Thank you for making Hamilton Medical Center your choice for your healthcare needs. Through expertise, technology, and a caring touch, we have made it our goal to exceed your expectations as we care for you and your family. Call 706.272.6511 or email jointmoves@hhcs.org for more information on class days and times.
If you have any questions, now or in the future, please contact Ashley Painter, Orthopedic Nurse Navigator, at 706.272.6511 or jointmoves@hhcs.org.
Causes of Shoulder Pain
The most common cause of shoulder pain is arthritis. Osteoarthritis is most common in people over 50 years of age and in people with a family history of arthritis.
Why a Shoulder Replacement?
When your everyday activities are being limited due to stiffness and pain, and you have found little relief from more minimally invasive treatments, it might be time to consider a total shoulder replacement.
Shoulder Replacement
There are two types of shoulder replacement surgeries: conventional shoulder replacement surgery and reverse shoulder replacement surgery.
A conventional shoulder replacement surgery implants a device that mimics the normal anatomy of the shoulder. A plastic “cup” is fitted into the shoulder socket (glenoid), and a metal “ball” is attached to the top of the upper arm bone (humerus).
In a reverse total shoulder replacement, the socket and metal ball are switched. The metal ball is fixed to the socket and the plastic cup is fixed to the upper end of the humerus. Your physician will discuss which option is best suited for you.
Find out more by attending our next Joint Moves Weekly Pre-Operative Educational Session. This class is held on the second Thursday of each month at 2:00 p.m. and the fourth Tuesday of each month at 6:00 p.m. The class is taught by Orthopedic Nurse Navigator, Ashley Painter, RN. You will learn to prepare for before, during, and after your joint replacement surgery. Call 706.272.6511 or email jointmoves@hhcs.org for more information.
Pre-Admission Testing
Blood work, a urinalysis, an EKG, and a chest x-ray will be administered as part of pre-admission. These tests will be done in your physician’s office or at the hospital in the pre-admission testing area. Please bring a complete list of all your medications (or the bottles) to your pre-admission visit.
During your pre-admission visit at Hamilton, your nose will be swabbed and sent to the lab to screen for antibiotic-resistant infections. You will also meet with an Anesthesiologist during this visit.
Your primary care physician may ask you to discontinue medications like Coumadin, Plavix, and aspirin 5 to 7 days before surgery.
If you are experiencing any problems with your teeth, an evaluation with a dentist before surgery may be needed. Infections can enter the bloodstream through the gums. Treating dental problems before surgery will decrease the risk of developing an infection.
Shower with Hibiclens (CHG) before surgery. On Page 8 within the booklet, there are specific instructions. Please follow these step-by-step.
The Night before Surgery
Do not eat or drink anything after midnight.
The Morning of Surgery
Upon arrival to the hospital, please check-in at the Admission desk. A pre-operative Registered Nurse (RN) will greet you and your family. A hospital gown and a warm blanket will be provided. The RN will start an IV. A sequential compression device will be placed on your non-operative leg to help prevent blood clots from forming in your legs. The RN will wash your operative leg and place sterile towels around it.
Antibiotics will be started through the IV. The surgeon will mark the surgery site and answer any questions you may have.
An operating room RN will transport you to an operating suite. The RN will ask questions about your surgical procedure. An anesthesia provider will be waiting in the suite. The anesthesia provider will monitor your vital signs throughout your procedure.
What happens after surgery?
After surgery, your surgical team will escort you to the recovery room where a post-anesthesia care RN will take care of you. A large pillow will be placed between your legs to remind you not to cross your legs. Once you are fully awake, you will be transported to your room.
IV fluids will continue the first day of surgery. Once clear fluids are tolerated, a regular diet will start.
Pain
During your hospitalization, your pain will be treated by a multimodal approach. This means that your doctors will use multiple oral, and possibly intravenous medications to treat your pain.
Your nurse will ask you to rate your pain using a pain scale so that you will receive the appropriate level of treatment for pain based on your physician’s orders. It is important that you communicate with staff regarding your level of pain and the degree of relief obtained. A common side effect of pain medication is nausea. Your physician will include orders for medication to reduce nausea, but it is important to take this medication prior to its onset. Please remember to take your pain medication with food.
It is important to start your pain medication before the pain becomes severe. It is also important to schedule your pain medication prior to physical therapy.
Most pain medications include acetaminophen. Adding additional Tylenol to this medication could affect your liver function. Please discuss this with your physician prior to taking.
You will also start receiving stool softeners during your hospital stay. These should be continued at home. A very common side effect of pain medication is constipation.
Diabetic Patients
Patients who have diabetes will have their blood sugar is monitored throughout their surgical experience. This will help with the healing process.
Activity
After surgery, it is very important that you take deep breaths and cough every hour while awake. The nurse will instruct the use of an “incentive spirometer.” This device should be used every hour while awake to help prevent pneumonia after surgery.
Once you have been sent to your hospital room, Physical Therapy will see you within 6 hours from the time you arrived in the Post Anesthesia Care Unit. They will provide you with a walker and assess the strength of your surgical leg. Most patients are able to walk at this time. The goal before discharge will be to walk at least 150 feet. Your surgeon would like you to get out of your bed for all meals and to walk at least 3 to 4 times a day. If you have stairs at home, please let physical therapy know. They will provide you with an assessment and further education to meet those needs. Please have family present during your Physical Therapy Sessions. Physical Therapy will see you again the next morning to continue your exercise program.
For safety, always use your walker until your therapist is in agreement that you are stronger to use another device. Never use your walker to pull up from your chair.
- Obtain a raised toilet seat or bedside commode, it will make it easier to get up and down.
- When you are going up or down stairs, use your stronger leg first.
- Do not turn or twist your operated leg.
- Continue to use your ice packs for pain and swelling, they should go home with you from the hospital.
Going Home
Discharge from the hospital will occur 1 to 2 days after surgery. Physical therapy will continue at home with a home health therapist or return for outpatient therapy. Someone will need to be at home with you for the first week.
Medicines
Prescriptions for pain and medicine to prevent blood clots are giving at discharge. Hamilton’s pharmacy (HMC Rx Care) can fill those for you.
