Steps in preparing for surgery: 1. Pre-screening blood work 2. Physical exam by your medical doctor 3. Selecting your support person 4. Pre-operative classes ( Joint Boot Camp ) 5. Register at Mississippi Valley Surgery Center 6. Provide your health history information to the Mississippi Valley Surgery Center health history nurse 7. Additional pre-admission, lab and diagnostic testing 8. Contact your insurance company 9. Discharge planning 10. What to bring Pre-screening blood work: Your surgeon s office will order a pre-screening blood test after you have been scheduled for your surgery. Additional pre-admission lab work and diagnostic test will be ordered closer to your procedure date. Physical exam by medical doctor: Three to four weeks before your scheduled procedure, you will need to undergo a complete physical examination with your family physician. Based on your health history and/or test results, you may require further evaluation. This will help identify any medical problems you may have that could put you at an increased risk during or after your surgery. Selecting your support person: This is the most important member of your team. Their commitment and active participation is the key to ensuring a successful, timely recovery. It is also vital for your success to select a support person to be with you throughout this journey. Your support person will be an active participant in preparation (this class), the day of surgery, and for several days after you are discharged home. It is critical and a requirement that you have a support person to be with you for the first several days after the surgery. 3
Pre-operative education class: To fully prepare you for your surgery, your orthopedic surgeon would like you to attend our pre-operative teaching class (Boot Camp). This class will enable you to participate in your care and gain a better understanding of the post-operative recovery period and exercise program. We encourage your support person to attend this class with you. Register at Mississippi Valley Surgery Center: To serve you better, we ask that you pre-register as soon as possible after your procedure is scheduled. You have 3 options available to complete your preregistration: over the phone by calling 563-344-6600, in person at our facility, or online at your convenience, Go to www.mvhealth.net/patients/pre-registration, click Patient Start Here (this will take you to the Simple Admit website) Enter password: MVSC563SURG Provide your health history information: We are a separate facility from your surgeon s office, therefore we will need to obtain your health history information. In addition to your medical and surgical history, our pre-admission nursing staff will need to have a list of ALL your current medications and be aware of any allergies that you may have. This is to include prescriptions, insulin, inhalers, over the counter medications, vitamin and herbal supplements. If registering online, please make sure you have all the above information available including your medical insurance cards and your state ID or driver s license, before you begin the online process. Pre-admission lab and diagnostic testing: Additional lab work will be ordered by your surgeon. Your surgeon has ordered a complete blood count (CBC), comprehensive metabolic panel (CMP), Hemoglobin A1C, Urinalysis, Methicillin-resistant staphylococcus aureus (MRSA) screen and an electrocardiogram (EKG). Testing includes laboratory and diagnostic tests. These tests may be done during your physical exam or you may prefer to have them done after your pre-operative teaching class. Results of your tests can be sent to your medical doctor. If your physical exam shows that you have any risk factors, you may need additional testing. Contact your insurance company: Please notify your insurance company to inform them of your upcoming procedure and confirm details of your coverage. Your surgeon will prescribe several medications for you after your procedure. Certain medication that may be prescribed for pain management post-operatively are Celebrex and Lyrica, which may require a pre-authorization before insurance coverage. 4
Discharge Planning Meal planning: Prepare/purchase and freeze small portion meals for times you may be alone. Stock up on items that can be frozen for later use such as bread, vegetables and fruits. Preparing your home environment for a safe recovery: Remove scattered rugs and clutter around the house. Make sure that all stairways have hand railings and are secure. Tuck away long phone cords and lamp cords. Arrange furniture so that you can easily move about your house with crutches or a walker. Non-skid tub/shower mats. Select a chair from your home with a back, firm seat cushion and arms that you can designate as your chair after you return home from surgery. The height of the seat should be about 18-19 inches off the ground. If your bedroom is upstairs, you may want to prepare a sleeping area downstairs for the first week or two after you return home from surgery. Help at home: To ensure your safety, you need to have a friend or family member available to help you for the first few days after you return home from the center. What to bring: A walker or crutches. All prescribed home medications, as well as, new medications that have been prescribed by your surgeon. Loose, comfortable clothing to wear to and from the surgery center. Tennis shoes or flat rubber soled shoes that tie or slip-on. Personal hygiene toiletries. Eyeglass, contact lens and denture cases. Leave jewelry, valuables, credit cards, and large sums of cash at home. CPAP or BiPAP machine, if you use one at night when you sleep. 5
Health tips for the weeks before your surgery Diet and Nutrition: Good nutrition is an important factor in healing. Eating well and maintaining a healthy weight also help eliminate unwanted stress to your joints and may reduce the risk of heart disease, high blood pressure, diabetes and cancer. To achieve good nutrition, we recommend a balanced diet of a variety of foods each day from the USDA recommended food groups. (http://choosemyplate.gov/food-groups/). Add foods to your diet that are rich in iron, such as lean meat, poultry and fish. Include vitamin C rich foods such as strawberries, orange juice, cantaloupe, green peppers, tomatoes, potatoes and broccoli with each meal. These foods help the body absorb iron and other nutrients. Refer to (http://www.choosemyplate.gov/) for additional resources and information on nutrition and health. Limit your alcohol intake to one glass of wine or beer, or a cocktail per day starting about 5 days prior to surgery. After surgery, check with your doctor before resuming alcohol consumption. Iron and Vitamin Supplements: Iron is an essential mineral that plays an important role in a variety of body functions. Your surgeon may have prescribed or recommended that you begin an iron supplement. Iron carries oxygen and carbon dioxide within your red blood cells to other body tissues. It is also necessary for the production of energy and the support of your immune system. Stop Smoking: Studies have shown that tobacco and nicotine impair the body s ability to heal bones and wounds. Smoking increases your risk of complications during and after surgery. Postoperative complications related to smoking can include pneumonia, surgical site infection, and joint replacement failure. You are encouraged to quit smoking. For more help, visit the American Lung Association website. http://www.lung.org/stop-smoking. Exercise: Exercise is key to your recovery! One of the goals of the pre-operative education class is to introduce you to a physical therapist and your exercise program. Your exercise program begins before surgery, and continues while you are in the center and when you return home. New exercises will be added as your physical condition changes. 6
The day before surgery Arrival time: You will receive a call from the Health History nurse with your arrival time the afternoon before surgery. Special instructions will be given to you at this time. You will be instructed not to eat or drink after a scheduled time period. It is very important to follow all the instruction as directed by the nurse or your procedure may be cancelled. We apologize ahead of time if there is an extended wait for your surgery. The operating room is a very dynamic place and the schedule can either speed up or slow down depending on the day. We want you to arrive in plenty of time for us to prepare you and answer any last minute questions. If the surgeon gets ahead of schedule we can get you in sooner, but please be aware that sometimes the opposite occurs and you may have to wait a little longer. We will be sure to keep you updated throughout the process as to your expected time of surgery. Prepping your skin: You have been given SAGE wipes to prep the skin around the surgical area. Please use these wipes the evening before your surgery, (see attached instructions). DO NOT use any body lotion and no shaving around the surgical area for 24 hours before your procedure. DO NOT BATHE OR SHOWER MORNING OF YOUR PROCEDURE. (If you have any scrapes, rash, scabs, infections, or breaks in the skin, anywhere, on your operative extremity, please contact your orthopedic surgeon immediately.) Report any cold/flu symptoms or infections to your surgeon: Symptoms to report may include: An elevated temperature Sore or scratchy throat Nasal drainage that is yellow or green Cough or chest congestion Ear ache Nausea, vomiting or diarrhea Problems with urination Open sores, scrapes, rash, scabs, bug bites or breaks in the skin anywhere on the body. 7
The day before surgery- Knee Preparing the Skin before Surgery Preparing or prepping skin before surgery can reduce the risk of infection at the surgical site. To make the process easier, this facility has chosen disposable cloths moistened with a rinse-free, 2% Chlorhexidine Gluconate (CHG) antiseptic solution. The cloths are called SAGE wipes. The steps below outline the prepping process and should be carefully followed, so that you can help yourself prevent an infection. The evening before surgery: 1. Shower or bathe and shampoo your hair. 2. Do not put lotion or powder on your skin. 3. Let your skin dry for 1 hour-your skin needs to be dry and cool for the antiseptic solution to work. 4. Wash your hands and then open the package of SAGE wipes, being careful to avoid contact with the wipes and the outside of the package. This will reduce the risk of the wipes becoming dirty. Use the wipes at room temperature. 5. With the first wipe, gently wipe down the front of the Surgical leg, from mid thigh, down the front of the knee to Mid-calf. (The skin will feel sticky or tacky as you use the wipes) 6. With the second wipe, gently wipe down the back of your surgical leg, from mid-thigh, down the back of the knee to mid-calf. Have someone help if you cannot reach all areas. 7. Put on clean pajamas/sleep wear and sleep on clean sheets. 8. Throw the wipes away; do not flush them down your toilet. *If itching or redness occurs and persists after using the wipes, rinse the affected areas. Please tell your nurse when you arrive to the center, if this occurred. The morning of surgery: 1. Upon arising, do not bath or shower. You may wash your face and hands. 2. Do not put any lotions, powders, perfumes, make up or jewelry on your body the day of surgery. 3. Put on clean, loose fitting clothing to wear to the surgery center. 4. At the center your nurse will use a second package of SAGE wipes on your surgical extremity. 5. Please bring this instruction sheet with you the day of the surgery and give to your nurse. 8
The day before surgery- Hip Preparing the Skin before Surgery Preparing or prepping skin before surgery can reduce the risk of infection at the surgical site. To make the process easier, this facility has chosen disposable cloths moistened with a rinse-free, 2% Chlorhexidine Gluconate (CHG) antiseptic solution. The cloths are called SAGE wipes. The steps below outline the prepping process and should be carefully followed, so that you can help yourself prevent an infection. The evening before surgery: 1. Shower or bathe and shampoo your hair. 2. Do not put lotion or powder on your skin. 3. Let your skin dry for 1 hour-your skin needs to be dry and cool for the antiseptic solution to work. 4. Wash your hands and then open the package of SAGE wipes, being careful to avoid contact with the wipes and the outside of the package. This will reduce the risk of the wipes becoming dirty. Use the wipes at room temperature. 5. With the first wipe, gently wipe down the side of your operative hip starting at your waist line down to mid-thigh. (The skin will feel sticky or tacky as you use the wipes) 6. With the second wipe, gently wipe down the front of your hip, starting at your waist line, moving to mid-thigh. Have someone help if you cannot reach all areas. 7. Put on clean pajamas/sleep wear and sleep on clean sheets. 8. Throw the wipes away; do not flush them down your toilet. *If itching or redness occurs and persists after using the wipes, rinse the affected areas. Please tell your nurse when you arrive to the center, if this occurred. The morning of surgery: 1. Upon arising, do not bath or shower. You may wash your face and hands. 2. Do not put any lotions, powders, perfumes, make up or jewelry on your body the day of surgery. 3. Put on clean, loose fitting clothing to wear to the surgery center. 4. At the center your nurse will use a second package of SAGE wipes on your surgical extremity. 5. Please bring this instruction sheet with you the day of the surgery and give to your nurse. 9