- Safety Issues
You will need to make your home safe for yourself after your procedure(s)
since you will be on crutches, wheelchair, and/or walkers.
- Places that need thought:
- Bath – If you have a tub, then you will need a seat for the tub, Grab Bars on the side of the tub for access, a hand held shower head.
- Kitchen – you will need to reach things AND you will be on crutches – hot liquids (coffee, tea, etc.) will not be easy to transport, so a small thermos is pretty handy.
- Stairs – any stair that you use should have railings, also going up and down stairs on your butt is not a bad idea.
- Things that need thought
- A month or so BEFORE your surgery, Make a list that contains things that you would be normally be doing during that time of the year AFTER your surgery. Some will be time-of-year based: EG In the fall I need to put snow tires on cars, getting the summertime equipment (lawn mower, weed wacker, etc) put away for the winter, getting sand, snow shovels ready for the winter, etc, etc, etc. Some will be time based: haircut and other related activities - Get these done BEFORE your surgery. You will not be able to for several months after your surgery.
- Pets – I have 2 large dogs – they are very sensitive and will generally be careful around me, BUT things can happen. I took a nasty spill with my first surgery because I did not want to disturb the pooch – if they are in your way make them move – they will get over it.
- Throw Rugs – They can (and will) slip especially if there is one crutch on the rug and one on the floor – be VERY careful
- Comfort Issues
- Clothes: Warm clothing; if you are doing this in the winter months – as I did both times, layers of loose fitting clothes will be your friend.
- Small blankets if you are stuck in a CPM machine or a wheelchair will make it more comfortable.
- Shorts are indispensable as you need access to your knee – to remove/replace your brace, or the Estim units, and the ice will have better conductivity with no layers between the pack and your leg.
- Bed – a pillow under your leg will help AND several pillows will raise the leg enough to help with the swelling
- Find a place to put CPM machine that is comfortable – I use a couple of cinder blocks with a couple of pieces of plywood on top in front of a sofa.
- Have plenty of books, magazines, papers, Netflix, Cable, whatever you enjoy, because you will have a lot of time on your hands – make the best of it
- Access to a TV will help since you will spend a lot of time sitting in one place
- Radio/Ipod – If and when you get sick of the TV.
- Laptops are portable and easy because they are small, light, and keep you in touch
- A small knapsack will help carry things when you are crutching around
- A fanny-pack same as the knapsack, but smaller and more convenient.
- Arrange things so that the knee that had the procedure is the LAST one moved (if possible) – into a car, onto a bed, into the tub, etc
- You will be renting a Continuous Passive Motion (CPM) machine. This machine will be a key part of your PT. You strap your leg in this machine, and it will cycle through some angular amount at some rate. You get to choose both the angle and the rate. My PT calls for 6 hours a day for the first 6 weeks or so.
- a Leg lifter will be indispensable since using your quads is not allowed at first
- you might end up with a Neuromuscular Electrical Stimulation (NMES) unit which can prevent and retard disuse atrophy and assist in muscle re-education. This is the unit I used:
- I was given a Bledsoe Brace after surgery. This MUST be worn and locked at the extended position at any time you are moving
- Your Physical Therapy is your Full Time Job. I cannot emphasize this enough. You will go through enough pain, discomfort, boredom, that you better make it work, and PT is key to making this work. The PT person is your friend (it won’t seem that way because they will make you sore but pay attention, they are there to help!
- If you need to move, put on your brace and lock it – even if it is to move a couple of feet.
- Get a walker – when you get up in the middle of the night to go to the restroom, it is easy to lose your balance on your crutches – at least it is easy for me, a walker makes it more difficult to loose your balance.
- Did I mention that Your Physical Therapy is your Full Time Job.
- Take your time. Every thing takes much longer than you are used to!
- Don’t do everything your self – regardless of how difficult it is, this will only get you hurt. For this period you will need to depend on people, be grateful.
- Places that need thought:
A couple of words on Pain
Ok, what you will go through will smart just a little bit, just kidding it's gonna HURT. I don't care what your pain threshold is, how tough you are, this will wear you down. I have read that knee surgery is some of the most painful surgery out there. That is the bad news. The good news is it will not be chronic like what you are likely going through on a daily basis, AND your doctor will perscribe some medications. Use them! Tylenol will allowed, Ibuprofen, on the other hand, inhibits connective/cartilage growth so should not be used. In the hospital, talk with your anasthegiologist BEFORE surgery. You want an aggressive pain management protocol in place BEFORE you wake up, probably one of the various pain pumps which allow the patient to self-administer some amount of pain medication up to a prescribed limit.
In my case, for both surgeries, I had both an epidural as well as a general.
A word about the primary caregiver
This is as difficult for the primary caregiver as it is for the patient. As the primary caregiver you will need to deal with someone who is in significant pain, has limited mobility at best, after several weeks will be bored stiff, and who is probably wondering why they chose this in the first place. Suddenly the primary caregiver needs to be concerned with:
- Their own needs
- The needs of the patient
- The extended family responsibilities such as kids, pets, errands previously done by the patient
To make this work, each needs to understand what the other is going through and be patient.
My Typical Day
REMEMBER: EVERYTHING takes longer than you think when you are on crutches
|8:30 – 9:30||Get up, shower, shave, and dress|
|9:30 – 10:30||Grab a cup of coffee/tea/breakfast, read email|
|10:30 – 12:00||CPM machine, read, watch the news.|
|12:00 – 1:30||workout upper body, ride the bike (with NO resistance) just flexing the knee|
|1:30 – 2:00||Grab some lunch, relax the knee – good time to ice|
|2:00 – 3:00||Time for some NMES|
|3:30 – 4:30||Lie down, elevate the knee, and grab a nap if you can|
|4:30 – 6:00||back to the CPM machine, icing still a good thing|
|6:00||grab some dinner|
|Before bedtime, back to the CPM machine and continue icing.|