Frequently Asked Questions
Quality care provided by an Orthopaedic surgeon
Dr Oscar Brumby-Rendell is a founding director of the Adelaide Shoulder & Upper Limb Clinic. An Orthopaedic surgeon, Dr Oscar Brumby-Rendell manages sport, arthritis and trauma injuries, specialising in upper limb surgery of the shoulder, elbow, wrist and hand. With local and international training, including a competitive International Bone Research Association fellowship and microsurgical training at the National University Hospital (Singapore), Dr Oscar Brumby-Rendell is a leading surgeon in his field who works towards improving diagnosis methods, treatment options and patient outcomes.
Driving
- You must have a current driver's licence valid for your vehicle.
- You must have the ability to control the vehicle in emergency conditions.
- You should be able to testify your driving abilities in a court of law.
There are no enforced regulations regarding driving after surgery, but a safe recommencement of driving depends on your specific procedure, driving ability and advised recovery restrictions.
- you are part of a car accident while you are wearing a brace or cast
- you are under the influence of sedative pain relievers that may affect your judgement or concentration
- you recently had a fractured bone and X-ray evidence displays that the injury has not fully healed
- you have undergone a "recent surgery"
There is no clear definition of a "recent surgery". Speak to your car insurer for further information if you have questions. More information is available on Pubmed: http://www.ncbi.nlm.nih.gov/pubmed/23450009
- Will my recovery process be impeded by my return to driving, and will my final surgical result be compromised?
- Can I safely drive? (i.e., Am I able to control my vehicle in emergency situations?)
- Can I safely perform the necessary driving manoeuvres? (i.e., Am I unable to drive due to temporary symptoms or a splint?)
- Do I have the necessary judgement and discernment skills for driving? (i.e., Am I consuming pain relievers that may compromise my judgement or affect my reaction time?)
- What type of vehicle you drive (transmission / power steering)
- Driving conditions (weather/ time of day / road conditions)
- Journey length
- Post-operative pain
- Consumption of medication
- Limb function post-surgery
- Judgement skills and driving ability
- After your surgery, you will usually consume sedative pain relievers (these have a similar effect as alcohol).
- Judgement, concentration and reaction time can be affected by these medicines.
- Do not drive when you are under the influence of these medicines.
- Being able to drive without pain
- Not needing to wear an extremity splint for recovery or pain prevention
- Movement range in the shoulder spanning to 90 degrees of abduction and 90 degrees of forwarding flexion
- Able to move the elbow to full or near full extension
- Proper hand and wrist function
- Almost equal strength in both upper limbs, which are not affected by impingement, pain or reduced muscle/nerve function
- Once the above has been achieved and you can perform regular driving motions, you must consider your reaction time. Is it affected by your surgery?
- A cast or splint must not be worn on your lower limbs, and you should not need crutches.
- Pain or reduced muscle/nerve function should not affect your lower limbs
- You should progressively return to driving, and intensity and duration should be increased over time as comfort enables.
- Practice driving manoeuvres in a controlled environment, such as a car park, before driving on the road.
- You may consider recommencing driving after you can perform all manoeuvres and emergency stop movements safely and repetitively.
My Surgery
It can be difficult to make the decision to undertake surgery, and Dr Brumby-Rendell will ensure you understand what your surgery involves and have time to process this given information. You will receive consent for your operation after you have decided you want to undergo surgery. Dr Brumby-Rendell's PA will organise for your surgery to be performed at the most suitable hospital and on an appropriate date. Before your surgery, all required paperwork will be organised.
More information regarding surgery preparation can be found here.
An essential aspect of the operative process is consent. This is where Dr Brumby-Rendell will extensively discuss with you the planned surgery. He will also provide information regarding the disease's natural history and treatment options, including no treatment. The risks and potential complications of your surgery will also be explained. After receiving this information, you can make more informed decisions regarding the treatment you wish to undergo.
Normally, you will sign a document that transparently describes the procedure and its benefits and risks, and this is filed. When you prepare for surgery, this document will be referred to.
Bring any previously conducted imaging, including X-rays, MRIs, CT scans and the associated radiologist's report(s) on your surgery day.
You must also bring your normal medications, including those that you were required to stop taking before surgery. As you must wait a few hours before your surgery, it is recommended that you bring a book or laptop to entertain yourself. We provide magazines and newspapers. It is also recommended to bring a dressing gown and some slippers. If you must stay at the hospital overnight, you may want to pack comfortable clothes and toiletries.
DO NOT BRING large amounts of money, jewellery or other valuable items.
Yes. Do not consume food within 6 hours or drink water within 4 hours of your surgical procedure. For instance, if your surgery is to be conducted in the morning, do not eat after midnight or drink water after 04:00am. If you have a midday surgery, you can have breakfast at 06:00am and drink water until 08:00am.
"You want a good operation, not a quick operation."
- Lee Van Rensburg, Shoulder and Elbow Surgeon, Cambridge University; Cambridge, United Kingdom.
Normally, patients are removed from the ward after 2 or 3 hours. Surgery does not take all this time. Rather, you will also be put to sleep and awoken here. Your specific surgery dictates the time you remain in the ward. Most surgeries do not take more than 60 minutes; however, more complex procedures can take many hours.
All private operations are conducted by Dr Brumby-Rendell. A surgical assistant supports him during surgery, and another qualified Orthopaedic surgeon may also assist Dr Brumby-Rendell in complex cases.
You will normally return home on the same day as your surgery if you undergo keyhole surgery; however, this varies depending on the anaesthetic given and your medical fitness. You must stay for at least 1 night if you had keyhole surgery to correct stiffness. This is to relieve pain and practice intensive physiotherapy. A short hospital stay is required for major, complex surgeries, including joint replacement surgery.
You must organise who will take you home from the hospital, and who will support you with everyday tasks once you arrive.
There is a very low risk of required back-up medical support, as Dr Brumby-Rendell conducts necessary pre-planning and investigation.
Each patient's surgical comorbidities will be evaluated by Dr Brumby-Rendell, and it will then be decided if the surgery should take place at a medical facility with intensive care support, such as Flinders Private Hospital.
Your anaesthetist will provide clarity to these questions before your surgery. Usually, "general anaesthetic" will be used to put patients to sleep.
Considerations for particular surgeries
- During this surgery, your tendons are usually cut, meaning these structures must be healed during recovery.
- Tendons usually take between 6 and 8 weeks to heal and become stronger around 3 months post-surgery.
- Your surgical results may be affected if you recommence driving before the 8-week mark.
- Usually, it will take between 8 and 10 weeks before you regain the ability to drive. After this period, a progressive increase to normal driving habits may be expected.
- Movement is encouraged immediately after surgery if no ligaments or tendons need healing. You can recommence driving when your physical capacities allow. Normally, this is around 4 weeks post-operation.
- If a tendon or ligament was operated on, you must wait to recommence driving until this structure(s) has healed. Generally, if a ligament or tendon has been repaired, you must wait until the tendon/ligament has healed. Usually, this takes between 8 and 10 weeks. After this period, a progressive increase to normal driving habits may be expected.
- Your surgical results may be affected if you recommence driving too early.
- Examples of minor surgeries include carpal tunnel decompression.Â
- It is beneficial to refrain from driving until wound healing is complete to ensure the sutures do not become loose and open the wound. Generally, this takes between 10 and 14 days.
- When driving, the scar may induce pain for around 6 to 8 weeks after surgery.
- Your ability to recommence driving depends on what car you drive (i.e., gear changing, power steering).
- Generally, patients recommence gentle driving approximately 2 weeks after their procedure.
Flying
This advice has been provided by Dr Brumby-Rendell as a generalised guide. Use this information as a reference only, and understand that your surgical result may be compromised if you fly too quickly post-surgery or with a bone fracture.
You will experience challenges during airport transit, turbulence and comfortable sitting throughout the flight due to your surgery. Your tolerance to turbulence will be significantly affected by a fractured bone.
Generally, you should wait the following period before flying:
- 1-2 days post-keyhole (arthroscopic) surgery
- 1-2 days post-cast application. Please note, you will unlikely be unable to fly if you have plaster on both legs. For more information and advice, contact your airline or travel operator.
- 4-5 days after an open, simple surgery (including hand or wrist surgery)
- 14 days after open, complicated surgery (including shoulder joint replacement surgery)
- 14 days after surgery conducted to promote fracture (broken bone) stabilisation
- 3 months after total hip replacement (during the first 6 weeks post-operation, restrictions are in place to prevent hip dislocation. Aeroplane seats do not meet these precautionary requirements.)
Please note, your ability to sit comfortably in your plane seat and tolerate turbulence is impacted by having a broken bone or recent surgery. Consider these factors BEFORE booking or boarding a flight.
Other medical conditions also have restrictions for flying.
Below is a general guide:
- Abdominal (tummy) surgery - wait 4-5 days or 10 days should the surgery be more complicated.
- Brain or neurosurgery - wait 6 weeks.
- Cataract or corneal laser surgery - wait 1-2 days or 10 days should the surgery be more complicated.
- Chest surgery (including coronary bypass graft) - wait 10 days, as long as you have not developed any complications.
- Colonoscopy - wait 1 day, as long as you have not developed any complications.
- Lung surgery - wait 3 months.
- Heart attack - wait 7-10 days, as long as you have not developed any complications.
- Heart failure - if an individual's condition is stable and they are utilising controlling treatment, they can generally fly on a plane.
- Pacemaker - once stable, individuals with a pacemaker or implantable cardioverter-defibrillator (ICD) can fly on a plane.
- Retinal detachment - wait 6 weeks.
- Carpal Tunnel
Ask Dr Brumby-Rendell for individual information regarding your ability to fly if you have undergone a major surgery BEFORE you book a flight.
Airline - There are unique regulations regarding flying eligibility for each airline. Before you fly, check these requirements with your airline, especially if you have undergone a complex surgery. You should also check the hand luggage restrictions. You will be allowed to sit in an emergency seat on all airlines; however, you may need to purchase an extra or upgraded seat if you cannot sit in the standard seat (i.e., if you cannot bend your knee or are wearing a large sling). For more information, view our selected airline information page.
Insurance
The insurer will cover all fees if patients have the required health insurance level. Some insurance companies, however, have different rebates, which can necessitate a surgical care gap. Our friendly, professional staff will discuss this with you at your consultation.
Our staff will give you an expected cost quotation if you do not have private health insurance. Please understand that this is only an estimated fee, as the actual required treatment may vary from the theoretical treatment.
WorkCover
The statutory body that assists businesses and workers in understanding work health and safety obligations is NT WorkSafe. Important links are provided below:
Important links:
To help you recommence work, Dr Brumby-Rendell can provide you with a fitness for work statement certificate.
The South Australian Return to Work scheme is regulated by ReturnToWorkSAÂ , which provides insurance for workplace injuries and protects workers and businesses in these situations.
Important links are provided below:
To help you recommence work, Dr Brumby-Rendell can provide you with a fitness for work statement certificate.
The Workers Rehabilitation and Compensation Act 1986 and the South Australian Workers Rehabilitation and Compensation Scheme (under this act) are governed and supervised by WorkCover. Minister for Industrial Relations, The Hon. John Rau MP, directs WorkCover SA.
This system aims to give compensation for workplace injuries. The funding of this authority is provided by employers to allow for employee fund management, the coverage of workplace injuries, entitlement inspections and worker rehabilitation.
An employee who has been injured may be compensated if:
- They received their injury at their workplace while fulfilling work responsibilities or while being employed
- They developed an illness or disease (including psychological) due to their employment
A worker may be entitled to the following, as dictated by their injury's nature:
- Income maintenance via weekly payments
- Reasonably incurred medical costs associated with their illness or injury
- Non-economic loss (permanent impairment) lump-sum compensation
Nominal interruption and apprehensions will be experienced by most workers who claim compensation. The following statistics show injured worker outcomes:
- Almost 80% progress candidly
- Almost 20% continue to experience disability and distress due to their initial work-related injury.
- Of this 20%, 5% are said to exhibit unequal outcomes, experiencing long-term disability and distress not justified by the work-related, initial injury.
It is not well understood why recovery rates and outcomes are varied. Complex social, psychological, and health provider factors strongly impact an injured employee's recovery journey.
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