Two weeks after the outpatient consultation, I received a letter saying that my operation would be at the end of June.
The next step was a two hour assessment at the hospital. Beforehand, I filled in a health questionnaire and another booklet about arrangements for my care after the operation and the layout of my house. It included questions about who would take me to the hospital and take me home afterwards and who would be there to help look after me afterwards.
There were more questions on the house, the stairs, access to the bathroom, the height of chairs. I counted all the stairs in our Victorian terraced house diligently and concluded there were a lot; three down to the kitchen, eleven up from the ground floor to the bathroom, five more up to my bedroom, seven more up to a shower room. I knew I would have to become skilled on going up and down stairs simply to move around the house. The questionnaire was given to the occupational therapy department, ( but I didn’t need any extra help.)
If prospective patients needed extra help and support, then the questionnaires would alert the hospital staff to advise. It also made me think about the week after the operation. My husband arranged to take two days leave from work and I invited a close friend to stay for the next two days.
At the assessment, I first saw a nursing assistant who weighed me and measured my height to calculate my BMI. Then I had an consultation with a nurse practitioner who discussed my health questionnaire, took my blood pressure, pulse and temperature, did an ECG, and took swabs from nose, throat and perineum to ensure that I was clear of MRSA. Finally, I saw a nurse and did a urine test and she took some blood to test for haemoglobin, urea and electrolytes, liver and kidney function and glucose levels.
The hospital also arranged a separate pre-surgery afternoon because if orthopaedic patients are as fit as possible and as prepared as possible, then outcomes are better. It means that patients spent less time in hospital and returned home as soon as possible.
A nurse practitioner spoke on what we should be doing in the run up to surgery, what we should be eating, how we should be exercising and how to prepare our homes for an operation.
Every hospital will have its own pre-operative advice but the main points I took away were as follows-:
- To eat a good diet as it will help with healing and repair and will aid the immune system in fighting infections. It’s important to make sure there is enough zinc and iron in the diet and to eat lean protein, vegetables and fruit for vitamin C, and green leafy vegetables, pulses, peas and beans.
- To keep hydrated; we were to drink one and a half litres to two litres of liquid a day. Tea could be counted in the calculation but not coffee. Good hydration helps prevent blood clots.
- To avoid alcohol for a week before the operation and not to drink any in the final 48 hours before the operation. There’s a risk of confusion and delusion after a major operation
- To try and not to do anything too stressful before the operation such as a renovation project (eek!)
- To avoid scratches and insect bites as they are an infection risk by wearing insect repellent and long sleeves and long trousers when gardening. If we had any bites or scratches or bruises in the week before the operation; we had to ring the hospital helpline and/or send a photo.
- To do pre-operative exercises three times a day as given to us on prescribed exercises for hips and knees.
- After the briefings, we were taken on a tour of the unit, to see the pre-operative ward where we would arrive before surgery, the post operative ward and the hospital wards themselves where we would recover.
I went to the dentist for a check up and then had a crown fitted. Any outstanding dental work can increase the risk of post operative infection, especially bacteria on the gum line.