Joint Replacement Patients are going back to school, too

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Created on Monday, 27 August 2012 13:07

Most patients needing hip or knee replacement have been out of school for some time. But it’s never too late to learn. And you can never be too prepared – especially when you’re having surgery.

That’s why the Ross Memorial Hospital is sending its patients back to school. But not just any school – PREP school.

PREP stands for Patient Road for Education and Preparation.

This school involves workbooks, teachers, question and answers – even homework.

There’s one class for hip replacement patients and one for knee replacement patients. When they attend, they’re asked to bring their coach – the person who will be their main helper when they’re back at home.

The first teacher is Laurie, a Nurse, who explains in great detail what is going to happen on the day of their surgery: what they bring, where they go, who they speak to, how the Surgical Safety Checklist will be done, and how long it will last.

They learn about moon boots that are inflated around the foot to help with circulation, and that physiotherapy begins the day after surgery.

Then they meet Kathy, a Pharmacist, who explains the importance of getting a MedsCheck, and understanding what medications must be stopped prior to a surgical procedure (blood thinners and anti-inflammatories, for example).

She explains what medications may be prescribed and what they do, including anaesthetics and pain medications. The patients learn that they will be meeting with an Anaesthetist who will discuss with them what medication is best for them.

Kathy also warns the patients not to try to be tough when it comes to pain control, because if they’re too sore after their procedure to move, they won’t be able to do their physiotherapy – and that is vital.

Kathy emphasizes the added risk that smoking can play, as it results in breathing and circulation problems and reduces a person’s healing abilities. “If you’ve ever thought about quitting, now is the time.”

She assures the patients that the hospital can help anyone who wants to quit smoking to access cessation support. Those who can’t quit can ask for nicotine replacement therapy during their stay; RMH is a smoke free property.

After Kathy, Jennifer the Dietitian speaks to the students about the importance of eating well before and after their surgery.

They learn that protein promotes healing, and foods high in fibre will provide a natural laxative in case they “get in a bind”.

They’re advised to start preparing some healthy meals and freezing them now, so that they’ll be handy later. They’re even provided with a sample meal plan.

Next comes Natalie, a Physiotherapist, who warns the students: “Right from the get go, we’re going to get you moving.” The longer a patient is stuck in bed, the greater the risk of developing a blood clot or pneumonia.

The students are shown how they’ll get up and out of bed after their surgery, and use a walker until they graduate to crutches or a cane. Natalie shows them the exercises they’ll do to get the joint moving, and the equipment they’ll need to get dressed, such as shoe horns and reachers. She also shows the students how they’ll ice their joints when they’re sore.

Then she gives them their home work: they need to start preparing their house now: raising the bed, preparing the bathroom, removing rugs, and bringing floor-level items up.

They also need to start exercising – today. Strengthening not only their legs, but their arms, too, will help them with all of the awkward movements they’ll be making until their mobility returns.

So she gets them started doing leg lifts in their chairs. “It doesn’t matter if you can’t hold it for five seconds yet. If you can only hold it for one second, that’s good. You can work your way up to five seconds. Just start.”

Natalie explains to the class that when they visit the doctor after their surgery, he or she will measure their movement and range of motion, and assess their progress.  

Being as prepared as possible will help joint replacement patients do as well as possible, and avoid returning to the hospital and delaying their ultimate goal – not an A+ … but better mobility, and a better quality of life.