Post-op

Q: How do I contact the office after hours?

A: There will be a point of contact 24 hours a day for any concerns you may have. Dr Jacob has an answering service that is available after hours at 405-424-5426. He is notified of all patient concerns. You will be contacted by a member of the staff if requested.

Q: When can I shower?

A: NO SHOWERS while your dressing is in place. NO EXCEPTIONS. The dressing is to stay on for 7 days. You can remove the dressing on postop day #7. Once the dressing is removed, and there is no drainage for 3 CONSECUTIVE days, then it is OK to shower. If the dressing is saturated, then contact the office immediately. NO baths or submersion of incision into water for 12 weeks after surgery- NO EXCEPTIONS. Please see your discharge instructions for complete details.

Q: How long do I have to wear my TED hose?

A: Dr. Jacob likes for patients to use them continuously for two weeks post-operatively. After the two week mark, you can take them off. If you get excessive swelling once the TED hose are removed, you can continue to wear them until the swelling is controlled.

Q: How long should I use the pain medication?

A: This is different for each patient; some are able to use only Tylenol after you leave the hospital, and others require pain medication as needed for 2-3 weeks. A general rule is that you should try to decrease your use of these medications as time passes.

Q: What should I do if I am going to run out of pain medication prior to my first visit?

A: Dr. Jacob will refill your pain medication for up to 90 days after your surgery. Most patients are off the majority of pain medication within 3 weeks after the surgery. If you need a refill prior to your follow up visit you must provide the office with a MINIMUM of a 72 hours notice. Dr. Jacob does NOT take refill requests for pain medication on FRIDAY, SAURDAY, or SUNDAY without exception. It is your responsibility to monitor your pain medication usage and request a refill in an appropriate time frame. Someone will need to physically pick up a paper prescription because in the state of Oklahoma, pain medication CANNOT BE CALLED INTO A PHARMACY. This is a state law.

Q: Do I need a special card to tell the airport screeners that I have a metal implant?

A: You do not need a card to get through the airport; however, your implant will likely set off the metal detector. In this day and age, you will need to be hand-screened, so please leave extra time when you travel. We do provide an implant card for your convenience, which will be available postoperatively.

Q: Can I get an MRI?

A: Yes, MRI’s are perfectly safe with a joint replacement implant. An MRI in the area of the implant, however, will not yield good pictures because of artifact created by the metal. Any MRI of a joint replacement should be performed at a facility that offers techniques used to suppress the metal artifact. Always inquire prior to scheduling at that facility if the MRI machines are compatible with joint replacements. Always tell the MRI technician prior to your MRI as well.

Q: When should I go to outpatient therapy?

A: Dr. Jacob likes to see you in follow up before you go to outpatient physical therapy; this way he can tailor your PT to what you need. However, if you feel that it is essential to begin outpatient PT right away, you can call the office, and we will provide a prescription and a list of places.

Q: When can I drive?

A: You should not drive as long as you are taking narcotic pain medication. You must be off of ALL prescription narcotic pain medication prior to driving. No exceptions. If it is your left lower extremity, you can resume driving when you feel your reaction times are back to normal (about 3 weeks). If it is your right lower extremity, Dr. Jacob needs to evaluate you prior to your return to driving. The effects of anesthetic, pain medication, and surgery can affect judgment and reflexes during the first weeks following your surgery.

Q: I feel “clicking” inside the hip or knee, is this normal?

A: The clicking is a result of the soft tissue (capsule) moving across the front of the implant, or the metal parts coming into contact with one another. This sensation usually diminishes as your muscles get stronger. It is NOT a sign that something is wrong.

Q: I am experiencing a lot of swelling, is this normal?

A: Fluid can accumulate in the legs due to the effect of gravity. It is not unusual that you didn’t have it in the hospital, but it got worse when you went home (because you are doing more!) To combat this, you should elevate your legs at night by lying on your back and placing pillows under the legs so that they are above your heart. (TOES ABOVE NOSE). There are also TEDS stocking (the white stockings from the hospital) that you should be wearing as well. If you did not get the TEDS from the hospital, or you need an additional pair you can purchase thigh high, medium (15-20 mm Hg) compression surgical stockings at most drug stores.

Q: My thigh, knee, and calf hurt. Is that normal?

A: Yes, your leg is twisted completely around during the surgery, so it is expected that you have soreness up and down your leg.

Q: Can I work out in the gym?

A: You can go to the gym and resume upper body workouts, as long as the hip is in a non-loaded position (you should be sitting, not standing, when using weights).

Q: When can I return to work?

A: It depends on your occupation. It is never a mistake to take more time off in the beginning of your recovery, as it will give you time to focus on your hip or knee. Dr. Jacob recommends taking at least 3 weeks off, although 6 weeks is ideal. Keep in mind that you may still be using crutches and it may be difficult to commute. Each patient is different and so is each recovery!

Q: When can I go to the dentist?

A: Please wait until 3 months after surgery for any ELECTIVE dental work, as the joint is still healing and there is increased blood flow to this area. Call Dr. Jacob’s office for antibiotics prior to any dental procedure. You will need prophylactic antibiotics before all dental work for life.

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Q: Can I travel?

A: In general, Dr. Jacob likes to see you before you fly. If you are traveling by car, you should be sure to take frequent breaks so that you don’t feel too stiff when getting up (every 1-2 hours if possible). This will also help to prevent blood clots. On an airplane, you should wear compression stockings (if within 6 weeks postop), and take a couple of walks during the flight. It is also recommended that you start taking enteric coated aspirin 325 mg the day BEFORE your flight and continue taking it until you have been home for a day. Having an aisle and bulkhead seat will help you get more space.

Q: Should I be taking any medications or supplements for bone health after a replacement?

A: Yes, Dr. Jacob recommends that everyone take calcium and vitamin D to help maintain bone strength. Generally 1500 mg of calcium citrate and 5000 IU of Vitamin D are adequate. A multi-vitamin may help provide your body with the nutrients it needs to recover post-operatively. Occasionally, Dr. Jacob will also prescribe a medication to help promote bone strength.

Q: How long do I have to take Aspirin and other blood thinners (Xarelto, Eliquis, Lovenox, Coumadin…) ?

A: Generally speaking, Aspirin is taken twice a day for six weeks for both hip and knee replacements. If you are on a blood thinner other than aspirin, Dr. Jacob will tell you when you can discontinue its use at your first post-op follow up office visit.

Q: Who should I contact for billing issues?

A: For both physician billing questions as well as hospital billing questions we have one convenient customer service hotline. 405-419-8444