Post Op Release Date....!!!

Bones, joints and muscles
1

Had my pre op assessment on Monday, 7th March, a three hour ordeal and a very pushy physiotherapist, pushing me to answer questions that I simply could not!

Spoke to my GP's surgery about transportation to and from the Clinic (Private) and a couple of options were suggested.  

I had been told - originally - that I woud be in the clinic for four days/three nights. I put a call through to the clinic asking what I should expect about the release from hospital procedure, and what time of day this was likely to be.  Explained that Iwas trying to line up transportation from the clinic home on the 7th, which is the expected date of release, or so I thought!  A staff nurse called me back  She had not met, so only had my notes.  

We went round and around about release time, for ever.  The outcome was the she had no idea when I would be released.  Stated that if I felt nauseous on the day of release, and they did not need my bed for another patient, I would be kept in!  What this boils down to is that should I feel nausesous, but they need the bed, I am out, anyway...!   She then went on to state, that I could - worst case scenario - be in there for a further two days.  I stated that this was not possible, as I had responsiblilties at home. Then she said that, in all likelihood I would be released late morning on the 7th, the date that I had been told to expect to be released.  

By the time the conversaton ended, I was in state of total confusion.  I asked why, I would still be feeling nasuesous by the fourth day.  No response other than to ask my age, and state that it varies patient to patient.  Can understand the last statement, but still sick into the fourth day?  I thought that this was brought about by the use of certain pain killers such as Tramadol - the opiates - which I would request was not given to me.  

Finally, I had to request that the nurse who actually spent time with me on Monday give a call, so that I could get more clarification on the confusing information I had been given.

However, the final outcome of my conversation was that I should book transport for 12N on the 7th!

Wondering what the forum makes of this, as I am totally confused, and do not want to book transportation should I not be cleared for release.  The confusing element of this is the statement that if the bed was needed, I woud be out, anyway!   Seems to me that this is misleading and nonsensical.

My general health is very good, but because of the OA, have been unable to do any cardiac vascular work.

2

I live in Brighton UK had my THR 2 weeks ago NHS - I was told in the pre-op assessment  that I would be in for 2 nights and out at 10am on 3rd day. I guess they cannot give you a definite answer because recovery is different for all of us and it seems that the procedure varies in different parts of the country.

3

It is very confusing and unsettling. I guess that there are too many variables for anyone to give a difinetive answer. I would assume that if things went drastically wrong, then your need for a bed would outweigh anothers.

I was also told that they would only know the release date on the actual day of release. But, the hosptal also had access to several taxi cpmpanies which could oblige.

4

Hi Susie, I would imagine that it is very difficult for the staff, private or NHS, to predict a release date, let alone a time. I was told in the morning that I could go home but with gathering signatures, completing paperwork and organising meds I eventually left hospital at 4pm.

There are all sorts of things that could help or hinder your release and I am not sure if I would book anything this far in advance. 

The lady in my ward was relying on NHS organised transport and I know that they did this a couple of hours before she was released and it all went smoother than my own release. As I waited for the last of my forms to be done someone had already moved into my bed - the poor ward manager must have a headache at the end of every day trying to get us all in and out!!!!

 

5

I expect they cannot say for sure - imagine if they said 12 on the fourth day and you book the transport but then due to unforeseen circumstances you can't go - then you have the hassle of cancelling the transport etc etc. I was told I would be in three nights- it ended up being five ( because I fainted and vomitted on day three) you can never predict what may happen. I was discharged at 5.30 pm on day five. In some respects you have to go with the flow and trust me I know how hard that can be. 

Catrin 

6

Hi susie,

my experience is that it's impossible to know how you will be after the op.

everyone really is different in terms of how much pain they have immediately after the op, which in turn dictates the level of pain relief, which in turn may or may not cause adverse levels of nausea.

personally I struggled initially to find pain relief that managed the pain reasonably well without causing nausea/hallucinations. after 3 nights we managed it, and I went home on day 4.

you may sail through it, or you may struggle a bit. It's impossible to say ahead of time.

i know that prior to my op I was anxious and stressed and confused about everything, desperate to have some knowns or givens. Have been a bit like that post op as well, but am gradually realising that our bodies are all different, and we have no way of knowing how we will react until that reaction happens.

i find it beyond frustrating, but am realising That this is how it is ......

7

Many thanks.  I have the best surgeon around, and he says that I can get behind the wheel at four weeks, and no restrictions.  My understanding is that the nausea is caused by the opiates that are given for pain relief, so I shall have to do more research on this, as they will have to avoided.

An exray is taken the day after surgery, so if there is a problem, it will be identified very quickly.

I di not find the nurse that I spoke with to be very helpful.  She seemed very confused and her answers were not clear or concise.  So I need to speak with the nurse whom I saw on Monday at the pre op.

Just have to play it by ear at this point, but I cannot be absent from home for too long.

8

Very difficult.  It looks as though I shall have to put some extra failsafe option in place, but that is very difficult, if not impossible, as there is no one I would trust with the keys to my home.  My daughter does not drive, so she would be dependent on her boyfriend to bring her here to take care of what would need to be done.

9

Hi Susie,

congratulations, you had your pre-op assessment ! 

I agree with the above responses - to give you the discharge date and time so far in advance , unfortunately, is not possible -- too many variables -

You don't know yet how you will feel -

I asked for another day/night because I felt so insecure about going home and being alone - Prior surgery I thought that I wanted to be home as soon as I was allowed - I would have preferred outpatient surgery (what did I know right?) if offered ....

Take it easy and one day at a time, darling

big warm hug

renee

10

Hi Susie -

Well done with the pre op all done now and you sound very organised.

The nausea and dizziness in my case was caused by the blood thinners, this is very common I was told, and can be quite severe at the beginning. I still felt nauseous for three weeks. The blood thinners are essential - and feeling nauseous and dizzy is not ideal in the very early days, especially as you will be home alone - it is great that the hospital are being so flexible about your stay, and seem to be very focused on your well being already, which is very encouraging so early on.

Secondly sometimes blood loss during surgery can cause low blood pressure, and feeling unsteady and sick for a while,

again all very normal, but you would be unlikely as a nurse or doctor to send a patient home without support feeling like this.

Can your transport choice not offer flexibility? I am sure they will understand that you can't be sure what day it will be.

Hopefully you will be coming home sooner than you think - and as soon as you ready they will assist you with how to manage at home.

You have this forum here to support you - and you will soon be on the road to recovery Susie x

11

Hi Susie,

They cannot give precise release times and dates, for many reasons. As had been said people vary, the most common reasons to feel nauseous are the drugs, painkillers etc used during and after the op. I did not feel sick at all, woke up after the GA and had lunch an hour later. The lady next to me was different. There are some people who take what they say as gospel and if it does not come to pass complain. I know you would not do that, but I think the more you press for an answer the less clear the answer becomes. At best I expect they tell you the release time for the 90% of patients who do as expected. They also like to have time to prepare the bed for the next patient so a mid to late morning discharge time is most likely. You are also likely to be fairly sure the day before which gives time to confirm the transport

12

Hi Maggie:

Many thanks.  During the pre op, I did tell the nurse that I had quite a sensitive stomach and was on PPIs.  I am concerned about the opioids' side effects, and have been researching alternative means of pain relief.  Most of what I have found contain cmbinations of different drugs, but containing opiods.  Acetominophen, combined with Vicodin or Perocet.  Catheters provding nerve blocks that can be used upon release, local anaesthetics (I would think these would be some time after the first few days post op, though).  

I am trying to avoid the usual symptoms assoicated with the narcotics, nausea, constipation, etc., but so far, not much progress.  Looks as though I am stuck with the side effects. but am now looking at ways of combatting both of these.

Having  a sensitive stomach is my main concern re pain relief as the results they produce may be worse than the pain itself!  

I am sure the anaesthetist can help and guide, but I am very research prone!  Part of my American training, and desire for knowledge.  Do not like being kept ignorant!

You are right about pressing the nursing staff for information about release.  They do have to safeguard the clinic against any form of lashback, should a patient be released too early.  But, the comment about possibly needing the bed, raised some interesting questions!

13

Hi susie,

i had intravenous paracetemol in the first 3 days after the op. For me it was just as effective as morphine for pain management, without the challenging side effects.

The nurses said that taken as IV the paracetemol is as effective as 10mg morphine.

i came home with cocodamol lowest dose (500mg paracetemol and 8mg codeine). I took plenty of dulco ease which prevented any severe constipation.

antiinlammatories are also effective. Not sure how you would react to these though if you have sensitive stomach.

Hope this helps.

lindsey

 

14

I had thr 6 days ago . I was told I could go home on the sunday or after but infact was discharged on the Saturday evening !! I had been faintimg due to low blood pressure and only got to using the crutches lunchtime the same day . I was surprised they let me home . Now home there are times I feel nauseous and you just cannot predict what will happen - good luck

15

I had a very bad experience with opiates, and so I hope to ask for the IV paracetamol next time.....what was your pain level day 2/3 with this method please? You have provided an answer to some worries I have had about the next replacement..thank you so much for your post Lindsey x

16

I had a very similar experience with the fainting, low blood pressure, until I came on the forum I had no idea how common this is.

Do you feel better now Khippie? 

17

Having been kept in the recovery room for a couple of hours due to extreme pain and being given LOTS of morphine, I was "astounded" (my 8 year old's new favourite word) at the relief the IV paracetemol gave me. 

On day2/3 the pain was definitely manageable (probably a 4 or a 5).

if I have to have the other hip done, I think I would try to find out in advance now it might be possible to have the IV set up at home. It might require some private nursing care, but it would only be for a week max.

having said that, looking back I did fine on the low dose cocodamol once I was home. The 8mg dose of codeine per tablet kept the pain enough at bay without tipping me over into Gaga land.

hope that helps x

18

I have my mum to thank for this as she suffers too ! Blood pressure s much better now :-) im coping thankyou - meds n movement all seem under control - hopr you're well x