Re: Tramadol/Outpatient Surgery Question

[Guest guest]

In a message dated 11/4/2006 3:33:35 P.M. Central Standard Time, cruisintheseas@... writes:

I do have one question for the group. My surgery center is getting ready to do TKR's here in the outpatient setting, keep the patient overnight, and send them home the next morning with an RN or LVN to take care of them at home. How does this sound to you? It is supposed to lower the infection rate (not being in a hospital) and increase comfort by getting home quickly

Hi , I've had both of my knees replaced, one at a time. I guess if you had someone a nurse with you 24/7 it might be better? It probably wouldn't have been at my house though, we have 2 dogs that are very attached to me in the house, and a cat. I had enough trouble keeping them away from my knee after 4 days in the hospital. I also really think that the hospital beds are easier to get in and out of at first. You can prop yourself up to eat and lower or raise the bed. I'm very short so I needed the bed lower.

[Guest guest]

I take Tramadol 2-3 times a day for osteoarthritis in my knees, right hip, and shoulders. I also have cervical facet syndrome and upper back pain. It is great for moderate pain, but if my pain gets severe I take Vicodin. I just wanted to thank everybody for all the great information on here. I haven't posted before, but i have been reading for awhile. I am a 47 year old nurse. I work in an outpatient orthopedic surgery center and I need a TKR in my left knee. Not having it done right away for a few reasons, the first one is mainly financial. I just cannot afford to not work right now for the months of rehab I would need. Second, is my age. I do have one question for the group. My surgery center is getting ready to do TKR's here in the outpatient setting, keep the patient overnight, and send them home the next morning with an RN or LVN to take care of them at home. How does this sound to

you? It is supposed to lower the infection rate (not being in a hospital) and increase comfort by getting home quickly Harnett <wjkh@...> wrote: "Also has anyone ever take Tramadol? Just wondering if that worked for anyone." Hi

Phyllis I have my THR in 3 weeks time, and used to use Tramadol for my damaged hip: It works ok for mild to moderate pain (it is a weak opoid) but is ineffective with strong pain. (I needed to switch to morphine.) All the best

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[Guest guest]

>I do have one question for the group. My surgery center is getting ready

>to do TKR's here in the outpatient setting, keep the patient overnight,

>and send them home the next morning with an RN or LVN to take care of them

>at home. How does this sound to you? It is supposed to lower the

>infection rate (not being in a hospital) and increase comfort by getting

>home quickly

OMG, I would have DIED! No way would I have wanted to be home that quickly

- I used the equipment the hospital provided, the round-the-clock care they

offer, and the lack of any responsibility (the meals just appear <G>), as

well as the training available. I also needed the higher-power pain meds

that are more available in the hospital than at home. In fact, I know my

doc would have let me go home after my Wednesday surgery on Friday if I had

wanted - I elected to stay until Saturday at noon, and was glad I did.

NOT a good idea, in my opinion .... and I totally believe in outpatient

surgery centers, as that is where my hubby makes his living as an anesthetist!

Ann

[Guest guest]

Well.......I would have to be talked into it. I think you need a

longer hospital stay than over night. At this point I would not be

comfortable with that set up.

On Nov 4, 2006, at 1:02 PM, Merlich wrote:

> I take Tramadol 2-3 times a day for osteoarthritis in my knees, right

> hip, and shoulders.  I also have cervical facet syndrome and upper

> back pain.  It is great for moderate pain, but if my pain gets severe

> I take Vicodin.

> I just wanted to thank everybody for all the great information on

> here.  I haven't posted before, but i have been reading for awhile.  I

> am a 47 year old nurse.  I work in an outpatient orthopedic surgery

> center and I need a TKR in my left knee.  Not having it done right

> away for a few reasons, the first one is mainly financial.  I just

> cannot afford to not work right now for the months of rehab I would

> need.  Second, is my age.

> I do have one question for the group.  My surgery center is getting

> ready to do TKR's here in the outpatient setting, keep the patient

> overnight, and send them home the next morning with an RN or LVN to

> take care of them at home.  How does this sound to you?  It is

> supposed to lower the infection rate (not being in a hospital) and

> increase comfort by getting home quickly

>

>

> Harnett <wjkh@...> wrote:

>> " Also has anyone ever take Tramadol?  Just wondering if that worked

>> for anyone. "

>>  

>> Hi Phyllis

>> I have my THR in 3 weeks time, and used to use Tramadol for my

>> damaged hip: It works ok for mild to moderate pain (it is a weak

>> opoid) but is ineffective with  strong pain. (I needed to switch to

>> morphine.)

>>  

>> All the best

>>

>>

>

> Cheap Talk? Check out Messenger's low PC-to-Phone call rates.

>

>

I am too blessed to be stressed

[Guest guest]

Hi ,

This sending the patient home has good points to it. Hospitals are places

where people under high stress are herded together. Stress creates stress

and this rubs off on health care workers and the patients. Some are saying

for every 24 hours you are in hospital you will have 1 medication mistake.

The risk of getting infections in hospitals is high. The cost of supplying

the normal necessities of life to the patient all add up to why the hospital

would implement this.

One advantage of health professionals treating people in their own home is

that they get to know so much more about the patient and their living

circumstances. The health professional could find the most suitable chair,

remove those scatter rugs, see the things that are likely to cause a problem

with recovery. I would imagine it would be essential to have staff who the

patient can relate well to.

One danger is that the patient will be left feeling totally unsupported and

not do the things they need to do for recovery if the support time is too

short or they find the staff member not supportive. I notice with my

clients that families tend to think that once a person has been discharged

from hospital they don't need assistance any more. Sometimes people having

major surgery seem to get less support from their family, once they are

discharged from hospital, than they do when they have the flu. I think the

thinking goes something like this " the hospital wouldn't have let them out

if they weren't ok to fend for themselves now. "

Another issue I see with older people is that in times of illness nutrition

can go out the window. Tea and toast, cheese sandwiches and the like are

easy to prepare when spirits and energy are low. Variety is often lacking

and takes energy to think about and prepare. At least in hospital a variety

of food is put in front of them. The reality is that for some of my clients

they haven't eaten so well in years. It is easy to overlook the value of

this aspect of institutional care.

As long as the patient is well supported it could be a good thing. Modern

medicine tends to treat the bits of the body rather than the person.

Aussie Margaret

RTHR 1990 revised 2004

RE: Tramadol/Outpatient Surgery Question

|I take Tramadol 2-3 times a day for osteoarthritis in my knees, right hip,

and shoulders. I also have cervical facet syndrome and upper back pain. It

is great for moderate pain, but if my pain gets severe I take Vicodin.

| I just wanted to thank everybody for all the great information on here.

I haven't posted before, but i have been reading for awhile. I am a 47 year

old nurse. I work in an outpatient orthopedic surgery center and I need a

TKR in my left knee. Not having it done right away for a few reasons, the

first one is mainly financial. I just cannot afford to not work right now

for the months of rehab I would need. Second, is my age.

| I do have one question for the group. My surgery center is getting ready

to do TKR's here in the outpatient setting, keep the patient overnight, and

send them home the next morning with an RN or LVN to take care of them at

home. How does this sound to you? It is supposed to lower the infection

rate (not being in a hospital) and increase comfort by getting home quickly

|

Send instant messages to your online friends http://au.messenger.

[Guest guest]

Margaret you have stated some great thoughts here.

On Nov 4, 2006, at 3:27 PM, Margaret wrote:

> Hi ,

>

> This sending the patient home has good points to it. Hospitals are

> places

> where people under high stress are herded together. Stress creates

> stress

> and this rubs off on health care workers and the patients. Some are

> saying

> for every 24 hours you are in hospital you will have 1 medication

> mistake.

> The risk of getting infections in hospitals is high. The cost of

> supplying

> the normal necessities of life to the patient all add up to why the

> hospital

> would implement this.

>

> One advantage of health professionals treating people in their own

> home is

> that they get to know so much more about the patient and their living

> circumstances. The health professional could find the most suitable

> chair,

> remove those scatter rugs, see the things that are likely to cause a

> problem

> with recovery. I would imagine it would be essential to have staff

> who the

> patient can relate well to.

>

> One danger is that the patient will be left feeling totally

> unsupported and

> not do the things they need to do for recovery if the support time is

> too

> short or they find the staff member not supportive. I notice with my

> clients that families tend to think that once a person has been

> discharged

> from hospital they don't need assistance any more. Sometimes people

> having

> major surgery seem to get less support from their family, once they are

> discharged from hospital, than they do when they have the flu. I

> think the

> thinking goes something like this " the hospital wouldn't have let them

> out

> if they weren't ok to fend for themselves now. "

>

> Another issue I see with older people is that in times of illness

> nutrition

> can go out the window. Tea and toast, cheese sandwiches and the like

> are

> easy to prepare when spirits and energy are low. Variety is often

> lacking

> and takes energy to think about and prepare. At least in hospital a

> variety

> of food is put in front of them. The reality is that for some of my

> clients

> they haven't eaten so well in years. It is easy to overlook the value

> of

> this aspect of institutional care.

>

> As long as the patient is well supported it could be a good thing.

> Modern

> medicine tends to treat the bits of the body rather than the person.

>

> Aussie Margaret

> RTHR 1990 revised 2004

>

> RE: Tramadol/Outpatient Surgery

> Question

>

>

> |I take Tramadol 2-3 times a day for osteoarthritis in my knees, right

> hip,

> and shoulders. I also have cervical facet syndrome and upper back

> pain. It

> is great for moderate pain, but if my pain gets severe I take Vicodin.

> | I just wanted to thank everybody for all the great information on

> here.

> I haven't posted before, but i have been reading for awhile. I am a

> 47 year

> old nurse. I work in an outpatient orthopedic surgery center and I

> need a

> TKR in my left knee. Not having it done right away for a few reasons,

> the

> first one is mainly financial. I just cannot afford to not work right

> now

> for the months of rehab I would need. Second, is my age.

> | I do have one question for the group. My surgery center is getting

> ready

> to do TKR's here in the outpatient setting, keep the patient

> overnight, and

> send them home the next morning with an RN or LVN to take care of them

> at

> home. How does this sound to you? It is supposed to lower the

> infection

> rate (not being in a hospital) and increase comfort by getting home

> quickly

> |

>

> Send instant messages to your online friends

> http://au.messenger.

>

>

>

[Guest guest]

HAS ANYONE ACTUALLY RENTED OR PURCHASED ONE OF THOSE BEDS THEY HAVE OUT NOW, THAT MOVE UP AND DOWN AT THE HEAD AND FOOT LIKE A HOSPITAL BED -- THEY HAVE QUEEN SIZE BEDS LIKE THIS WITH INDIVIDUAL CONTROLS? THEY'RE EXPENSIVE BUT I BET COMFY, ESPEICALLY AFTER A TK OR TH REPLACEMENT, OR AM I WRONG????????????????????????? I TOO HAVE A VERY AFFECTIONATE DOG -- A COCKER SPANIEL AND I FEAR SHE'LL JUMP ON MY LEG, OUCH!

Hi , I've had both of my knees replaced, one at a time. I guess if you had someone a nurse with you 24/7 it might be better? It probably wouldn't have been at my house though, we have 2 dogs that are very attached to me in the house, and a cat. I had enough trouble keeping them away from my knee after 4 days in the hospital. I also really think that the hospital beds are easier to get in and out of at first. You can prop yourself up to eat and lower or raise the bed. I'm very short so I needed the bed lower.

[Guest guest]

Both my hubby and I have these beds. He needs one because of having

esophageal surgery and he can not sleep flat. they are wonderful. I

hope I never have to sleep on a regular bed again.

On Nov 4, 2006, at 5:02 PM, lindy wrote:

> HAS ANYONE ACTUALLY RENTED OR PURCHASED ONE OF THOSE BEDS THEY HAVE

> OUT NOW, THAT MOVE UP AND DOWN AT THE HEAD AND FOOT LIKE A HOSPITAL

> BED -- THEY HAVE QUEEN SIZE BEDS LIKE THIS WITH INDIVIDUAL CONTROLS? 

> THEY'RE EXPENSIVE BUT I BET COMFY, ESPEICALLY AFTER A TK OR TH

> REPLACEMENT, OR AM  I WRONG?????????????????????????  I TOO HAVE A

> VERY AFFECTIONATE DOG -- A COCKER SPANIEL AND I FEAR SHE'LL JUMP ON MY

> LEG, OUCH!

>>   Hi , I've had both of my knees replaced, one at a time.  I

>> guess if you had someone a nurse with you 24/7 it might be better? 

>> It probably wouldn't have been at my house though, we have 2 dogs

>> that are very attached to me in the house, and a cat.  I had enough

>> trouble keeping them away from my knee after 4 days in the hospital. 

>> I also really think that the hospital beds are easier to get in and

>> out of at first.  You can prop yourself up to eat and lower or raise

>> the bed.  I'm very short so I needed the bed lower. 

>>

" If you are all wrapped up in yourself, you are overdressed. "

[Guest guest]

I am in total agreement. As a nurse, and a future patient, I do not think it is a good idea, but they are going ahead with it anyway. This is the way healthcare is going. The nurse at home would be able to give pain injections vs just oral medication, and cook, etc......I just cannot imagine going home in the car after only 12-15 hours of post op care. I can see the point on infection control though. We are starting off with a healthy, younger population to see how it works out. I will let you all know Ann Lauer <aelauer@...> wrote: >I do have one question for the group. My surgery center is getting ready >to do TKR's here in the outpatient setting, keep the patient overnight, >and send them home the next morning with an RN or LVN to take care of them >at home. How does this sound to you? It is supposed to lower the >infection rate (not being in a hospital) and increase comfort by getting >home quicklyOMG, I would have DIED! No way would I have wanted to be home that quickly - I used the equipment the hospital provided, the round-the-clock care they offer, and the lack of any responsibility (the meals just appear <G>), as well as the training available. I also needed the higher-power pain meds that are more available in the hospital than at home. In fact, I know my doc would have let me go home after my Wednesday

surgery on Friday if I had wanted - I elected to stay until Saturday at noon, and was glad I did.NOT a good idea, in my opinion .... and I totally believe in outpatient surgery centers, as that is where my hubby makes his living as an anesthetist!Ann

Everyone is raving about the all-new .

[Guest guest]



it's nice to know someone has one of these beds and is enjoying it.

Both my hubby and I have these beds. He needs one because of having esophageal surgery and he can not sleep flat. they are wonderful. I hope I never have to sleep on a regular bed again.

[Guest guest]

I could be wrong, but my initial reaction to hearing that TJR patients are now being sent home the next day or the day of, is that insurance companies are trying to save money. Then again, I've never had a TJR.

Ann S.

RE: Tramadol/Outpatient Surgery Question

I am in total agreement. As a nurse, and a future patient, I do not think it is a good idea, but they are going ahead with it anyway. This is the way healthcare is going. The nurse at home would be able to give pain injections vs just oral medication, and cook, etc......I just cannot imagine going home in the car after only 12-15 hours of post op care. I can see the point on infection control though. We are starting off with a healthy, younger population to see how it works out. I will let you all know

Ann Lauer <aelauerearthlink (DOT) net> wrote:

>I do have one question for the group. My surgery center is getting ready >to do TKR's here in the outpatient setting, keep the patient overnight, >and send them home the next morning with an RN or LVN to take care of them >at home. How does this sound to you? It is supposed to lower the >infection rate (not being in a hospital) and increase comfort by getting >home quicklyOMG, I would have DIED! No way would I have wanted to be home that quickly - I used the equipment the hospital provided, the round-the-clock care they offer, and the lack of any responsibility (the meals just appear <G>), as well as the training available. I also needed the higher-power pain meds that are more available in the hospital than at home. In fact, I know my doc would have let me go home after my Wednesday surgery on Friday if I had wanted - I elected to stay until Saturday at noon, and was glad I did.NOT a good idea, in my opinion .... and I totally believe in outpatient surgery centers, as that is where my hubby makes his living as an anesthetist!Ann

Everyone is raving about the all-new .