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Reportage: Fatima, - Get ready for surgery

Doctor examining a knee.
Picture is not linked to any patient.

In this series of reports, you will learn about the process for surgical treatment of advanced osteoarthritis, starting from when a patient first sees an orthopedic specialist to ultimately receiving surgery. We will give you insight into the multiple healthcare visits one needs in order to undergo joint replacement. If you or someone you know is waiting to see an orthopedic doctor for assessment of osteoarthritis that may require surgery, this series will give you an idea of what the healthcare process will look like.

The majority of those who see an orthopedic specialist for the first time get there through referral from a primary care doctor. In this series, we follow patients during their visits to specialist doctors at Skåne University Hospital in Lund. All patients have given their consent to our presence during their healthcare visits, and we have informed them that this text will not contain any personal information that can be linked back to them. All names in these reports have thus been replaced, and the images are not from the patients themselves.

It has now been almost 11 months since Fatima met the orthopedic specialist in Lund, and she has now been called to an enrolment interview at the hospital where the surgery will take place. Today, in addition to meeting the orthopedic specialist, Fatima will meet a nurse, an anesthesiologist and a physiotherapist. Today, it is clear how important it is for the different teams and specialties within healthcare to work together, to make various assessments and help the patient with different parts of their treatment procedure.

At the doctor's visit, Fatima meets the same doctor she saw about a year ago in Lund, who will also perform her surgery. However, it is not always the same doctor one sees during the entire process; a colleague may perform the operation to provide as timely care for the patient as possible. Nonetheless, these colleagues work closely with each other, and should there be lingering questions beyond what is answered in the patient’s medical record, the doctors will communicate to one other to address these.

Fatima’s current visit to the orthopedic specialist is similar to her first visit. This time, the doctor follows-up on how she has been feeling since her last visit. Has the pain become significantly worse, or is it still at the same level? Has it become problematic to work, or has the patient suffered from any other medical conditions during the waiting period that are good for the orthopedic doctor to know about? Fatima's problems have worsened over these months and she has had to adapt her duties at work in order to continue. As a retail employee working at a store, Fatima’s work previously involved a lot of standing and walking, to perform inventory to unpack goods. In recent months she has increasingly needed to be seated in order to work, and therefore works more at the cash register.

The nurse explains a little more about the upcoming operation and answers questions. Sometimes, patient samples (e.g. blood) are also taken, as needed before the operation. The anesthesiologist makes his own assessments for surgery after speaking with Fatima, and the physiotherapist explains what to expect post-surgery, giving tips on exercises and answering questions.

Now Fatima has little over a month before her planned surgery, and she will go home and prepare for it. Since she lives with her partner, she will have the help that she needs for the first days after the operation. If one lives alone, one may consider having someone stay over or help out in the first few days after surgery, during initial recovery. But this may not be needed for everyone.