This comprehensive packet, prepared by Hawai‘i Straub Benioff / Hawai‘i Pacific Health for patient Nathan (Nate) Gustavo Kawasaki (DOB 6/9/2005), outlines every aspect of his upcoming minimally invasive total hip replacement (anterior approach) scheduled for 6/25/2026. It begins with a personalized welcome letter from Dr. Cass K. Nakasone, reassuring the patient and describing the fast‑track recovery benefits of the anterior approach (no hip precautions, early ambulation, possible same‑day discharge). The document then details pre‑operative requirements (fasting, medication adjustments, CHG skin prep, required IDs, insurance, transportation, advance directives, disability forms, and MyChart resources). It explains anesthesia options, intra‑operative processes, and immediate post‑op expectations (walking with PT, use of Zip® skin‑closure, pain‑management protocol, DVT prophylaxis, incentive spirometry, and early mobility). Extensive wound‑care guidance for Zip® or staples, including removal instructions, dressing changes, and signs of infection, is provided. A full postoperative activity guide covers return to work, driving, travel, sex, exercise, and the “as‑tolerated” philosophy. The packet lists home equipment (walker, elevated toilet seat, shower chair, etc.), rehabilitation options (inpatient vs. short‑term facilities, partner facilities, transportation, and cost considerations), and a detailed schedule for physical‑therapy visits and home‑exercise programs (quad sets, ankle pumps, heel slides). Pain‑management education covers opioid safety, dosing, side‑effects, and disposal. DVT education explains pathophysiology, risk factors, symptoms, and diagnostic steps. Emergency after‑hours instructions for fever, bleeding, wound concerns, and medication refills are included. The document also contains administrative details: appointment confirmations (post‑op x‑ray 8/7/2026), contact numbers, facility maps, MyChart enrollment, parking directions, and a list of home‑health agencies. Finally, it provides a cold‑compression therapy rental program, Zip® removal guide, daily surgical site assessment chart, and a safety‑reporting protocol. The overall tone is instructional, supportive, and reassuring, aiming to empower the patient and caregivers to manage recovery safely and efficiently.
Topics
Personalized Welcome Letter and Overview of Anterior Approach Hip Replacement
A greeting from Dr. Cass K. Nakasone outlining the benefits of the minimally invasive anterior approach, emphasizing no hip precautions and rapid discharge.
Pre‑Operative Preparation: Fasting, Medications, and Skin Antisepsis
Instructions on when to stop eating/drinking, medication adjustments (aspirin, Tylenol), and use of 2 % chlorhexidine cloths the day before surgery.
Day‑of‑Surgery Workflow: Admission, Anesthesia, and Immediate Post‑Op Care
Step‑by‑step guide to checking in, the Surgical Admission Center, anesthesia options (regional, general), and early mobilization protocols.
Pain Management and Opioid Safety Guidance
Explanation of opioid mechanisms, side‑effects, safe usage rules, tapering schedule, and adjunctive acetaminophen use.
Zip® Surgical Skin Closure Device – Care, Removal, and Dressing Guidance
Detailed instructions for keeping the Zipline device in place, removal after ~14 days, handling adhesive residue, and dressing changes without disturbing the device.
Early Mobility, Assistive Devices, and Home Physical Therapy Plan
Recommendations for using a front‑wheeled walker, home PT exercises (quad sets, ankle pumps, heel slides), frequency of outpatient PT, and equipment (elevated toilet seat, shower chair).
Activity Restrictions, Return‑to‑Work, and Driving Guidance
Guidelines for resuming work, driving, swimming, and other activities based on tolerance and pain levels.
Deep Vein Thrombosis (DVT) Prevention and Symptom Monitoring
Explanation of DVT pathophysiology, use of intermittent pneumatic compression devices, and red‑flag symptoms requiring immediate contact.