Hip Replacement: Making Arrangements for Surgery

Making Arrangements for Surgery

When you go for surgery, ask a family member or friend to go with you. Even when you are going for pre-admission, it’s a good idea to have someone with you. They can listen and take notes for you—or do some of the walking if that’s what you need! Be sure to give your family or friend plenty of notice about your upcoming tests and surgery so they can make plans.

Write down the name and dose of every medicine, herb, and vitamin you take. Bring this list with you to the hospital.Make a list of all prescription and non-prescription medicines you are taking and any allergies to medicine or food that you have. Take this list with you when you go to the hospital (for pre-admission and surgery) so you won’t forget anything when asked. You will be told when to stop taking vitamins and supplements like St. John’s wort, garlic or echinacea. If you’re not sure which medicines to stop and which ones to take the morning of surgery, ask your surgeon.

Let your surgeon or the hospital know if you will need a language interpreter, most hospitals have trained interpreters who will help you talk with the doctors and nurses. Also let the hospital know if you you are deaf or hard of hearing.

This is a really useful and inexpensive series of videos on hip replacement

This is a really useful and inexpensive series of videos on hip replacement

Pre-Admission Procedures

A total hip replacement is major surgery and involves the possibility of a number of complications. Therefore, it is important that anyone having a hip replacement should have a thorough exam to make sure they don’t have any conditions that would increase their risk of complications. The exam should check for a weak heart, low oxygen levels, hepatitis, urinary tract problems, blood pressure, metabolism, diabetes, etc. that could interfere with surgery. The patient should also be free of muscle or nerve conditions that will interfere with the success of the new joint. You will also be evaluated to make sure you can withstand the blood loss in general as well as from your hip.

A few days before surgery you will need to have certain tests and be “pre-admitted” to the hospital. This pre-admission visit can take several hours. Your surgeon’s office staff will tell you where to go and which tests you will need. You may need

  • a chest x-ray to see how well your lungs are working
  • an electrocardiogram (EKG) that shows how your heart is working
  • blood tests that show chemistry and blood counts
  • a urine analysis to show how your kidneys are working

During pre-admission you may be asked

  • to fill out insurance forms, or provide authorization forms from your insurance company; be sure to bring your insurance card(s)
  • if you brought written orders from your surgeon, lab test results, or paperwork from the blood bank
  • the name, address, and telephone number of someone to contact in case of an emergency
  • to list all medicines you take, including over-the-counter medicine, natural remedies, and dietary supplements
  • to list your food and medicine allergies, and how you react to each
  • if you have a known allergy to latex. Certain foods allergies can indicate a sensitivity to latex including avocados, bananas and chestnuts.

You will be told about your rights for advanced directives which are your written directions for your care should you become unable to make decisions. If you have a living will and health care power-of-attorney, bring a copy of these with you. If you have questions about advanced directives, ask to talk with a social worker.

Anesthesia

An anesthesiologist may talk with you during your pre-admission visit. She will ask about your past history with anesthesia and if you are allergic to any medicines. The anesthesiologist will explain the type of anesthesia that will be used during surgery. There are two methods of anesthesia normally used for this type of surgery. You will either be numb in a specific area (regional anesthesia) or completely asleep (general anesthesia). With regional anesthesia a specific part of the body is numb — such as from the waist down. Regional anesthesia includes epidural anesthesia (medicine injected into your back) and spinal anesthesia (medicine is placed in the spinal canal). With general anesthesia you will be completely asleep during surgery.

If you take daily insulin, heart, or blood pressure medicine, ask the anesthesiologist at what time you should take your medicine the day before and morning of surgery. To help control nausea, the anesthesiologist may give you medicine to take before surgery.

Blood Transfusion

With today’s advanced surgical methods, blood loss during surgery is much less than in the past, usually about 1 or 2 units. However, you may still need a blood transfusion. If so, the blood you receive is matched with your blood which has been carefully tested. The blood can come from

  • yourself (autologous blood donation) – you donate blood at a local blood bank or the
    hospital. Many surgeons prefer this method because it is the safest for you. Usually, you
    can donate up to 3 units at 1 week intervals beginning 3 to 4 weeks before surgery.
  • a designated donor – this can be a family member who has blood compatible with yours
  • a blood bank – blood is supplied by the American Red Cross

Ask your surgeon which would be best for you. If you or a designated donor give blood, the last donation must be completed at least 48 hours prior to surgery. Also, if you donate blood, be sure to eat and drink as directed to help rebuild your blood before surgery. Iron supplements can be taken during the period you are donating blood.

Hospital Nursing Station

Your Hospital Visit

The Night Before Surgery

Be sure to follow all instructions for eating, drinking and taking medicines before surgery.
If you have questions, call your surgeon’s office. It’s important that your stomach is empty before surgery so that you don’t have complications with anesthesia. You must stop eating and drinking by midnight the night before surgery. This keeps the stomach empty which will reduce nausea and vomiting and help make your surgery safer. Not following your surgeon’s instructions about eating and drinking could cause your surgery to be postponed.

You may be given a special soap or an anti-bacterial soap, such as Dial, and asked to scrub your hip and leg the night before and the morning of your surgery. This soap helps kill germs and prevent infection. Do not put lotion or cream on your hip after washing with the anti-bacterial soap. Put on clean clothes to wear to the hospital.

Call your surgeon if you have any change in your health such as a sore throat, runny nose, cough, fever, or problems with your teeth or skin. Any condition that could cause an infection in your hip or cause complications with anesthesia may mean your surgery has to be postponed.

Do not smoke or drink alcohol the night before. Don’t take any medicines for 24 hours before surgery that your surgeon has not OK’d. If you have any questions about how how to get ready for surgery, call your surgeon’s office.

The Morning Before Surgery

In the morning before surgery, you can shower or bathe, brush your teeth, and shave. Do not eat or drink anything. However, follow your instructions about taking your daily medicine or pre-surgery medicine from the anesthesiologist. When you dress, do not wear makeup, jewelry, dentures, hair pins, contact lenses, or artificial limbs. Your family can bring these to you later. Wear your elastic stockings if your surgeon has ordered them.

Most people are admitted to the hospital the morning of surgery. Follow the instructions given to you during your pre-admission visit about when to arrive at the hospital. The hospital will have the results of your pre-admission tests and all forms that you have completed.

Be sure to bring

  • your glasses, dentures, or hearing aid, if you use them
  • a walker, if you have one
  • shoes with nonskid soles and a closed heel
  • a knee length robe
  • clothing that will be easy to put on and comfortable to wear home
  • any items you were asked to bring during your pre-admission visit

At the hospital, someone will take you to a room or the surgical suite. A nurse will help you get ready for surgery and answer last minute questions. You may be given medicine to make you a little drowsy and relaxed just before you go to the operating room. When you go to surgery, your family will be shown to a waiting area.

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