How Medical Procedures and Hospital Stays Have Changed

[MineralMan]

My wife had hip joint replacement surgery on Monday morning at 7:30 AM. By noon, she was up, using a walker and getting physical therapy. The next day, she came home at about 2 PM after two PT sessions. Remarkable, really. They do the surgery with a spinal block and major tranquilizer. As soon as the spinal block wears off, they get you up.

So, today, she's home and back at her desk off and on, doing normal things. The walker for a few days, then a cane and then, well, back to normal. She has no particular restrictions on movement, no stitches to be removed, and remarkably little pain. They gave her some oxycontin pills, but she hasn't felt the need, and is taking Tylenol instead. the bandage over the incision is waterproof, so she just got out of the shower, with me standing by, just in case. She has a followup appointment in a couple of weeks to remove the bandage and that's it. She has some exercises she's supposed to do, but the main advice was to walk as much as she can tolerate.

One of the physical therapists at the hospital said that hospital stay time for that surgery has gone from 10-12 days when she started working at her job, and now, a lot of patients head home the day after surgery.

It's remarkable, really. Remarkable.

[gademocrat7]

1. Glad your wife is recovering well.

[MineralMan]

4. Yeah. Me, too!

[catbyte]

2. Times have changed. I had an appendectomy in 1974 & was in the hospital for 5 days. My

husband had his around 2002 & they kicked him out the next day. Neither one of us had complications. $$$ talks!

I'm glad that your wife is okay.

[Warpy]

3. Part of that is the improvement in the prosthetic hips

There used to be a lot of movement restrictions around the old ones like no sitting, needing to sleep with a foam pillow pushing your legs apart. It's no wonder that people who broke hips had a 50% mortality rate within 6 months.

And that was better than having a hole drilled through your tibia for traction for several months.

Medical care has improved greatly and convalescence at home makes sense for most people.

[MineralMan]

5. Yes. And apparently, they do the surgery differently, too.

She had an anterior incision, rather than the posterior approach that they used to use. That older surgery required cutting a muscle. None of that with her surgery. I suppose if I have to have one eventually it will be done as outpatient surgery.

Now, if everyone could afford to have these things done if they needed them. Sadly, that is not always the case. We'll hit my wife's out of pocket maximum just from the 20% of the costs. But, after that, the year is free sailing, so that's not so bad. We have the money to cover that right now, so no worries.

[MuseRider]

6. Sitting in a waiting room right now

awaiting a doc to tell me what my poor hip needs. I think in this case it is much better this way.

[LeftInTX]

7. I'm glad to hear everything went well

She didn't have general anesthesia???

I had knee surgery in 2013. They gave me general and local. The local really helped with the post-op pain and lasted for hours. Even with general, I was singing, "If I had a hammer" as I spit the tube out. I felt it - LOL!!!

[MineralMan]

9. Nope. Just a spinal block and propofol.

The anesthesiologist made a point of calling it the Michael Jackson drug. I guess he thought that was funny. I didn't so much.

[LeftInTX]

10. Amazing!! How long did the surgery take?

(Mine took about 20 minutes)

[MineralMan]

13. Well, from the time she went into

surgery until she was in the recovery room, about 90 minutes. Of course, I was watching the board in the surgical waiting room, so I'm not sure how long the actual surgery took.

[CountAllVotes]

29. It is not funny

I don't take any jokes re: the late Michael Jackson to be "funny".

Said drug is one that is very necessary and your wife would have never gotten through the surgery she had as easily as she did without it.

As for Michael Jackson, Leave Him Alone IMO.

[ismnotwasm]

8. We want short as possible hospital stays

Congratulations on a successful surgery

Hospitals are great places to get sick--longer stays are not associated with better outcomes. The bundling Medicare reimbursement is also a factor. Also, Hospitals don't get paid for hospital acquired pneumonia, urinary track infections, central line infections, or pressure sores.

[MineralMan]

12. After the recovery room, joint replacement patients are

whisked away to a floor dedicated to those patients and with its own dedicated staff at the hospital she was at. Less chance for infections I guess. They were pretty strict about hand contamination, too.

As the shift nurse said, "We have no sick patients on this floor."

It was a pretty slick process, overall, I thought.

[ismnotwasm]

18. It sounds like you were at a good hospital

[MineralMan]

19. It was the one in her network.

Lots of very good hospitals here in the Twin Cities of MN. We have a great healthcare system available here.

[ismnotwasm]

21. I am glad to hear it

All hospitals try I feel, some have poorer management or a lack of resources. We have good systems here in the Seattle area as well, but you do hear the occasional horror story.

[sheshe2]

11. Glad your wife is recovering nicely, MM.

Best to you both.

[mrmpa]

14. I'm not one for long stays.....

But next day release I think is crazy. What about the possibility of infection or you live alone and are isolated from family and friends?
I had my toe amputated in December, the surgeon wanted to send me home about 2 hours after the surgery, but the internist wouldn't. allow that to happen until the next day and it was a late release.

[MineralMan]

16. She doesn't live alone. She lives with me.

You're far more likely to get an infection in a hospital than at home anyhow. The reality is that the bandage on her incision is waterproof, so it's unlikely to become contaminated. They released her because she had met all of the physical therapy goals, and because she had a caregiver at home. They don't release patients who don't have the support they need where they are going.

Frankly, there wasn't really much reason to keep her any longer than that. She was ambulatory, could get in and out of a car and in and out of bed and the shower on her own. What would the hospital do that she couldn't get at home? I help her with anything she needs and I'm just about to go up and help her do the prescribed exercises, which I observed during her PT sessions.

We know what to watch for that might be a problem, and she doesn't need any skilled nursing care.

[mrmpa]

23. I understood that she lives with you...

I was responding to your post in a general way. Not specific to your circumstances.

[The Sand Reckoner]

32. Not only is there significant risk of infection in a hospital

but hospitals are where some of the nastiest, most drug-resistant bugs reside. Always best to come home as soon as possible.

[Maeve]

15. So glad to hear!

Tell her how many responses and cheers are flooding to her from DU!

[MineralMan]

17. I will. Thanks!

[kcr]

20. It really is amazing.

It sounds like your wife is doing well and that is good news.

[Waldorf_]

22. It is remarkable. I had liver surgery last summer for cancer. Was in recovery all day. Got to my

room around 10:30 at night. At midnight two nurses came in and said "Time to get out of bed and walk a few steps". I thought they were crazy. 20 yrs. ago I would have probably been confined to a bed for a week or so.

[Lucinda]

24. I am so glad it is going well for her!

I have severe osteoarthritis in both hips, and to a lesser extent, both knees, so I expect mine will be a much longer process because of the damage to the other joints holding up my rehab.

Editing to remove my question which I see you answered already. I had the window open for a while and you must have mentioned it before I posted!

[Ilsa]

25. Was it the Anterior procedure? I heard

Great things about it, but haven't seen one yet.

It was a lateral hip procedure when I did floor nursing.

[MineralMan]

35. Yes. Much easier recovery, I hear.

[MicaelS]

26. Best wishes to your lovely wife.

And you, of course. Thanks for a positive story amidst all the negatives.

[guillaumeb]

27. Best wishes to your wife, and you also.

[Aristus]

28. While shorter hospital stays are often associated with insurance company stinginess,

(and rightly so,) a lot of hospital stays have shortened due to improved, less invasive medical procedures.

[CountAllVotes]

30. yes, and some are released way too soon

They are supposed to keep patients with serious pre-existing conditions overnight for observation.

They failed to do this with me. It was a grave error is all I will say about it.

Shame on these greedy pigs.

[Aristus]

33. I agree.

[unblock]

31. standing by as she showers, "just in case"

say no more, say no more; nudge, nudge; wink, wink!

[MineralMan]

36. LOL!

[MindPilot]

34. It is amazing. My mom had a hysterectomy back in the 60s.

She was in the hospital for well over a week, and had an incision that looked like they had started an autopsy.

Couple of years ago my GF had the same thing. We checked in at 7, and were home before noon; that included a trip to the pharmacy. Her incisions had a couple of bandaids.

Glad your wife is doing OK!