Patient Journey

Initial Meeting

During your initial meeting Dr Robinson will:

  • Ask detailed information about your symptoms and history of your current and past ailments
  • Perform a thorough physical examination
  • Review any x rays, diagnostic reports or other documents

To confirm a diagnosis other possible diagnostic investigations such as blood tests or imaging tests may be additionally required.

After reviewing these results, Dr Robinson will recommend appropriate treatment options.

Treatment Options & Plan

Dr Robinson will take time to explain your options for treatment. Depending on the diagnosis your choice could include:

  • Watchful Waiting
  • Non Surgical
  • Surgical

It’s not uncommon to have questions or doubts. Dr Robinson encourages you to seek clarification on any issue before you leave the clinic.

Our aim is to provide you with all the information that you would need to make informed decisions about managing your health. If you still have questions when you leave the office, please do not hesitate to contact us - we are here to help.

Where surgery is the chosen path, our staff will detail costs and other logistics with you.

Preparing for Surgery

Once it is decided that surgery will help you, you'll need to learn what to expect from the surgery and create a treatment plan for the best results afterward.

As you prepare for your surgery, it is important to be proactive. Preparing mentally and physically for surgery is an important step toward a successful result.

Before the surgery you should make sure that you understand what the surgery entails and also what to expect in the weeks and months to follow.

Understanding the process and your role in it will help you recover more quickly and have fewer problems.

Before surgery, Dr Robinson will give you a complete physical examination to make sure you don't have any conditions that could interfere with the surgery or its outcome.

Other pre surgery activities could include:

  • Final Testing - Routine tests, such as blood tests, and X-rays, are usually performed a week before any major surgery.
  • Medications - Discuss any medications you are taking with Dr Robinson and your family general practitioner to see which ones you should stop taking before surgery.
  • Aspirin - If you are taking aspirin or other anti-inflammatory medications please discuss them with Dr Robinson as you will need to stop taking them one week prior to surgery to minimise the risk of bleeding.
  • Warfarin / Plavix / Asasantin / Clopidogrel / Xarelto or other blood thinning medications should be stopped one week prior to surgery to minimise the risk of bleeding. All such medication should be discussed with Dr Robinson so together a plan can be formulated that may require bridging Clexane injections OR consultation with other medical specialists.
  • Medical Optimisation - referral to a General Physician may be required prior to surgery to ensure you are fit to undertake a general anaesthetic. Other further non-orthopaedic investigations and treatment may be required to ensure your medical fitness for surgery.
  • Weight Loss - If you are overweight, losing weight before surgery will help improve your capacity to undertake an general anaesthetic, decrease the rate of intra-operative and post-operative complications as well as making your recovery from surgery that much easier
  • Tobacco - If you smoke, you should stop or cut down to reduce your surgery risks and improve your recovery. See your general practitioner and visit Quit HQ
  • Gum Disease - Have any tooth, gum, bladder or bowel problems treated before surgery to reduce the risk of infection later.

Other Preoperative activities could include:

  • Diet - Eat a well-balanced diet, supplemented by a daily multivitamin with iron.
  • Infections  -Report any infections to your surgeon. Surgery cannot be performed until all infections have cleared up.
  • Support - Arrange for someone to help out with everyday tasks like cooking, shopping and laundry.
  • Easy Reach - Put items that you use often within easy reach before surgery so you won't have to reach and bend as often.
  • Easy Access - Remove all loose carpets and tape down electrical cords to avoid falls. Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.

Day Surgery Procedure Patients

If you are having Day Surgery, remember the following

  • Have someone available to take you home, you will not be able to drive for at least 24 hours.
  • Do Not drink or eat anything in the car on the trip home. The combination of anaesthesia, food, and car motion can quite often cause nausea or vomiting.
  • After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours.

Procedures

On the day of surgery you will be under general anaesthesia for description of your actual procedure go to the procedure page on this website.

Post - Operative Care

Hospital Recovery

After the surgery, you will wake up from the anaesthesia in a recovery room or intensive care unit (ICU). After the surgery, you will continue to receive fluids through the intravenous line (IV line) inserted in your arm until you are able to tolerate regular liquids.

As proper nutrition is very crucial for your body to restore the damaged tissues and return to normal, your surgeon may either restrict what you drink and eat, or place you on a special diet.

Your diet will be gradually changed from fluids to a regular diet.

Physical activity in most cases will start on the first or second day itself after your surgery. Your nurses and physical therapists will assist you with this activity until you feel comfortable enough to progress on your own.

To help you with your home recovery, your surgical team will give you some instructions to follow. If unsure you should ask for clarifications and follow these instructions closely and diligently.

Before that, your doctor will make sure that you have normal vital signs and bladder function, you can eat without feeling nauseated and there are no signs of infection at the incision site.

Ongoing Care

After your procedure, regular post-procedure follow-up visits are important to ensure your complete recovery and a successful outcome.

Your hospital discharge instructions will have the periodical follow-up visits listed. Depending on your surgery your first visit may be scheduled 10 days to 3 weeks after the procedure.

You may be required to have regular follow up visits – six weeks, three months, six months, nine months and then annually to assess your recovery and progress.

Other appointments may be arranged if any post operative problems arise.

Home recovery

Remember to arrange for someone to take you home, as driving may not be recommended for several weeks following surgery

After the surgery, pain medications and sometimes antibiotics are prescribed to control pain and prevent infection. Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty controlling the pain.

If you had surgery on the hand or the elbow, keep that extremity elevated and use ice as directed. This will help decrease swelling and pain.

Your doctor and other members of the hospital staff will also give you some self-care instructions for you to follow at home that are crucial to your recovery. These are a list of "dos and don'ts," which you will be asked to follow for the first 6 to 8 weeks of your home recovery. These may include the following:

  • Get plenty of rest.
  • Abstain from smoking as nicotine slows bone healing.
  • Good nutrition is essential for a successful recovery. Eat a healthy diet, high in protein and rich in fresh fruits and vegetables and drink plenty of fluids. Avoid heavy, fattening foods and foods that are high in calories.
  • Short walks for the first few weeks after the shoulder surgery are encouraged. Walking is a low impact exercise that builds strength and maintains muscle tone. The distance you walk can be gradually increased. Deep-breathing exercises are also helpful.
  • Avoid carrying or lifting anything heavier than 4 kilograms.
  • Avoid bending at the waist. Rather, bend at your knees to pick up things. Also avoid twisting the back.
  • Check with your doctor when you are allowed to return to driving. You are not allowed to drive while wearing a sling.
  • Avoid any strenuous activities. Even avoid vacuuming and more strenuous household cleaning. Do not go for swimming, golfing, running or participate in any other sports activity until your doctor permits.
  • Most dressings are waterproof and showers can commence after surgery. Observe dressings regularly to ensure they are watertight.

Wound care

When you will be discharged, you will still have a surgical dressing on your incision(s).

Dressings are usually left intact until the first postoperative visit. If there are issues with the dressings these may require earlier review with Dr Robinson or your general practitioner.

If any of the following signs of infection are observed, you should call your doctor immediately. These signs include:

  • Fever higher than 38.5°C
  • Increase in redness or swelling around the incision(s)
  • Extra fluid drainage from the incision(s)
  • Opening of the incision has open areas along its length
  • Experiencing chills, nausea/vomiting
  • Suffering any type of trauma such as a fall or a car accident
  • Difficulty in urinating or controlling your bowel movements

And in such a situations you should contact your doctor immediately.

Rehabilitation Program

The rehabilitation program includes physical therapy, which is started soon after the surgery and is very important to strengthen and provide mobility to the shoulder.

You will be able to perform gentle daily activities after surgery. A referral to an allied health provider will be made at this time of surgery. This will be in the form of an occupational hand therapist or physiotherapist.

In consultation with Dr Robinson the occupational hand therapist and physiotherapist prepare an exercise program. Much of the exercise program can be done at home. Regular attendance at the hand therapist of physiotherapist will improved your recovery from surgery and your result. It is essential that you perform the exercise program as instructed.

Return to Work

Depending on the condition treated and your operation you may return to light or suitable duties at work. You will not be fit to perform work duties that involve:

  • Prolonged standing,
  • Heavy lifting,
  • Bending or
  • Excessive stair climbing for a minimum of 6 weeks.

Driving

Depending on the condition treated and operation your fitness to drive in addition to your insurance may be altered:

  • Anaesthetic - no driving for at least 24 hours after a general.
  • Pain - ongoing pain alters your ability to react to the changes in driving situations that may result in an accident.
  • Immobilisation - cast / splint / sling immobilisation alters your ability to react to driving situations
  • Insurance - you should check with your insurer what set time periods that they require you not to drive after your operation