Just to update as of today -
I had a PT appt. My insurance is only approving two more appts at the moment, so we've split them up as Dr. Kelly wants me to be evaluated closer to surgery. Now it's up to me to do more "homework" as I call it. I have been doing some excercises in the pool and will keep that up as much as possible. Also, my PT gave me more shoulder excercise to do so I can strengthen it up for the crutches. He is recommending some type of "elbow crutch" but I will have to do some research. The key is to keep as much pressure off of my hands and shoulders as possible, since I'm such a complete wreck!
He explained more about the psoas muscle release and said it should be fine, but with all that Dr. Kelly will be doing on my hip, I will probably be on crutches 4-5 wks. G-d give me strength, that is going to be rough!
So, onwards and upwards as they keep telling me. I have much to accomplish before I even have the surgery, but I'm hoping all this work will pay off with a (touch wood) quicker recovery!
01 August, 2007
Questions to ask regarding surgery
Surgery Questions
*Is there an advantage to doing this procedure/surgery sooner vs. later or not at all?
*Arthroscopic surgery? Outpatient?
*How long does the surgery take?
*What specifically will you do in surgery (what is/are the specific procedure(s) you’ll be doing on me)?
*How would the labral tear be fixed?
*If there is arthritis and cartilage damage - is there anything you can do? If there is more damage than the labral tear, will you fix everything then?
*Success rate - What percentage of patients improve following the procedure? After full recovery - what are the restrictions?
*Will you be the one doing the surgery?
*Will students/residents be assisting in my surgery? -Is there a way for me to request or be assured that only you will do the surgery (no students)?
*What are the benefits of the procedure in terms of pain relief, functioning/mobility? How long will the benefits last?
*What are the risks involved with this surgery? Complications specific to me?
*What if I have had bad experiences in the past with general anesthesia, what other options do I have? What anesthetic will be used? What are the risks? Do I have a choice about the type of anesthesia that will be used on me? What are the pros and cons of my choices? I react v. badly to general and would prefer to not have this. Will I meet with the anesthesiologist in advance? Will he or she know my needs/allergies? (Allergic to: Sulfa, Indocin, ) Can I request Dr. Jules? What is “combines spinal epidural w/ sedation?)?
*What amount of pain relief can I expect from the surgery?
*Will I need any tests or medical evaluations prior to the surgery?
*Will the surgery need to be repeated after a certain amount of time? Increase chance of needing hip replacement in future?
*What type of complications have you experienced with other patients? Both in surgery and after? What are the risks of this surgery, both short and long term? (i.e. - Blood clot, infection, failure to heal, vascular necrosis, nerve palsy, damage to the femoral neck, etc.) And what can we do to reduce these risks?
*Are all various dr’s and hospital services covered by Oxford? If not, what would cost be out of pocket?
*Need pre-approval, who takes care of this?
*Do I need to stop any medications before surgery? How long prior to / after?
Post Op Questions
*What equipment will I need during recovery? (Crutches (how long) ((Millennial Crutches))? Brace? Wheelchair? Walker? CPM machine? Toilet seat riser? Shower bench/transfer? Etc.)
* Will it be provided by the hospital/surgery center? If not, where do you suggest I get the items?
*Will you prescribe crutches for me ahead of time – what type considering my shoulder and hand issues?
*What are my limitations during recovery?
*How long till I can shower?
*How long until return to FULL activity in sports? (Gym? Swimming? Walking distances? Stairs? Sitting for length of time, ie theatre, work, etc.)
*How long will the recovery take?
*Will I need assistance at home afterwards? For how long? /Will I need 24-hour help? For how long?
*What will discharge instructions be?
*When can I realistically return to work?
*Will I have any disability following surgery?
*Will I have pain following the procedure? What pain relief or pain control measures will I be given? (I have bad reactions to vicadin and that sort. Have used Ultram and Ultracet with some success. V. sensitive to medications.)
*Any other medications you prescribe post surgery? Anything for nausea or a laxative b/c of the pain killers?
*How many post-op visits required?
*How long do stitches/staples stay in? Which do you use?
*How long will I be in PT for?
Discovery Questions
*Do I have arthritis or no arthritis? If so, how much?
*Is the underlying femoral neck misshapen and also causing the impingement or a result of the impingement? if so would that be reshaped as well? how about the socket?
*Do I have FAI (femeroacetabular impingement)? (Untreated FAI can lead to repeat labral tears.)
*How was the bursa?
*Any signs of: Hip dysplasia? Hip instability? Degenerative disease in joint? Osteoarthritis? If so, how severe?
*Are ligaments and tendons intact and supporting the joint?
*Any sign of ligamentum teres syndrome (what does thickening of it mean/imply)?
*Any chondral damages?
*Any implications of bone marrow swelling (edema)?
*Is there an advantage to doing this procedure/surgery sooner vs. later or not at all?
*Arthroscopic surgery? Outpatient?
*How long does the surgery take?
*What specifically will you do in surgery (what is/are the specific procedure(s) you’ll be doing on me)?
*How would the labral tear be fixed?
*If there is arthritis and cartilage damage - is there anything you can do? If there is more damage than the labral tear, will you fix everything then?
*Success rate - What percentage of patients improve following the procedure? After full recovery - what are the restrictions?
*Will you be the one doing the surgery?
*Will students/residents be assisting in my surgery? -Is there a way for me to request or be assured that only you will do the surgery (no students)?
*What are the benefits of the procedure in terms of pain relief, functioning/mobility? How long will the benefits last?
*What are the risks involved with this surgery? Complications specific to me?
*What if I have had bad experiences in the past with general anesthesia, what other options do I have? What anesthetic will be used? What are the risks? Do I have a choice about the type of anesthesia that will be used on me? What are the pros and cons of my choices? I react v. badly to general and would prefer to not have this. Will I meet with the anesthesiologist in advance? Will he or she know my needs/allergies? (Allergic to: Sulfa, Indocin, ) Can I request Dr. Jules? What is “combines spinal epidural w/ sedation?)?
*What amount of pain relief can I expect from the surgery?
*Will I need any tests or medical evaluations prior to the surgery?
*Will the surgery need to be repeated after a certain amount of time? Increase chance of needing hip replacement in future?
*What type of complications have you experienced with other patients? Both in surgery and after? What are the risks of this surgery, both short and long term? (i.e. - Blood clot, infection, failure to heal, vascular necrosis, nerve palsy, damage to the femoral neck, etc.) And what can we do to reduce these risks?
*Are all various dr’s and hospital services covered by Oxford? If not, what would cost be out of pocket?
*Need pre-approval, who takes care of this?
*Do I need to stop any medications before surgery? How long prior to / after?
Post Op Questions
*What equipment will I need during recovery? (Crutches (how long) ((Millennial Crutches))? Brace? Wheelchair? Walker? CPM machine? Toilet seat riser? Shower bench/transfer? Etc.)
* Will it be provided by the hospital/surgery center? If not, where do you suggest I get the items?
*Will you prescribe crutches for me ahead of time – what type considering my shoulder and hand issues?
*What are my limitations during recovery?
*How long till I can shower?
*How long until return to FULL activity in sports? (Gym? Swimming? Walking distances? Stairs? Sitting for length of time, ie theatre, work, etc.)
*How long will the recovery take?
*Will I need assistance at home afterwards? For how long? /Will I need 24-hour help? For how long?
*What will discharge instructions be?
*When can I realistically return to work?
*Will I have any disability following surgery?
*Will I have pain following the procedure? What pain relief or pain control measures will I be given? (I have bad reactions to vicadin and that sort. Have used Ultram and Ultracet with some success. V. sensitive to medications.)
*Any other medications you prescribe post surgery? Anything for nausea or a laxative b/c of the pain killers?
*How many post-op visits required?
*How long do stitches/staples stay in? Which do you use?
*How long will I be in PT for?
Discovery Questions
*Do I have arthritis or no arthritis? If so, how much?
*Is the underlying femoral neck misshapen and also causing the impingement or a result of the impingement? if so would that be reshaped as well? how about the socket?
*Do I have FAI (femeroacetabular impingement)? (Untreated FAI can lead to repeat labral tears.)
*How was the bursa?
*Any signs of: Hip dysplasia? Hip instability? Degenerative disease in joint? Osteoarthritis? If so, how severe?
*Are ligaments and tendons intact and supporting the joint?
*Any sign of ligamentum teres syndrome (what does thickening of it mean/imply)?
*Any chondral damages?
*Any implications of bone marrow swelling (edema)?
learning to not plan
Being a Virgo I live for planning. Only problem is, how can you "plan" what is going to occur when you have surgery. Planning is like a panacea to me, it keeps me calm, makes me feel I have some control over things. But realistically, you cannot have control over some things in life, and this is where my anxiety begins.
After speaking to Dr. Kelly's PA and getting all of the information I need I thought I would feel a bit better. I'd be able to start making those lists, ordering what I need, planning where and when I would stay post op, sort out work, all that fun stuff. It seems I was wrong. I can sort out some of the things, but the truth is, I don't know how I will feel after, I don't know if I'll be up for a car ride to the island a couple days after or not, so I am having to let that all go. Which is very difficult for me. I kept my poor mum on the phone last night going on and on about everything that I can't control. Bless her for her patience, I hope she can keep it as I can only imagine I'm going to get worse in the weeks ahead. Perhaps I should buy pressies for everyone that will have to deal with me to butter them up! :-)
I guess I will try to sort out what I can and just try to let the rest happen as it will. But I will admit this, I'm scared. After having 4 hand surgeries, I know what pain is, and I'm thinking it may be worse to know what I'm getting into. Then again, I really have no choice, so must make the best of it.
Sorry it to ramble it just seems to help to get it written down as I think about it all. I just have to remember - one step at a time.
After speaking to Dr. Kelly's PA and getting all of the information I need I thought I would feel a bit better. I'd be able to start making those lists, ordering what I need, planning where and when I would stay post op, sort out work, all that fun stuff. It seems I was wrong. I can sort out some of the things, but the truth is, I don't know how I will feel after, I don't know if I'll be up for a car ride to the island a couple days after or not, so I am having to let that all go. Which is very difficult for me. I kept my poor mum on the phone last night going on and on about everything that I can't control. Bless her for her patience, I hope she can keep it as I can only imagine I'm going to get worse in the weeks ahead. Perhaps I should buy pressies for everyone that will have to deal with me to butter them up! :-)
I guess I will try to sort out what I can and just try to let the rest happen as it will. But I will admit this, I'm scared. After having 4 hand surgeries, I know what pain is, and I'm thinking it may be worse to know what I'm getting into. Then again, I really have no choice, so must make the best of it.
Sorry it to ramble it just seems to help to get it written down as I think about it all. I just have to remember - one step at a time.
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