"Outpatient" THR scheduled!

[HopAlong]

It's been 10 months since I was rejected for a THR because of being overweight.
Well the pain got so bad,that I just looked for another doctor. Not only did I find a MI THR expert who does 1,000 hips and knees per year, but he said the surgery will be only 40 minutes, AND I can have the surgery in the surgicare center at 7:00 AM and go home at 4:00 PM THE SAME DAY!

I trust this doctor because he comes highly recommended, and is one of the few in NJ experienced in minimally invasive. Has anyone here ever had an "outpatient" THR before??? He did give me the choice of a traditional hospital stay vs. the surgi-center; I hope I made the right choice by choosing the surgi-center. I am scheduled in 3 1/2 weeks. Any opinions or experiences to share???

Still Painfully Hopping Along!!!

 

[Laurie]

Yikes, I am no expert but did have a RTHR, in NJ no less, last August. I recovered extremely well but just on the concern of blood clotting, vitals (was very woozy the second day), pain management variations, etc, would not have wanted to go home in a day. Perhaps with a private nurse and bedside equipment, ....and hospital is close, but...

Josephine????

Am curious, where in NJ is this outpt surgery offered? (I am in Northern NJ in Morritown area)

Laurie

 

[HopAlong]

https://www.hartzbandjoints.com/

Here is a link to the practice. Did you have minimally invasive with robotics Laurie? They have a nurse come to your house 2-times a day after surgery, and they have the patient inject themself at home with an injection that prevents clotting.....once a day for a week.

 

[Josephine]

Well, it was pretty much inevitable as I said somewhere else. So long as the home conditions are good - someone sensible to look after you and a good place. No reason why not, really.

 

[Laurie]

Hi,
Josephine has spoken. My sugery was called MI--I have metal on metal biomet, my surgeon said the incision would be about 5 inches but also said that if he needed to make it bigger to see, he would. Ended up with a 6 inch scar that is fading nicely at 5 months.

AGain, great we have several personal choices. Your surgeons certainly sound like experts from the website--Paramus is about a half hour from here.

For me, I decided to take advantage of the hospital care--and it was great at Saint Clare's hospital in Denville. I also made the choice to go to a subacute rehab at our local Morristown Memorial -- wasn't completely happy there and was glad to go home. In truth, 4 days or so post surgery, I was feeling better than I thought I would before the surgery.

PLease let us know how it all goes. Some of us may be looking for additional joint surgeries down the line (my left hip is real good now, but was told it is not perfect when xrays were taken)

Laurie

 

[HopAlong]

You probably live near me, Laurie I am also 1/2 hour from Paramus. I live in Little Falls.
How long did your procedure take? When this doctor said only 40 minutes for a THR, I never heard of that before either! But while I waited for my consult, I interviewed another one of his patients who told me his THR took only 38-minutes! He was 2 weeks post-op and walking without pain with a cane.
The doctor was very confident and pleasant, and had a good sense of humor, which took the edge off my nerves a little bit too.


Thanks for your comment Josephine..... That helped take the edge off too. My husband said he would take a day off work to help me through the 2nd day after. I am at the point now where I can't walk without holding on to everything in site, the pain is unbearable now, so the recovery shouldn't be much different. (I hope anyway.)
I don't know how to give myself a shot, so hopefully the visiting nurse can teach me how.

 

[Troweltalk]

Lets step back and take another look...

A. At least one doctor turned you down for the procedure becasue of your weight, and you kept looking until you found someone who said "yes". So it sound like you had more than one say "no."

B. Not only did this surgeon say yes, but promised a 40 minute surgery and the ability to go home at the end fo the day.

Being overweight brings up several concerns about the procedure (I'm no light-weight at nearly 250lbs). Is the surgeon requiring you get any pre-surgery screening done, EKG, diabetis screening, chest x-ray, etc?

I came out of surgery with a tube inserted in the wound, which drained into a suction device for a day before they removed it. I was told this was SOP to prevent fluid buildup. Hard to imagine going home with that thing still sticking out of me, not to mention the IV that had the pain meds attached.

I suppose you've no problem with general anestesia? I was nausious for the first 12 hours after I woke up.

My grandmother use to say, "if something sounds too good to be true, it usually is."

Just saying...

 

[Josephine]

They will show you. Just think - young diabetics learn how to give themselves insulin shots - how hard can it be? And actually, it's not that much worse than stabbing yourself with a sewing needle or pin! (though that would be accidental, of course!) And the needles on those little syringes are ultra fine.

 

[Laurie]

Hi, Gotta admit, all of what Mudpro said crossed my mind but I didn't want to be a nay sayer as I am not totally up on all medical options.

I forgot about that drain. I too had that and it wasn't taken out until the morn of third day. What I remember was the wooziness/nausea. I almost had to have a blood transfusion but fortunately was spared that.

I remember my Dr telling me that the wave of future is shorter and shorter surgery times/hospitalization, mostly encouraged by insurance cos. When you think about it, what is the real benefit? I felt better knowing I was under medically sound hospital care those first few days. Plus it was a load off hubby during that time. Just my point of view/experience.

My surgery took about 1.5 hours (funny, I can't remember exactly). My surgeon, Dr. Frank Capecci, is here in Denville, NJ. He has been doing hips and knees for years. I liked him due to his local reputation and logical approach. He also wasn't a heavy seller on any type of surgery. At one point I was considering getting an opinion on resurfacing. He would have referred me as he doesn't do them--but after hearing his opinion on this surgery specific to my case, I decided on the THR. So far so good.

BTW, I am 56, in very good shape (weight was never an issue re: surgery), hitting the gym again several times a week. Can't wait to get out hiking again after this brutal winter passes.

Laurie

Little Falls is down the road a bit--probably a little far from Saint Clare's if you were exploring other options.

 

[Jamie]

HopAlong, although it's good to have input from everyone here on the forum (information is POWER), ultimately you have to decide if you trust your surgeon and are comfortable with what he has proposed for you. In getting to that comfort level, I suggest you make a list of your concerns in writing and discuss all of them with him prior to the surgery. Don't be worried about taking his time for this extra discussion. A good doctor would want you to be comfortable with the procedure. I'll echo what Mudpro said about getting good prep work prior to surgery. That would be important anyway, but even more so if you have any health issues at all. Best of luck to you and please continue to post both before and after your surgery. You'll have TONS of support here!

 

[HopAlong]

I think the big difference in time spent in the hospital vs. outpatient is the choice of anesthesia. This doctor uses an epidural and a shot of something in a IV that makes you sleepy. But he also gives you the choice of being awake----I'd rather sleep. And I think they also inject a femeral nerve block as well, which lasts for up to 36 hours.....So the pain can't return until the next day at least.
With general anesthesia, you experience the nauseous hangover afterwards, but not with a epidural or spinal. I had a spinal with my C-section 17 years ago, but I was awake the whole time.

Josephine, have you assisted both local & general anesthesia THR's?

If there is a drain, I guess the visiting nurse will know what to do with it.
I know Denville well. I miss the Bonzai restaurant there! They changed I saw. My son has friends in Mountain Lakes, so I drive him up that way a lot.

Actually, I was going to wait until I lost all the weight I gained (from quitting smoking) before having the surgery, but then after reading from this site, I realized there were overweight patients having successful THR's.
I called this practice, and the nurse told me that there is no weight limit. I wish i had found this doctor a year ago.......its hard to lose weight when you can hardly move without screaming pain. But I am sure after the surgery I will be able to lose the weight. I used to be really fit.

I am a little nervous about same-day, but I do like sleeping in my own bed too.

 

[HopAlong]

Thanks MudPro & Jamie...

Yeah i have to have an EKG, blood work and a chest x-ray next week. I am also going to the dentist to rule out any potential infections. I could always change my mind and ask for the traditional hospital stay, but I want to go home before the femoral nerve block wears off too.

 

[Laurie]

Hopalong,

Sounds like you are on top of it all. Sure will be interested in hearing about the procedure, all the details, etc.

As Jamie said, you will get alot of support here.

I haven't been to the new restaurant that replaced Bansi. Heard it was excellent though.

Am at work waiting for a meeting to start...then must navigate this yucky weather home.

Take care, and keep posting.

Laurie

 

[Judles]

Hi Hopalong! I'm another hippy RTHR and although it sounds so much easier to do this type of surgery on an outpatient basis, In record time, I totally agree with Jamie, Laurie & Mudpro! Do you have family and friends to help you once you return home after the surgery,,,Did the doctor explain to you that this is major surgery,,,,you will have to be monitored at least for the first 24 hours! Believe me, this is not like a root canal and if I were you, I'd be thinking of the MANY downsides of a surgery on this kind of basis! Especially, the fact that you are overweight, you really need medical supervision! Believe me, there is enough stress involved in this whole process,,,,,,without burdening your husband those tough first few most crucial days! Just the coordination of PT, OT, etc alone! Of course you want relief,,,,,,but most importantly you want to be SAFE! Please think this decision through carefully!/Good luck to you and hopefully you won't be hopping along much longer! Keep us posted!

 

[HopAlong]

Thanks Judles.

All of this reading had me wondering if I should call and change my mind about outpatient surgery, and go the hospital route. But now I am really on the fence because I googled "same day hip replacement" and found articles dating back to 2003, stating that most MI hip replacements are same day.
Here is one: https://www.scienceblog.com/community/older/2003/G/20035171.html

I think it is only the doctors that are trained by Zimmer, that do true MI replacements. Or rather "the most" minimally invasive. Even in 2003 patients were walking away the same day with the Zimmer-trained doctors according to articles I pulled up.

I'm still not sure if I should change to a hospital yet.

 

[Laurie]

Hopalong, You seem determined to do same day. You didn't give your age or medical status. While I am sure it can be done, again, what is the hurry? Only my opinion, and my RTHR is still pretty fresh (Aug 26), but as was said, feeling safe and medically cared for was comforting.

Though I am no spring chicken, I was in excellent health and good shape, relatively young (55) and even at that, the 2-3rd days were the lowest points--all uphill after that though. I am so grateful for the evening nurse who at 2 a.m. gave me a sponge bath and saltines. Felt like heaven that 2nd night. And I knew she knew just how to move my leg so it wouldn't dislocate. (oh, and don't forget the bootie things they make you wear to keep the blood from clotting--)

Know we sound discouraging but just want to give you our experiences. If you do go ahead with the same day, will look forward to hearing how you managed. Take it your hubby is encouraging this route?

Take care,
Laurie

 

[JudyS]

Hi Hopalong

I had my hip replaced in June, traditional posterior a little extra time in the hospital as I was in a research study, 5 days total.
I just got home last week from 10 days in the hospital for back surgery.
My thoughts are if you have a great nurse, the hospital route is great. The blood people cominmg in at 5 am I sure could do without. The nice nurse's aid with the blood pressure cuff at all hours of the day and nite, I could also do without!!!
The nurse who comes to your home will certainly teach you how to inject the medication, it is no big deal, the fact that a nurse comes twice per day sounds great. I would say the big thing would be freind/husband support at home. If you have it, all should be good.
My last stay was anything but normal.
My stay with the hip replacement, I know I would have got more rest at home. Lots of pros and cons with each and I am sure if you are not really stable they will send you to the hospital instead of home.

Good luck with your decision
Judy

 

[HopAlong]

I am 48, no spring chicken either, although they consider it young in the ortho's office LOL.
I was all ready to call them and switch today to inpatient, but even the inpatients go home the next day with the Zimmer-trained THR's, so I won't be missing that much by skipping out early I guess........or I hope rather.

I remember when I was in the hospital 17 years ago having a c-section, they bothered me so much---even when they weren't poking and prodding, they were gabbing and giggling loudly all night! Errrr!
The third night I went to the nurses station, and said I have an announcement to make!

"Although you all are very kind, I am deliriously tired, so take all the blood, bp, temps, you want right now, because I am locking my door so I can sleep!"
So they did, and even offered me a sleeping pill too. That was the only night I was able to sleep.

 

[Laurie]

Hopalong, Our hospital experience really does make a dfference. I had such a good one at my hospital -- however, the days at the subacute rehab hosp were more like your experience. I couldn't wait to get out of there (was feeliing better from day 4-8 as well).

In any case, good luck to you and keep posting. BTW, 48 sure sounds young from my vantage point!!!!

Laurie

 

[Laurie]

Hopalong, I was curious so pulled up the Zimmer site. Sounds like you are having the anterior approach. If so, perhaps Josephine can direct you to the thread discussion on the advantages of this--seems there was lots of chat about the virtues vs the posterior several months ago. May be more to consider anyway.

Laurie