total preop hip surgery - enhanced recovery after surgery hip class... · your hip is most prone to...

Total Hip Replacement: Enhanced Recovery After Surgery

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What to expect at home

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Today’s session

Enhanced Recovery: What’s it all about?

Get ready for surgery and recovery

Questions?

Fifth Agenda

Physician Assistant

Enhanced Recovery After Surgery (ERAS)

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ERAS Video

▪ Introduction to ERAS Video

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Enhanced Recovery After SurgerySpeed healing and reduce risk of infection

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Drink clear liquids &

carb drink until 2 hours

before arrival.

Eat soon after surgery.

Control pain Move sooner Eat & drink

Mixture of medications with less narcotics.

Stay ahead of the pain.

Get up soon after surgery.

We will help you sit, then stand and walk.

Prepare physically and mentally Be your healthiest

▪ Quit tobacco

▪ Be active

▪ Prevent illness, cuts, scrapes, and infections

▪ Sleep well, eat healthy, drink water

▪ Relax kp.org/surgerypodcast

▪ Control blood sugar, if you have diabetes

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https://kp.org/mydoctor/hipreplacement

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Emmi: Prepare for your surgerySearch knee surgery or hip surgery on kp.org/mydoctor

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Enhanced Recovery Prevent infections before surgery

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Mouth care Skin care

Going home

▪ When?

– Patients are able to go home on the day of surgery, unless there is a medical need

–Prepare now for transportation and help at home

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What’s common at home?

▪ Pain will increase at times

– Take medications on time

– Rest, ice, and elevate leg

– Move your joint, but don’t overdo it

▪ Swelling can be present for months after surgery

▪ Bruising or color changes anywhere on your leg or foot

▪ Not sleeping well for first 2 - 3 months

- Get up and stretch

- Take naps

- Don’t use sleep medications

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12 © 2015 Kaiser Permanente. All Rights Reserved.

Care after discharge

You will get a call from orthopedics the day after surgery. Please read your discharge instructions for details.

▪ Call if you have these symptoms

– Fever over 101.5

– Excessive bleeding at incision

– Vomiting or diarrhea

– Uncontrolled pain

– Any Concerns

KP Preventive Carehelps you remember

Try a video visit with your doctor or physical

therapistDownload our app. Talk with your doctor or physical therapist

on your smartphone.

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My Doctor Online

PHYSICAL THERAPY

Preparing for and recovering after your surgery

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Physical Therapy

▪ In the Hospital right after surgery.

▪ Physical therapy in your home (Home Health Physical Therapy): 24-48 hours after discharge from the hospital.

▪ Outpatient Physical Therapy (at your home facility) begins after you have met your goals with home health physical therapy for further strengthening and return to activities.

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Physical Therapy: Hospital Goals

▪ Before you are discharged from the hospital, we will show you how to:

– Get in and out of bed.

– Sit, stand, and walk.

– Climb stairs, if you have them at home.

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Positions to avoid

▪ The chances of dislocation is very low.

▪ Your hip is most prone to dislocating the first 4-6 weeks after surgery.

▪ It is OK to bend your hips beyond 90 degrees as long as your knees

are apart and not together.

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Positions to Avoid

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Acceptable positions

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Heel slides

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Quad thigh squeezes

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Gluteal (buttocks) squeezes

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Moving at home

▪ Limit walking to around your home and to appointments until your home health physical therapist sees you

▪ Do your exercises

– At least 3 times a day

▪ Prevent swelling

– Ice and elevate your leg.

– Slowly increase activities

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OCCUPATIONAL THERAPY

Preparing your home and equipment to assist with activities of daily living

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Think about your home ?

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Clear, wide

pathways?

Where will

I sleep?

Where will

I sit?

Good

lighting?

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Is your home ready?

√ Wide, clear pathways for walker

√ Remove clutter and things on the floor

√ Bed or recovery area on 1st floor

√ Firm chair with armrests and high back

√ Good lighting between bed and bathroom

√ Grab bars in shower

√ How will you confine pets?

√ Will you have meals prepared or frozen?

Recovering from Total Joint Surgery

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Toilet seat frame

- Provides arm rests only to give

you support when seated and

allow you to use your arm

strength to assist in transfers

on and off the toilet

Raised Toilet Seat w/ arms

- Also available without arms

- Decreases the distance your

body has to travel from a

standing to a sitting position,

saving you energy

3-in-1 Commode

- Available with drop arms, with

and without backrest

- Allows for use in a wide open

room

- Can be placed for convenience

to limit the distance you have

to walk to the bathroom

- Bucket can be removed for

placement over bathroom

toilet

http://www.ableforlife.com/Bathroomsafety.html

Recovering from Total Joint Surgery

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Bath Bench for tub showers

-eliminates the need for balance and

strength to step over the tub side

- makes transferring into the shower

easy and safe

Shower Chair for walk-in shower

stalls

- Provides a safe place to sit

while washing hard to reach

areas of the body

- Decreases the energy it

requires to take a shower

Handheld shower head

- Makes sitting while showering

easier as you are able to

control the direction and

pressure of the water

http://www.ableforlife.com/Bathroomsafety.html

Total Joint Kit

▪ Sock aide

▪ Reacher

▪ Elastic shoe laces

▪ Long handled shoe horn

▪ Long handled bath sponge

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30 © 2015 Kaiser Permanente. All Rights Reserved.

Is your helper ready?Plan to have help for 2 weeks consistently

▪ Prepare meals.

▪ Help keep your spirits up.

▪ Do laundry and chores.

▪ Take care of family and pets.

▪ Run errands. Drive you to and from appointments.

▪ Help with medications, icing, and elevating.

▪ Help with mobility and daily activities.

PATIENT CARE COORDINATOR

Equipment, coverage and assistance at home

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Discharge planning

▪ What’s my coverage for medical equipment?

▪ Where can I get a walker? Discharge planning department will be calling to order the week before surgery

▪ Skilled nursing care is rarely necessary because patients do better at home.

▪ Resources

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To Summarize: Be Prepared

▪ Prepare your body, mind, and home.

▪ Prepare to go home on the day of surgery. Have transportation and help at home ready.

▪ Follow Enhanced Recovery instructions.

▪ Actively participate in rehab to return to your usual activities.

▪ Good luck with your recovery and please remember to read your discharge instructions!