How do I decide I need surgery?

The decision to have elective surgery e.g. Joint replacement is yours and should not be made in a rush. This decision should only be made after discussion with your surgeon and only once you are satisfied with the information you have received and when you believe you have been well informed.

It is important to keep in mind that your surgeon cannot guarantee that the surgery will meet all your expectations or that the surgery has no risks.

Preparing for your surgery

You may also be asked to come in for some tests such as:

• A chest x-ray
• An ECG (heart tracing)
• Blood & other tests or
• A full health assessment by a Physician

Please make sure you inform your surgeon:

1. You have diabetes or any allergies.
2. You take Warfarin, Aspirin, or any other blood thinning drug as you may need to stop taking these days prior to your operation.
3. You are having medical or alternative treatments; for example herbal.
4. You will not have anyone at home to help you after your discharge from hospital.
5. Some medical aids require authorisation for in- hospital physiotherapy. Please ask the doctor’s admin staff for your ICD-10 codes and the physiotherapists card prior to surgery so that you can obtain your physiotherapy authorisation and provide the physiotherapist with the authorisation at your first session.

Ensure you bring along clothing that is easy for you to put on and remove, given the type of surgery you’re having/ e.g. shoulder surgery patients will manage best with buttoned/zipped shirts and tops. Patients having lower limb surgery to avoid bringing slip-in shoes along to the hospital. A hand-out from the physiotherapist for hip surgery patients can be obtained from doctors rooms or the physiotherapist will provide it at your first session to assist with preparing for home-coming.

How long before my surgery should I stop eating and drinking?

If you are having a general anaesthetic, you must eat nothing for 6 hours before your operation. You can have water only up until 3 hours before.

What happens when I arrive at the hospital for my operation?

• You will usually be admitted via hospital reception.
• You must bring your ID book and medical aid card to hospital reception.
• You will usually be admitted to the surgical ward.
• You must remove all jewellery, makeup, nail varnish, contact lenses or glasses, dentures, dental plates and hearing aids. You should lock away any valuables.
• Nursing staff will check your blood pressure, pulse and temperature.
• Support stockings which are put on after admission to minimise the risk of thrombosis (blood clots). You will also receive a patient wristband with your details on.
• You will be expected to have a head to toe shower with a medicated solution to minimise the risk of infection for some operations e.g. hip or knee joint replacement.
• You may need to have some more tests including x-rays, ECG and blood tests after admission.
• Your anaesthetist will see you to discuss your anaesthetic and pain relief after the operation.
• You will be asked to sign a consent form to confirm that you understand the procedure and agree to go ahead with it if you have not already done so.
• Please do not hesitate to ask any questions that you may have about the operation.
• The Physiotherapist will assess you and plan your post-operative physio therapy treatment. He/she will teach you bed exercises and home exercises, as well as how to get in and out of bed safely. Physiotherapy rehabilitation will most likely have to be continued after discharge in which case transport arrangements will have to be considered by the patient. Appointments will be given before discharge, or you will need to call or email the physiotherapist. The patient may continue rehab with a physiotherapist closer to home, if more convenient, in which case a letter will be given to the patient by the hospital physiotherapist. Please discuss this with the physiotherapist during hospital sessions.
• Patients must please bring chronic medication with when being admitted.

Will I be in pain after my operation?

• Good pain relief is important and some people need more pain relief than others.
• It is much easier to relieve pain if it is dealt with before it gets bad.
• Pain relief can be increased, given more often, or given in different combinations.
• Please ask help from the nurses on the ward if you are in any discomfort.

When will I be discharged from hospital?

You surgeon will advise you approximately how long you can expect to stay in hospital, this will be discussed after your operation.

Please make arrangements for a friend or family member to take you home. If your are having hip surgery please ensure that the person collecting you when you are discharged, brings along a few pillows for you to sit on. The physiotherapist will educate you as to why this is necessary.

You will be given medications and painkillers to take with you.

You will be given advice and information by the physiotherapists on the exercises and the do’s and don’ts.

Tips to make your homecoming more comfortable following surgery:

• Securely fasten electrical cords around the perimeter of the room.
• Rearrange furniture so you can manoeuvre with a walker or crutches.
• Remove any throw or area rugs that could cause you to slip.
• Temporarily change rooms to avoid using stairs i.e. make the living room your bedroom (mainly for patient’s having joint replacement surgery)
• A hand-out from the physiotherapist for hip surgery patients can be obtained from doctors rooms or the physiotherapist will provide it at your first session to assist with preparing for home-coming.

Are there complications to having surgery?

All surgical procedures have risks, despite the highest standards of practice. While every attempt is made to minimise risks, complications can occur that may have permanent effects.

Please ask questions if you are unsure or need more clarification as it is important that you have enough information to fully weigh up the benefits and risks of surgery.

General risks of surgery include:

• Allergies to anaesthetic agents, antiseptic solutions, suture materials or dressings
• Pain and discomfort around the incisions
• Nausea, typically from the anaesthetic, this usually settles down quickly
• Bleeding from the incisions
• Separation of wound edges
• Slow healing - most likely to occur in smokers and people with diabetes
• Wound infections

How soon can I drive/ fly after my operation?

Your surgeon will review your progress 1-2 weeks after your discharge from hospital and discuss these issues in more detail with you.

It may be in your interest to inform your motor vehicle insurance company that you are resuming driving after your operation.

How much will it cost?

You should discuss surgeons costs before treatment rather than afterwards.

You can also expect bills e.g. x-rays, pathology, anaesthetic and hospital fees.

If further treatment is needed due to complications or you choose other options, extra costs are likely to apply.