There are about 6 million orthopedic surgeries per year. Whether you are having a total hip, knee, or shoulder replacement, here you will find helpful information to help prepare you before you have your surgery.
Why am I having orthopedic surgery?
You are likely in lots of pain because of your arthritis in your joints, or a prior bone trauma.
Your orthopedic physician likely started you on steroids, and other treatments, but this is not a permanent solution.
Often times, your orthopedic physician has determined you need to have a procedure to hopefully eliminate the pain after your recovery with a brand new part.
Some of these very common procedures are known as replacements-total hip, partial/total knee, total shoulder, and total ankle replacements.
If you are on this page, most likely you were made aware by an orthopedic team that you were going to need devices for home, commonly known as durable medical equipment in the medical field.
The Pre-Op Process
Depending on your health, height and weight, your physician will determine what kind of medical clearance you need prior to scheduling your surgery.
For instance, you might need cardiac clearance if you have a heart condition. Ideally, the office staff will help you make this process smoother by giving you a clear picture of the steps you need to achieve prior to your surgery.
Once you achieved medical clearance, your orthopedic office team will (hopefully) assist with the required medical equipment for home use prior to your surgery.
If they haven’t, this page was created for people like you. In addition, they might refer you to a home care agency for therapy at home.
Finally, you will probably have prescriptions of your medications that you will need after your surgery. Do fill these medications prior your surgery because sometimes your insurance might need extra information from your prescribing doctor.
Planning Ahead for My Surgery
Like in most planned procedures, planning ahead is key to having a smoother process during, and after surgery.
I always recommend my patients to contact their health insurance to discuss their coverage not only about their hospital stay, but also about their medical equipment, medications, and home care.
Many times, patients get frustrated because at the last minute, they are facing unexpected co pays, uncovered expensive medical equipment, and even requiring a prior authorization for their medications.
Therefore, contacting your health insurance is not only highly recommended, but crucial. Additionally, communication with the Orthopedic Doctor team, is also highly encouraged to identify any potential delays, and necessary items prior your surgery.
What to Expect During My Stay at the Hospital
During your hospital stay, you might be having a replacement of either a total hip, knee, ankle, or even a shoulder. Your doctor will prescribe some strong narcotics to help alleviate the pain.
On the very first day of your surgery, your assigned physical therapist will need to evaluate you in about two hours after your surgery. This is a mandatory task, as you had an elective procedure, you will be required to participate with your therapist throughout your hospital stay.
He or she will have recommendations for home, your discharge planner will review those, and then meet with you to discuss those recommendations.
When you are meeting your discharge planner, also known as case manager, social worker, etc., you will be discussing what will you need for home.
If you still don’t have your medical equipment, or your home care prearranged, your discharge planner will make referrals to your insurance providers, or any other agency of your choice.
You will likely have a long waiting time to receive your medical supplies, and this will depend on the availability of items, your coverage, and the time of the year, among others.
Your home care agency will again be based on your insurance coverage and in-network agencies. Arranging home care in the hospital is a lot smother than trying to get your medical equipment prior to your discharge.
For all patients that are going home, and had either a knee, or hip replacement, you will need a Front Wheeled Walker, and a 3 in 1 commode.
For those that had a shoulder replacement, sometimes your therapist might recommend a 3 in 1 commode to assist as a support during your shower.
If you weight over 300 lbs then you will need a bariatric medical equipment.
Otherwise, a shower chair might just be enough for the shoulder surgeries. Other helpful items for all above are the hip kits or grabbers, and shower chairs.
Sometimes, your physical therapist has recommended that you go to a Subacute Rehab Facility. Keep in mind that even when your therapist, your doctor, and the rest of your health team have recommended short term rehab, it is your health insurance who will determine approval in going to a skilled nursing facility.
Therefore, if prior to your surgery you were planning in going to a Skilled Nursing Facility, contact your health insurance for coverage information.
Also, tour the facilities that are in network with your insurance, again you will need this information when you call your health insurance.
Remember also that having a social problem does not meet medical necessity (like “I live alone”, “everybody works and no one can care for me at home”, etc).
This is because your procedure is elective; you need to have medical criteria which your insurance will determine based on your current medical status.
Important Reminders to Consider
Going home is not only your best option, but patients will recover better and faster when they are home.
Consider going to a rehab only if it’s really necessary, and keep in mind there are higher risks of infections when patients go to a rehab or skilled nursing facility; regardless of their location.
How do I know if I should go home instead of rehab? If you are able to walk with minimal assistance (you will be using your walker), and you were told you walked over 50 feet, it is almost safe to say you will be recuperating at home just fine.
Having aide at home is a must, therefore, contact a family member, or a friend to help you for at least six weeks (2 weeks full time) after your surgery.
Many families plan their 2 weeks vacations request to help patients during this time. Then, they can work around their schedule when is time for the outpatient therapy.
There are some health plans that will never cover items such as 3 in 1 commodes; or give you a choice of a Front Wheel Walker, vs a 3:1 commode. In this case, of course, choose the most expensive item (the commode), and purchase the least expensive (walker) out-of-pocket.
Most health insurances (if not all) have a reimbursement option if you purchase your medical supplies before your surgery, and had coverage for the specific item you want reimbursement on.
Just contact your insurance about this option, and if you do, I recommend you purchase those items to save you some trouble.
If you have any questions, or concerns, leave a comment below or send me an email to firstname.lastname@example.org, and I will be more than happy to assist you.