Preparing for Surgery & Procedure

:: Preparing for Surgery

After consulting with Dr. Altenburg you will speak with his receptionist on choosing a date for your surgery. Please incorporate time for recovery when choosing this date. Full recovery is considered 6 weeks. Dr Altenburg performs surgeries on Tuesdays and Thursdays and Portneuf Medical Center. He does prefer to do revisions on Thursdays. Once a date in decided you will be asked to attend a coulple of pre-operative appointments that Dr. Altenburg's receptionist will set up for you.

Two to Four weeks prior to Surgery

• We require all patients to undergo medical clearance by the hospitalist team at Portneuf Medical Center. This appointment will consist of a complete physical, lab work, and EKG. This is for your safety and is a very crucial part of surgery.
• You may be asked to attend joint school. This is not required for all patients but is highly recommmended. Joint school is an educational class put on by Portneuf Medical Center. During this class hospital staff will come speak to you reguarding what to expect during surgery. This staff consist of: physical therapist, licensed social worker, and surgical floor nurse. It is also recommended you bring a family member or friend with you to this class.

One week prior to Surgery

Stop taking any aspirin, anti-inflammatories, and anti-coagulant medications as instructed. If you have any questions please contact your physician.

Day before Surgery

• You will need to come back the day before surgery to speak with Dr. Altenburg. At this appointment he will go over the procedure, equipment used, benefits and risks of the surgery. We may also ask for some additional x-rays if needed. If you have any last minute questions this is the time to bring them.
• His receptionist will tell you what time to check into hospital
• Do not eat or drink anything after midnight the night before surgery.

Day of Surgery

• Please leave all valuables at home.
• Remove all excess make-up, nail polish, and body peircings prior to checking into the hospital.
• Check into hospital admissions at the time instructed.

Anesthesia

There are two options for anesthesia: General or Regional. We prefer the use of a spinal (regional), as it allows for pain control immediately post op, and tends to minimize anesthetic side effects including, but not limited to, nausea, vomiting, corneal abrasions, etc. Some patients that have spine pathology, or bleeding disorders may not be candidates for the regional block. In this case, general anesthesia will be used.

Spinal vs. Epidural:

In the majority of cases, a spinal block is sufficient as opposed to an epidural. The two blocks differ in the location of the medication into the spine and an epidural is convenient for long cases, where the anesthesiologist can continually dose, according to the time. A spinal block is typically adequate for our procedure as surgical time is usually always under three hours. The anesthesiologist will speak with each patient prior to the procedure to go over the pros and cons. Ultimately, the decision is made by the patient.

One of the most frequently asked questions is, "Will I be awake for the procedure if I use a spinal?" This decision is also made by the patient. Prior to the block, the patient is sedated so they feel very sleepy and unaware of the injection. In most cases, the patient prefers to sleep during the procedure, so after the regional block is completed, additional sedation will be given so the patient can sleep during the surgery. This should also be discussed with the anesthesiologist the day of surgery.

Post Surgery

• You will be discharged from the hospital with Home Health Services. Nursing and Physical Therapy will come three times a week.
• Your blood will also be drawn three times a week for Coumadin Therapy.
• Please remeber your post operative appointment with Dr. Altenburg. Total knees two weeks post surgery, total hips six weeks post surgery
• Total knees will start outpatient physical therapy after their two week follow up appointment. Total hips - there is no therapy required after home health is finished.

Post Surgery Precaution

Please call the office if you are expierencing any of the following:

• Fever greater than 100.5
• Progressively increasing pain
• Excessive bleeding or drainage
• Reddened or painful calf

Persistent nausea or vomiting