Our Care Plan

Initial meeting

During your initial meeting Dr Graham will:

Ask detailed information about your symptoms and history of your current and past ailments,
Review any x-rays, diagnostic reports or other documents available to him,
Perform a thorough physical examination

To confirm a diagnosis other possible diagnostic investigations such as blood tests or imaging tests may be additionally required.

After reviewing these results, Dr Graham will recommend appropriate treatment options.

Treatment options & plan

Dr Graham will take time to explain your options for treatment. Depending on the diagnosis your solutions may include:

Watchful Waiting
Non-Surgical
Surgical

It’s not uncommon to have questions, Dr Graham encourages you to seek clarification on any issue. He is very approachable and happy to assist with enquiries.

Our aim is to provide you with all the information that you need to make informed decisions about managing your health. If you still have questions after leaving the office, please do not hesitate to contact us - we are here to help.

Where surgery is the chosen path, our staff will detail costs and other logistics with you.

Preparing for surgery

Once it is decided that surgery will help you, you'll need to learn what to expect from the surgery and create a treatment plan for the best results post surgery.

As you prepare for your surgery, it is important to be proactive. Preparing mentally and physically for surgery is an important step toward a successful result.

Before the surgery, you should make sure that you understand what the surgery entails and also what to expect in the weeks and months to follow. Understanding the process will help you recover faster.

Before joint replacement surgery, you will be required to attend a Pre-Admission clinic at your chosen Hospital location. There they will carry out a complete physical examination to make sure you do not have any conditions that could interfere with the surgery or the ideal outcome.

Other pre-surgery activities could include:

Final Testing - Routine tests, such as blood tests and x-rays, are usually performed a week before any major surgery.
Medications - Discuss any medications you are taking with your doctor and your family physician to see which ones you should stop taking before surgery.
Aspirin - If you are taking aspirin or anti-inflammatory medications or warfarin or any drugs that increase the risk of bleeding you will need to stop taking them one week before surgery to minimise bleeding (please confirm with Dr Graham or your GP prior to ceasing any medication).
Blood Bank - Discuss with your doctor options for preparing for potential blood replacement, including donating your own blood, medical interventions and other treatments, prior to surgery.
Weight Loss - If you are overweight, losing weight before surgery will help decrease the stress you place on your new joint. However, you should not diet during the month before your surgery.
Tobacco - If you smoke, you should stop or cut down to reduce your surgery risks and improve your recovery.
Gum Disease -Tooth, gum, bladder or bowel problems should be treated before surgery to reduce the risk of infection later.

Other pre-surgery activities to consider include:

Diet - Eat a well-balanced diet, supplemented by a daily multivitamin with iron.
Infections -Report any infections to your surgeon. Surgery cannot be performed until all infections have cleared up.
Support - Arrange for someone to help out with everyday tasks like cooking, shopping and laundry.
Easy Reach - Put items that you use often within easy reach before surgery so you won't have to reach and bend as often.
Safety Precautions - Remove all loose carpets and tape down electrical cords to avoid falls. Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.

The procedure

On the day of surgery, you will be under general anesthesia for the duration of your procedure (go to the procedure page on this website). Or, if you are having Day Surgery, remember the following:

Have someone available to take you home, you will not be able to drive for at least 24 hours.
Do not drink or eat anything in the car on the trip home. The combination of anaesthesia, food, and car motion can quite often cause nausea.
After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours.

Initial post operative expectation

Hospital Recovery

After the surgery, you will wake up from anaesthesia in a recovery room or intensive care unit (ICU). After the surgery, you will continue to receive fluids through the IV inserted in your arm until you are able to tolerate regular liquids.

Your diet will be gradually changed from fluids to a regular diet.

Physical activity in most cases will start on the first or second day after your surgery with joint replacement. Arthroscopy and ACL procedures will see you up and moving on the same day. Your nurses and physical therapists will assist you with this activity until you feel comfortable enough to progress on your own.

To help you with your home recovery, your surgical team will give you some instructions to follow. If unsure you should ask for clarifications and follow these instructions closely and diligently.

Ongoing care

After your procedure, regular post-procedure follow-up visits are important to ensure your complete recovery and a successful outcome.

Your hospital discharge instructions will have the details of your initial post operative. Regarding joint replacements, Dr Graham's staff would have already made this appointment and you will have this information. Depending on your surgery your first visit may be scheduled 14 days to 6 weeks after the procedure.

You may be required to have regular follow up visits – six weeks, three months, six months, nine months and then annually to assess your recovery and progress.

Other appointments may be arranged if any post-operative problems arise.

Home recovery

Remember to arrange for someone to take you home, as driving may not be recommended for several weeks following surgery.

After the surgery, pain medications and antibiotics are prescribed to control pain and prevent infection. Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty controlling the pain.

Your doctor and other members of the hospital staff will also give you some self-care instructions for you to follow at home that are crucial to your recovery. These are a list of "dos and don'ts," which you will be asked to follow for the first 6 to 8 weeks of your home recovery. These may include the following:

Get plenty of rest.
Abstain from smoking as nicotine slows bone healing.
Good nutrition is essential for a successful recovery. Eat a healthy diet, high in protein and rich in fresh fruits and vegetables and drink plenty of fluids. Avoid heavy, fattening foods and foods that are high in calories.
Avoid carrying or lifting anything heavier than 4.5 kilograms.
Avoid bending at the waist. Rather, bend at your knees to pick up things. Also, avoid twisting the back.
Check with your doctor when you are allowed to return to driving.
Avoid any strenuous activities including strenuous house work. Do not go swimming, golfing, running or participate in any other sports activity until your doctor permits.
Most dressings are waterproof and showers can commence after surgery. Observe dressings regularly to ensure they are watertight.

Wound care

When you will be discharged, you will still have a surgical dressing on your incision(s).

Dressings are usually left intact until the first post operative visit. If there are issues with the dressings these may require earlier review with the surgeon or GP.

If any of the following signs of infection are observed, you should call your doctor immediately. These signs include:

Fever higher than 38.5°C
Increase in redness or swelling around the incision(s)
Extra fluid drainage from the incision(s)
An opening of the incision has open areas along its length
Experiencing chills, nausea/vomiting
Suffering any type of trauma such as a fall or a car accident
Difficulty in urinating or controlling your bowel movements

And in such a situation you should contact your doctor immediately.

Rehabilitation program

The rehabilitation program includes physical therapy, which is started soon after the surgery and is very important to strengthen and provide mobility.

Our support team or physiotherapist will prepare an exercise program. Much of the exercise program can be done at home or at a gym, under your physiotherapist’s guidance.