Leaving the Hospital

Discharge from the hospital can be a bit worrisome, but please be assured that your care team will not discharge you until it is safe for you to leave. We will encourage you to leave the hospital as soon as possible, because this is known to speed recovery after hip replacement surgery.

Daily Guidelines

The guidelines below will generally apply whether you are going directly home or to an extended-care facility. Your health care team will also provide you with additional instructions depending on the type of surgery.
In the first week after leaving the hospital, please follow these daily guidelines:

• Take all your medications as directed.
• Follow the “hip precautions” you have received to protect your hip.
• Continue your exercise routine on your own or with a physical therapist.
• Follow your instructions for wound care.
• Drink plenty of liquids and eat healthy foods.
• Take a stool softener or laxative if needed while taking narcotics for pain management.

Signs and Symptoms to Report

If you experience any of the following signs and symptoms when you leave the hospital, call your surgeon right away.

• More than one temperature greater than 101.5°
• Signs of infection (redness, swelling, draining wound, increasing pain) at the surgical wound
• Arm, leg or calf tenderness or pain
• Leg pain not relieved by rest, ice, and pain medication
• Nausea and vomiting that won’t go away
• Inability to urinate that lasts longer than 24 hours
• Inability to move your bowels that lasts longer than 48 hours
• Swelling in either leg that does not decrease when your leg is elevated for a few hours or overnight (but it is common to have swelling
• of your lower leg that decreases each morning after you have been in bed all night)
• Sudden pain or an inability to walk

Please seek emergency treatment if you experience:

• Chest pain
• Shortness of breath
• Rapid heart beat
• Abdominal pain

Protecting Your Joint From Infection

After knee replacement surgery, it is important to protect your new joint from infection. An infection in one part of your body can travel in your blood and possibly spread to your new joint.
Here are some types of infections that can cause problems. If you have any of these symptoms, you should report them immediately to your primary care doctor.

• Urinary tract infections. Symptoms of a urinary tract infection include a frequent and urgent need to pass urine, pain in your lower back or lower pelvic area, cloudy or foulsmelling urine, chills or fever, lack of energy or appetite, or sand-like material in your urine.
• Skin infections. Injuries to your skin should receive prompt care. After an injury, wash the area with soap and water and apply a bandage. Serious cuts may require stitches. If an injury develops swelling, redness, drainage, enlargement, or blistering, or if you develop a  temperature, immediately call your primary care physician.
• Dental infections. Good dental hygiene is important. You should see your dentist regularly for dental care even if you are not having any dental problems. When you see your dentist, be sure to inform him or her that you have had joint replacement surgery.

If you have a dental or surgical procedure for which the surgeon or dentist feels it is possible that you may get an infection, you should take antibiotics before the procedure. The dentist or surgeon performing the procedure can prescribe an appropriate antibiotic.

Getting Back to Your Usual Activities

During the first few weeks at home, you can adapt what you learned at the hospital to your own setting. You should continue doing the exercises provided by your therapist.
Staff from a home-care agency, such as a nurse or therapist, may visit as you make the transition to home. Home therapists may update your exercises and work further on home management activities. Most people continue with outpatient physical therapy once home therapy is complete.

Many people feel very tired when they leave the hospital. For this reason, it is best to pace yourself as you return to your daily routine. If you feel tired, take a short morning or afternoon nap. As you recover, your energy will increase.
Keep in mind that you cannot do everything yourself. Don’t be afraid to ask for help with daily tasks such as grocery shopping, laundry, and housecleaning. Take care of yourself. Try to find ways to be good to yourself during this time.

Outpatient Rehabilitation Services

For your convenience, an appointment for outpatient physical and/or occupational therapy can be scheduled with the Newton-Wellesley Hospital Rehabilitation Department by calling 617-243-6172, Monday through Friday between 7 a.m. and 8 p.m.