No, a doctor’s referral
is not necessary as we carry out a full clinical
examination; x-rays are taken; as well as
blood and urine tests. There is a consultation
with the orthopaedic consultant the day before
surgery. However, it is helpful to have the
support of your GP or doctor. Direct Healthcare
International, where possible, prefer to work
with your doctor or GP. This can only benefit
the patient in the long run. Should your GP
or doctor wish to know more about our organisation
we would welcome a contact from them.
Would
it help if I brought my MRIs, x-rays, etc
with me?
We undertake our own investigations,
high definition x-rays and CT scans. MRI scans
are not necessary, if you have x-rays, CT
scans or MRI's bring them with you.
Should
I inform the doctor if there is anything
unusual in my medical history?
Yes - this should be declared
in the pre-surgery enquiry form, which we
will pass on to the surgeon, it is helpful
to mention any major points again. To download
the pre-surgery questionnaire click
here
Will
I have the opportunity to ask questions?
Yes, the surgeon is quite
open to questions and will explain everything
in detail.
Can
my partner attend the consultation?
Yes, they are welcome to attend.
Will
I need any aftercare?
Our program is designed to
incorporate sufficient physiotherapy thereby
leaving little or no requirement for aftercare.
Comparative studies have shown that our patients
are in better condition when they return home,
after 6months, and 12 months, than those treated
in other leading facilities.
What
condition will I be in when I return home?
With hip & knee replacements
or resurfacing, you will be able to walk easily
with the aid of the stick or crutch provided.
You should be capable of walking approximately
150 yards or more before getting tired. Depending
on your physical condition, you may have some
anti coagulant injections to take home with
you and some stitches may need to be removed
after you return home.
Can
I bring a relative or friend?
Yes, there is an in house
modern bed & breakfast facility especially
for friends & family members. We would
prefer it if at least one person accompanies
you.
On which
days is the surgery undertaken?
Orthopaedic surgery is performed
either on a Tuesday or Thursday, general surgery
Wednesday and MRI scans Tuesday. The day before
surgery is set-aside for patients clinical
and pre surgical examinations and tests.
How
many main orthopaedic procedures are done
at the Hospital per year?
Both consultant surgeons have
been operating at this hospital since 1992,
performing up to 1000 major procedures per
year.
How
many people does your organisation treat
a year?
We have been in the healthcare
service profession for over five years and
successfully facilitate approximately 1400
treatments a year.
What
steps are taken to prevent blood clots (thrombosis)?
The hospital may administer
low weight heparin 'B' to prevent thrombosis.
You may also receive some of these drugs to
take home with you.
I wish
to fly shortly after my surgery is this
safe?
Yes flying even long haul
is quite safe, ask the surgeon about this;
as you are receiving low weight heparin 'B'
to prevent thrombosis there should be less
risk than usual.
Will
I need a blood transfusion?
For hip surgery, it is less
likely that blood will be needed; for knee
surgery, it is quite possible. If you are
unable to receive transfusion for religious
reasons a “cell saver” machine
is available.
If needed,
is this included in price?
Transfusion is included in
the price as is the use of the “cell
saver”.
What
is the blood screening policy?
European policy on filtration
and testing of blood is very strict. The hospital
is equipped with its own accredited laboratories.
Blood samples can be screened day or night.
The ICU can locally provide blood-gas analysis
and ionography under the supervision of the
central laboratory, which is responsible for
quality.
Practical arrangements describe:
Indications
Method of transfusion
ABO and rhesus control
Blood units are supplied by the Blood Transfusion
Centre, which is regulated by Belgian Law,
pertaining to blood and derivative of blood
of human origin, in addition, the European
guide to “qualification assurance of
blood donation and preparation use”
is strictly followed (edition of 8th January
2002 under code R 9515)
Articles 8 & 4 of the Belgian law state
that blood must be screened for hepatitis
B and C, HIV, syphilis and anti HBc antibodies.
What
type of anaesthesia is used?
The anaesthetist will discuss
the type of anaesthesia used prior to surgery.
If you have a preference, please state this
to the anaesthetist or surgeon.
Loco-regional anaesthesia (spinal, epidural
or combined) is used when possible. General
anaesthesia can be used alone or in combination
with a loco-regional technique.
Loco-regional
With spinal anaesthesia, a small amount of
local anaesthetic is injected through a small
bevel needle into the cerebrospinal fluid
surrounding the spinal cord. This gives a
fast and profound anaesthesia in selected
segments of your body.
With epidural anaesthesia, a narrow catheter
is placed in the epidural space for postoperative
analgesia.
With combined spinal epidural anaesthesia,
after identification of the epidural space,
a spinal needle is advanced into the intrathecal
space, allowing injection of the spinal component.
After this an epidural catheter is left in
the epidural space for post-op analgesia.
General
If you are undergoing general anaesthesia,
you will be put asleep by IV-medication. A
mask or a breathing tube then gives an anaesthetic
gas for maintenance of anaesthesia.
You will receive pre-medication (a light sedative)
before going to the Theatre. This relaxes
you and minimizes the discomfort of the procedures
(IV-line, loco-regional techniques) performed
while being awake.
The loco-regional will be administered before
the induction of general anaesthesia (if applicable)
for reasons of safety.
Could
you tell me a little more about the intensive
care facilities?
The hospital has a fully functioning
24 - hour accident & emergency department,
paramedics, and fully equipped intensive care
unit. Response time for a doctor to be at
bedside day or night is under 2 minutes.
How
long will I stay in Intensive care?
Usually, less than 1 day,
however, if you have any history of heart
problems; are overweight; or have other risk
factors, we may keep you in intensive care
for a longer period. This is a perfectly normal
precautionary procedure.
Is there
any additional cost associated with this?
Providing the length of stay
in intensive care is just a couple of days,
there is no additional cost. Please see the
DHI overrun insurance for details.
What
if something goes wrong after I return home?
DHI have a number of aftercare
and emergency systems in place should they
be needed. Please remember that these should
only be used in the event of an emergency
or urgent need. Patient seeking urgent advice
should follow the steps laid out below. If
the patient ‘s condition appears serious
a local GP or accident and emergency hospital
should be contacted in the first instance
otherwise:
Call DHI (preferably during
office hours) if necessary use the 24hr
response emergency phone number.
The treating surgeon will
be contacted and asked take direct contact
with the patient or their physician.
The patient may be asked
to attend their GP if this is more practicable
or their local hospital.
A doctor can be called
to attend at the patients home (UK only)
in the event of any significant problems.
The doctor can take a wound swab which will
be tested in our labs, report and if necessary
medicate.
If the problem appears
significant but not an emergency the patient
may need to return to the operating facility
for further examination and treatment.
DHI also employs consultant
surgeons and labs (within the UK) that will
assist in the event that it is needed.
Please remember that DHI have
successfully sent thousands of people for
treatment. No significant or urgent medical
problems have occurred. No patient has ever
had a cross infection of any kind in one of
our partner hospitals.
What
is the risk of infection?
Our partner hospital has successfully
treated hundreds of our patients with no cases
of cross infection. Should a patient be found
to have an infection on arrival, they are
isolated and treated accordingly. Should a
case of secondary infection occur, it would
manifest itself during the stay in hospital.
Belgium has one of the lowest secondary infection
rate is in Europe. Rates in the UK and Eire
continue to remain at alarming levels. In
the USA occurrences are on the increase. As
recently as 2006 reports from within the UK
and Eire health services, the news media,
and senior consultants indicate that the problem
remains acute in most hospitals. So far, all
our clients have remained free of secondary
infections.
What
make of prosthesis is used is it FDA approved?
The surgeon’s can fit
both Smith & Nephew "Birminham Hip"
(FDA approved) or Zimmer prosthesis. These
are the two leading prosthetics manufacturers.
DHI’s aim is to ensure that surgeons
use the best implants available. See (www.zimmer.com)
What is the expected life of this implant?
Zimmer’s prostheses are extremely durable,
under normal conditions they should last for
many years.
When
the implant wears out what are my options?
This is called a revision
procedure. It costs a little more because
the surgical procedure to remove the old prosthesis
is more complex.
I understand
that there is cemented as well as cement-less
fixation, which is the surgeon likely to
use?
The surgeon prefers to work
with cement-less fixation, unless the indications
are for a cemented fixation such as weak bone
structure. The reason for not using cement
is that the tough alloy used in the construction
of the prosthesis is both porous and rough
(on the outside) where it meets the bone,
this enables the bone to grow and fix itself
to the prosthesis (like the barnacles on the
hull of a ship). After a short while, the
bone grows over the prosthesis and the two
become firmly fixed together. With cement,
there is a slight chance of the cement breaking
down and working loose.
Could
you tell me a little more about the physiotherapy
facilities?
The success of a surgical
procedure such as a hip or knee replacement,
a hip resurfacing, or spine surgery, largely
depends on rehabilitation. To achieve the
best and fastest results, rehabilitation needs
to be started early, be intensive and task-specific
(early standing and walking). A highly skilled
team of 10 physiotherapists and 3 occupational
therapists, under supervision of a medical
doctor & specialist in Physical Medicine
and rehabilitation, combines the latest rehabilitation
techniques with an extensive experience and
a personal approach. They also instruct you
on the practical and ergonomic issues following
these interventions.
The Hip
Surgery Brochure provides information
on a pre-surgery exercise program to follow
at home, and all necessary information.
Do you
offer accommodation for my carer?
Yes, please enquire for details.
What
charges are not included?
Any phone calls made during
your hospital stay.
It would
be nice to speak to someone who has experienced
using your services, could you please provide
a reference that I could reach by telephone?
Yes, we have many previous
patients willing to act as referees. Please
contact and we will provide some details.
I am
not very mobile. Can you assist with wheelchairs?
We recommend asking us to
arrange wheelchair assistance if you have
any mobility problems. Please ensure that
we are informed at the office so that we can
best assist you.
What
can I do to prepare for Surgery?
For five days before
surgery you may wish to take some vitamin
& iron tablets and use an antiseptic
cleansing shower gel (Hibiscrub)
Complete and return the
patient pre-surgery enquiry form
Bring with you slippers,
trainers or walking shoes, loose comfortable
clothing, dressing gown or bath robe, personal
toiletries, eye glasses, dentures, reading
materials or anything to help you relax
such as a personal walkman and music
Bring phone numbers of
people you may want to call
Bring a small amount
of money for small items such as telephone
calls
Passport
Bring your European Health
Insurance Card (formerly Form E111 obtainable
from your local post office)
Bring any medication
and a list of any medicines that you have
been taking
How
long is the duration of stay?
Hip replacement – 11
days Hip resurfacing – 11 days Hip revisions
- 16 days
Where
can I arrive and still be picked up by your
chauffeur?
You can arrive at the following
places:
Train
stations:
Lille international (Euro star)
Brussels Midi
Airports:
Brussels National Airport, Zaventem
Brussels South Airport, Charleroi
Seaports:
Zee Brugge
Calais
Can
I stay longer if required?
Yes, there is additional stay
available. We recommend an additional period
of stay for women over 75, and men over 80,
or if there are any mobility problems. The
extra stay includes full physiotherapy and
enables the patient to recover more fully
before returning home. Please ask about the
cost of the additional stay
Home
Indications 
