Galesburg Orthopedic, Ltd

Prior to your scheduled surgery, please check with your employer and insurance company for authorization, second opinion and pre-certification requirements. Not notifying your insurance company as required may result in a penalty reduction in their payment of your bill. This will increase the amount you will be required to pay.

You will receive a letter from Galesburg Orthopedic Services a few days before your surgery. This may be given to you during your office visit or sent to you in the mail. If you are under 18 years of age, you parent or guardian must come with you to sign your operative permit. This form has all of your pre-op information and it is very important that you understand it. It describes the procedure to be performed, your assigned Pre-Op doctor and the appointment time, your educational class time (if desired), your Post-Op appointment and all of the Pre-Op testing needed and the date it’s due by.

When you meet with our nurse, please be prepared to inform us of any drug allergies or sensitivities you may have as well as any medications, herbs and/or vitamins that you are taking. It may be helpful to write them down in a list because you may be asked for this information several times.

Reasons to notify your physician:

Changes in your general health will affect your surgery. If at anytime prior to your surgery any of the following conditions develop, please notify your physician.
Symptoms of cold, flu or infection
Fever and/or chills
Irritation of eyes, ears, throat, or gums, and any dental problems
Boils, or skin abrasions or cuts
Stomach or intestinal illness such as, diarrhea, nausea, and vomiting or blood in stool
Kidney or bladder changes that include burning with urinating, blood or pus in your urine, and needing to urinate more often or an urgent sensation with urinating
If there is any possibility that you may be pregnant

Preparing for surgery is a crucial step towards a pleasant surgical experience. First, you need to have a nursing assessment with our nurses and learn detailed Pre-Op, Post-Op instructions. Our nurses or your family doctor can perform the physical exam and health history. It is also wise to meet with your physician and discuss the procedure, risks and benefits of the surgery as well as signing the informed consent form for the procedure. You will want to meet with your anesthesiologist and review your medications and the procedure you will be undergoing. Finally, you will want to meet with your preferred physical therapist. If you do not have a physical therapist already, our nurses will arrange one for you. Here, you will learn about the exercises, braces, and walking aids you might need. Meeting with all of these individuals before surgery will help you feel more comfortable when the day of surgery comes and will help your transition after surgery go a lot smoother.

Before the day of surgery, you will want to arrange to have an adult (someone over 18) available to drive you home after discharge, and have someone stay with you at least 24 hours once you are home. You will not be allowed to leave the hospital alone.

Certain lab work must be done before any surgical procedure. These tests may include an x-ray, blood test and urine test. A chest x-ray and EKG will also be necessary if you have not had one done in 6 months. The form you received from us lists the needed labs. Some lab tests require that you not eat for 3 to 6 hours before the test is done so be sure to ask your doctor if you need to fast. These may be done at your local hospital. The lab reports need to be faxed to our office at 309-342-1060 and also to your family physician. We would encourage you to have these tests done prior to the day of surgery - however, not more than 7 days before. Having the tests done before the day of surgery will save time on the day of surgery and allow the doctor ample time to review your reports.

You will need to schedule an appointment with your family physician for a history and physical, preferably after your lab work is completed, so he can review it during your visit. The history and physical report must also be faxed to our office.

A type and screen lab must be done at the hospital in which you will be having your surgery. Depending on when you are arriving in town, it can be done the day before or the morning of your surgery. A script for this lab will be given to you at the time of your visit in our office.

Do not eat or drink anything, including water, after midnight the night before your surgery. This helps to prevent your from vomiting and breathing stomach contents into your lungs during surgery. It is also preferable for you to not smoke after midnight the night before your surgery. If you do eat, drink or smoke after midnight, please call the hospital. Or, if you are an inpatient, please tell your nurse. If you smoke, eat, or drink after midnight, your surgery may need to be postponed.

Please bathe or shower the night before or the morning of surgery. Be sure to carefully and thoroughly cleanse the operation area. It is best to use your usual bedtime pattern to get a good night’s rest the night before surgery.

Plan to arrive at your designated hospital a little earlier than your scheduled surgery time. This will allow time for the hospital staff to prepare you for surgery and answer your questions. Depending on your situation, your arrival time will vary. Please contact your nurse or the hospital to confirm what time you need to be at the hospital. If, for any reason, you are unable to come to the hospital for your scheduled surgery, please call the hospital as soon as possible.

Wear comfortable casual clothing that is easy to get on and off (drawstring – style sweat pants, boxer-style shorts, or loose clothing); keeping in mind what bandages or dressings you might have after surgery. Jewelry, make-up, fingernail polish, false fingernails, and contact lenses must not be worn the day of surgery. All body piercing must be removed. If you have acrylic nails, one should be removed for monitoring purposes. A small locker will be available to you for your personal belongings. Leave all jewelry, money, watches and valuables at home or with family. The hospital cannot be responsible for your valuables.

If you have crutches, a walking aid, brace or sling, please bring them to the hospital the day of surgery. You may need these after surgery. You may also wish to bring reading material in case you have a long period of waiting in between procedures.

Once you arrive at the patient preparation area, a nurse will take a brief medical history and answer any questions you may have regarding your surgery. You will be asked to sign an operative and anesthesia permit. Signing the consent form means that you understand your physician's explanation of the surgical procedure. Your blood pressure, temperature, pulse and respiration will also be recorded. You will be asked to put on a hospital gown, and an IV is started.

Be sure to inform your anesthesiologist and physician of your medications. Your doctor will advise you on when to take your medications the morning of surgery. Some of your medications might cause complications during the surgery so take the medications only as directed by your anesthesiologist or physician. You will most likely be able to take your regular medications on the day of surgery, but just to be safe, bring your medications to the hospital and ask your nurse.

An anesthesiologist (a physician who specializes in administering anesthesia) or a nurse anesthetist (a nurse who specializes in administering anesthesia) will visit with you in the patient preparation area. They will ask questions about your health, your family's health history, medicines you are taking and whether you have had surgery previously. The answers you give will help them administer the most appropriate anesthesia for you. You may be given medications just prior to going into surgery to help you relax. This medication will be given through your IV line.

Your surgery will either be done by local anesthesia or a general anesthesia. Local anesthesia is medication that will numb the operative area but will not put you to sleep. General anesthesia is medication that will put you in an unconscious state.

When you leave for surgery, your family will be directed to the surgical waiting area, which are usually located near the patient holding area. They are welcome to stay there as long as they like, however, if your family needs to leave the hospital, they must inform the nurses in the surgery department with how they can be reached. Medical staff will notify them when your procedure is completed, how you are doing, and where they can be reunited with you. We encourage family members to be with you during the later stage of recovery. To promote a restful environment for all patients, we recommend limiting young children to brief visits.

It is difficult to give an accurate time on how long you will be in surgery and recovery. On the average, your stay will be at least 3-4 hours from the time the surgery actually starts. This does not include the 1-2 hours needed for your surgery preparations. The nurses will give their best estimate of time after you have arrived.

After surgery, you will be taken to the recovery room. The usual length of stay in the recovery room is 1 hour, but it may be longer according to the surgical procedure and the type of anesthesia.

While you are in the recovery room, your physician will usually meet your family to let them know how you are doing and answer any questions they may have. The nurses will be checking your blood pressure, pulse, respirations, temperature and your dressings frequently. They will also be checking the sensation and circulation in the surgical area.

You may have an IV and other tubes for drainage. You may experience blurring vision, dry mouth and chills as you wake up from the anesthesia. The area of your surgery may burn and hurt. Please do not hesitate to ask the nurse for pain medication. It is important for you to try to move around in bed and to take good deep breaths. This will help you wake up and speed your recovery.

Outpatients: After 30 minutes to one hour, you will be taken from the recovery room to the outpatient surgery area and continue to recover and be discharged. Nursing staff will continue to monitor your recovery, provide medication for pain and/or nausea, and give ice chips and liquids. During this final recovery stage, your nurses will review home going instructions, obtain prescriptions, and a physical therapist may stop in to see how you are doing. Discharge is based upon your recovery from the effects of anesthesia, and if your pain is under control. If additional observation is required, you may be admitted to the hospital. Your physician determines if you are ready for discharge. The medications and/or anesthesia you received will make it unsafe for you to drive a motor vehicle or operate power tools for at least 6 hours. You will also not be able to walk home. Upon leaving, you must be accompanied by a responsible adult. We recommend that an adult stay with you overnight to assist you during your recovery at home.

Inpatients: After one hour or more, you will be taken to your hospital room. The nurse will stop by the family waiting area to inform your family that you are going to your room. They will be able to visit you there. While you are an inpatient, you will receive excellent patient care in your room. Your doctor, nurses, and staff members will visit you frequently and make sure you have a healthy and speedy recovery.

Going home after surgery is a happy time, as well as an apprehensive one, as you wonder how you will care for yourself. Following is a list of questions for you to ask your doctor or nurse before leaving the hospital. We recommend that your responsible adult also be present for your home instructions.

Food & drinks
Medications
Bathing & showering
Signs of infections
First follow-up visit
Driving
Bandages & dressings
Pain (what to expect and do)
Stitches/incision
Returning to work
When to call the doctor
Activity

It is normal to feel drowsy for 24 - 48 hours after surgery and to require pain medication at regular intervals. These symptoms will gradually subside and each day you will feel less sleepy and painful.

Walking helps to wake up the entire body system. Please make sure you have appropriate help the first few times you get up in order to avoid any unexpected falls.

Eat what appeals to you, remembering that your digestive system will be sluggish after anesthesia. It is best to stay on a simple diet, increasing to your normal diet as you can tolerate. If vomiting is persistent, contact your physician.

Taking deep breaths and coughing helps to minimize the possible risk of pneumonia. To reduce the discomfort coughing may cause, try holding a pillow snuggly over the surgical area.

Please feel free to call the office or hospital with questions, concerns or problems.

Crutches are used for a short time. Put only as much weight on your surgical leg as advised by your physician.
Always wear your brace when walking, or as instructed by your physician.
Daily exercises are important for the return of a functional and healthy bones and joints

Keep your wound and bandage clean and dry. Change and remove bandage as instructed.
Your wound should not come in contact with water. Change any bandage immediately if it becomes wet or bloody.
You may shower with a plastic bag securely taped beyond the upper edge of your brace. If you had surgery on your leg, it is recommended to sit on a chair in the shower, keeping your bandaged leg out of the direct water spray. If you had surgery on your arm or shoulder, it may be easier to take a bath and hold your wound out of the water.

Applying ice for the first 24-48 hours often surgery will reduce pain and welling.
Elevating the incision above heart level as much as possible will also reduce pain and swelling.
Elevate your arm or leg after exercises and always at night with your knee above heart level.
Take pain medication as prescribed. Do not drink alcohol when you are taking this medication. Take medication 30 minutes before exercises.
Eventually pain subsides and Tylenol should control your pain.

A physical therapist will instruct you on crutch ambulation (if needed), range of motion and strengthening exercises. Continuing these exercises after your surgery is important to maintain range of motion, reduce scar tissue and strengthen weakened muscles. Your physician will specify when you should begin an exercise program to gain motion and/or to strengthen muscles.

We understand that surgery can be frightening and confusing with so many special instructions. If you would like to have a tour of the surgery department or a chance to talk with a nurse about your upcoming surgery, please feel free to call your doctor's office to set up an appointment. The tour and visit can be extremely helpful for children, first-time surgical experiences and the elderly. Family members are also welcome.

Follow-up visits are necessary for your doctor to chart progress, change bandages, check for any complications and evaluate your rehabilitation progress. If you had a total joint replacement, you will need to set up an appointment 6 weeks after the surgery as well as 6 months after.

Swelling, tingling, pain or numbness in your toes, which is not relieved by elevating your knee above heart level for 1 hour.
Drainage that is foul smelling, green or yellow, or drainage where there was none before.
Chills or temperature above 101.3F or if greater than 100.4 F for 24 hours.