St. David’s Center for Joint Replacement Pre-Operative Education

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(upbeat music)
- Hi, my name is Megan Laframboise.
I'm the orthopedic neuroscience navigator
here at St. David's Medical Center.
Thank you for trusting us with your care.
We have an exceptional program here
at St. David's Medical Center.
It is important that you complete this online program
because we will teach you all you need to know
about the joint replacement process.
The class will discuss what to expect
while in the hospital after surgery
with the focus on pain management, mobility,
and preventing complications.
This class will increase your knowledge
to reduce anxiety, decrease the length of hospital stay,
and help establish realistic expectations
to improve surgical outcome.
We hope you'll enjoy this educational video
and thank you for choosing St. David's Medical Center.
(Light music)
(gentle music)
- Welcome to our Joint Replacement Pre-Op Education class.
Over the next 25 minutes, we will discuss a general overview
of the joint replacement process and hospital stay
at St. David's Medical Center.
Any specifics to your procedure
should be discussed directly with your surgeon.
This class will provide education and empowerment
about the joint replacement process,
and can help you to identify techniques
to decrease risk factors of complications after surgery.
It will also help prepare you
for your joint replacement surgery and help reduce anxiety
about the surgical process.
Our goal is to create expectations
of what you will experience here
at St. David's Medical Center and to assist
with beginning the process for your transition
back home after surgery.
Our mission at St. David's Medical Center
is to provide exceptional care to every patient every day
with a spirit of warmth, friendliness and personal pride.
Our vision is to be the finest care
and service organization in the world.
Our St. David's staff follows what we call the ICARE values,
which include integrity, compassion, accountability,
respect and excellence.
The goals of our facility are exceptional care,
customer loyalty and financial strength.
We function under a patient centered team approach
when providing care at our facility.
You can see here that you and your family members
are at the center of our care team.
Your surgeon and their physician's assistant are at the top;
they are the individuals performing your surgery
and they will see you every day while you're here
at the hospital with us.
A hospitalist is an internal medicine doctor
that is consulted by your surgeon to assist
with your medical care after your surgery.
A pharmacist is heavily involved in our care team
and manages all of your medications that you will take
while in the hospital.
The nursing team, both registered nurses
and patient care technicians, will be with you
24 hours a day.
We have a day shift and night shift team
that works 12-hour shifts.
Our physical and occupational therapists will see you
for therapy sessions twice a day and our nurse case manager
will assist with discharge planning
and durable medical equipment.
Once you have made the decision for surgery,
we recommend improving your nutrition
through healthy eating.
We encourage iron and protein rich foods, lean meats,
fruits, vegetables and grains.
Notify your dentist of your upcoming
joint replacement surgery.
Your orthopedic surgeon does not want you
to have any dental procedures for three months
following your joint replacement surgery.
Dental procedures can introduce bacteria
into your bloodstream,
which can increase your risk for infection.
After this three month period,
you will require oral antibiotics
prior to any dental procedure for at least one year
following your joint replacement.
If you wish to obtain a handicap placard for your vehicle,
contact your surgeon's office to get a prescription
to bring to the DMV.
Pre-Surgical Testing is ordered by your surgeon
to be completed prior to your surgery,
to ensure that you are well enough
to have your joint replacement procedure.
Here are a few examples of tests that may be ordered.
The tests that are ordered depend
on your medical and surgical history.
An EKG is a heart function test.
Stickers are applied to your chest to determine
if your heart is well enough for surgery.
A chest x-ray is an x-ray of your lungs and heart,
and a urinalysis is a sample of your urine.
Blood tests are lab tests run on blood samples,
and a MRSA swab is a swab of the inside of your nose.
You will complete your testing seven to 10 days
prior to your surgery.
However, this testing can be done up to 60 days
prior to surgery.
You will complete your testing here
at St. David's Medical Center
or at your Primary Care Physician's office,
if your surgeon has instructed you to do so.
Our Pre-Surgical Testing nurses will call you
and obtain a list of your home medications
and medical and surgical history.
They then will assist you in making an appointment
to come in, in order to have your testing done.
If your surgery is coming up and you have not heard
from one of our Pre-Surgical Testing nurses,
please call the Pre-Surgical Testing department
at 512-544-3333 to make an appointment.
Please bring your driver's license and insurance cards
with you to your appointment.
If you have an Advanced Directive
or Medical Power Of Attorney document
and would like us to have this on file
in your medical record, you may bring it with you
to your appointment and we will make a copy.
If you have been seen by a specialist to have testing done
prior to your surgery, the Pre-Surgical Testing nurses
will instruct you to bring any copies of these medical tests
in with you to your appointment.
We do also ask that you bring in a list
of your home medications.
Though we go over this list with you on the phone,
we would also like to have a written-out copy to ensure
that our list is complete and accurate.
Please allow two to three hours for this appointment
to complete the ordered testing.
The Enhanced Surgical Recovery program
at St. David's Medical Center was developed to help you
have an improved surgical outcome by recovering
more quickly and safely after surgery.
The benefits of the ESR program include faster recovery,
eating sooner after surgery, better pain control
with fewer side effects, reduction of nausea
or upset stomach after surgery,
increased early movement and walking,
shorten hospital stay, and returning to your normal life
at a quicker rate.
Get specific instructions from your surgeon
regarding when to stop taking blood thinning medications
prior to surgery.
We typically ask that you stop taking these medications
seven to 10 days prior to surgery.
These medications include Non-Steroidal
Anti-inflammatory Drugs, or NSAIDS, such as Motrin,
Ibuprofen, and Aleve. Celebrex and Meloxicam;
certain herbal supplements like fish oil, vitamin E
and glucosamine, and prescription blood thinners
like Coumadin, Aspirin, Plavix and Xarelto.
Please ask your doctor about taking your medications
before surgery.
The pre-operative nurses will instruct you
only on what medications to take on the day of your surgery.
Before surgery we recommend performing
a safety check of your home.
This includes removing throw rugs
and tacking down loose carpeting.
If you are able, remove electrical cords
and other obstructions from your path,
so you will not have to lift your assistive device
over these items when walking.
Having adequate lighting during the nighttime
is very important for your safety,
so placing nightlights in areas that you may walk to
during the night is highly recommended.
If you have a small pet that may stand close to your feet
or is easily excitable, we recommend having someone there
to assist you with your pet for the first few days
after your surgery.
You will be instructed by Pre-Surgical Testing
to shower with Hibiclens soap, an antimicrobial soap
that is used to prevent infection.
You will shower with this soap for five days
prior to surgery.
On the day before your surgery,
you will call Pre-Surgical Testing at 512-544-3333
between three and six p.m. to check what time
you should arrive to the hospital.
If your surgery is scheduled for Monday,
you will call the Friday beforehand.
You are allowed to have clear liquids up to two hours
before your surgery time.
We ask that you do not have mints or chewing gum
after midnight, as this can trick your body
into thinking you are about to eat something.
If you have uncontrolled acid reflux or gastroparesis,
we ask that you do not eat or drink anything after midnight.
For all of our surgical patients,
we require that you do not drink alcohol
for 24 hours prior to surgery.
If you normally consume alcoholic beverages regularly,
please notify your surgeon.
Though you will be provided a hospital gown
when you come in for your surgery,
you are not required to wear this gown
for your entire hospital stay.
You will wear the gown typically for the first day,
so that the staff is able to assess your incision site
and manage your surgical drain if you have one.
After this time you may change into your own clothing.
For our hip and knee replacement patients,
we recommend loose fitting shorts or pants,
and knee length gowns, clothing that is easy
to slide up over your incision site.
For our patients having shoulder replacement surgery,
we recommend button up shirts or large,
loose fitting tee shirts that are easy
to slide up over your surgical arm.
We encourage patients to bring glasses,
hearing aids and dentures in labeled containers.
Bringing a list of your home medications with you
on the day of your surgery is highly recommended as well,
so that the nursing staff can ensure that we have your list
accurately entered into your electronic health record.
You will have some down time in between
your therapy sessions, so please feel free to bring
your iPads, laptops, cell phones and books with you.
When coming in for your surgery,
we recommend that you leave valuables,
such as jewelry, at home.
The hospital is not responsible for any lost
or stolen items.
St. David's has walkers in every room for patient use,
so you do not need to bring your own assistive devices
in with you to the hospital.
For patient safety, the hospital will provide
your medications to you.
If it is a medication available at a regular pharmacy,
such as CVS or Walgreens, we should carry it
in our pharmacy.
Medications that we do not carry include inhalers
and experimental or compounded medications.
The nurses in Pre-Surgical Testing will instruct you
on which medications to bring with you
on the day of your surgery.
Once at the surgery center,
you will change into a hospital gown.
Our staff will assist you with wiping down your entire body
with antimicrobial CHG cloths to help prevent infection,
and will place an IV so that we will be able
to administer medications to you during and after surgery.
You will discuss your allergies
with your Pre-Operative nurse and sign
your surgical consent for surgery.
An anesthesiologist or nurse anesthetist will meet with you
and discuss the type of anesthesia they will be using
during your surgery, and your surgical nurse
will come in and meet you.
Before you are taken to the operating room,
your surgeon will come and mark your surgical site.
When you are transferred into the operating room,
your family will be escorted
to the surgery center waiting room.
You will be in surgery for about 1 1/2 to two hours,
though this time frame can change
depending on the progress of your surgery.
Your family will be contacted by the surgical nurse
once the surgeon has started the procedure,
and will be updated throughout the surgery.
Once the surgery is completed,
the surgeon will either update your family members
in the waiting room, or call the contact number
that they have on file.
When you surgery is completed,
you will be transferred to the Post Anesthesia Care Unit,
or the PACU, for recovery.
While in the PACU or recovery room,
we will monitor your vital signs and pain level frequently.
You will begin to wake up from anesthesia.
Patients are usually in recovery for about one to two hours
depending on your progress.
If you take longer to wake up from anesthesia,
you may be in recovery longer.
Once you are awake and stable,
you will be transferred to your room on the fourth floor.
This is where your family will be able to see you
and you will be given a menu to start ordering food.
Our orthopedic unit here at St. David's is 4 East.
You will have a private room,
with access to our guest wifi account,
and a television with basic cable.
We do not have set visiting hours,
this means your guests can come and go as they please.
We do not lock the unit or hospital down at night.
We provide recliner chairs in every room
that fold out into a bed if you wish to have a guest
stay overnight with you.
Visitors can park in Parking Garage 1 and may park for free
if they are over the age of 65.
Most joint replacement patients will be in the hospital
for one to two nights depending on progress,
but some patients do stay longer.
The staff at St. David's Medical Center
participates in hourly rounding to ensure
that we are meeting your needs.
Our goal is to anticipate your needs
before you have to call for assistance.
Someone from the staff, a registered nurse,
patient care technician or physical therapist,
will be checking on you once an hour during the day
and every two hours at night.
We also perform bedside shift report during shift change.
The staff will enter your room
with the oncoming staff member and discuss your plan of care
with you so that you can be involved in your care.
Our communication board is used to keep you updated
on your plan of care and your healthcare team.
It is located on the wall of your hospital room
and includes the name and phone numbers
of the staff involved in your care,
as well as the dietary and room service phone number.
This board will also be used to record your daily goals.
We have an example of getting out of bed
and walking 150 feet.
We will ask you at the start of our shift
if there is something in particular
you would like to accomplish during that shift,
and we will record this on your white board.
We will do our very best to try and assist you
in reaching your goal.
Your pain management plan is also located
on the white board.
We will write what pain medication we have you on,
as well as the next time your dose is due,
so that you are aware of how often
you can take your medication.
Depending on your surgeon's preference,
you may have a surgical drain
placed in your incision during surgery.
This is used to collect the excess fluid
from your incision site to help with swelling and bruising.
The nursing staff will manage the care
of your surgical drain and this drain is usually removed
on Post-Operative day one or two.
Lab tests are performed the morning after surgery,
and sometimes each day while you're here at the hospital
depending on your surgeon's preference
and your recovery process.
Bowel protocol is a very important part
of your hospital stay.
One of the most common side effects
of narcotic pain medications and anesthesia is constipation.
We will start you on a stool softener and/or laxative
beginning on Post-Operative day zero.
Our meal service at St. David's Medical Center
is called Distinctive Dining.
It is very similar to room service.
You may call the dining service between the hours
of 6:30 a.m. and 7:30 p.m. to order your meals,
which will be delivered within 45 minutes to an hour.
We have a variety of menus
for different dietary preferences,
so let us know if you have a specific dietary need.
For your safety, all of the medications from our pharmacy
are given a barcode that the nursing staff can scan
in order to record the administration
into your electronic health record.
This helps us keep a record of what medications you receive
while you are in the hospital.
We ask that you never take your own supply of medication
without approval from your registered nurse or doctor.
The nursing staff will explain the purpose
and potential side effects of all the medications
we give you.
Due to possible drug interactions,
herbal medications that are not FDA approved
are not allowed in the hospital,
but you will often be able to resume these medications
when you are discharged home,
depending on your surgeon's orders.
It is normal to feel some post-operative pain
after a joint replacement surgery.
Here at St. David's we use a zero to 10 pain scale
to assess your pain level.
Zero being no pain and 10 being the worst pain imaginable.
Communicating with your nurse and physician
is the best way to achieve effective pain control.
If a medication is not working for you,
please let the staff know.
We can work with you to determine the best
pain management plan for you.
We will establish a comfort goal;
a pain level at which your pain is under control
where you can rest, perform daily activities
and participate in therapy.
Our goal is to keep your pain level controlled
and keep you as comfortable as possible
following your surgery.
Oral pain medications are used as the primary form
of pain relief after surgery.
You will continue these medications
when you are discharged home from the hospital.
You will start this medication the afternoon
or evening of surgery.
It takes effect within about 30 to 45 minutes
and lasts for four to six hours.
These medications are most effective
if taken on a routine basis,
so we will keep you on a schedule
while you are in the hospital.
These can be narcotic or non-narcotic medications.
IV pain medications are used as an as-needed basis
if the oral medications are not working.
These medications take effect within 10 to 15 minutes,
but last for about two hours.
Local anesthetic is a medication that is injected
by your surgeon during your surgery into your incision site
to numb the area.
This medication lasts for 12 to 72 hours.
Pain is very different and unique for every patient.
Your prescribed pain medication will vary
depending on your history,
and the severity of pain you are having.
The side effects of narcotic pain medications include
constipation, nausea or vomiting,
respiratory depression and sleepiness and itching.
You will be very closely monitored by our staff
while you receive pain medication at our facility.
If you start to run out of your pain medication at home
and you feel that you need more,
please contact your surgeon's office for refills.
Emergency room doctors will not refill pain medications.
Icing after joint replacement surgery is very important.
This will help control pain and swelling.
Each patient will be provided with cold packs after surgery.
These are applied to your surgical site
immediately following your surgery,
and will be rotated every three to four hours
with new cold packs.
The set of four cold packs that you receive
are yours to take home with you.
Cold therapy units are typically used
following shoulder replacement surgery.
This motorized unit is filled with ice and water
and is kept on your surgical site 24 hours a day.
The ice will need to be replaced about every four hours.
The potential complications following
a joint replacement surgery include blood clots,
pneumonia and surgical site infection.
A blood clot, also known a deep vein thrombosis,
can form in one of the more of the deep veins in your body,
usually in the legs.
Pneumonia is a lung infection.
The signs and symptoms of surgical site infection
will be discussed in a few minutes,
but reporting these early is very important
to your recovery.
There are simple activities that you can do
to prevent these potential complications.
Your surgeon has specific orders
to help prevent blood clots.
Anticoagulant medication, also known as a blood thinner,
is a medication ordered by your surgeon
that you will start following your surgery.
The type of medication depends on your surgeon's preference
and your medical and surgical history.
You will take this medication for two to four weeks,
depending on the type of medication that is ordered for you.
T.E.D hose are white stockings that are worn on both legs
to prevent swelling and blood clots.
You will wear these until your follow-up appointment.
The Sequential Compression Device is worn on both legs
while in bed to compress the calves.
This helps with circulation to prevent blood clots.
The incentive spirometer is used to help you
take deep breaths following your surgery
to keep your lungs open.
The nursing staff will instruct you on how to use this
when you are admitted into the hospital.
You will use this at least 10 times per hour while awake.
The hospital follows strict infection prevention protocols.
The staff performs hand hygiene regularly,
before and after entering your hospital room,
and before doing any dressing changes
or handling your incision.
You will be given IV antibiotics prior to
and within 24 hours of surgery.
You will not need to go home on oral antibiotics
after your surgery.
The signs and symptoms of surgical site infection
include redness or increased pain at your incision site,
and change in your incision site color,
odor or drainage amount.
If you suspect you have an infection,
or if your pain is out of control,
call your surgeon or your home health care provider.
Your incision will be covered with a dressing
immediately following your surgical procedure.
The type of dressing depends on your surgeon's preference
and the type of surgery you are having.
If your surgeon uses gauze and tape,
this dressing will need to be completely waterproofed
before showering.
If your surgeon uses an Aquacel dressing,
this dressing is water resistant.
You will need to cover the dressing
with Press and Seal Saran wrap when showering at home.
You cannot submerge this dressing in water,
so you will not be able to take a bath or go in a pool
until the dressing is removed
and you are cleared by your surgeon.
You may shower Post-Operative day one
following your surgery.
The nursing staff can assist you with showering.
The best way to prevent blood clots,
pneumonia and constipation is to get up and move.
We strongly encourage all of our patients to get out of bed,
participate in therapy sessions and to take walks.
This will significantly help your recovery.
It is important that you take proper safety precautions
and ask for assistance before getting out of bed.
Do not get up without assistance.
The nursing staff is trained to assist with walking,
standing, changing positions and helping you get out of bed.
You will be considered a high fall risk
following your joint replacement surgery.
This is due to possible decreased strength after surgery,
anesthesia and pain medications, local anesthetic
or nerve block and anticoagulant medications
that can make you more likely to be injured from a fall.
You will receive a pair of yellow socks,
with a matching yellow wristband
upon admission to the fourth floor.
This will notify the staff that you are a high fall risk
and that you need assistance with getting up and walking.
Your safety is one of our main priorities.
You will start your physical and occupational therapy
either the afternoon of your surgery
or morning after surgery.
You will see both a physical and occupational therapist
while you are here at St. David's Medical Center.
These sessions will be twice a day,
and are performed in your hospital room
and in the hallways of the fourth floor.
The therapists are consulted by your surgeon
for mobility and safety training
and activities of daily living.
If you have stairs in your home,
our therapists will teach you how to safely go up and down
a flight of stairs following your surgery.
On the day of your discharge,
your surgery team will meet with you
and determine that you are ready to go home.
Your nurse may need to obtain approval
from the other physicians involved in your care
to make sure that you are medically stable
to be discharged home.
Our case manager will make arrangements for your equipment
and continued therapy.
Once we have received all of the appropriate orders,
your nurse will give you printed discharge instructions,
including an updated home medication list.
Please take the time to review your instructions
with your nurse and ask any questions you may have.
Our expected discharge time is 11 a.m.,
so if you are able, please have a ride available
and ready to pick you up at that time.
If you do not have a follow-up appointment
already scheduled, you will need to call and make one
when you are discharged home from the hospital.
The nursing staff will provide instructions
on when to make your follow up appointment upon discharge.
Typically, these appointments are scheduled one to two weeks
from the day of your surgery,
depending on the type of surgery you had
and your surgeon's preference.
At this visit, your surgeon will remove any stitches
from your incision site
and perform a dressing change if needed.
Do not resume driving until you are cleared to do so
by your surgeon and while taking narcotic medications.
Thank you for participating in our educational video,
and we look forward to seeing you
for your joint replacement surgery.
(light modern music)
- I'm Troy Dill.
I'm the nurse care manager for the orthopedic unit
at St. David's Medical Center Austin.
I'm gonna talk to you about the discharge equipments
and therapies that you're gonna need.
Now I wanna talk about today is gonna cover 95%
of my patients and it's a brief overview.
So for all my cases, what I except you're gonna need is
a two-wheel rolling walker.
If you've already got one, that's fantastic.
If you don't, I'll work on ordering one for ya.
We can that ordered and delivered
in about four to six hours for private insurance.
When I said delivered,
I'm talking about here to the hospital room.
So you have it in the trunk of your car
when you're going home.
For Medicare, well we'll order it.
A lot of times you might have to go and pick it up
from the certified vendor that Medicare requires.
But either way we're expecting you need that walker
for about two weeks, about 10 days, two weeks.
And you're doctor, normally he'll tell ya
or the home physical therapist will tell ya
when you can graduate off that walker
and move you to either a cane or nothing.
The rolling walker we expect
all of our patients are gonna need.
Now some other equipment I'm gonna talk about right now,
you may or may not need,
but I just you to be aware of what's out there.
So what we're gonna be looking at
is a bedside commode or a shower chair.
Now the insurance companies, for a bedside commode,
they may cover that, shower chair, they may not.
Medicare won't cover a bedside commode
unless you don't have a toilet in your house.
So the bedside commode, what we're lookin at
is not so much to use it at the bedside,
we're expecting you're able to walk,
get up and walk household distances after discharge,
what we're lookin at is to use it like a riser,
set it over your toilet,
and so that way you've arm rails and a seat that's elevated
just to help you get up and down.
This is really for patients
who are having problems right now before your surgery,
getting up and down off the toilet.
The bedside commode, if it's not covered by your insurance,
that is something that you can find at retail stores,
Walgreens, Wal Mart, CVS, Amazon, Lowe's, Home Depot,
a lot of places, generally for like $60 to $70.
So with a shower chair, any equipment for the shower,
the insurance companies won't cover that stuff.
So we just need to look at when you go home,
you just need to evaluate if you need this stuff.
So best case scenario is you go home,
you've got a walk-in shower at your house,
and you've got a bench built into it, that's perfect.
But if you don't have a bench,
well then you can look at buying a shower chair,
which essentially is just a cheap chair,
waterproof, you can buy em at any of those retail stores,
for generally about $30.
But now if you've a tub/shower combo
is your only way of takin a shower,
well then there, I want you to be really safe.
So at that point, if you're not safe,
that first day you're at home,
well then hey, have a seat, do a sponge bath,
that's the easy part.
But if it continues for a few days
where it's you just can't get over that sill safely
well then maybe you need to look at getting like
a tub transfer bench.
And essentially it's something like this
where it's two legs that sit in the tub,
two legs sit outside of the tub,
so you can sit down safely outside of the tub,
swing your legs across.
It does get in the way of your shower curtain or the door,
so could let water pool right outside your door,
I do want you being really careful about that,
I don't want you slipping.
These are normally about $60 to $70,
you can buy them at retail stores.
But I want you waiting and seeing what you really need
before you go home.
When you get home you can wait two or three days
and that's when you can really assess
if you need any of this equipment.
Cause again, this is stuff that the insurance companies
typically won't cover.
So that covers all the equipment,
the durable medical equipment.
So next I wanna talk about the disposition,
like what's gonna happen after your surgery.
And we're gonna work on settin you up to go home
with home physical therapy.
But also really importantly
to have a friend or a family member there with you
for the first two to three days at least.
Mostly just to call for help if you need it
but also to help you out around the house
just a little bit.
Now if they can stay with you
for the first two weeks that's absolutely fantastic.
Besides having that friend or family member there with ya
what we're lookin at setting up is
the home physical therapy.
I use home physical therapy, home health company,
that's interchangeable.
So when I talk about home health care
your surgeon has a preference but your choice wins.
If you've got a home therapy
or home health company you prefer, that's your choice.
Otherwise I'll talk to ya
and I'll offer you your surgeon's preference,
I'll get your permission,
we'll send a referral out,
and we need to find out two things from them.
One, are they in-network with your insurance and two,
can they come out and service your location?
Now the ideal is that we get it all set up
and this should happen about 95% of the time,
we get the home health your doctor wants.
They should come out every other day for about two weeks,
each visit lasting about 45 minutes to an hour.
Generally it's just for physical therapy.
Cause that's really all you're gonna need.
We're gonna be getting you up
the first night of your surgery, that night.
So you're gonna be up and moving,
we're gonna get you going pretty quickly there.
So there's some combinations of private insurance,
and location where I just can't find an agency
willing to accept.
That's generally about a 5% of my patients
but it's a possibility.
If that's the case we might have to jump to
the second step a little bit earlier.
Now the second step is normally
after you go and see your doctor
at your two week follow-up.
You go in and see him and he normally sets you up
for outpatient therapy.
That's where you go to a physical therapist office
or a rehab center, but somewhere convenient for ya.
And so if you've got a place down the street
and you'd like to use them
or you've used somebody in the past
you can continue using, that's your choice.
Otherwise, typically your doctor or his PA
will be the one who help you set up
for that outpatient physical therapy
and they'll send the orders over from his office.
It used to be the case where all our patients
would come in and stay for five to seven days
and then we'd send them to another facility,
like a skilled nursing or a rehab facility.
And you'd go there and stay for another
two to three weeks.
That just doesn't happen anymore,
we've made such advancements in orthopedics
that nowadays you're goin home post-op, day one or two,
and you're already up and walking
and you're doin really well.
Essentially it's to the point
where the insurance companies don't authorize us
to send you to these facilities
and I just want you to be aware
they're only gonna be looking at,
severe medical criteria to meet these points.
We're talking things like Parkinson's,
or having a previous stroke,
they're not gonna take into consideration
what they consider social issues.
Which are things like living in a tenth floor walk-up
with 15 kids and no elevator access
and nobody else to help ya.
But they also don't take into consideration
other orthopedic factors like,
if you're other knee is starting to hurt,
and you're gonna need that surgery soon.
That doesn't play into their ability to accept.
And that's for both private insurance and Medicare.
That concludes my portion of today's presentation.
We look forward to reaching out and speaking with you
either post-op day one, the day after your surgery,
or via phone if you have one those Friday cases.
At this point I just wanna say that I appreciate
that you chose St. David's Medical Center Austin
and I'd like you to have a good day.
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(gentle upbeat music)
- Hi, my name is Brian, and this is Lena.
We are Physical Therapist Assistants here at
St. David's Medical Center.
Today we are going to be going over post-operative
total knee and total hip exercises.
The following exercises are for total knee
and total hip post-op.
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Ankle pumps.
Moving your ankles forward and backward.
10 reps, three to four times per day.
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Quad sets.
Tighten your quad, hold three seconds,
10 reps, three to four times per day.
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Heel slides.
First, bend your knee and your hip as far as you can,
then use sheet to assist further into the range of motion.
10 reps, three to four times per day.
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Short arc knee extension.
First, flex your foot.
Keep the back of the knee in contact with the roll,
raise your lower leg up, hold, and then relax.
10 reps, three to four times per day.
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Knee extension stretch.
Place foam roller under lower leg, allow gravity
to straighten the knee for 15 minutes,
three to four times per day.
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Straight leg raises.
Bend non-operative leg, then you're gonna
flex your foot on the operative side,
tighten your quad and raise your leg no higher
than the knee that's bent.
And relax.
Repeat 10 times, three to four times per day.
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Glute sets.
Squeeze buttocks, hold for three seconds,
10 reps, three to four times per day.
(upbeat acoustic music)
Lateral leg slides.
On operative side, point toe up towards the sky.
Move leg out to the side and back in.
10 reps, three to four times per day.
Performing these exercises will be important
to your recovery time.
Thank you for choosing St. David's Medical Center.
(gentle acoustic music)