THR Pre-surgery quarantine?

[Eman85]

Sounds like your OS has a program in place and good communication with their patients. That's a very good sign as many don't seem to inform their patients or listen to them.

 

[PolarIce]

Yes I am very lucky that way! I have an awesome surgical team, and an amazing surgeon.

 

[Hip4life]

I had recent (non-joint) surgery in which my only option was general anesthesia. I wasn’t too keen on it as in the past (fairly distant) I had terrible nausea. To my great surprise and delight, they can tailor GA now to the patient as well as the surgery. I was given a scopolamine patch behind my ear to prophylactically treat the nausea. They also were able to keep the anesthetic gas at a minimum. I woke up fairly clear headed and not one bit of nausea. The anesthesia team and I discussed the specifics of all this right before surgery. Tell them all your history as well as concerns/needs and that should go a long way to help mitigate possible anesthesia side effects.

 

[PolarIce]

That's fantastic! My biggest worry actually is pain management when I get out of surgery. I have been on pain killers for so long, that my system has gotten used to most pain killers, and I'm worried that I'm going to be in significant pain in recovery. That is the problem i had after the last surgery despite me talking about it with my anesthetist. Something I will talk about again before going in the O.R. but something you can never stop worrying about.

 

[subie2021]

Polarice,
Can you call your surgeon or his patient advocate and ask about what they do for pain? I had sedation with a spinal, but before that was administered I went to the "block room" where the anesthesiologist did an ultrasound guided injection of a pain med into my hip. And just before closing my leg up, the surgeon hosed down everything in there with Exparel, which gave me really good pain relief for several days.
Although I was given oxy for pain, it made me dizzy and nauseated so I went without meds until the OS office called me in a script for something else...and honestly, I didn't need even that so much for pain, rather as a knockout pill to get some sleep.
By the time the Exparel wore off, tylenol and advil was enough to keep me comfortable.
No one mentioned anything about this to me pre-op, so maybe your guy's office doesn't talk about it unless asked, also.
Good luck!

 

[PolarIce]

Here they refer you to the anesthetist on the day of. I did mention my worries to the anesthetist in my pre-op appt, but they still refer you to bringing this up to the anesthetic working that day.

I was told that because of the procedure I am getting done and the complications they are expecting, that I would need a General Anesthetic. For my previous 3 big hip operations, they gave me an epidural first, then a general anesthetic. Once I woke up, I had the push button for self administration of pain meds(but I was also in hospital for 7 days for each of those). I wonder if they would consider doing a spinal with the general anesthetic? I'm not sure. Im also not familiar with how long a spinal actually lasts and if it would be any good to have if I am getting a general(would the benefits of the spinal outlong the length of the surgery to give me some pain management for the initial recovery phase on day 1).

 

[Hip4life]

There is so much controversy about opioids that if you miss out on this discussion before your surgery, you might have to deal with a lot of pain before you get it sorted out. I speak from experience with this. We can hope pain won’t be a problem but I’d rather be prepared. I love what @subie2021 shared above. What a great approach to pain management especially if the “regular” pain killers might be off the table. Maybe this is the silver lining to the opioid crisis. We will have better, more creative and more humane (vs “you just need to tough it out”) solutions for pain management. Knowing these current options just gives us more empowerment.

 

[Bodie’sMom]

@PolarIce I had a spinal, no general and my knee, started to ache, when the surgeon put the staples in. I was completely thawed out, when they rolled me to recovery.

During my pre-op, I spoke to the anaesthetist about making sure, I slept through the op and was told it was standard procedure and that was in my handout too. Unfortunately, on surgery day, it was a different one. For anyone reading this, in the future, don’t make my rookie mistake. Always talk to the anaesthetist, that is attending your surgery, with any questions or concerns

 

[subie2021]

IME the spinal lasts for only a short period of time. Like an hour or so after surgery (it's gone before you leave recovery). I don't think you'd want to extend it because you wouldn't have the use of your legs.
At the hospital I used, patients are given a list of names of possible sleeper dudes and get the one scheduled for that day, so there's not much of a chance to speak to him days before surgery. On the day of my THR, he came into my cubicle to introduce himself and explain a little, and the next time I saw him was in the block room. It seemed to me he and the surgeon worked out something between them...so they could both do their jobs and keep me asleep or at least clueless during the procedure...rather than each working independent of the other
That's why maybe speaking with someone at the OS office might help, so the surgeon could confer with the anesthesiologist about your concerns.
Also, my OS and I had an appointment close to the surgery date, about a week before. If you have similar, it would be a good time to discuss your concerns.

 

[PolarIce]

I called the surgeon's office and they referred me back to surgery day. Its the same set up here to surgery day as what you described. The day of they will come to the bedside(sometimes it might even be in the pre-op room before going into the O.R. Then the next time you see them is in the O.R.

 

[Elf1]

I had same experience, didn't see anesthesiologist until I was being prepped for surgery. We discussed my background, have had spinal fusion at L5/S1 so there's hardware and scar tissue and I have a version of spina bifida. Was decided it wouldn't be a good idea to be poking needles in my spine so general it was. I believe they can put something in your IV that can help with nausea, just can't remember the name of it.

Most of my nausea issues were from the pain meds they were giving me. Had discussed one pain med with him that is something I tolerate well and the hospital did their own thing. Gave me something that just makes me nauseous, groggy and does nothing for the pain. Soon as I saw my OS the next morning I told him it needed to be changed.

Also, don't forget to ask them for ice and more ice, especially since you think your meds may not work as well. Wishing you all the best!

 

[Layla]

My biggest worry actually is pain management when I get out of surgery.

My surgeon used Exparel during my THR. Exparel is a non-opioid anesthetic that blocks nerve impulses in your body, injected into the area before closing, gradually wearing off over a 72 hr period. This along with some prescribed meds and my fave, ICE, helped keep my pain at a very tolerable level. I hope whatever you’re prescribed for your surgery works toward keeping your pain manageable and allows you to rest well.
Wishing you comfort as you wait. Not too long now.

 

[Moosehead]

@PolarIce, my friendly advice is to worry about yourself, not your workplace. You are finally getting the proper treatment and relief after a long struggle. Be selfish.

You absolutely should work from home. It will help you and your surgical team take care of you.

Ironically, taking care of yourself will also get you back to work, too.

Best wishes for your surgery!

 

[Billie]

I quarantined for 7 days prior to surgery and have isolated since surgery (12/29)

 

[Mojo333]

@Billie and welcome to Bonesmart. Thanks for adding a response to the quarantine question as it is interesting to see what the different protocols are.

I am guessing you had hip surgery? If you would like, you could start a recovery thread so you can share your experiences.
Let us know if you need help with that and which hip was replaced and we can add the information to your signature.

 

[Elf1]

@PolarIce definitely take care of yourself first, don't worry about work.

When I had my spinal fusion I went back a bit early as the military unit I was supporting was asking for me. My company wouldn't agree to teleworking even though I did teleconferencing ALL day, every day.

They all agreed that they would be ok with phased return if I came back. Yeah, that lasted a week! Someone had to leave for a family emergency, which I felt really bad about, but back into full tilt boogie I went. Nobody bothered to step in to lend a hand.

We tell folks that you have to watch about going back to work even with phased return as most employers and fellow co-workers see you back and think you're back 100%.

 

[Coddfish]

I had a spinal, not a general. Operation at 2pm, they said I would get feeling back within 3 or 4 hours. It was close to midnight before it actually wore off - quite helpful in getting me through the first few hours, especially as I discovered shortly afterwards that I couldn’t tolerate opioids - hallucinations and vomiting. I didn’t see an anaesthetist (this is in the UK) until I met her in the operating theatre. I knew from my pre-op that the plan was a spinal.

 

[PolarIce]

I wonder what options we will get. From the original pre-surgery clinic, the nurse there did mention that the more complicated cases(like me), usually go under a general anesthetic because they need the patient to be completely relaxed for the extra maneuvers they will need to take in the O.R. I have had 30+ orthopedic surgeries, and have always opted for a general. If they give me the option, I would much rather go with a spinal if possible. The only thing that makes me anxious with that, is I have had 3 epidurals in the past when they had to rebuild my pelvis and they had issues getting the right spot in all of the epidurals(2 were very spotty, and 1 they did too high calling a code blue, because I lost the ability to breath on my own).

 

[Bodie’sMom]

I’ve only had 5 surgeries, 2 being c-sections with epidurals, 2 generals and last a spinal for my hip. I was told, a spinal was much easier to give than an epidural, technically wise, with a much smaller, thinner needle. I had a hard time after general anaesthetic. Even though my spinal wore off quick, I was not sick and felt much more with it, after. I hope you have an option

 

[PolarIce]

Thank you so much for your input and info @Bodie’sMom. I will definitely keep you all posted on Wednesday what they give me for option. I got word that they allow one person to come with you now for surgery. As of last week, they didn't allow anyone to come with you because of the covid restrictions. I will have my hubby with me.