| al management for the different varieties of arthritis | | | | now offer instruction on how to prepare for the |
| has improved tremendously over the last 20 years. | | | | operation and what to expect afterward. The classes |
| However, there are still many patients for whom | | | | are usually very instructive but even better, they let |
| medical management either doesn’t work or | | | | you interact with other people who are going to have |
| who progressive joint damage that requires surgical | | | | the same type of procedure. |
| intervention. | | | | Ask about the potential risks. What are they and what |
| The thought of surgery is frightening because of the | | | | are the relative odds? While this is no guarantee either |
| many potential risks that can occur whenever general | | | | way, it will give you a ballpark figure. |
| anesthesia and a major surgical operation are | | | | Find out where the surgery will be done. What is the |
| considered. | | | | infection rate at that institution? |
| Here are some tips and questions to consider before | | | | How long is the surgical result supposed to last? When |
| proceeding with joint replacement surgery… | | | | will it need to be repeated? What are the possible |
| Sometimes there are conventional medicines that | | | | complications for a repeat operation? |
| haven’t been tried yet that might offer relief. | | | | What are the activity limitations immediately following |
| You need to make sure your rheumatologist has | | | | surgery? What is the estimated time for rehabilitation |
| looked at them all. | | | | and recuperation? |
| A change in dosage – ie. an increase- may be all | | | | Will you need to go to a rehabilitation facility or will you |
| that is required. Sometimes the use of two medicines | | | | be able to go directly home from the hospital? |
| together is a solution. There may be synergy. | | | | If you are employed you will need to have a good idea |
| Make sure all the different options other than surgery | | | | as to how long you’ll be out of work. |
| have been explored. Sometimes clinical research trials | | | | What types of educational material, ie. books, |
| will offer a treatment that is very effective but that is | | | | pamphlets, videos does the surgeon have to look at |
| currently not available to mainstream patients. | | | | that might paint a clearer picture of the operation? |
| If surgery is a definite, then find out what the different | | | | Are there other patients who have had the same type |
| surgical options that are available could be. Sometimes | | | | of surgery you can chat with to get a better idea as |
| minimally invasive procedures will be involved and that | | | | to what to expect? |
| would be a plus. | | | | Are there any preparations that will be required before |
| Do your homework! The internet is a great source of | | | | surgery? For instance, patients will often be asked to |
| information. | | | | bank their own blood before the operation. |
| Make sure you get at least two opinions. | | | | Talk with your rheumatologist about your medications |
| Check out the credentials of the surgeon. What is his | | | | and ask whether you need to discontinue any of them |
| or her success rate? What is his or her complication | | | | prior to the operation. Often, rheumatologists will ask |
| rate? | | | | patients to temporarily discontinue methotrexate and |
| How many procedures of the sort you’re going | | | | biologic medications a few weeks before the |
| to have do they do in a given year? A surgeon who | | | | anticipated operation. Non-steroidal anti-inflammatory |
| only does one or two a month is not going to have the | | | | drugs (NSAIDS) also need to be held a few days |
| experience of one who does joint surgery daily. | | | | before surgery as well. |
| Consider going to a pre-surgery class. Many hospitals | | | | |