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Advanced Planning for Surgery

I am a planner, and I always have been. When I was 15 years old and had my hips and knees replaced, I thought about how I may need to plan to do it again in 20 years or so, and I was right! Having a plan puts me at ease. It is there when I need it, so I don’t have to stress and scramble.

For me, surgery is inevitable

As someone with severe juvenile rheumatoid arthritis, I have accepted that I will inevitably have health issues. I’ll need treatment, which may be outpatient, but sometimes it may require hospitalization. I will likely need surgery and definitely physical therapy.

Preparing for unexpected health issues

Although I may not know my exact needs until they happen, I can plan for when they eventually come around.

This is why, even when I am doing OK with my health, I am always working to:

  • Save up my sick leave (as much as I can) for when I may need to be out from work for an extended time.
  • Maintain a health insurance plan with good coverage (in case of hospitalization and surgery or other infrequent medical expenses).
  • Contribute to savings for the eventuality of having more medical bills or other related expenses.

These 3 ongoing activities help me feel more comfortable when a health situation arises, such as surgery. I know that I am fortunate to have the opportunity to plan in such a way, as it is not always possible for people with RA to do so.

Planning for a scheduled procedure

Recently, I was advised to undergo a left shoulder reverse replacement, where the ball and socket are reversed on the new artificial joint. It’s probably overdue, but in any case, the decision has now been made, and the surgery is scheduled.

Unlike my last major surgery, where I had an infected artificial knee and needed to act urgently, I have the luxury of time to plan. My shoulder is being custom designed and 3-D printed (isn’t that so cool!) as I write, so I have had about 2 months to plan and prepare for the upcoming surgery.

When surgery is months away

My first activities were concentrated on getting cleared for the surgery and making sure my doctors had all spoken with each other about my particular case. This will look different for each RA patient, but for me, I wanted my orthopedic surgeon (who treated my knee infection and then put in a new joint) to speak with the shoulder orthopedic surgeon. Then I wanted the shoulder surgeon to speak with my rheumatologist. Finally, everyone wanted me to see a spinal surgeon to make sure my neck would be okay for anesthesia. This whole process took about a month between various doctors’ visits, sharing information between them, having some scans, and then prodding the doctors (sometimes repeatedly) to call each other.

The goal is that when all is said and done, I’ll have my RA medications planned out for before, during, and after my surgery. Also, the team will be on board with my various complexities, such as my tiny, fragile bones, and my anesthesiologist will be ready to handle care with my limited neck motion.

One month away

The second set of activities will mostly focus on the more standard surgery preparations, with a little extra attention given to my medical complexities. I have scheduled a physical at the 30-day countdown mark so that I can be checked over to catch any concerns prior to surgery. Following this, I have blood work that will cover the basics, but also check for some extra items to be careful. Then, about 2 weeks before the surgery, I’ll visit for the standard surgical workup, like an EKG. One additional piece is that I’ll be persistent about requesting a brief meeting with the anesthesiologist so they can examine my neck and make a safe plan for my care.

A couple of weeks away

Another important piece of preparing for surgery is to line up my support. As soon as I had the surgery confirmed, I started telling my workplace about what would be happening and how much time I would likely be out. It’s important to me to set clear expectations while also explaining that the timeline could change depending on any complications and the smoothness of recovery.

At the same time, I reached out to family members to let them know and explain the process. Hopefully, I have put them at ease! Next is to contact friends and other supporters to let them know I am having surgery and that I will be less available while I recover. It’s been heartening to hear the same reaction on repeat: how can I help? As it reaffirms, I have good people in my life who are willing to help as they can.

Of course, the decision for surgery was made with my spouse, so he is involved in planning every step of the way.

The final countdown

This will be the time for all those things I didn’t think of (or plan for) to pop up. Who knows what they will be, but hopefully, having an overall solid plan and support network will help me to navigate those surprises. Because surprises always seem to happen!

While it’s not always easy to plan for surgery or health issues, it certainly can help put me at ease or make me feel less stressed while making the bumpy process of medical treatment a bit smoother. Hopefully, these thoughts can help others as they experience the health issues that often come with RA and other chronic illnesses.

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