just attended a conference that included a session and discussion on this. Delegates from many countries including the US, Canada and the UK debated this approach. Obviously it's a global trend.

Bottom line all agreed - for some patients this approach works. But doctors are very selective in nominating patients for enhanced recovery.

If your doctor feels you are healthy enough for outpatient, I think you should consider it. But ultimately, the decision would be yours. You have to feel comfortable with the idea.

Well said birdwatchr! You as a patient must feel totally comfortable with going home the day of surgery. Don't feel pressured but do discuss any concerns with your surgeon.

The first days following surgery can be tricky. But with the right support in place including knowing what to expect and who to call - you should be fine.

 

[Celle]

It's important to remember that you're not being sent home because you've recovered, but because you still need to recover.
Do make sure that you have a good plan in place for pain control, you have enough medications, and you have a means of contacting your surgeon if you are concerned about anything.

 

[OJ2]

I stayed one night in the hospital, but I think I could have done just as well with outpatient. It was nice not having to get up to use the bathroom because I had a catheter, but the catheter itself was uncomfortable and I always had the feeling I needed to "go". And when I got home, getting myself to the bathroom was no problem whatsoever. I know my dear hubby felt more comfortable with me being in the hospital one night, but he is very uneasy with medical issues. It is always nice being in your own homes, with your own things, in your own bed, eating what you want to eat. And your surgeon is only a call away.

 

[Iloved3]

I was terrified that two days in the hospital would not be enough, but it was fine and I think I could have gone home except for the drain my surgeon put in. Could home health have pulled my drain on day three?

 

[Celle]

Could home health have pulled my drain on day three?

I think that depends on the level of their training, and on the surgeon's protocols.

 

[MyAussieGirl]

I don't know but I do know we all heal different and different from time to time. I have had 2 the...one hip I was in 2 nights the other one was just one night. I can see it being a huge plus to heal at home if at all possible

 

[Jennszoo]

I went home same day for both my TKRs. Surgery at 7:30, I was leaving around 1:30-2. It was scary, but I did well. And I appreciated not having to ask permission to get up, medicate, sleep, elevate, etc.

 

[Josephine]

My doctor feels people who have outpatient TKR do much better than those who stay in the hospital a few days.

The evidence is that patients are less likely to have problems and much less likely to get infections if they are sent home early. But the key factor is that patients MUST know they are not sent home because they are all healed and recovered but TO heal and recover. A big difference!

But ultimately, the decision would be yours.

Well it depends - ideally it should be your decision but many hospitals do this to save money by emptying the beds more quickly. So since they have a patient already booked to jump into your bed as soon as you are considered ready to go home, then home you have to go. Of course, if there are mitigating factors such as other conditions like diabetes, respiratory or heart issues or that you are returning home to an empty house, then any sensible surgeon will allow one or two extra nights stay.

 

[KBSunny]

Thank you for the helpful shares! I had not thought about having to ask to 'get' or 'do', and since I am fiercely independent, that could be what tips the scales as long as my surgeon agrees it is still a good idea for me to head home. Thank you

 

[birdwatchr]

@Josephine
Thank you for explaining those parts! I'm not in the medical field, so those observations do not occur to me. I can see where it could cause some confusion just going on someone else's experience if the medical part is not included and explained.

 

[Jennszoo]

When I asked about the outpatient thing, I was told my surgeon preselects the candidates best suited to recover at home (about 30%) and they've never had anyone from that group not go home or have complications that require an admission.

 

[pdx]

If you're not ready, they won't discharge you. Catheters get removed pretty quickly now, as they should be! They won't let you go if you can't do a few steps, have your IV out, etc. I would have LOVED to go home right away after my second. The first ... no, as I had a reaction to meds. Good luck!