Virtual joint class transcript
For joint replacement patients who cannot attend our joint class, you can now read a transcript from the class and learn how to prepare for your surgery and what to except following your procedure.
00:00
- [Narrator] Welcome to the Joint Replacement Class
00:02
at TriStar Centennial Medical Center.
00:05
The first portion of this class will be taught
00:07
by an orthopedic nurse navigator or educator
00:10
and the second portion of this class will be taught
00:12
by a member of our physical therapy team.
00:16
Our program mission statement is to become
00:18
the best joint replacement center in the nation
00:21
by providing our patients passionate care
00:24
while achieving exceptional outcomes
00:26
through the use of research- and evidence-based practices.
00:30
Today we're going to educate you
00:32
on total joint replacement surgery
00:34
and share some expectations of before and after your surgery
00:38
in hopes of alleviating any stress or anxiety
00:41
you may be feeling.
00:42
If you have any questions,
00:44
please notify your surgeon's office.
00:48
In preparation for your surgical procedure,
00:50
you must be cleared medically,
00:52
listen to the joint education class
00:55
and go through pre-admission testing.
00:57
While going through pre-admission testing,
01:00
you will receive a special cleanser.
01:02
This cleanser is to be used
01:03
the night before your surgical procedure
01:05
and the morning of your surgical procedure,
01:08
unless instructed differently.
01:10
The cleanser comes with a new, clean loofah
01:12
that is to be used to apply the cleanser.
01:15
Please do not use an old wash cloth.
01:18
Use the cleanser from head to toe,
01:20
keeping it out of your eyes, ear canals and mouth.
01:25
When drying off after using the cleanser,
01:27
please use a clean, fresh towel.
01:30
Once you are dry, do not apply any lotions,
01:33
creams, makeup or powder to your skin.
01:38
The cleanser pack will come with detailed instructions
01:41
and a diagram on how to use.
01:44
Remove any nail polish and acrylic from your fingernails.
01:48
Do not write on your legs.
01:50
Your surgeon will initial
01:51
the surgical site in the holding room.
01:54
No eating or drinking after midnight
01:56
the day before your surgical procedure.
01:59
You will be given a bottle
02:00
of Ensure Pre-Surgery Clear Nutrition drink
02:04
during pre-admission testing
02:06
to drink the morning of your surgery.
02:08
Please drink it before you arrive at the hospital.
02:12
The drink helps your body prepare for
02:14
and recover from surgery.
02:16
If you are lactose intolerant,
02:18
on a gluten-free, kosher or halal diet,
02:21
you may consume the Ensure Pre-Surgery drink.
02:24
Please contact your surgeon's office
02:26
with any additional questions.
02:30
Please identify a coach or caregiver
02:32
that can actively participate with your care after surgery.
02:36
You will have medications in your system
02:38
that can prevent you from remembering
02:40
the post-operative education
02:42
your navigator will review with you.
02:44
Also, it is important for your coach or caregiver
02:47
to be present during your physical therapy
02:49
and occupational therapy sessions
02:52
which occur the day of your surgical procedure
02:54
and the morning after your surgical procedure.
02:57
Their presence will help facilitate
02:59
a smooth and safe transition from a hospital setting
03:03
to an in-home setting.
03:06
Whether it be a family member or friend,
03:08
please have transportation set up
03:10
to carry you from the hospital to your home.
03:15
Discharge planning starts in your physician's office
03:17
before you are admitted to the hospital
03:19
for your surgical procedure.
03:22
What this means is once discharged from the hospital,
03:25
most of our patients attend outpatient physical therapy.
03:28
Please get a preferred list from your surgeon's office
03:31
and select one of your choice.
03:33
Please visit where you plan to attend
03:35
outpatient physical therapy and set up your appointments.
03:39
Ask your surgeon's office what day
03:41
to set up your first appointment
03:43
and how many sessions to set up per week.
03:47
Admission to a rehab facility is less likely
03:50
in single joint replacements
03:52
and most patients go home the day after surgery.
03:55
If a facility is necessary for you,
03:58
your surgeon will let you know.
04:01
We ask you to bring several things with you
04:03
on the day of your surgery.
04:05
Please bring your educational booklet
04:07
that you receive from your surgeon's office.
04:09
We will continue to add additional education to the booklet.
04:13
Please bring loose-fitting, comfortable clothing.
04:16
Clothing that works well would be shorts and a t-shirt,
04:19
gown with robe and loose fitting pajama pants.
04:23
Remember to bring clothing
04:24
that you are comfortable wearing in the hallways
04:26
where you will be walking.
04:28
Please bring your own personal preferred hygiene items.
04:31
If you forget, we do have shampoo, soap,
04:35
toothbrush and toothpaste.
04:37
If you wear a home C-pap machine while sleeping,
04:40
please bring it along with the tubing and mask.
04:44
We will provide distilled water.
04:47
Bring a copy of your living will
04:49
and durable power of attorney for healthcare.
04:52
If you have a rolling walker which has rolling wheels
04:55
in the front and tennis balls or skis in the back,
04:58
please put your name on it and bring it to the hospital.
05:01
If you do not have a rolling walker
05:03
and you have not had a piece of medical equipment
05:06
covered by insurance in the past five years,
05:09
your inpatient case manager can order you a rolling walker
05:13
to be delivered to your hospital room
05:15
before you are discharged home.
05:17
You may also purchase a rolling walker
05:20
at a medical supply company before your surgery
05:23
and bring it to the hospital day of your surgery.
05:26
Please put your name on your walker.
05:30
Please bring a list of the medications
05:32
you are currently taking.
05:34
Have the name, dosage and how often
05:37
you take the medications written down.
05:40
Also include a list of your allergies.
05:44
Please leave your jewelry, large amounts of money
05:47
and valuables at home.
05:49
Only debit and credit cards, no cash,
05:52
are being accepted throughout the hospital
05:54
to help contain the spread of germs.
05:59
On the day of surgery, you may park in garage B,
06:02
which is located on the corner
06:03
of Patterson Street and 23rd Avenue.
06:06
You may park on levels B1 through B3.
06:10
Enter the hospital via the connector located on level B3.
06:15
Follow the connector to the hospital entrance
06:17
where COVID-19 screening is currently set up.
06:20
After being screened and cleared to enter,
06:23
you will be given a green armband.
06:25
One support person will be allowed
06:27
to enter the hospital with you after being screened as well.
06:31
Continue down the hallway to the elevators
06:34
which are to be taken to the eighth floor.
06:39
Please arrive on the eighth floor pre-op
06:42
at the instructed time on the day your surgery is scheduled.
06:47
The eighth floor pre-op is in
06:49
Centennial Medical Center's main tower.
06:53
A nurse will escort you to a pre-op room
06:56
where they will take vital signs, review records,
06:59
and you will change into a gown.
07:02
Questions will be asked repeatedly by different caregivers
07:06
such as, what is your name, date of birth,
07:09
and what procedure are you having done?
07:11
This is for your safety.
07:15
While in the holding room,
07:16
oxygen will be placed by nasal cannula,
07:19
an IV will be started, your surgeon will speak to you,
07:24
anesthesia will speak to you,
07:26
and medications will be given to help you relax
07:29
and some for post-operative pain and nausea.
07:33
After surgery, you will recover in the PACU,
07:36
which is the Post Anesthesia Care Unit.
07:39
You will be in this unit from one hour up to four hours.
07:43
Your nurse in the PACU
07:45
will administer pain medications if needed.
07:48
If oral pain medications are needed,
07:50
a snack provided by your nurse is to be eaten
07:53
before these medications are administered.
07:56
Oral pain medications taken on an empty stomach
07:59
cause nausea and vomiting.
08:03
Your nurse will monitor vital signs
08:05
and check surgical dressings and drains.
08:08
Your nurse will ask you to cough and deep breathe
08:11
to exercise your lungs and to begin performing ankle pumps.
08:16
Ankle pumps are simply pushing your toes down
08:19
and pulling back up.
08:21
It is the same motion you do
08:23
when pressing a gas pedal in a car.
08:26
You will be asked to do 10 ankle pumps
08:29
every hour you are awake.
08:31
This motion promotes good circulation.
08:37
Once you are ready to leave the PACU,
08:39
you will be transferred to the Orthopedic Nursing Unit
08:42
located on the seventh floor.
08:45
Family will be waiting for you to arrive
08:47
in your assigned room.
08:48
Once in your room, your vital signs will be checked
08:51
and your pain level will be monitored routinely.
08:54
Exercises and mobility begin day of surgery.
08:58
You will be on a clear liquid diet.
09:00
Once your body can tolerate a clear liquid diet,
09:03
then your nurse will advance you to a regular diet.
09:06
The Orthopedic Unit is a room service unit.
09:10
You will be given a food menu
09:12
with the room service number printed on the front.
09:16
Please call this number to order each meal.
09:18
If you do not call to order your meal,
09:21
you will not receive a meal.
09:22
Again, it is very important to get regular food
09:26
in your stomach before you are given oral pain medications.
09:30
Oral pain medications can be given once you have eaten.
09:34
Pain medication is very constipating
09:36
so stool softeners will be started at bedtime.
09:39
Continue performing ankle pumps
09:41
10 times every hour you are awake,
09:44
which is pressing your toes down and pulling back up.
09:48
It is the same motion you do
09:50
when pressing the gas pedal in a car.
09:53
An incentive spirometer will be provided.
09:56
It is a device you breathe or suck in at the mouthpiece
10:00
10 times every hour you are awake.
10:03
The purpose of the incentive spirometer
10:06
is to promote deep breathing
10:08
and filling your lungs with air,
10:09
which will aid in preventing post-operative pneumonia.
10:13
Please use the incentive spirometer
10:15
while you are in the hospital
10:17
and after discharge from the hospital.
10:21
Pain management is very important after surgery.
10:25
You have been managing an arthritic type pain
10:28
and now we will be managing post-operative pain.
10:32
Your nurse will ask you to rate your pain
10:34
on a numeric pain scale with zero being no pain
10:38
ranging to 10 being the worst pain you have ever felt.
10:42
Please be open and honest with your nurse
10:44
when rating your pain.
10:46
It is critical for the management of your pain.
10:49
You should be medicated every four hours as needed.
10:53
The last time you received pain medication
10:55
will be displayed on your hospital television.
10:58
Please remember it is important to stay ahead of the pain.
11:02
Our goal for you is comfort.
11:04
We want to minimize your pain
11:06
to tolerate movement and therapy
11:08
but we cannot promise to take all your pain away.
11:12
Pain, inflammation and bruising is to be expected
11:15
after joint replacement surgery.
11:20
Post-op day one is the day after surgery.
11:22
This is the day most of our patients discharge home.
11:25
This is a very busy day.
11:27
When you wake up, make sure your breakfast has been ordered.
11:31
This can be done the night of your surgery
11:33
or the following morning when you wake up.
11:36
Your nurse will come in and remove your oxygen
11:39
if it hasn't been removed already.
11:41
Your IV will be disconnected from IV fluids.
11:44
Your foley catheter will be removed if one is placed.
11:47
If you had your knee replaced,
11:49
your nurse will remove the surgical bandage
11:51
and apply a waterproof bandage that stays in place
11:54
over your incision for seven days.
11:57
This bandage is safe to shower in.
12:00
You may not soak or submerge your incision in water.
12:04
If you have your hip replaced,
12:05
the waterproof bandage that remains
12:07
over your incision for seven days
12:09
is placed in the operating room after surgery.
12:13
This bandage is safe to shower in.
12:15
You may not soak or submerge your incision in water.
12:19
All patients will be given
12:20
two emergency bandages to take home.
12:23
Once your waterproof bandage is in place
12:25
and the drains removed if placed,
12:27
you can shower or sponge bathe and put your clothes on.
12:31
Your breakfast will arrive between 7 am and 8 am.
12:35
Please eat your breakfast
12:36
and take your oral pain medication.
12:38
Physical therapy and occupational therapy
12:40
will come work with you after breakfast.
12:43
After the completion of therapy and you have been cleared
12:46
for discharge by your surgeon and the hospitalist,
12:50
your nurse will review your hospital paperwork
12:52
for you to sign and help you pack up your belongings.
12:56
A transporter will take your from your hospital room
12:59
down to your ride home in a wheelchair.
13:02
When you arrive home,
13:03
continue using you incentive spirometer,
13:06
doing your ankle pumps and staying ahead of your pain
13:09
by taking your pain medications every four hours as needed.
13:16
- [Narrator] Pre-operative joint replacement education.
13:21
Welcome to the physical therapy portion
13:24
of the pre-op joint replacement education.
13:28
Once your surgery is complete,
13:30
faithful physical therapy
13:32
and closely following the guidelines
13:35
that your surgeon set out for you
13:37
are the most important parts of your recovery
13:41
and you did not come this far to not go the distance.
13:48
Why do I need a joint replacement?
13:51
By the time you schedule a joint replacement surgery,
13:55
you've usually been dealing with pain for a long time
13:59
and have exhausted your other options for relief.
14:02
You have not reached this point lightly.
14:06
We are excited to be part of your journey
14:08
to an improved quality of life.
14:12
As we move through this part of the presentation,
14:15
please keep in mind that every patient, joint,
14:19
surgery and surgeon is different.
14:23
This is an overview and your specific surgeon
14:28
might have different instructions for you.
14:31
If that is the case, please do as they say.
14:37
Joint replacements are considered an elective surgery
14:41
which means that your surgeon expects
14:45
you to have prepared everything you need
14:48
for a safe recovery in advance.
14:52
That is an important purpose of this presentation.
14:56
We want you to have time to get
14:59
everything you will need ready.
15:02
This includes making sure that you have a ride
15:06
to and from the hospital ready for when you're discharged,
15:10
making sure you have rides to and from
15:13
your upcoming physical therapy appointments
15:16
as you'll not be able to drive immediately,
15:19
making sure that you have people available at home
15:23
with you to assist meeting your needs after surgery,
15:28
making sure you have equipment
15:29
you'll need to recover safely,
15:33
and making sure you've prepared your home
15:36
with any adjustments necessary
15:39
such as installing grab bars in the bathroom,
15:42
improving lighting or removing throw rugs.
15:45
Again, the expectation is that all of these things
15:49
are finished before your surgery
15:52
in order to have the best recovery possible.
16:00
Here we have a diagram of the hip joint.
16:07
Here we have a diagram of the knee joint.
16:14
Physical therapy.
16:16
What can you expect in the hospital for physical therapy?
16:21
[Slide contents]
Physical Therapy
- Initiated day of surgery if up to floor by 6PM
- Completed twice a day until day of discharge
- Day of discharge, group therapy in AM
Occupational Therapy
- Initiated on the day of surgery and once a day until day of discharge
[End slide contents]
If your surgery is finished
16:24
and you are appropriate for therapy by 6 pm,
16:28
you can expect to see the physical therapist
16:32
and the occupational therapist together.
16:35
It is not uncommon for patients
16:37
to have a fuzzy recollection of this therapy session
16:41
which is why it's incredibly important
16:44
to have your coach or your advocate
16:47
present with you and available to take notes,
16:51
ask questions and track what's going on.
16:55
Depending on how the patient is doing,
16:57
that therapy session might simply include
17:01
standing up and walking to the bathroom,
17:05
or walking in the hallway.
17:07
It might also include performing the car transfer
17:11
and stair training in the rehab gym.
17:16
These will be performed prior to discharge
17:19
by each patient, so if they're not done at the first session,
17:24
then they'll be done the following morning
17:27
or at the next session.
17:29
Hip and knee replacement patients should expect
17:33
physical therapy sessions twice each day
17:37
there in the hospital just like the two sessions
17:41
we expect patients to perform on their own at home daily
17:47
once they've left the hospital.
17:53
Goals prior to discharge from the hospital.
17:58
Please keep in mind that our physical therapy
18:02
is patient-specific, so our goals
18:05
will be tailored to each individual patient.
18:09
For example, if you have not walked 100 feet
18:12
on your own in the past year,
18:15
we will make sure that your goal is appropriate for you.
18:19
That said, we want to make sure
18:22
each patient is safe for discharge.
18:25
We would love for you to be able
18:28
to walk 100 feet using your rolling walker.
18:33
We would love for you to be independent
18:36
with any surgical precautions that we might find out about
18:41
after surgery such as weight baring status changes.
18:50
We would love for you to be independent and safe
18:55
with your bed mobility and commode transfers.
19:00
We would love for you to be able to complete
19:04
the education on stair training, car transfers,
19:10
getting in and out of the bathtub,
19:14
and we would also love for you to be independent
19:17
with your basic home exercise program.
19:22
All of these things will take place
19:25
before leaving the hospital.
19:30
Prior to surgery.
19:34
In terms of physical therapy,
19:36
one of the most important considerations after surgery
19:41
is a patient's safety getting around.
19:44
Walking, standing, sitting.
19:47
Goal number one is reducing the risk of falls.
19:53
So number one, make modifications.
19:56
As soon as you complete this presentation,
20:00
I want you to pretend that you are being driven home
20:04
from the hospital after your surgery.
20:08
From the time you pull up to your home,
20:11
I want you to visualize each step that you will have to take
20:16
in order to get from the vehicle into your home and settled.
20:22
I want you to identify any fall risks
20:26
so that you can address them before your surgery.
20:30
The goal is not to overwhelm you with this process
20:34
but rather to encourage you to be proactive.
20:38
I'll talk you through some thoughts to consider.
20:42
Remember, you are using a rolling walker to get around.
20:49
If you have difficulty
20:51
getting in and out of your vehicle now,
20:54
it will likely be more challenging after your surgery
20:58
so think about your options.
21:01
Are you able to bring a different vehicle to the hospital?
21:05
Are you able to borrow one?
21:09
How many entrances do you have to choose from
21:13
in order to get into your home?
21:16
The one that you use now might not be
21:19
the easiest and safest one after surgery.
21:24
Which is the safest entrance to use after surgery
21:29
when you have the rolling walker?
21:32
Do you have to go up any steps?
21:34
If so, how many steps are there?
21:38
How stable are they?
21:40
Do you have any handrails that you can use?
21:44
Are there handrails on both sides of you or just one?
21:52
You might need to consider installing grab bars
21:55
or handrails if not.
21:59
If that is not an option, make sure you plan ahead
22:03
and perhaps have some additional folks at your house
22:07
or your home when you arrive
22:09
in order to assist you getting inside safely.
22:15
Make sure the people that are helping
22:17
are not at risk of injury themselves.
22:22
Next, make sure you temporarily remove
22:26
any welcome mats or throw rugs to reduce your fall risk.
22:31
You'll be using the rolling walker
22:34
so you wanna make sure to remove all obstacles
22:38
because you want a clear pathway through your home.
22:43
Are you able to fit the rolling walker into the bathroom?
22:49
Think about sitting down and standing up from the toilet.
22:53
Do you have grab bars or maybe a stable piece of furniture
22:58
like a vanity to push up from?
23:03
Do you have a walk in shower
23:05
or will you need to get your leg
23:07
over a bathtub in order to take a shower?
23:12
Regardless of your setup, a stable chair
23:16
or preferably a bench for the shower, is helpful.
23:21
Is your bed high up off the ground?
23:25
Will you need a stable stool in order to get into bed?
23:31
Do you have an alternative option
23:33
in case your bed is not a safe height?
23:38
In general, you want to avoid low chairs,
23:42
soft chairs, and chairs that do not have good arms,
23:46
or armrests, to push up from.
23:50
If you complete this exercise and realize
23:53
that your home is not a safe place to recover,
23:56
think about your other options.
23:59
Is there someplace else you could recover temporarily?
24:03
The important thing is that you can work on this now.
24:09
Number two, arrange for assistance at home.
24:13
It is a much better plan to have more assistance
24:17
and more support lined up then you actually need,
24:22
than to realize after surgery that you need more help
24:26
and need to request it.
24:30
Number three, arrange for transportation as needed,
24:36
especially to and from your physical therapy appointments.
24:42
Equipment.
24:45
Rolling walker.
24:48
Again, our goal is to reduce the risk
24:51
of falling after surgery.
24:54
We want our joint replacement patients
24:59
to use a rolling walker, very basic,
25:03
very standard, nothing fancy.
25:06
We just want the wheels in the front
25:10
and two prongs in the back.
25:12
We do not want patients to use a rollator,
25:17
or a walker with four wheels.
25:19
Those are too unstable.
25:24
Patients should expect to stay on the walker
25:26
for a minimum of two weeks if they're a knee patient
25:30
and one week if they're a hip patient.
25:33
However, patients should not
25:36
discharge themselves unilaterally from using a walker.
25:42
If you feel like you're ready,
25:44
then you should talk with your outpatient physical therapist
25:48
and the two of you make that decision together.
25:53
A rolling walker is only helpful if you use it.
25:58
This means both hands are on the rolling walker
26:01
in case you need to stabilize yourself for any reason,
26:06
which also means that you are not going to carry
26:09
a plate of food and a glass of water
26:12
from the kitchen to the living room dining room.
26:17
This is why we want someone to be there to help you.
26:21
There are strategies, like putting a bag or a basket
26:25
on the walker to help you get items
26:28
from one room to another.
26:31
We want you to know that everything you see in the movies
26:35
with the walkers is wrong.
26:38
We don't want you to stand
26:41
with them really far out in front of you
26:44
and we don't want you to pick them up off the ground.
26:47
Think of the walker as an extension of your body.
26:51
It's gonna move with you.
26:54
You want to stand tall with good posture.
26:58
You want your hips to be in line with the back prongs
27:02
of the walker and your body is staying in the little box.
27:07
The rolling walker is not helpful
27:10
if you walk into a room and leave it by the doorway,
27:14
which I've seen plenty of folks do.
27:17
Please use your rolling walker all the time
27:20
until you and your therapist decide
27:23
that you don't need it anymore.
27:27
It's very important that you have the rolling walker
27:30
in the vehicle transporting you from the hospital home
27:35
in case you need to get out of the vehicle
27:38
for any reason on your way home.
27:41
If you are planning to bring a rolling walker from home,
27:46
go ahead and put it in your trunk today
27:49
so that you don't forget it.
27:52
However, we do not want you to bring the walker
27:56
into the hospital.
27:58
For infection control, please leave it in your vehicle.
28:02
At the hospital, you'll use a rolling walker
28:06
that belongs to us.
28:08
If you're planning to borrow a walker
28:11
from a friend or relative or if you have one
28:14
up in the attic or down in the basement,
28:18
please go ahead and get it out soon
28:21
to make sure that it still works,
28:23
especially if it's 40 years old
28:26
and your grandmother used it.
28:28
We need for you to make sure that it is still safe to use.
28:34
Not having an appropriate rolling walker
28:36
can cause delays leaving the hospital
28:39
so please make sure the one that you're using is safe.
28:43
If you don't have one and are planning to get it
28:46
through insurance at the hospital,
28:49
we will make sure that you have it before you leave.
28:53
Straight cane.
[Slide contents]
Straight cane
- Borrow or purchase from pharmacy
- Straight handle
- Adjustable Height
- Therapist will progress you from walker to cane
- Used on opposite side of surgical leg
[End of slide contents]
28:55
Knee replacement patients usually progress to a cane
28:59
with instruction from their outpatient physical therapist.
29:04
Cryotherapy for knees, Polar Pak.
[Slide contents]
Polar Pak
- Freeze 8 water bottles (change every 6-8 hours)
- Run continuously when not walking/showering/therapy three times a week.
- Use gel pack/ice pack behind knee.
- Layer of protection between pad and skin (thin towel or pillow case)
- How to get to bathroom with all this on?
[End of slide contents]
29:11
Before I talk about the Polar Pak,
29:15
I wanna share with you some guidelines
29:18
that you are going to follow once you get home.
29:23
These guidelines will be reviewed with you
29:26
in the hospital as well.
29:29
During the day, make sure that you get up and walk around
29:34
five minutes out of every hour the first week after surgery
29:40
and 10 minutes every hour the second week after surgery.
29:45
Now again, this is during the day.
29:48
We want you to sleep through the night if you can.
29:53
Once you're done walking around,
29:56
we want you to perform your hourly exercises.
30:01
By that, we mean 10 ankle pumps,
30:05
where you put your foot on the gas,
30:09
10 glut squeezes, where you tighten up,
30:12
or you squeeze your butt muscles together,
30:17
10 knee presses where your leg is extended
30:22
as straight and you are pushing your knee down
30:27
into the bed or the sofa, wherever you are.
30:32
We also want you to do 10 breathing exercises
30:36
with the incentive spirometer
30:38
that you'll get at the hospital.
30:42
When you're finished, we want you to ice your surgical leg
30:47
and rest with your legs elevated
30:50
until you get up and walk around again the next hour.
30:56
If you're a knee patient, when you're resting,
30:59
we want you to make sure that your knee is straight.
31:03
We don't want it to be bent.
31:05
It always needs to be straight
31:07
or extended when you're resting.
31:10
Never put a pillow under your surgical knee.
31:15
This is very important.
31:17
Also, make sure that your legs are elevated
31:22
when you're not walking around in order to reduce swelling.
31:27
In addition, make sure that you spend 30 minutes
31:32
three times each day with your surgical leg
31:36
elevated above your heart.
31:39
The easiest way to accomplish this
31:41
is usually for your upper body to be flat
31:45
with you lying down and your surgical leg
31:49
above your heart supported by a pillow,
31:52
perhaps a wedge pillow.
31:55
Walking, hourly exercises, elevating, resting,
32:01
and icing are all critical components of your recovery.
32:07
Cryotherapy for knees, the Polar Pak.
32:11
If you're a knee patient, you'll be provided
32:14
a Polar Pak to use at home.
32:18
The Polar Pak has very clear and detailed instructions
32:22
on the lid and there are pictures
32:26
included in those instructions.
32:29
Make sure you do not put the white part of the pad
32:34
in direct contact with your skin
32:37
in order to avoid irritation.
32:40
We always want a clean barrier between the pad and the skin.
32:47
Leave the Polar Pak on at night
32:49
and any time you're not up walking around.
32:53
Be very careful, however, to take the Polar Pak
32:57
off your leg prior to standing up
33:00
in order to reduce the risk of a fall.
33:04
This is especially important to consider at night
33:07
if you need to get up and use the bathroom
33:11
because you'll likely be tired and groggy.
33:15
You might be wearing an immobilizer brace
33:18
if that is something that your surgeon asks you to do.
33:22
So, make sure that you take the Polar Pak off
33:26
before you walk around.
33:29
Cryotherapy for hips.
33:32
Hip patients are also expected to ice their surgical leg
33:36
however, a Polar Pak will not be provided.
33:40
Please have ice packs
33:42
already in the freezer before your surgery.
33:47
Hip patients should also provide a clean barrier
33:51
between their skin and the ice pack.
33:55
Six week goals.
33:58
Number one, walk without a limp or an assistive device.
34:04
Number two, be able to perform a single leg stance
34:09
on your surgical side for 10 seconds.
34:13
Number three, be able to perform reciprocal stairs
34:17
with or without the use of a rail.
34:20
Number four, be able to perform a sit to stand
34:26
from a chair without pushing up from the arms.
34:32
And if you're a knee patient,
34:35
be able to achieve active range of motion
34:39
which means that you are bending your knee,
34:42
the therapist is not bending your knee,
34:45
active range of motion of zero to 120 degrees.
34:51
That means your knee is straight and flat
34:55
at zero degrees and you get a bend of 120 degrees
35:03
back towards your bottom.
35:07
Don't.
35:10
[Slide contents]
Don't:
- Go beyond walking/standing limitations
- No pillows under surgical leg
- Get on treadmill for six weeks
- Use weight machines for three months
- Leg weights over 2# for six weeks
- Leg weights over 5# for three months
- No resistance on cardo for three months.
[End of slide contents]
Basically, we don't want you to go rogue
35:14
and we don't want you to do too much too soon.
35:17
It is absolutely possible to do too much too soon
35:23
after your surgery and we want to avoid that.
35:28
Please stick closely to the plan
35:31
that your surgeon and therapist have given you for recovery.
35:35
It might seem very simple and therefore not important
35:40
but following this plan can help avoid
35:43
serious complications.
35:46
Five minutes of walking and standing each hour
35:50
for the first week means just that.
35:54
It doesn't mean 20 or 30 or 50 minutes walking and standing.
36:00
Unfortunately, we have plenty of stories
36:03
of patients who decided to cook Thanksgiving dinner
36:06
or they went to a party and they felt great
36:10
standing up for hours only to wake up the next day
36:15
unable to walk due to swelling.
36:18
These patients have even asked us
36:20
to share their experiences with you
36:24
so that y'all don't have to go through what they did.
36:28
If you are wanting to get back to a specific activity,
36:32
please don't just start back on your own without consulting
36:36
your outpatient physical therapist or your surgeon.
36:41
If it is not on your list of physical therapy exercises,
36:47
we don't want you to be doing it
36:49
without specific permission.
36:53
You should, however, be performing
36:57
your physical therapy exercises from
37:01
your outpatient therapist one time every morning
37:06
and one time every afternoon.
37:08
So that's two physical therapy sessions every day
37:13
and on the days that you go to the outpatient clinic,
37:17
that counts as one session and you would then do
37:22
only one more session on your own
37:24
at home for a total of two.
37:30
The big key is to not overdo.
37:36
Do.
[Slide contents]
Do:
- Call your Orthopaedic Clinic PT if knee AROM is not 5-105 degrees by 3 weeks
-
Call us if you or your therapist has questions about Pain medicine or you
have issues such as:
- Constipation
- Itching
- Rash
- Drainage
- Begin scar massage 21 days post op. Continue for three months.
[End of slide contents]
37:38
We do want you to communicate
37:41
any concerns that you have immediately.
37:48
Thank you so much for your time.
37:50
We wish you the best and we're excited to see you.
37:56
Thanks for listening.