Alaska’s new-school way of preparing for medical procedures

Shelly Smith didn’t know she needed hip replacement surgery.

She’s always been active and thought the pain in her leg was a side effect from the stresses of starting a new job and a recent move. When her doctor said her MRI came back showing bone on bone rubbing and that she needed surgery, she panicked.

“I thought this was going to be the end of life as I know it,” Smith said. “I thought this can’t be, I’m only 55. How am I going to be able to do the things I love?”

Three weeks after her hip replacement, Smith began making Costco runs, playing with her dog, and planning a summer trip to hike Crow Creek Pass. She credits her short recovery time to a pre-surgery class titled the Hip Academy at Alaska Regional Hospital.

Prepping the operation

Alaska Regional currently has four Academies: Knee, Spine, Hip and Colorectal. Spearheaded by Director of Programmatic Development Dieter Saunto, who crafted similar programs at hospitals he’d worked for previously, the goal of the Academy is to make surgery easier for patients and their loved ones by covering what happens prior, during and after surgery, as well as recovery and expectations.

Smith likened her Academy to a Lamaze class. It made her feel ready for what was to come and alleviated her concerns about recovery.

“In my class they covered every step of the way,” Smith said. “From check-in to checkout. And they talked about things you maybe didn’t think about: like how to shower; best positions to sleep in; said not to let pets sit on your lap right away because it could affect the stitches. They tell you how to get better faster. I left thinking, ‘wow.’”

One of the biggest elements of the programs, Saunto said, is setting the table for what to expect. Patients learn about normal surgical pain and how to best describe how their bodies are feeling to their doctors to get the care they need. They’re guided through when they can reasonably expect to be able to walk, drive and exercise again. Their loved ones are presented with how they can help with at-home care.

Saunto primarily teaches the Colorectal Academy. Of the four, it’s the only mandatory Academy, as robotic surgery is involved. More recently, Donna Koecher, an operating room nurse for the last 40 years, took over the Academies for Spine, Knee and Hip. All are provided free to patients because of the benefits they provide, not just to patients, but also to surgeons and staff.

Getting schooled in surgery

While the patients go home with an extensive informational packet they can refer back to, there is no reading while at the Academy. Instead, Saunto said, they use the space to provide room and time to ask questions, address concerns and diffuse what the patient may have read on their own online.

“If we just sent this info to their house there’d be no buffer helping them through it,” Saunto said. “The way the class is formatted, we allow time to ask and answer questions. I’ll often meet patients who you can tell are nervous or scared, but as they go through the Academy, you watch their demeanor change. They’re more educated. There’s no mystery.”

“There’s this ‘ah-ha’ moment, especially with patients that think they know it all,” Saunto said. “We will walk them through and they’ll say, ‘Oh, I didn’t know that,’ or ‘Oh, I was doing it wrong.’ Most patients have said it was worth it. That they didn’t want to come, but they’re glad they did.”

Making patients feel comfortable and cared for is a core value of the Academy, which is why Saunto and Koecher greet each patient in pre-op and follow them throughout their entire hospital stay. They want patients to have a consistent face who is familiar with their case the whole way.

“[The Academy has] made it easier for patients and staff, because they have an understanding of what they’re getting into,” Koecher said. “They are less apprehensive, they understand the process from beginning to end and are able to participate in care.”

Smith attributes the lessons she learned in Hip Academy for her rapid recovery.

“They stressed to me that I should get up and try walking right away, which I was surprised about,” Smith said. “But that first night, I got up and walked four times. When I got home, my friend said, ‘You don’t even look like you’ve had hip replacement surgery.’ Even my physical therapist was surprised by how well I was doing.”

Moving forward

The Academies are constantly being updated; As producers and surgical tactics change, the Academies change. Because of regular medical advancements, it is recommended that returning patients who have had prior surgery attend the Academy again.

Saunto said he often has nurses tell him they can tell which patients have gone through an Academy before. For some it’s obvious — they brought their book. For others, it’s because of how they carry themselves.

When Smith’s doctor broke the news to her about needing surgery, they also said she’d probably need to get the other hip replaced in five to 10 years. Though terrified by the prospect of the first replacement, she says now she’s not worried about the possibility of the second.

“After this class and this surgery, I know I can do it,” Smith said. “I know that I’m going to be just fine.”

This story was produced by the creative services department of the Anchorage Daily News in collaboration with the Sponsor. The ADN newsroom was not involved in its production.