While you are in surgery, drains and catheters are inserted to remove fluid from your body. A Foley catheter will drain out your urine for about 24 to 36 hours. Surgical drains will drain blood and other fluid from the incisional area for 2 to 3 days, preventing the formation of a painful hematoma. We will empty these drains every 12 hours and record the amounts. If you feel the drains are heavy, please ask us to empty them for you. The removal of drains and catheters produces a momentary unpleasant and even painful sensation that usually does not require medication. Once in a while a Foley catheter needs to be reinserted after it is discontinued. This is not a set back. After about 12 hours, it will be removed again.
You will receive antibiotics through the IV to prevent infection. Signs of infection are redness, swelling, heat, tenderness, or excessive pain at the surgery site. Drainage from the incision and fevers may also indicate infection. We will be checking you frequently for these signs.
Complications from surgery and prolonged bed rest include deep vein thrombosis (blood clots) and postoperative pneumonia (lung congestion). We will work with you to prevent these complications in several ways.
To prevent blood clots, we ask that you pump your ankles back and forth to simulate walking. Walking is actually the best prevention but we realize you have limitations. Some of you will be wearing white support hose (TEDs) which will be removed twice a day for an hour at a time. They fit tight but not so tight as to cut into your skin. Let us know if you experience pain or burning with these hose. While you are in bed, you will wear a compression device on your legs or your feet that will squeeze and release at intervals. Both the TEDs and the compression devices keep your blood from clotting. If you are having a joint replacement, you will receive a blood thinner called Coumadin (Warfarin) for several weeks after your surgery to prevent blood clotting. Instructions will be given to you about the side effects of Coumadin and about Coumadin's interaction with certain foods.
In most cases, you will be out of bed with Physical Therapy the morning after your surgery. You will be out of bed at least twice a day or more during your hospitalization unless the doctor indicates otherwise.
To prevent lung congestion, you need to deep breathe and cough frequently. We will give you a plastic device called an Incentive Spirometer. The incentive spirometer helps you exercise your lungs. Please see the instructions for Incentive Spirometer Use. You need to use the incentive spirometer 10 times an hour while you are awake. Often, a fever after surgery is due to lung congestion and vigorous work with the incentive spirometer will return the temperature to normal.
You will be assisted with a daily bed bath. Showering is not allowed until your incision is closed. If you need to use the bathroom, we will assist you to get there. Sometimes it is easier to use a bedside commode or bedpan. Please call us.
Your surgical dressing may stay on for several days before the doctor changes it. If it feels wet or becomes soiled, please tell the RN or Care Partner. If your incision is open to air, please do not let anyone touch it.
The phlebotomist will take a small sample of your blood each morning as ordered by your doctor. These samples will determine your Coumadin dose, if you have had a joint replacement, and whether or not you will need a blood transfusion or electrolyte replacement.
The nursing shift changes at 7am and 7pm for a 30-minute exchange of report on all the patients between the RNs. During that time, the Care Partners are available to answer your calls. If your pain is increasing before 7 o'clock, please call us so we can medicate you sooner rather than later.
Your family and friends are welcome to visit. Our visiting hours are open and flexible. Because our rooms are semiprivate we ask that no more than 3 visit at a time. A federal regulation prevents us from giving out information about you over the phone. We will be happy to forward calls to your bedside. If you do not want calls or visitors, please let us know.
If you have any questions about this portion of the website, please contact us at orthospineinfo@mednet.ucla.edu.
