Once your surgery has been scheduled, there will be a period of time prior to your admission to the hospital. This time should be used to organize and plan for both your hospital stay and your care after discharge. The suggestions given here are a guide in assisting you to make the best decisions concerning your surgical experience as well as your full recovery. With this goal in mind, please feel free to adapt any of the following to your individual situation.
1. MAKE LISTS – Making lists can help organize your thoughts and plans during this time. Included here are several ideas for lists you may find helpful to you.
- QUESTIONS – No doubt you and your family members will have questions regarding your preadmission, surgical and post-discharge care. Making a list of these questions will help ensure that any and all information needed is obtained. Keep the lists with you (perhaps in a notebook) before, during and after your surgery so that they can be answered by the appropriate people involved with your care.
- MEDICINES – Throughout your preoperative as well as your postoperative care, many people may ask what medicines you take. Be prepared by making a list of all of your medications (both prescription and over-the-counter). Include medicines that you are taking for medical as well as orthopedic reasons. Add to the list any vitamins or nutritional supplements you also may be taking. Be sure to also list any allergies you have to medicines or other substances. Keep this list handy and definitely bring it with you at the time of your preadmission work-up, as well as the day of admission to the hospital
- APPOINTMENTS – Depending on where your preadmission testing is performed, you may have several appointments before your actual admission to the hospital. Preadmission appointments may include doctor appointments, lab tests, blood donations, X-ray appointments, and preoperative class appointments. Keep yourself organized by listing the date and time of any appointments necessary and checking them off as they are completed.
- PLANNING – Take time to plan for your care after surgery. Planning and preparing ahead of time will make your experience much more pleasant and productive. By making a list of whom and what will be needed to assist you throughout this time, you can be assured that nothing important will be missed. Ideas for planning might include a list of who will be available to assist you to travel to appointments and stay with you after discharge, if necessary. The list might also include your plans for home care assistance, meals and rehabilitation after discharge from the orthopedic unit.
2. EVALUATE YOUR HOME – One of the most important goals of surgery is for you to return home and function as independently as possible. By evaluating your home for safety and ease in functioning before your surgery, you can avoid what may later seem like large obstacles to your recovery.
- MULTI-LEVEL VS. ONE-LEVEL HOMES – If you live in a multi-level home, consider where you will spend most of your time during the day, keeping in mind that you should be able to climb stairs after discharge. Many patients in a two-level home bathe and dress upstairs and then come down to the first level and remain there the rest of the day. If there is no access to a bathroom on the first level, it may be necessary to obtain a portable toilet. While there is no set limitation to the number of stairs you can climb, certainly in the first several weeks after discharge, stair climbing may be tiring. As stability, confidence, and strength continue to improve, stair climbing can become more frequent. A one-level home presents minimal problems since all rooms are available to the patient.
- STAIRS – INSIDE/OUTSIDE – As mentioned, all patients are taught how to climb stairs while in the hospital. Evaluate any steps at your home prior to your surgery. Make sure that the handrails are sturdy. If you desire, install rails on both sides of the steps for maximum convenience going up and down. If outside steps do not have a handrail, perhaps now is the time to install one, if possible. Evaluate the entrances to your home. Select the one that has the easiest access for you while using crutches or a walker. You'll find if you work on these ideas now, your recovery time won't be hampered by trying to make these decisions.
- BATHROOMS – Safety is the keyword when you look at your bathroom. Make sure you can maneuver. Remember, you will be using a walker or crutches for six weeks. Some ideas to consider are:
- Shower/tub rail.
- Rail on wall by toilet (many times a sink to the side of the toilet can be used for support).
- Raised toilet seat.
- Shower/tub bench.
- Nonslip mat inside tub/shower.
Many patients who have been living with joint problems already have some of these items in their bathrooms. While not all of the equipment listed is required, the most important is the raised toilet seat. If you are not currently using one, you may want to wait until you attend the preoperative joint class or until your admission to the hospital. By doing so, you and the occupational therapist can decide which type is best suited for your bathroom.
The second most important item is the tub bench. This allows the patient to be seated while in the shower, since standing without support is not allowed the first six weeks after surgery. If you intend to use a tub bench after surgery, please be aware that it will be necessary to remove any tub doors in order for the bench to fit inside the tub. Our recommendation is to purchase a tension rod and shower curtain, and store the tub doors until they can be used again.
The other important aspect to consider in the bathroom is to have any supplies within easy reach. If possible, place shampoos, shaving equipment, toilet tissue, etc., within easy reach (waist to chest level) and where there is little or no bending or reaching required. You'll find that this is the most efficient way to maneuver, meets any position restrictions recommended in the postoperative phase and is by far the least likely to cause discomfort or injury after surgery. An added plus is that you'll be able to quickly identify when supplies are running low.
- KITCHENS – Again, planning ahead can mean the difference between a recovery period that runs smoothly or one that you feel is constantly frustrating. Using safety and efficiency as the primary guides, take a look at your kitchen. Think about meals and the equipment used for them. Put pots, pans, canned goods, and cleaning supplies at waist to eye level for ease of access. When using crutches or a walker, you're not going to want to be bending too low nor reaching too high, for safety's sake.
- Use your upper cabinets or counter space to store your most frequently used equipment.
- If you plan to prepare meals and freeze them before having your surgery, try to place them in containers that will go from the freezer to the oven, stove, or microwave to make life easier. (Don't make any containers too heavy if you are the one who will need to get them out.)
- Remember the refrigerator, too. The same rules apply – try to keep the items you'll use most frequently on the upper shelves to maximize energy conservation and maintain any position restrictions you may have.
- GENERAL HOUSEHOLD – In general, most households need just a few adjustments in order for you to function more effectively after surgery. As with all the suggestions given here, remember to adapt what may be suited to your individual needs.
- Floors – Be sure that your pathways are cleared. If you have small items sitting on floors or stairs, you may want to put these away for now. If you have small children at home, educate them now to put away toys, books, etc. so that everything is up from the floor.
- Pets – If you have indoor pets, arrange to have someone available to help care for them. You will need assistance with their care while using a walker or crutches. In addition, consider the safety factor of functioning in your home with an indoor pet. Remember, you will always want a clear pathway in order to avoid injury.
- Carpets – Scatter rugs should be put away for later use. They can cause you to lose your footing and perhaps fall. Even those with rubberized backs can be an obstacle to crutches or walkers, so remove them while recuperating.
- Furniture – In general, you will be most comfortable sitting on higher furniture with arms. Sofas or chairs that are too low can cause problems, both with bending too much sit and straining too much to stand.
Pick a comfortable, moderate height chair or sofa for sitting so that your knees are on a level with or slightly lower than your hips when you are seated. Foam cushions on chairs or sofas that are too low may help to keep you on the right level and are available through the occupational therapy department while you are in the hospital.
Recliners, if the correct height for comfort and any position restrictions, are a popular type of chair for use at home.
- GET COMFORTABLE! – Make sure that the things you need, such as the telephone, TV remote control, newspaper, magazines or books, are within your reach. You may want to place a small table near the chair or sofa where you will be sitting after surgery in order to keep these things handy.
A FINAL WORD – All patients are unique and have their own needs. The suggestions and ideas presented here are based on our past experience with other patients. It is our hope that this information can be helpful to you and your family in preparing for your upcoming surgery.