By the time people reach the point of needing artificial hips and knees, they probably know about pain. But oddly enough, pain is what’s mostly on their minds as surgery approaches: How badly will it hurt?
That’s the primary concern people voice when they sign up for the free pre-operative joint replacement surgery class taught for the past 17 years by Shanti Reynolds, RN, at Sierra Nevada Memorial Hospital (the class actually started about 25 years ago).
The good news, she tells them, is that once they recover from their surgical wound, they should be mostly free of the pain their troublesome joints have been causing.
“Some people have waited so long to get joint replacement surgery that they’ve been feeling bone-on-bone pain when they move,” she said. “The cartilage is gone, and there is nothing left to prevent the bones from rubbing together. I reassure them that after those joints are replaced with nice, new equipment, their movements will be smooth and pain free, and that we’re going to take care of them.”
The class is scheduled on the second and fourth Wednesdays of each month, at 2:30 p.m. in a first-floor classroom in SNMH Building 3.
But her class covers much more than concerns about pain. She tries to reach each patient that is scheduled for joint replacement surgery to inform them about the class. About 70 to 80 percent of the patients attend, she estimates, noting that patients who have already had a joint replaced usually don’t need it, and decline.
The class lasts 60 to 90 minutes, covering pre-operative interview information, infection and pain control, the information they’ll need to provide in advance, such as a list of current medications, along with post-operative expectations and safety issues. Attendees are also encouraged to ask questions.
“I let them know that there will be a whole team of people looking after them,” she said. “It’s a real collaboration between the surgeons, anesthesiologists, nurses, and other staff, and then with physical and occupational therapists.” The hospital’s therapists work with patients until they are discharged, but many patients will continue to need therapy after they return home, which is usually four to five days for hip replacements, and three to five days for knees. Follow up home therapy is usually provided through professionals at Sierra Nevada Home Care who work with the doctors’ offices, she said.
Reynolds said she is inspired to continue the class because of its value to patients.
“After all these years, success keeps me teaching,” she said.
Gail Woodburn, PT, is one of the physical therapists working with patients while they are still hospitalized. She or another therapist sees each patient the day after surgery to help him begin to move safely. Some will need to take precautions for months afterward, she explained.
“It all depends on the patient,” she said. “We find that the worse the pain was prior to the replacement surgery, the better they get along after. In some ways, (the surgery) is a relief.”
It’s important to get patients out of bed and moving to avoid potential post-operative complications like blood clots, she said. Some patients also work with occupational therapists to learn how to use adaptive devices or accomplish everyday tasks while they heal.
For information about joint replacement surgery, consult with your primary care physician.
All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.