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Physical Therapist's Recommendations: How to Prepare for Surgery?

Physical Therapist's Recommendations: How to Prepare for Surgery?

Scheduling an elective orthopedic surgery will often allow you adequate time to prepare yourself and your home for post surgical convalescence. There are a good number of things that you can do in advance to make this time more comfortable and less stressful. You should speak to your surgeon and their staff about medications, insurance coverage for assistive equipment, and specific precautions or limitations on activity, but not many patients realize that a pre-operative or "Prehab" visit(s) with a physical therapist can help you learn the proper exercises and use of assistive devices for mobility before you enter the hospital. A physical therapist can also help you understand what to expect with regards to the rehabilitation process, mobility, and activities of daily living once you return home. It may be beneficial to you to learn some of these mobility techniques and precautions before entering the hospital and while not in acute pain. Some common examples:

 

Physical Therapy before Spine Surgery

 
There are difference precautions depending upon the specific surgery, but most patients are advised to avoid "BLT" or bending, lifting, and twisting.  You may need to learn how to get in/out of bed, cars, and reach for things differently in order to protect the surgical site.
 

Physical Therapy before Hip Surgery or Knee Surgery

 
Most patients have limited range of motion after surgery, due to a combination of pain, swelling, and surgical precautions. You may benefit from learning alternate strategies for bed mobility, transfers, and dressing prior to your surgery. A physical therapist can also familiarize you with how to fit and use your walker, crutches, or cane specifically for the types of environments you need to navigate.
 

Physical Therapy before Total Hip or Knee Replacement

 
Joint instability or replacement: Prior to surgery, some patients benefit from a series of visits to safely maximize range of motion and strength, as well as decrease pain and inflammation. In some cases, "Prehab" can help accelerate your recovery after surgery.  It may also help limit any further decline while waiting for surgery.
 
If you think you might benefit from visiting a physical therapist prior to your surgery, please call us and we can help you make arrangements with your physician. We would be happy to help you when you're ready.  In the meantime, here are some additional things you may want to consider while preparing for surgery.
 

Home Safety Questions Before Surgery

 
Do you have stairs or steps at home? Are there rails for safety? If you expect a long convalescence, you may want to consider having rails installed. In some cases a temporary ramp or downstairs living quarters may be helpful.
 
Are your walkways clear of obstacles? Are your doorways wide enough to accommodate a walker or wheelchair?  Area rugs, cords, furniture, and plants may need to be moved to decrease chances of you tripping and falling, as well as improving the maneuverability of your walker or wheelchair, if applicable.
 
Is your bathroom handicap accessible? You may need to consider whether you can access the facilities with a walker or wheelchair. A raised toilet seat with or without armrests may also be helpful. Can you step into a tub or will a tub bench be necessary? Can you stand in the shower safely or would you benefit from a shower chair? Grab bars and non-skid appliqués or mats can also decrease your chance of falling. A long handled scrub brush and hand held shower accessory may help if you cannot bend over or stand up. Place items in hard to reach areas on the countertop to avoid reaching and bending.
 
Arrange items that you regularly need close to the bed or chair where you will be spending a lot of time, i.e. facial tissue, water bottle, tablet device/phone and charger, medications, waste basket, crossword puzzle book, etc.
 

Home Self Care Questions 

 
Do you have laundry facilities in a convenient location? You may want to wash as much as you can before surgery.
 
Do you live close to grocery and restaurant delivery areas? You may want to stock up on frozen and non-perishable food, as well as cook some meals and freeze them. Placing items in easy reach at counter height will help decrease bending and reaching. If you do not have help at home, using disposable dishes and cups may help if you cannot wash dishes or stand at the sink for a while.
 
Will you be able to dress without help? There are many adaptive aids that can increase your independence, including but not limited to: dressing stick, long handled shoe horn, reacher/grabber, sock aid, and leg lifting strap.
 

Transportation Considerations before Surgery

 
Will you be able to drive? If you will be able to drive after surgery, or if family members/friends will be driving you, you may want to download a handicap placard application, fill out your personal data, then take to your doctor to complete so that the placard is available before leaving the hospital. Some other options include public transportation or medical or private transportation services like Access, Uber, or Lyft. Some services like Access require you to meet certain criteria and sign up prior to using the services, so it might be helpful to investigate transportation options early.
 
Will you be able to get in/out of the vehicle? After hip or knee surgery, many patients have difficulty getting in and out of low or compact vehicles because of decreased range of motion and maneuverability.
 
Unfortunately, some patients experience nausea after surgery. You may wish to have a leak proof bag available for the car ride home.
 
This blog entry is for informational purposes only and is not a substitute for personal and professional medical or physical therapy advice or treatment. If you have any questions or would like more information, please contact our office. You may also contact your physician for a referral to physical therapy.

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