Table of Contents Notes,Introduction 3 ,About Hip Replacement Surgery 3 . Pain Management Before Surgery 5 ,BEFORE Your Joint Surgery 9 . DURING Your Hospital Stay 15 ,COMPLICATIONS How to Prevent Them 17 . Caring For Yourself At Home 19 ,Exercise Guide 31 . Resources 37 , Acknowledgements This booklet adapted from booklet . Before During and After Your Total Joint Replacement Booklet developed by Vancouver Coastal Health Authority as . well as Your Total Hip Replacement and Your Total Knee Replacement by The Physical Therapy Department of The. Mary Pack Arthritis Program and The Reconstructive Orthopedic Health Care Team at Vancouver General Hospital . 2 39, Stop smoking resources Introduction, QuitNow 1 877 455 2233 free call Joint replacement is major surgery that needs a lot of hard work and healing People. www quitnow ca who are prepared have a smoother recovery this means getting you and your home. ready During the wait for surgery you need to improve your health and fitness This. BC Cancer Agency www bccancer bc ca book will describe what you will do to be successful before during and after surgery . Hospital stays are short It is healthier for you to recover at home where you will eat . Health Canada www gosmokefree ca, sleep and heal better Most people go home within two to three days after surgery with. help from family or friends The hospital team will help you get moving and safely return. to daily activities , Internet Resources, If there is a difference between this book and instructions from your surgeon family. The Arthritis Society www arthritis ca doctor or health care team FOLLOW THE INSTRUCTIONS OF YOUR. The American Academy of Orthopedic Surgeons http orthoinfo aaos org SURGEON DOCTOR TEAM . National Institute of Arthritis , Musculoskeletal and Skin Diseases NIAMS www niams nih gov hi. Dietitians of Canada www dietitians ca, About Hip Replacement Surgery. Osteoarthritis Service Integration System OASIS www vch ca oasis The common cause of joint disease is arthritis Surgery is only for those people with. Physiotherapy Association of BC PABC www bcphysio org badly damaged joints that can t be helped by exercise weight loss medications etc . Canadian Orthopedic Foundation www canorth org, Surgery may . American Academy of Orthopaedic Surgeons http orthoinfo aaos org relieve pain. Other Orthopedic Sites www myjointreplacement ca improve walking standing dressing bathing etc. www eOrthopod com, Most people have good results following their first joint replacement With daily. www mayoclinic com, exercise the new joint usually lasts 15 20 years or more . Please note When looking for information on the internet visit government . The type of surgery will be decided by your surgeon based on your . university and professional association web sites Not all information found on the. internet is credible reliable or correct age, bone strength. Additional resources are available for loan from the Arthritis Learning Center . shape and condition, of the joint, general health. weight, activity, 38 3, Components of the total hip replacement Resources. Health Care Resources, General Medical and Dietitian Information. HealthLink BC Phone 811 or 711 Hearing impaired , Web www healthlinkbc ca. Dietitians Web www dietitians ca, Community Resources While in hospital you may ask to meet with a social worker. to talk about resources you may access in your community . Meal Resources Search for companies that provide ready to eat or frozen meals . Help in your home Search under home support services or home making for a. trained support worker to assist you with your personal care and or cleaning . Transportation, HandyDART Custom Transit , HandyDART service is available throughout some communities in the province Book. at least 3 working days in advance for rides during the week and 7 days in advance for. weekend service See https bctransit com, Disabled Parking Placards SPARC . Tel 604 718 7744, The Surgical Procedure for Hip Replacement E mail permits sparc bc ca. Web www sparc bc ca, A cut is made over the top of the femur thigh bone The muscles are moved and the. joint is pulled apart The damaged cartilage and bone are cleaned away The new socket The application process takes 2 3 weeks if mailed in or 10 minutes if done in. cup is fit into place in the pelvic socket person The placard is good for use throughout BC . The head ball at the end of the femur thigh bone is removed Some bone marrow is An application form must be completed to qualify for these services After completing the form have your. doctor or therapist confirm your need and then submit it to the appropriate office . removed from the hollow of the femur so that the metal stem can be placed . The new hip is put together and the muscles and skin are sewn in place with sutures and. or staples The hip is then tested for movement and stability The surgery usually takes. about 1 5 hours ,Cemented Joints, One or both parts are held by bone cement that bonds to the metal It hardens quickly. to allow weight bearing and walking the same day as surgery . 4 37, Pain Management, 14 Mini squat Uncemented porous coated joints. Stand tall facing the sink with feet, shoulder width apart The parts are coated with tiny beads New bone grows into the spaces between the. Hold on with both hands beads to make a strong bond The new bone growth takes 6 12 weeks and you may. Push hip back and bend slightly as if need to keep your weight off your new joint when moving or walking . starting to sit down, Do not lean forward Hybrid Joints. Return to standing position, Repeat times When one part is held by bone cement and the other part is coated in tiny beads that. Do times per day new bone grow into This bone growth can provide additional long term joint stability . Some parts of the new joint may be screwed in place to keep the joint stable . Surgeons have reasons for choosing one of the above options please ask your surgeon. for details on what has been selected for you , Revision Joint Replacement Surgery. If your new joint fails a repeat surgery may be needed The old parts may be replaced. 15 Wall Slide with new ones Repeat surgeries are more complex and the parts may not last as long. Stand with back against wall as the first surgery Reasons for joint failure may include loosening wearing of the joint . Place feet shoulder width apart and bone loss or infection . about 2 feet from the wall To take care of your new joint See Recreational Activity Guidelines page 28. Bend your knees and slowly slide, down the wall keeping your knees in. line with your second toe Pain Management Before Surgery. Keep your weight on your heels, Do not slide too far down the wall. Why is there pain , Slowly slide back up the wall Vancouver Coastal Health. Repeat times Pain may be caused by tissue damage infection swelling joint injury or. Do times per day osteo rheumatoid arthritis , Tips If knees spread wide as you In osteoarthritis the joint surface that acts as a cushion is worn down This leads. lower hold a rolled towel between to swelling which causes pain or stiffness . thighs to keep thighs together Rheumatoid arthritis is a disease where the immune system attacks the joint. surface and tissues which causes swelling stiffness and pain . Why is pain control important , Pain can affect your daily activities and quality of life . Untreated pain may lead to anxiety depression poor sleep high blood pressure and. poor wound healing , If you are feeling pain talk to your doctor and or health care team about a pain plan . 36 5, Pain Management, When talking about your pain include the 11 Hip Abduction Hip Side Lift. Stand tall at a kitchen counter, place Stand on non operated leg and lift your operated. type throbbing stabbing dull leg out to the side, things that change or cause pain Keep your toe pointed straight ahead. rate of your pain on a scale of 0 10 Do not lean to the side and do not twist your hip. or pelvis , Repeat times, Do times per day, 3 Main Types of Pain Medication 12 Standing Hip Extension Straight Leg Behind. Stand tall at a kitchen counter, 1 Acetaminophen Tylenol Long acting or arthritic formula . Stand on non operated leg and, Works by lowering pain signals. lift your operated leg up and, Discuss with your doctor if you regularly consume alcohol back while keeping the knee. CAUTION Do not exceed 4 000 mg per day straight, Do not bend forward and do. 2 Non Steroidal Anti inflammatory Drugs NSAIDS ibuprofen Advil not twist your hip or pelvis. Motrin ASA Aspirin diclofenac Voltaren celecoxib Celebrex naproxen Slowly lower your leg to the. Naprosyn starting position, NSAIDS are used to treat pain and swelling Repeat times. CAUTION Let your doctor know if you have a history of stomach ulcers heart Do times per day. failure or kidney disease, 3 Narcotics Opioids codeine oxycodone morphine hydromorphone. Dilaudid fentanyl, Work by blocking the pain signals 13 Standing Knee Flexion Knee Bend. CAUTION Discuss use of narcotics opioids with your doctor if you regularly Stand tall at a kitchen counter. consume alcohol or other addictive substances Bend your knee and lift your heel towards. your buttocks, These pain medications are available in different forms Do not twist your hips or bend forward. Immediate release fast acting medications can work in as little as 30 minutes but at your waist or back. last only a few hours and may be taken as needed Stand on non operated leg. Sustained release long acting medications work in 1 to 2 hours but last longer Repeat times. Your doctor may order all these medications together as they help to control your pain Do times per day. in different ways Vancouver Coastal Health, 6 35, Pain Management. 7 Knee Extension Straightening over a Roll Side Effects of Pain Medications. Recline on bed place a large folded pillow, under your knee. Tighten core muscles, Lift foot up to straighten your knee NSAIDS . Slowly lower leg down Side effect Management, Repeat times Stomach upset Take with food Coated tablets may help. Do times per day Vancouver Coastal Health, Bleeding Let your doctor pharmacist know if you have a bleeding. disorder or are on a blood thinner, 8 Lying Hip Extension Bridging. Allergy Let your doctor pharmacist know if you have an allergy or. Lie on your back with knees bent press a breathing problem with ASA Aspirin or any NSAID. large rolled towel between thighs use only, one flat pillow or none for your head Kidney Function Inform the doctor pharmacist if you have poor kidney function. Vancouver Coastal Health, Tighten core muscles page 31 32 . Tighten lower buttocks and lift hips up keep, back relaxed. Keeping pressure on towel slowly lower hips Narcotics Opioids . Repeat times Side effect Management, Do times per day Sleepiness Allow a few days to get used to the sleepiness Do not drive. until you know how the medication affects you Do not mix. 9 Weight Shift Side to Side with alcohol or other medications that may cause drowsiness. Stand with feet shoulder width apart without talking to your doctor . Tighten core and lower buttock muscles Dry Mouth Use a sugar free candy or lollipop. Shift your body weight from one leg to Nausea Vomiting Take with food Lie down if you have nausea You may also use. the other Gravol dimenhydrinate , Repeat times, Vancouver Coastal Health. Constipation Prevention is key Drink lots of fluids up to 8 glasses a day . Do times per day Use a laxative and or stool softener under doctor advice. Allergy Let your doctor pharmacist know if you have an allergy to any. 10 Standing Hip Flexion Hip Bend,Exercise Guide, narcotics opioids . Stand tall at a kitchen counter, Stand on your non operated leg and lift your operated. Do not lift your knee higher than your hip, Keep the angle between your trunk and your thigh less. than 90 degrees or prescribed limit , Do not bend forward and do not twist your hip or pelvis. Repeat times, Do times per day, 34 7, Pain Management. Common concerns about taking pain medications 4 Static Glutes Buttock Tightening. Lie on your back with legs straight, Tolerance Over time you may need more pain medication to get the same effect Squeeze lower buttocks together gently . Medication or doses may need to be changed by your doctor to get the best pain relief as if holding a pencil between your. Physical dependence Over time your body may adapt to pain medication When the buttocks Vancouver Coastal Health. medication is stopped suddenly you may feel withdrawal symptoms such as headache Hold 6 seconds. sweating and nausea This can be avoided by lowering your dose over time Repeat times. Addiction Addiction to these drugs rarely occur when taken for pain relief People Do times per day. may confuse addiction with physical need for pain relief These are not the same . If you have a history of addiction to alcohol or drugs talk to your doctor to develop a. pain plan 5 Lying Hip Flexion Heel Slides, Lie on your back with knees bent Vancouver Coastal Health. feet in line with shoulders, Other Pain Relief Options. Tighten core muscles page 31 32 , Sleep Sleep is important to lower your pain to keep back and pelvis still. Slide one leg down the bed re set, Heat and cold Follow your doctor s orders your core muscles slide leg back up. Relaxation exercises May help you rest sleep and distract you from pain Use Ensure you maximize range without. music to relax the mind and body Breathing or meditation can help you lower stress exceeding 90 degrees of hip flexion. and heal or prescribed limit , Walking aides A cane walker or crutches can take stress off your joint and lower Repeat times. your pain Do times per day, Repeat on other side, Talk with an occupational or physiotherapist They will teach you how to use. equipment to move walk and do your activities more comfortably . Joint protection Using a brace or splint may help Talk to an occupational or. physiotherapist for information 6 Hip Abduction Leg out to the side. Discuss with your surgeon or physiotherapist before starting this exercise . Massage A therapist will massage your muscles to relax and lower the pain Arthritic. Lie on your back with one leg bent, joints are tender so tell the therapist about your condition . Tighten core muscles to keep back and pelvis still. Exercise Guide, Exercise programs A program may be set up to help you become more fit Contact Leading with the heel slide straight leg out to the side knee cap and foot point to. the Arthritis Society or your local community center the ceiling . Re set core muscles and slide leg back, To reduce the risk of a sore heel caused by friction consider using a garbage bag. under your heel to assist with the slide out, Repeat times. Do times per day, Repeat on other side, 8 33, When your hip hurts too much to stand or walk these muscles. become weak and don t work well This can lead to back pain stiff. BEFORE Your Joint Surgery, back stiff hips and poor balance With practice they will tighten. without you thinking about it Get Your Body in Shape. Learn to use these muscles before and during each exercise . It is important to get in the best physical shape possible Work on building your. Pelvic floor bladder muscles strength and staying active . Joint Surgery, Before your, Pull your bladder muscles to your belly button After surgery you will rely on your arm strength See a private physiotherapist fitness. OR imagine you are gently trying to hold your urine trainer or aquatic Osteo Fit class that supports people with arthritis . Hold for 6 seconds then slowly relax The Arthritis Society is an excellent resource Contact the Arthritis Answers Line at. Repeat 6 8 times 3 times a day 1 800 321 1433 or www arthritis ca . Choose low impact activities like swimming water aerobics stationary cycling or chair. Lower abdominal muscles aerobics If exercising is new to you consult your family doctor to ensure there. are no health concerns before starting , Pull your belly button into your spine OR imagine slowly zipping up a tight. pair of pants Avoid activities that increase pain in your joint Your activities should be as pain . Hold for 6 seconds while breathing quietly then slowly relax as if you unzip your free as possible . pants Keep upper chest relaxed Repeat 6 8 times 3 times a day. Stop Smoking, Exercises After Surgery, If you smoke you are at a higher risk for pneumonia infection poor healing and or. 1 Deep Breathing and Coughing Exercises loosening of the implant after surgery If you are thinking about quitting or have made. Breathe deeply in through your nose and out through your mouth the decision to quit go to www quitnow ca or call 8 1 1 and ask for QuitNow . Do 3 6 big breaths in a row, After the deep breathing try to cough Healthy Eating. Repeat 1 5 times per hour, The nutrients from food provide us with the strength energy and ability to heal People. 2 Ankle Pumping who eat well heal faster and are less prone to infection For more information call 8 1 1. Lying on your back pump both ankles or see www dietitians ca. up and down as far as is comfortable,Exercise Guide. Repeat often during the day The following are important . 3 Static quads Thigh muscle tightening Iron is needed to build up hemoglobin Hemoglobin in your blood carries oxygen. Lie on your back with your hip straight through your body If your hemoglobin is low anemia you may feel tired dizzy and. weak or get short of breath easily Good sources of iron include meat beans tofu . Gently tighten the front of your thigh, some green leafy vegetables and fortified whole grains . Hold seconds, Repeat times Calcium heals your bones and keeps them strong Good sources of calcium include . Do times per day dairy dark leafy greens and nuts Note Drinking more than 4 cups of coffee or. caffeinated products each day will take calcium from your body so limit these items . 32 9, Vitamin D helps your body absorb calcium Look for vitamin D fortified foods and get. 15 minutes of sunshine every day , Exercise Guide. Vitamin B12 and folate folic acid prevent some types of anemia Good sources of You are about to have hip replacement surgery Patients who prepare for surgery and. vitamin B12 include meat dairy and eggs Good sources of folate folic acid include leafy take part in their care can recover in less time and with less pain . green vegetables beans fortified grains and orange juice . You may get different instructions from your surgeon doctor or physiotherapist Always. Protein is needed for healing High protein foods include meat dairy eggs beans and follow the directions of your care team . Joint Surgery, nuts Include protein at every meal . Before your, Before starting any exercise program check with your physiotherapist. or doctor This guide is meant to be used under the direction of your. Bowel Health physiotherapist , Constipation is a common side effect of pain medications and less activity You should Caution . take enough fibre from plants and fluids to keep your bowels moving If you have too much pain in your hip to exercise or if any of the exercises. cause more pain or swelling in your hip stop Tell your physiotherapist or. Healthy Weight, If your whole leg becomes swollen or hot tell your doctor right away . If you are overweight you can safely lose approximately. about 2 pounds a week The best weight loss 3 6 POUNDS OF FORCE General Guidelines Before Surgery. is through healthy food choices and activity on your knees and hips. If you exercise before surgery you can have a faster and easier recovery Exercise can. Being too thin can make it harder for your body to heal . help to keep your hip moving and get your muscles stronger . Talk to a dietitian if you are overweight or too thin To find out more information on. It is important to find activities that keep you moving A private practice physiotherapist. nutrition or specific nutrients , can suggest exercises that are best for you . Call 811 to speak to a dietician or go to www healthlinkbc ca. Possible suggestions may include , Dietitians of Canada Website www dietitians ca swimming water walking water aerobics water running. cycling stationary or bicycle , Planning for Discharge walking with a cane or walker pole walking. You will require help with shopping meals housekeeping and sometimes personal. care You MUST identify someone as your support person to help you after. To keep pain and swelling under control , discharge Someone MUST stay with you 24 hours a day for at least the first 3 days Put ice on your joint if told to by your surgeon. Exercise Guide, and be available for 10 14 days after this Pace yourself. Use a walking aid such as a cane crutches or walker. You MUST arrange transportation home from the hospital If family or friends can not. help you may choose to contact a private agency listed under Home Support in the Talk to your doctor or pharmacist about taking pain medications regularly. yellow pages If you are having difficulty managing at home now or are concerned about. managing at home after your surgery call BC Healthlink at 8 1 1 for information about Learn to Tighten Your Core Muscles. local resources Core muscles are deep muscles that support. your spine and pelvis They provide stability , control and good posture when you move . 10 31, Goals following Hip Replacement Surgery Helpful Hints. This table lists goals for set time frames Each person heals differently and the time Arrange for someone to look after your home i e water plants care for pets and. it takes to meet goals may differ Also the goals may differ if you had severe joint pick up mail . issues before your surgery Talk to your surgeon or physiotherapist if you are Your ride home should have space for you to sit in comfort in the passenger seat. concerned You may be eligible to use HandyDART for more information See. You may find that pain and swelling increases as you begin new exercises increase Transportation page 37. Joint Surgery, Before your, movement in your hip or return to regular activities Continue to manage your pain and. swelling see Pain Management Before Surgery page 5 Preparing Your Home. By the end of week 3 You need to make changes in your home BEFORE surgery . Move your leg in and out of bed by yourself, Move on and off a raised chair bed and toilet without help Stairs and hallways. Walk at home using a walker cane or crutches Install a railing along inside and outside stairs. Use the stairs safely with cane or crutch Remove rugs cords clutter and anything that could trip you. Remove all plant items from steps, By the end of week 6 Remove mildew or ice snow from outdoor steps. Bend your hip to 90 degrees Have good lighting and use night lights to show a clear path to. Slide your leg out abduct to 25 degrees the bathroom. Straighten your hip fully to 0 degrees, Walk several blocks with a cane or crutch in the opposite hand Bathrooms. Walk up to 15 minutes with a cane or crutch in the opposite hand Install a grab bar or hand rail in your shower or bath. Ride an upright stationary bike seat raised so your hip doesn t bend more than Remove sliding glass doors from bathtubs and install a shower. 90 degrees curtain,After Caring For,Yourself at Home. Be sure that your shower or tub has a non slip coating or mat. By the end of week 9 Install a hand held shower head. Walk for longer periods of time use a cane if you walk with a limp Use a raised toilet seat. Sit and stand from a raised chair without using hands to help. Balance for a short time on your operated leg, Move items you use often to be safely reached . Climb up and down stairs with alternating feet Use a cane or hand rail for support. Buy frozen meals or freeze your own Stock up on canned food and. other basic items See Health Care Resources page 37 for. By the end of week 12, more information on Meal Catering. Walk without a limp Discuss goal for walking time with your physiotherapist. Have a high stool for sitting when doing activities at a counter. Sit and stand from a normal height chair and toilet without pushing from hands. Stand on the operated leg while maintaining good posture and alignment Furniture. Climb up and down stairs with alternating feet and little or no railing support Add extra firm cushion or raise height of chairs chair should. Return to driving with surgeon s permission have a firm back and arm rests 2 . 30 11, Check that the top, Extra mattress Bedblocks. Sexual Activity, of your mattress is, at least as high as Resume sexual activity when you are comfortable some changes may be needed to. your knee If it is avoid pain , too low place the. Some positions to try , frame on blocks, or add another Lying on back with legs apart and operated leg straight or slightly bent. Joint Surgery, mattress Lying on your side with operated leg on top bent slightly at the hip and knee and. Before your, supported on a pillow or partner s thigh partner also lying on their side . Care must be taken in the first 3 weeks to maintain wound healing. Equipment Discuss any concerns with your surgeon or therapist . You will use a walker or crutches to get around and everyday activities such as using a Living with your new joint. toilet dressing cooking or carrying items may be difficult . Your new joint should last 15 20 years if you avoid high risk activities and follow the. You may need the following tips in this book and from your therapist s . long handled reacher grabber If you are having another surgery procedure or dental work tell your doctor or dentist. long handled shoe horn that you have a joint replacement . sock aid, loose comfortable clothes Consult with your surgeon if you are worried about . extra firm cushion 4 in x 16 in x 18 in , Possible infection see Infection page 18. safe supportive shoes that either slip on or do up. with elastic laces or velcro Your operated leg suddenly feels short. You begin to limp or cannot put weight through your operated leg. After Caring For, Yourself at Home, raised toilet seat. long handled bath sponge Loss of hip movement strength painful clicking or feeling unstable. bath transfer bench shower seat Unrelieved pain in your hip or leg that lasts more than a few days. Your occupational or physiotherapist will show you how to use these devices in your. education class or in the hospital , How to Get Equipment. Red Cross Depots or service clubs health units have crutches walkers canes raised. toilet seats and grab bars to borrow free of charge for 3 months You will require a. referral from your health care team to borrow equipment Medical supply stores have. most equipment you need if you wish to purchase , At least one week before your surgery arrange purchase or pick up your. equipment from the Red Cross or service club health unit There are Red Cross. Depots throughout Interior Health , 12 29, Recreational Activity Guidelines Preparing Yourself for Surgery. Regular exercise is important Activity should be done 4 7 days a week to keep you The Pre Surgical Screening PSS Program will ensure you have . moving and strong Choose activities that are low impact and have a low risk of injury or a review of your physical history and medications. falling screening tests completed, As each situation is different speak with your surgeon and therapist about teaching about what to expect before during and after your surgery. any physical activities that you wish to do a chance to ask questions so that you feel ready for your surgery. Joint Surgery, Before your, Anesthesia, Recommended activities . Your anesthetist will discuss options with you to help choose the best anesthetic . walking using a treadmill shock absorbing footwear Options include . swimming water aerobics deep water running Spinal anesthetic blocks feeling from the waist down You may also be given a drug. recreational cycling using a stationary bike to help you relax . no impact aerobic dance e g Joint Works General anesthetic puts you to sleep during the surgery . Activities you may be able to do with caution , Notify your healthcare team if you had delirium confusion with other hospital stays . discuss with your surgeon or physiotherapist , hiking easy trails If you drink alcohol regularly you are at risk for delirium related to alcohol. withdrawal For six weeks before surgery limit alcohol to no more than one drink 8. downhill and cross country skiing, ounces of beer 3 ounces of wine or 1 ounce of spirits per day . dancing, doubles tennis avoid running twisting Infection. using a step machine or rowing machine Call your surgeon s office if your surgery is within a few days and you think you have an. After Caring For,Yourself at Home, weight lifting infection e g sore throat infected cut bladder infection boil etc . lawn bowling, gardening yardwork Blood Clots, golf using a cart Tell your surgeon and health care team before surgery if you have had a clot in the past . Activities to AVOID Medications, One week before surgery stop or adjust medications vitamins and supplements as you. discuss with your surgeon or physiotherapist , were told in your pre surgical screening call or visit . running jogging, jumping skipping rope Hair Removal. singles tennis badminton squash, DO NOT remove hair in any area of your surgery for 7 days PRIOR . skating inline and ice , contact sports football soccer hockey . high impact sports basketball volleyball , horseback riding. 28 13, Getting Ready for Surgery A Checklist to Help you Prepare General Activity Guidelines. As soon as you have seen your surgeon begin working on the After your hip replacement surgery you may need to follow rules to allow healing and. following prevent dislocation sometimes for up to 3 months Your healthcare team will let you. know the rules you must follow See pictures below . Consult a physiotherapist or fitness instructor for an exercise program. Begin a healthy eating plan ,Joint Surgery, Before your. Contact your family doctor if , pain is altering your sleep appetite or activity . difficulty walking due to severe pain or unsteadiness . feeling depressed or sad for longer than two weeks . having trouble dressing bathing preparing food etc . prepare your home for easy use and safety , Consider who will support you when you go home You will need someone in your. home for the first 72 hours and then available for 10 to 14 days until you can move. around easily , 3 months prior to surgery , Make plans with your support person . Have a check up with your family doctor and have your hemoglobin checked If. you have any medical issues see your specialist to ensure that you are in the best. possible shape , After Caring For, Yourself at Home. Take any iron supplements ordered by your doctor Eat iron rich foods . 1 week before surgery , Get all required equipment . Pack clothing for hospital stay , Confirm support person will be available on discharge. Day Before Surgery , Please carefully follow You must exercise to improve your strength and mobility. Instructions on when to stop eating and drinking before your surgery Continue to use aids as suggested by your therapist You may choose to use raised. Instructions on which medications to take the morning of surgery toilet seats and cushions on chairs longer than recommended if you are finding them. Instructions on how to clean prepare your skin helpful . Use a new bar of regular soap or liquid soap to shower or bathe the evening before. and wash your hair, 14 27, Sleeping DURING Your Hospital Stay. Ensure the top of your mattress is level with or above your knees. Follow the guidelines for sitting and standing to get on and off your bed safely Day of Surgery . Use 2 large pillows between your knees and ankles when sleeping on your back or. your side Have a shower or bath before coming to the hospital. When turning in bed use a pillow Do Not wear any scented products make up nail polish or jewellery. between your knees to prevent your Go to the Admitting Registration area. hip from crossing the midline Bring all medications with you as directed by Pre Surgical Screening. After Surgery, Getting in and out of a car, Recovery Room. Hospital Stay, During Your, Park well away from the sidewalk or curb so you have room You may need oxygen for a short time or overnight. If you are going home in a high vehicle you may need a footstool and help to get into A nurse will check your pulse and blood pressure. and out of the vehicle You will be given pain medications on a regular basis Tell your nurse if you. Move the front passenger seat back as far as possible have pain . Back up to the seat and place one hand on the dashboard and the other on the back You may have leg massaging devices that gently squeeze your calf muscle to help with. of the seat blood flow, Lower yourself slowly while sliding your operated leg forward and slide back across. the seat until you can swing your legs into the car The Hospital Ward. To slide easier put a plastic bag on top of Once you are ready you will be taken to the surgical ward . the seat You will be told how much weight you can put on your operated leg weight bearing. Use a firm raised cushion with a smooth status ,After Caring For. Yourself at Home, surface on the car seat if you find the seat You will be helped to sit on the side of your bed stand and or walk the day of. is too low surgery You will learn how to move on your own and walk more every day . Reverse this process to get out of the car A nurse will ask you if you have pain or feel sick nausea . and have your walker or crutches ready A nurse will check your blood pressure temperature oxygen levels as well as the. when you stand up colour warmth movement and feeling of your leg . If you have concerns about getting in and You will use a commode or a raised toilet seat when you use the bathroom . out of your car discuss this with your, You will have an intravenous IV in your arm to give you fluids and medications . Your IV will be removed when no longer needed , Continue to use any aids as told by your You will be given a blood thinning medication after surgery see COMPLICATIONS. therapist How to Prevent Them page 17 , You should change position from your back to your side every 2 to 4 hours. while awake to prevent skin or breathing issues ALWAYS KEEP PILLOWS. BETWEEN YOUR LEGS WHILE IN BED for the next 6 to 12 weeks . You may have devices to squeeze your calf muscles to stop blood clots from forming . A nurse will change your dressing and teach you how to care for your incision .
A recreational vehicle, a vehicle displaying restricted plates, a government-owned vehicle, is not an apportionable vehicle; except that a truck or truck tractor, or the power unit in a combination of vehicles having a gross vehicle weight of 26,000 pounds (11,793.401 kilograms), or less, nevertheless may be
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