Everything you need to know about having surgery

Video Transcription

So you’re having surgery. So there’s a few things I wanted to cover about your surgery. Basically any orthopedic surgery on the muscular skeletal system has two main goals. One is to relieve pain, the second is to restore function, so whether we’re talking about shoulder surgery, knee surgery, or really any of the surgery in orthopedics, those are the two main goals. Just like any surgical procedure, there are risks. The benefits, really, is what you hope to get out of it, and that will be our goal together to attain hopefully very little to no pain to get you back to normal function. But there are risks, and so some of those risks that we’ll talk about are bleeding and infection, nerve injury. The likelihood of these is very low, but they’re not zero. The things that we do to try to prevent these begin right away with our first interaction where we try to take a good medical history and make sure that there are no complicating factors, and if there are, we try to minimize those by having you see your primary care doctor to get medical clearance, maybe even get some additional tests to help them and to help me with your surgery.

The most important thing would be to minimize your risk of problems when we have the surgery, so that really starts with having a world class team. My staff, the anesthesiologists and all the staff that I work with, both at the Andrews Institute and Gulf Breeze Hospital, their attention to detail, the fact that we have exceedingly low infection rates, which are much smaller than the national average just at baseline mean that your risk of infection, although not zero, is very low. Of course, we use antibiotics in every patient, and there’s a number of different things with sterile technique and things we do during surgery to minimize those risks. We try to have you stop blood thinners. Even things as simple as over the counter pain medications, Tylenol is about the only one that won’t make you bleed. All the other antiinflammatories, Motrin, Aleeve, tramadol, etc, those really need to be stopped for a minimum of about five to seven days before surgery to minimize that risk of bleeding and bruising after surgery.

Of course, if you’re on a prescription blood thinner, we’ll need to talk to you in more detail about how long you need to be off of that. One complication many of my patients ask about is blood clots, deep vein thrombosis, and pulmonary embolism. Luckily, the chances of this complication happening are exceedingly low in all arthroscopic procedures. They are a little bit higher in joint replacements, particularly in joint replacements of the lower extremity, so much so that if you’re having a knee replacement, you’ll be put on aspirin or some other blood thinner for several weeks to months postoperatively to protect against a deep vein thrombosis. If you have a family history or personal history of having had blood clots, you will likely already be on blood thinners, and as I mentioned, you will need to stop all those preoperatively, but we will them again immediately after your surgeries over.

There are more specific potential risks when we talk about surgery, especially if it’s on a joint. The problems that can arise that are not ideal or would be stiffness or lack of full range of motion and potentially continued pain in general. The longer you’ve had the problem and the more chronic the problem, the more challenging it may be to regain full function. In most cases, you still attain that benefit of having pain relief, but it is sometimes a little bit more work for you to maintain the full motion that we generally are shooting for when we have the surgery, so you may end up with some stiffness. In terms of continued pain, of course that is not something that that we want, but sometimes it happens. Generally it’s not nearly the pain that you’re experiencing before surgery, and we do everything we can both surgically and then through rehab to minimize that.

Now speaking of rehab, that is a huge part of almost every orthopedic procedure. Mostly what I do in shoulder and knee surgery, you will be beginning therapy within weeks if not days depending on what the surgery is. You have to be a complete committed participant in this in order for you to attain full function of your surgery, so you’ll hear in a great detail the specific limitations of your surgery from your therapist as well as from us immediately postoperatively. There are some more specific risks that I won’t get into too much detail, but obviously there are specific risks to the specific surgery. For instance, if you’re having a joint replacement, there’s potential that the joint can wear out depending on how active you are, which joint we’re replacing. There may be some restrictions that go with that. We always talk about that before surgery.

There are also specific risks that have to do with things like risk to nerve injury. There’s really a whole long list of of things that are very, very, very unlikely to happen, and in most cases it’s not even something that we need to discuss in great detail, but in cases like revision surgery or incredibly complex joint reconstructions, there will be a higher than normal risk of those nerve injuries, which we will do everything possible to avoid that. But that is something that you need to understand going in to that surgery if you’re one of those patients that has a very complex problem.

The bottom line is, my goal for you is to have a great result, hopefully no pain whatsoever at the end result and hopefully full function. In order to attain those goals, we’ll get to know each other well on the postoperative period, seeing each other frequently along with the rest of my team. If you have any questions regarding the specific risks of your surgery, if you have other questions, I encourage you to write them down. You can ask me on the morning of surgery, and we can go over them then, or if they may be a little bit more in detail, I’d be happy to see you back in the office or you can contact me through the website or email, or even call the office. Thanks.

Everything you need to know about having surgery

Video Transcription

So you’re having surgery. So there’s a few things I wanted to cover about your surgery. Basically any orthopedic surgery on the muscular skeletal system has two main goals. One is to relieve pain, the second is to restore function, so whether we’re talking about shoulder surgery, knee surgery, or really any of the surgery in orthopedics, those are the two main goals. Just like any surgical procedure, there are risks. The benefits, really, is what you hope to get out of it, and that will be our goal together to attain hopefully very little to no pain to get you back to normal function. But there are risks, and so some of those risks that we’ll talk about are bleeding and infection, nerve injury. The likelihood of these is very low, but they’re not zero. The things that we do to try to prevent these begin right away with our first interaction where we try to take a good medical history and make sure that there are no complicating factors, and if there are, we try to minimize those by having you see your primary care doctor to get medical clearance, maybe even get some additional tests to help them and to help me with your surgery.

The most important thing would be to minimize your risk of problems when we have the surgery, so that really starts with having a world class team. My staff, the anesthesiologists and all the staff that I work with, both at the Andrews Institute and Gulf Breeze Hospital, their attention to detail, the fact that we have exceedingly low infection rates, which are much smaller than the national average just at baseline mean that your risk of infection, although not zero, is very low. Of course, we use antibiotics in every patient, and there’s a number of different things with sterile technique and things we do during surgery to minimize those risks. We try to have you stop blood thinners. Even things as simple as over the counter pain medications, Tylenol is about the only one that won’t make you bleed. All the other antiinflammatories, Motrin, Aleeve, tramadol, etc, those really need to be stopped for a minimum of about five to seven days before surgery to minimize that risk of bleeding and bruising after surgery.

Of course, if you’re on a prescription blood thinner, we’ll need to talk to you in more detail about how long you need to be off of that. One complication many of my patients ask about is blood clots, deep vein thrombosis, and pulmonary embolism. Luckily, the chances of this complication happening are exceedingly low in all arthroscopic procedures. They are a little bit higher in joint replacements, particularly in joint replacements of the lower extremity, so much so that if you’re having a knee replacement, you’ll be put on aspirin or some other blood thinner for several weeks to months postoperatively to protect against a deep vein thrombosis. If you have a family history or personal history of having had blood clots, you will likely already be on blood thinners, and as I mentioned, you will need to stop all those preoperatively, but we will them again immediately after your surgeries over.

There are more specific potential risks when we talk about surgery, especially if it’s on a joint. The problems that can arise that are not ideal or would be stiffness or lack of full range of motion and potentially continued pain in general. The longer you’ve had the problem and the more chronic the problem, the more challenging it may be to regain full function. In most cases, you still attain that benefit of having pain relief, but it is sometimes a little bit more work for you to maintain the full motion that we generally are shooting for when we have the surgery, so you may end up with some stiffness. In terms of continued pain, of course that is not something that that we want, but sometimes it happens. Generally it’s not nearly the pain that you’re experiencing before surgery, and we do everything we can both surgically and then through rehab to minimize that.

Now speaking of rehab, that is a huge part of almost every orthopedic procedure. Mostly what I do in shoulder and knee surgery, you will be beginning therapy within weeks if not days depending on what the surgery is. You have to be a complete committed participant in this in order for you to attain full function of your surgery, so you’ll hear in a great detail the specific limitations of your surgery from your therapist as well as from us immediately postoperatively. There are some more specific risks that I won’t get into too much detail, but obviously there are specific risks to the specific surgery. For instance, if you’re having a joint replacement, there’s potential that the joint can wear out depending on how active you are, which joint we’re replacing. There may be some restrictions that go with that. We always talk about that before surgery.

There are also specific risks that have to do with things like risk to nerve injury. There’s really a whole long list of of things that are very, very, very unlikely to happen, and in most cases it’s not even something that we need to discuss in great detail, but in cases like revision surgery or incredibly complex joint reconstructions, there will be a higher than normal risk of those nerve injuries, which we will do everything possible to avoid that. But that is something that you need to understand going in to that surgery if you’re one of those patients that has a very complex problem.

The bottom line is, my goal for you is to have a great result, hopefully no pain whatsoever at the end result and hopefully full function. In order to attain those goals, we’ll get to know each other well on the postoperative period, seeing each other frequently along with the rest of my team. If you have any questions regarding the specific risks of your surgery, if you have other questions, I encourage you to write them down. You can ask me on the morning of surgery, and we can go over them then, or if they may be a little bit more in detail, I’d be happy to see you back in the office or you can contact me through the website or email, or even call the office. Thanks.