The Total Joint Center
If you would like additional information about the Total Joint Center or
wish to make an appointment, please call 401-793-5852.
Total Joint Center Physicians
The 3 North (3N) team consists of highly trained registered nurses, certified nursing assistants, and unit secretaries. In addition, various members of the care team may visit with you at some point during your stay, including those from physical therapy, occupational therapy, case management, social work, spiritual care, and pet therapy. The Miriam Hospital is a teaching hospital and our nurses are usually training student nurses throughout the year.
Visitors: Family members and friends can visit with you as soon as you arrive on 3N. All patient rooms on 3N are private rooms and lend themselves nicely to accommodating visitors. Each room is also equipped with a couch that converts to a bed for family whom you may want to stay with you overnight.
It is normal to experience pain after surgery. It can feel like a dull ache, pulling, tightness, cramping, burning, stabbing, or other unpleasant sensations. It can range from mildly irritating to severe. Controlling pain is an important step in your recovery. The nursing and physician staff will work closely to provide you with optimal pain control throughout your stay.
Benefits of good pain control: Pain control and the ability to move will facilitate a faster healing process. Adequate pain control will allow you to participate in therapy and care with your staff and family. Early and frequent mobility will help prevent complications such as blood clots, pneumonia, and constipation.
The Pain Scale
0-3 = Minimal/Mild Pain - Treated with non-pharmacologic methods (repositioning, ice, etc.)
4-7 = Moderate Pain - Treated with a combination of medications and alternative methods
8-10 = Severe/Intense Pain - Treated with medications
Your care providers will be assessing your pain level frequently (about every three hours), and re-assessing your pain level within 60 minutes after you receive pain medications.
Oral pain medications are used for moderate pain (pain scores ranging from 4 to 7).
Intravenous pain medications are used for severe pain (pain scores ranging from 8 to 10). Your surgeon will prescribe a combination of pain medications to provide pain relief for you.
A patient-controlled pump may be ordered for you. This allows you to administer a small amount of pain medication periodically. The doses are set by your doctor so that there is little to no risk of overdosing on the medication. Your recovery nurse will teach you how to use this once you awaken from anesthesia.
All medicines can have side effects, but not everyone will experience them. Most happen during the first hours of treatment and gradually go away. The most common side effects include constipation, nausea, sleepiness, dizziness, itching, and slowed breathing. It is extremely rare that a patient becomes addicted to pain medication if it is taken as prescribed.
Non-medication treatments:There are also non-medication treatments that can be used to control pain:
Positioning (Activity) - Your doctor might suggest changing positions to alleviate pain.
Cold therapy often works well to control pain. It can also relieve itching and muscle spasms.
Relaxation techniques such as yoga, prayer and meditation help relieve anxiety and tension. Doing these activities produces a relaxation response that calms and reduces your stress.
Distraction therapy reduces pain by taking your mind away from it. Music is an example of distraction therapy.
Positive thinking - Individuals who stay positive and hopeful often feel less pain or are less bothered by the pain they feel.
Describing your pain: You can help the nurses measure your pain by describing it:
Onset of pain - When did the pain start?
Location - Where does it hurt? Does it radiate?
Quality - Describe the pain. Is it sharp, shooting, burning, aching, cramping?
Intensity - Is the pain constant or does it increase and decrease? What makes the pain worse?
Response to treatment - Is there anything that helps relieve the pain? How long does the relief last?
Keeping your pain under control: Everyone feels pain differently and responds differently to pain control treatments. You will be the one to decide what level is acceptable to you. Be sure to:
Talk with your doctor about pain control methods that have worked or not worked for you before.
Talk about any concerns you may have about pain medications.
Tell about any allergies to medications you may have.
Ask what you can expect. Will there be much pain? Where will it occur? How long is it likely to last?
Take your pain medications as instructed or ask the nurse for pain medication as soon as you start to feel pain or discomfort.
Take pain medication before beginning activities that may hurt.
Blood will be drawn each morning between 4 and 7 a.m.
The nursing team and your physician will review your blood work before making decisions regarding your treatment plan.
Preventing Blood Clots
After surgery you may wear compression stockings and/or have foot pumps while you are in bed. Foot pumps are devices that go around your feet and provide intermittent pulsation, helping to circulate blood and prevent clots.
Your doctor will also treat you with medications to help prevent blood clots. You may receive either aspirin or Coumadin. If you receive Coumadin, daily blood work while you are in the hospital will help to determine the proper dose to give you.
A urine catheter may be inserted while you are asleep in the OR. Your nurse will remove the catheter after your surgery. The nurse will monitor your ability to urinate after the catheter is removed.
Many of the medications you receive while you are in the hospital may cause constipation. Your doctor will prescribe medications that prevent constipation and help you to have a bowel movement. These include stool softeners and laxatives. Moving around will help to "wake up" your digestive system.
Because of medications and the nature of joint replacement surgery, your balance and strength may be compromised after surgery. It is extremely important that you call the nurse for assistance prior to getting out of bed or moving from the bed to the chair. A fall after joint replacement surgery can lead to infection, fracture, re-admission to the operating room, bleeding, and a prolonged hospital stay.