Merlin Part II of V: Preparing for Knee Surgery

Preparing for Knee Surgery

Living alone and facing knee replacement surgery poses some unique challenges that could impact the recovery process. This cannot be underplayed since recovery is largely dependent on the support of a network of people, both professionals and social. While we might assume that there are professional networks in place into which we can be linked through – doctors, social workers, and in many cases insurance companies, unless we have a wide network of family and active friendships – people who live near you and whose schedules allow an easy inflow of support – there can be problems. Grocery shopping, doctor visits, a sympathetic ear, timely nutritious meals, laundry, and getting dressed – especially underwear and support hose – can present hurdles that may not, at first blush, appear to be potential challenges until faced with the fact that we cannot do it all on our own.

Preparing for Knee Surgery – Patient Care Culture

We need to pay attention to the culture of the practice and go with our gut. A really good surgeon is not only a skilled professional, but one who puts the patient first. This means that the people who surround him/her will operate within the general mind-set that patient-care is the sole purpose of the practice. We can expect a warm, welcoming, concerned group of people who are happy to meet our needs.

The first time I entered Dr. Ralph Salvagno’s office at the Center for Joint Surgery and Sports Medicine I was using a cane. I slowly approached the receptionist and gave my name and the time of my appointment and asked to be directed to the water cooler (I had forgotten my filtered water). The very pleasant receptionist instantly said, “Please take these papers to fill out and have a seat. I’ll get you a glass of water.” Warm, fuzzy feeling! We are supposed to feel valued and supported throughout the entire process from consultation and surgery prep to recovery and discharge.

I take my initial cues from frontline personnel because leaders, in this case doctors, generally surround themselves with people of like attitudes and beliefs in a culture that is an extension of themselves. The point is to find a culture that is more in line with your individual preferences. And if that means consulting with more than one surgeon, then that is what we need to do in preparing for knee surgery.

The Right Hospital Environment

It is my experience that surgeons tend to have long term affiliations with hospitals that are extensions of their cultural orientation and therefore are a good fit i.e. the hospitals are organized to work within the parameters laid out by the surgeon.

My surgery was scheduled at the Meritus Hospital in Western Maryland. Within that culture of being patient-centered, there is a pre-surgery orientation which included a detailed exploration of the procedure using 3D models with moving parts where patients could ask questions and share concerns. It was a valuable exercise conducted by both professional and former knee recipients in an easy, relaxed kind of forum where all questions were welcomed.

This was followed by a rehab orientation amidst the equipment and machines used for those purposes with physiotherapists, occupational therapists, and social workers that also included one-on-one counselling and identifying advocacy needs. This served to demystify the entire process from preparing for knee surgery to recovery, and allay many fears. By the end of this exercise I was integrated into the culture of Meritus Hospital, and with the same kind of patient-centered focus as Dr. Salvagno’s clinic.

This takes us back to the care needed in selecting a surgeon so that the hospital experience will be a positive one and patients can throw their full attention into their healing. Meritus Hospital proved to be the kind of facility where a distinctly patient-centered culture is served by a high level of staff synergy, and intense teamwork. By the time I was discharged to a rehabilitation facility, I felt confident about my recovery.

The Friend Network

My conversation with the surgery coordinator at Dr. Salvagno’s office, Patti, was an eye opener. By the end of my visit with her very early in the game, I had a realistic picture of what I would face once I got home. That meant I had to line up my support base of friends, neighbors, acquaintances, and other service delivery people.

Once I let everyone in my network know that I was about to have knee surgery, I made a list of who would be best suited for which task, and confirmed it with them. Living alone meant that once home, I would be alone most of the time. So in preparing for knee surgery, next, I began to cook and freeze food for at least six weeks, froze small Ziploc bags of fruit and cooked veggies, and pulled together a bunch of take out flyers. The week before the surgery, I thoroughly cleaned the house, did all the laundry, and cleared a well-defined pathway for a walker around primary living areas. Throw rugs had to be picked up, utility cabinet removed from bathroom, bedroom had to be re-arranged, and end tables had to be cleared of bric-a-brac so I had space to place essentials. Raised toilet seat, hand-held shower head, shower chair, and non-skid stepping stool by the bed all had to be put in place with the help of friends.

Part III: Managing Pain

In Part III Merlin will discuss the “ups and downs” of managing pain after knee replacement surgery. It is a gripping account of her navigation through a whole host of surprising challenges related to the pain after knee replacement.