Total Knee Replacements in Mumbai – Knee Surgery Day
Thank you for opting to have your surgery done with us.
I hope that you are cognizant of the other methods of treatment of your problem which has been discussed with you by me, my staff and assistants in my clinic, in advance, at the time of your consultation, and I trust if you have had any queries, they have been answered.
Based on our discussions, we have determined the suggested plan of action as the best option under the circumstances, keeping in mind your requirements and our current expertise.
To help you understand the process, I am comparing it to taking a flight from Mumbai to a foreign destination.
Just like before a flight, you need passports, visa, ticket bookings, like-wise for the operation, you need to book a date for admission and a date and time for surgery.
Just like the visa process, we need to know that you are fit for surgery and therefore, you need to share your medical history with us, alongwith ALL the medication that you normally take including tablets such as Aspirin and Clopilet which are blood thinners and can cause bleeding at the time of surgery, and medication for Asthma (you may need more oxygen during the surgery) and Diabetes (if your blood sugars are high, then wound healing is very poor). All inputs by you help make us more prepared to help you.
Specific medication & conditions of the heart (ECG, 2D Echo), lungs (PFT/X-rays), liver and kidney etc., need to be known as various drugs can interact with these functions. The physical act of giving you anesthesia may require extra tests like specialized x-rays of your spine, CT or MRI screening of parts of your body, so that we are better prepared to tackle your spinal position during the process of the surgery.
Just like you have a security check before taking a flight, we need the Physician and the Anesthetist to look through these pre-operative medical reports and to examine you so that we may reduce the risks still further.
Just like in an aircraft before take-off, there is a safety drill in case of any risks, likewise, in any surgery we are taking RISKS but minimizing it by trying to cover as many events as we can.
Just as every landing at an airport, the pilot has to contend with cross-winds, haze, other flights, weather changes, quality of communication etc., similarly every surgical procedure is individualized, some are longer, some are shorter and there are multiple variables.
The OTC is like a ticket. Just like you pay for a ticket before your travel. The Hospital expects you to do an OTC (Operation Theatre Clearance) so that the hospital and you are both aware of the expected expenses. Against your paid ticket you get a boarding pass, likewise against an OTC, the institution permits you to be taken to the theatre for surgery. This is based on averages, but in your individual case the total expenses may be more if there are complications or emergency requirements which may or may not be related to the actual surgical procedure.
You need to be aware therefore that this is an estimate only based on an AVERAGE and is NOT a PACKAGE.
Recovery thereafter is a natural process, and we as doctors help nature help you, with medication, nursing, physiotherapy and other techniques required for your recovery. I reiterate that healing is a process dictated by nature, we only help in this. Just as nature has storms, weather changes, etc, recovery can sometimes in your individual cases be slower and therefore worrisome to you.
Such delays are also worrisome to us as individuals and as a team. The nurses, other staff and my team help the recovery process. Your concerns will be addressed.
Just like in the airline industry the cost of the ticket for travel supports the airline staff, the salaries, the fuel for the aircraft etc., for our team to successfully execute the whole process, there is staff in the hospital which is supported by the expenses incurred for your case, for administration, security, laundry, dining, meals, air-conditioning, water, catering etc.,
Like certain budget airlines offer cheaper fares and skeleton services many doctors and medical facilities will be able to offer you these at lesser rates. In our institutions we have overheads to ensure that checks and measures are carried out for your safety and these necessitate the charges quoted by us.
Just like in any travel there is an Economy class or Business Class or First class at different charges, helping you reach the same destination, similarly in the hospital there are various classes of admission with different levels of comfort, helping you attain the best results. My team’s training, experience, etc., should make this a smooth landing.
I hope this helps you understand the process and I really look forward to greeting you on the other side with every success in your case.
– DR. SANJAY AGARWALA
SA:bf:10th July 2018
What to Expect on Knee Surgery Day
Sometimes a knee replacement is the only option for reducing pain and restoring a normal activity level. If your doctor decides that knee surgery is right for you, here is an idea of what to expect during days leading up to and the day of your surgery.
Once you and your orthopaedic surgeon have decided to proceed with knee replacement surgery, there are several activities that must occur to help make sure all goes well.
First you will have your initial surgical consultation, which will include preoperative X-rays, a complete past medical history, a complete past surgical history and a complete list of all medications and allergies. This consultation will also include orthopaedic examination and discussion of the knee replacement surgery procedure.
Next you will have a complete physical examination. Your internist or family physician will determine if you are in the best possible condition to undergo knee surgery.
You may wish to donate blood prior to your knee replacement surgery in the event that a transfusion is required after surgery.
Your doctor may recommend that you see a physical therapist before surgery to learn exercises to begin prior to surgery. You will also get an overview of the rehabilitation process after knee replacement surgery. This will prepare you better for your post-operative care.
Preparation for the Hospital
You may want to bring the following items to the hospital for your knee replacement surgery:
- Clothing: underwear, socks, t-shirts, exercise shorts for rehabilitation
- Footwear: walking or tennis shoes for rehab; slippers for hospital room
- Walking aids: walker, cane, wheelchair, or crutches if used prior to surgery
- Insurance information
The evening before surgery you should not eat or drink after midnight. Your surgeon may provide you with special soap. You should shower and use this soap to scrub the surgical area for five minutes, or as long as prescribed. Prepare your belongings for the hospital, relax, and get a good night’s rest before your surgery day.
On the morning of your knee replacement surgery you will be admitted to the hospital. Your vital signs will be taken, you’ll be given a clean hospital gown to wear during the procedure, and an IV will be started to give you fluids and medication during and after the procedure.
You may be provided an elastic stocking to decrease the likelihood of blood clots. You will be asked to empty your bladder. All jewelry, dentures, contacts, and nail polish must be removed. The surgical leg will be scrubbed and shaved in preparation for surgery. The anesthesiologist will come into your room and discuss the type of anesthesia that will be used. Finally, you will be taken into the operating room.
Surgery and Recovery
A total knee replacement involves cutting away the damaged bone of the knee joint and replacing it with a prosthesis. You will be under anesthesia during the procedure.
After your surgery is completed, you will be transported to the recovery room for close observation of your vital signs, circulation, and sensation in your legs and feet. As soon as you awaken and your condition is stabilized, you will be transferred to your room.
When you wake up you will find a bulky dressing applied to your incision in order to maintain cleanliness and absorb any fluid. There may be a drain placed near your incision in order to record the amount of fluid being lost from the wound.
Your doctor may prescribe a PCA device (patient-controlled analgesia) that is connected to your IV. The unit is set to deliver a small, controlled flow of pain medication and is activated when you firmly press the button on your machine. Press the button anytime you are having pain.
You may have a catheter inserted into your bladder as the side effects of anesthesia may make it difficult to urinate.
A continuous passive motion (CPM) unit may be placed on your leg to slowly and gently bend and straighten your knee. This device, if prescribed, is important for quickly regaining your knee range of motion.