I was hoping to get some advice from some RN's..my mom is having a total hip replacement in aprox a month and half. I know this is a routine procedure but my mom has some other circumstances...
a.) in 2002 she had a pulmonary embolism, a blood clot that formed in her leg and traveled to her lungs...(sorry if i am using the wrong terminology, we just learned about it in patho and thats partly why im worried)..she ended up being ok but now she is on heprin for the clot.
b.) she has put off this surgery for sooo long that she basically has no hip joint left, she has needed this surgery since I was 7 and i'm now 24...so needless to say her hip is in very bad shape.
c.) she has some other conditions that also make me worry like HTN, and Diabetes type 2 and arthritis in her leg that is being operated on.
I have an appt to speak with her MD that is performing the surg. but I also wanted to get some advice from some nurses.
I am worried that she will get another blood clot. I am also worried that her other conditions will make her even more susceptible. She wants to check into rehab for a week or so if her insurance will cover it. I know that recovering from the surgery will be hard for her and I just wanted to know if there were things I should watch out for and maybe that I can help her do to prevent getting another clot.
I appreciate everyone who takes the time to read this, I am not expecting medical advice, just maybe some personal experiences or things you have seen on the job...it would help ease my mind a bit..hopefully...
The doctor will probly have her discontinue her heparin or coumadin a couple days prior to surgery. She may want to go donate a couple units of her own blood for transfusion post op, joint patients routinely need a couple units 2-3 days post op.
Make sure she is clear from the anethesiologist if she is to take her blood pressure medications and which ones the morning of surgery. They will restart them following surgery but the nurses should know and she should be able to tell them which ones she has already taken that morning. She should also know that depending on her blood pressures following surgery they may delay starting the BP meds a day or so. If not sure about that ask!!!!!
Your mom has the right idea about a transitional care unit or rehab unit to help with her physical therapy following surgery.
They will use the SCD hose post op while/when she is in bed and most likely TED or support hose of some kind and she needs to be encouraged to do the ankle pump excersises as she recovers(think old tredle sewing machine, same action).
Make sure she is clear that she needs to follow instructions of the nurses and doctor immediately post op and during recovery. No laying in bed feeling sorry because it is hurting, that wont do her any good at all. Not that she will, but you wouldnt believe the people who come in and think they can just lay around in bed "recovering" and dont want to get up and get moving. Sometimes the nurses have to get a little harsh about getting the patients moving, its not being mean, its just fact and has to be done to get people up on their feet again. The more she lays the more likely she is to get a clot, so cooperation with staff and physical therapy is crucial.
Also make sure your mother askes to be turned if the nurses arent as attentive to that as they should be. She should be getting turned to her unaffected side at least every 2 hours while she is in bed. If not to prevent pneumonia as much to prevent pressure areas.
Never be afraid to ask, anything. If the nurse cant answer it, the doctor should.
Last edit by meownsmile on Jul 4, '05
Quote from ELKMNin06
One more Q. what is the risk of anasthesia in her conditions?
I am in anesthesia school right now, and can answer some of your questions, if you want:-) I'm currently in my ortho rotation, so I can shed a little light on your situation. Regional anesthesia is much preferred to general anesthesia. A lot of places still do all knees and hips under general, but research has shown that patients have less bleeding, fewer incidences of DVTs, and less pain after they have had regional anesthesia when compared to general anesthesia.
We typically do most hips under spinal anesthesia, occasionally epidural if it is going to be long or if they are doing both hips. Even when patients have been on blood thinners (heparin, coumadin, etc) our orthopods typically transition them to lovenox during the perioperative period, and they usually do very well.
I see that you are from Ohio - me too!
Last edit by heartICU on Jul 7, '05