Tips on Preparing for RA surgery

If you’ve decided to have surgery for RA-related joint damage, it is important to prepare carefully for your surgery. There are some practical things that you can do to help your surgery go smoothly and to make your recovery a success.


Tips for preparing for surgery

Get into great shape
  • Exercise (consider working with a PT to develop a comprehensive pre- and post-surgery program)
  • Eat well, lose weight, and stop smoking
  • Make sure that existing medical conditions are under control
Make a recovery plan
  • Before surgery, work with your doctor to put together a detailed recovery plan
  • Your plan should include recovery milestones and strategies for dealing with complications, if they arise
Make a post-surgery care plan
  • Arrange transportation to and from the hospital
  • Set up a support system of friends and family who can take care of household chores and other practical aspects of life while you are recovering
  • Make sure that you have volunteers lined up to get you to and from appointments
Find out what insurance covers
  • Make all your insurance arrangements before you have surgery so there are no surprises during your recovery period
  • Find out what out-of-pocket expenses you will be responsible and what services (including rehabilitation and nursing care) are covered


Make sure you are in good shape

The first bit of advice that any doctor will give you if you’re planning to have surgery is to make sure you prepare for surgery by getting in the best physical shape possible. Think of surgery as a marathon. To ensure that you cross that finish line, you’ll need a comprehensive program of training that involves exercise, healthy eating, and controlling any health problems you may have.

Start a program of regular exercise. Since most surgery to address RA-related damage can be planned well in advance, you should make sure that you are engaged in a regular program of exercise. This is especially important if you are going to have major joint replacement surgery. Results from studies have shown that a program of exercise before major joint replacement surgery can decrease pain and speed up recovery after surgery.1,2

Talk to your doctor about working with a physical therapist (PT) in the months leading up to your surgery. A PT can work with you on a targeted program of strength and flexibility training specifically designed to get you ready for surgery and prepare you for a program of rehabilitation after surgery.

Healthy eating and nutrition. In addition to getting the exercise you need, you should make sure that you are eating well and getting proper nutrition. You can do this by following USDA nutritional recommendations for a healthy, balanced diet. Also talk to your doctor about what supplements, including vitamins and minerals, might benefit you. It is especially important that you let your doctor know about any and all supplements, including vitamins, mineral, herbs, and other substances, you are taking. Some of these may need to be stopped well before surgery if they increase your risk for bleeding or have other effects that make them dangerous to take around the time of your surgery.

Other important basic health issues. As you prepare for surgery, you should make sure that you are taking care of any health conditions you may have, including hypertension, cardiovascular disease, and diabetes. Work with your doctor to get the treatment you need for these and other chronic health conditions. Also, as you prepare for surgery, if you are a smoker, you should take the opportunity to stop smoking.3

If you are overweight, make it a goal to lose weight before your surgery. This is especially important if you are having major joint replacement surgery. Carrying around extra weight places increased stress on joints and can make it more difficult to rehabilitate after surgery. Extra weight can also decrease your chances for a successful surgical outcome and shorten the life of a surgical repair. In terms of general health, losing extra weight can have many benefits, including reducing your risk for cardiovascular events and improving control of chronic conditions like diabetes. Use a program of regular exercise and healthy eating to help you achieve a healthy weight before you undergo surgery.3


Put together a recovery strategy or plan with your doctor

Don’t forget to sit down with your doctor before surgery to put together a plan for your recovery. You will want to make as detailed a plan as possible, complete with recovery milestones and strategies for dealing with complications, if they arise.

Having a plan on paper will help you to set goals during rehabilitation and know what to expect from week to week. For instance, if you are having total major joint replacement surgery, your doctor will probably want your rehab team to visit you at home for the first month to six weeks. Following this, you will start an outpatient rehab program. Having physical goals written down on paper will help organize and motivate you. The success of a major surgical repair, such as joint replacement, greatly depends on following an exercise routine.


Put together a care plan for after surgery

Planning for surgery doesn’t just cover your selection of a surgeon and preparation in the months and weeks leading up to surgery, it must also cover the days, weeks, and months after your surgical procedure. This post-surgery period, especially rehabilitation, follow-up, and after care, are, in a sense, just as important as the procedure itself.

Practical planning. There are some basic arrangements that you and your caregivers (friends and family) will need to attend to before you undergo surgery. The list will vary from person to person and will be different depending on the extent of your surgery, but it should cover items including:

  • A plan for getting to and from the hospital or surgical clinic
  • Having someone with you to take care of basic chores (meal preparation, shopping, house cleaning, walking pets, personal care activities) during the period when your mobility and function is restricted
  • Transportation to and from doctor’s appointments and rehabilitation sessions


Taking care of practical aspects of life will be easier if you have family living with you, but if you live alone, you will need to recruit your friends and family to volunteer for specific activities or care shifts. This isn’t as difficult as it sounds, especially now in the digital age with Internet tools. There are some handy online systems available for coordinating care among a circle of friends and family during a period of recuperation from illness or surgery. Check out Lotsa Helping Hands and Care Calendar.


Do your homework on insurance coverage and other financial matters before surgery

The last thing you need to do while recovering from major surgery is to grapple with the complexities of insurance coverage. Make sure that you take care of this important bit of planning before you have surgery. Different insurance plans have different requirements in terms of out-of-pocket expenses and you will want a clear picture of how much of the cost of care (both surgery and rehabilitation) you will have to cover.

Call your insurance representative and find out what arrangements you need to make for the financial aspects of both surgery and rehabilitation. Depending on your coverage, you may discover that you qualify for more services than you think. It makes sense to take advantage of whatever benefits you qualify for under your insurance.

If you are covered by Medicare and have questions about what services are covered under Medicare, you can get an answer by calling 1-800-MEDICARE (1-800-633-4227).

If you are employed, speak with your human resources representative and find out how best to plan your surgery from the standpoint of your work schedule.

Written by: Jonathan Simmons | Last reviewed: September 2013.
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