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Slide 2 Pre-Op Shoulder Surgery Information Welcome! Slide 3 Goals Inform the patient about what to expect Before, during, after surgery Reduce anxiety Answer questions Help you become better-prepared Slide 4 Information From The Nurse Slide 5 We Care About You!!! In an effort to personalize your care while in the hospital, please let us know of any needs ahead of time If you have any specific requests, please contact the Patient Navigator at 866-552-9357 Slide 6 What To Bring List of medications and allergies Glasses, hearing aids, dentures Flat, supportive, non-slip walking shoes Incontinence products -you may prefer a specific product not provided by hospital (If staying overnight) Slide 7 What To Bring Comfortable and loose clothing to wear after surgery Oversized T-shirt or button-down shirt Wear 2-piece outfits (i.e. top and bottom) Slide 8 On the Day of Surgery CHG (Chlorohexadene Gluconate) wipes will be used to cleanse and disinfect the surgical site before surgery begins CHG reduces bacterial growth on the body CHG will help reduce the chance of infection following surgery Slide 9 Equipment After Surgery Slide 10 Oxygen Used a short time Let us know if you have sleep apnea and if you use oxygen or CPAP/BiPAP at home (if so, bring mask and machine with you to hospital) Slide 11 IV or Intravenous Therapy May have one or two lines Fluids (blood, antibiotics, pain medication) Will leave it in until not needed. Slide 12 Dressings and Drains You may have a drain in place. Leave the dressing on until the Doctor says to take it off. Slide 13 Foley Catheter To Drain Urine Rotator Cuff patients typically do not have catheter placed Total Shoulder patients usually do have catheter placed Helps to keep track of fluid balance Put in after you are asleep Slide 14 Interscalene Nerve Block/Catheter ***Some surgeons prefer not to use this*** Numbs the shoulder region Patients will also receive IV sedation to go to sleep Stays in from one to two days Some patients may be sent home with catheter in place Slide 15 Shoulder Sling/Immobilizer Purpose: to immobilize arm after surgery Length of time: dependent on Physician Keep shoulder still! Do not remove sling unless instructed by your Physician or Slide 16 Fall Precautions After surgery, it is common to be off balance and unsteady For your safety, you may not get up on your own and must call for assistance Slide 17 Cryotherapy - Polar Care Device Your Physician may choose to use cryotherapy (cold therapy) Sends a cold signal to the brain to help with pain management Helps with pain and swelling You take this home with you Ambulatory or Day-Surgery/Outpatient patients may or may not have Polar Care ordered Slide 18 Rating Pain 0 to 10 pain scale Pain patterns Mechanical Pain Surgical Pain Slide 19 Know the Zone! Our staff will make every effort to help control your pain We will automatically give you pain medication around the clock We ask that you partner with us and ask for additional pain medicine if needed Alternative pain options may be used such as cold therapy and distraction Our goal is to keep you in the 3-4 Pain Zone (or less) Slide 20 Compression Devices (While in the hospital) Helps prevent blood clots Worn on the calf of each leg Help to push the blood back into circulation Wear them when you are in bed or in the chair Slide 21 Walking and Exercising Helps to prevent blood clots from forming Exercise in and out of bed Ankle circles, foot pumps, tightening leg and buttocks muscles Slide 22 Diet Initial diet is typically clear liquid unless otherwise designated by your physician Diet will advance as tolerated Constipation due to pain medications High fiber Increase activity Fluids Nausea-will have medication available Slide 23 Call for Help Never get out of bed or chair unless you call for assistance Call as soon as possible. Try to ask for help when a staff member is already in the room. Slide 24 Discharge Discharge from the hospital will occur 1 to 3 hours after surgery ends Slide 25 Discharge Plan Transportation (depends on what is medically necessary) Most patients will go home in a car with family or friends. Slide 26 Prescriptions Your Surgeon will typically write prescriptions for Pain medications Anti-inflammatories Antibiotics (if needed) Nausea (if needed) Slide 27 Follow-Up Follow-up appointments are usually within 5- 10 days after discharge from the hospital During your Pre-Op visit to your Surgeons office, your Post-Op follow-up date and time will be scheduled Slide 28 Precautions In most cases, your shoulder will be immobilized in a sling following surgery You will not be permitted to move your arm until your Physician/Therapist say so This includes no lifting, pushing, pulling, sports, etc. Slide 29 Therapy Progression Passive Range of Motion (PROM) Active Assisted Range of Motion (AAROM) Active Range of Motion (AROM) Resistive Exercises *** In order to prevent injury, Passive Range of Motion should be maintained until your Physician and Therapist advance your therapy Slide 30 Activity Your Surgeon and/or Therapist may instruct you to squeeze a ball or towel to decrease hand or arm swelling Slide 31 Prior to Surgery You may want to practice performing basic activities (bathing, dressing, eating, etc.) before your surgery using only the non- operated armespecially if your operated arm is your dominant arm Slide 32 Positioning Use pillows or rolled towels to position/support arm while lying in bed or sitting in chair Its not uncommon for patients to sleep in a recliner because it can be a comfortable position Slide 33 Positioning Seated (reclined) Supine (on back) Side-Lying (on non-operated side) Slide 34 Infection Prevention To prevent infection, do not get incision wet until your Physician says it is alright Slide 35 Helpful Tips Pick up loose rugs and move furniture to the edges of the room, make sure pets are out of the way While at home prior to surgery, move low- and high-lying items to waist level (i.e. in kitchen/bathroom cupboards, refrigerator) Arrange to be transported home in a car that is easy to get in/out of Slide 36 If You Are Staying Overnight Please bring toiletry items Toothbrush Toothpaste Incontinence products-you may prefer a specific brand not provided by the hospital Books, magazines, hobby items Slide 37 If You Are Staying Overnight You will be oriented to your room Call bell TV Controls/Volume Thermostat Slide 38 If You Are Staying Overnight Medications you receive in the hospital may come in different colors and/or shapes than the same medication you take at home Always ask nurse what meds are for Slide 39 If You Are Staying Overnight Your Surgeon may choose to use a PCA machine PCA - Patient Controlled Analgesia Pain Button Administer to self Close monitoring NO ONE IS TO PUSH THE BUTTON EXCEPT THE PATIENT!!! Slide 40 If You Are Staying Overnight Preventing Fever and Pneumonia Incentive Spirometer Breathe in 10-12 times an hour while awake Helps to expand air sacs in lungs Slide 41 If You Are Staying Overnight Condition H (Help) Dial 3111 and give room number Gives family and friends a way to call a Medical Emergency team to the bedside Call if You notice a change in your loved ones condition You still have serious concerns about your loved ones condition after speaking to the healthcare team Slide 42 If You Are Staying Overnight Dial L.O.U.D. (5683) on phone if sleep disturbed Anonymous call TIGR TV Channels Relaxation/Meditation channels Comfort Cart Slide 43 If You Are Staying Overnight Before going home You may fill your prescriptions at our Plaza Pharmacy (Located on the First Floor of the hospital) Hours of Operation: Mon-Fri (9:00AM-4:30PM) (919) 954-3921 Slide 44 Discharge Please remember that once the Physician has written orders to discharge you home, there are still many things that have to be completed before you will be leaving the hospital. We want to make sure you have everything you need-prescriptions, home health or rehab arrangements, and information about your home care. Sometimes this process can take up to 4 or 5 hours. We know youll be eager to leave the hospital, and we want to be sure everythings in place to ensure a smooth and safe transition. 43 Slide 45 If You Are Staying Overnight Physical Therapy Slide 46 If You Are Staying Overnight Physical Therapy Treatment Sessions Available seven days/week One or two sessions per day with the Therapist A Physical Therapy/Occupational Therapy evaluation will be performed (if you are staying overnight in the hospital) Slide 47 If You Are Staying Overnight Occupational Therapy Slide 48 If You Are Staying Overnight Your Occupational Therapist will evaluate your adaptive equipment needs Reacher Sock aid Bathing sponge Slide 49 Pre-Surgical Checklist Please discuss the following with your Surgeon before surgery takes place Date and time of follow-up appointment(s) Date and Time of Therapy appointments When you can shower When you can drive Exercises to perform at home Activities allowed/not allowed following surgery Slide 50 Thank You!!!