Today's Woman Surgery and Recovery May 2017

Recovering at Home:

By Carrie Vittitoe Photos Melissa Donald

Sometimes preparing for surgical recovery is more stressful than the surgery itself. If you are recovering at home, how do you make your home recovery friendly? How do you ensure that you can manage on your own if you can’t have a caregiver with you at all times? What items do you need to make recovering at home a success?

Planning Ahead Thinking Ahead

You might think you have to spend thousands of dollars to redo your bathroom in order to make it safe following joint surgery, but in reality, you can modify it very easily with grab bars and elevated toilet seats for under $300, says Jamie Hagan, owner of Community Home Medical and Hanger’s HomeCare in Southern Indiana, A visit to a medical equipment store can feel overwhelming, and in your

enthusiasm to be prepared, you could buy things you won’t need or use.

An important question to ask your physician is what recovery items he or she recommends. It is also a good idea to check with friends and colleagues who have had similar surgeries to see what they found helpful when recovering at home.

Planning for a successful recovery also means taking the time to get things done that you won’t be able to accomplish post-operatively. Kathy Bolger, a graphic designer with Today’s Publications, had foot surgery in May 2016. “I knew I would be immobile for awhile so I saw my dentist, and had other routine health checkups like seeing my eye doctor and dermatologist before my surgery,” she says. She also scheduled hair salon visits prior to her hospitalization. Taking care of to-do list items means after surgery you can focus solely on your recovery.

Rentals

Many patients find that they are not comfortable lying flat in bed following surgery, and some physicians recommend that patients sleep in recliners to alleviate pressure on surgical sites.

It is possible to rent recliners and hospital beds for at-home recovery.

Brenda Davis, retail manager of Gould’s Discount Medical, says a lift chair recliner can be rented for $95 per month with a one-time $50 delivery and pickup fee.

While these recliners might prove useful for sleep, patients need to ask their surgeon about their daily usage.

Norton Orthopaedic Specialists surgeon Dr. Joseph Greene says, “Patients have to work on getting the knee straight after surgery.”There is a concern with patients spending too much time in a recliner because it prevents the knee from straightening out completely.

While short-term use of the lift function is usually acceptable, most patients shouldn’t rely on it because it keeps from building muscle mass and strength in their legs as part of rehabilitation.

Gould’s also rents hospital beds which are billable to insurance if the patient qualifies. Davis says it is important for patients to ask questions about what private insurance and Medicare cover. There are all kinds of variables, including the patient’s diagnosis and condition, that determine whether or not insurance covers durable medical equipment. Semi-automatic beds, which may be rented for $140 per month, lift at the head and feet and can be raised in the middle using a crank.

Fully-automatic beds, which rent for $165 per month, also lift at the head and feet but have a remote that can raise and lower the middle of the bed.

Commonly Used Equipment for Joint Replacement and Foot Surgery

Of course, the equipment you need depends on the surgery you have. Hagan says patients who undergo knee or hip replacement usually find it helpful to have a folding, rolling walker and a hip kit, which includes a variety of helpful tools, like a 26-inch reacher for grabbing items, dressing sticks, sock aides, and sponges on long handles for bathing. Davis says Gould’s sells many hip kits, which run $36.95 and include seven aids for daily living.

Walkers come in a variety of styles and range in price from $30 to nearly $200. Some include seats that allow an individual to stop and take a rest as needed. There are many accessories that make walker use more versatile.

For example, Gould’s sells scooter bags and mobility handbags that can be attached to walkers and allow users to carry items from one room to another.

A cane will likely also come in handy following joint replacement surgery, and there are many kinds available. Standard base and quad base canes range in price from $15 to $50 depending on the style and size.

Canes can be found at a variety of retail establishments, including Walgreens and Kroger.

Following her foot surgery, Bolger used a knee scooter on the advice of her surgeon. Her home is on one level Continued on page 6 >>> SURGERY & RECOVERY / 2017

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<<< Continued from page 5 and she was able to get around, although she says it wasn’t often graceful. She says, “If I had it to do over again, I may have chosen crutches.”

Simple Items That Make Recovery Easier

Recovery success can come in the form of simple, inexpensive items, such as dry shampoo, which cleans the hair and scalp without water. Dove, Suave, and Garnier are three of the more common dry shampoo brands that can be found at any local retailer and sell for $6 or less.

If you are unable to shower for a few days following surgery, having body wipes at home can help you feel refreshed. ShowerPill’s Athletic Body Wipes and HyperGo’s AfterSports Wipes are two brands available that cost under $15.

While it may not be necessary to purchase slip resistant shoes following surgery, having a few pairs of slip resistant socks is probably a good idea. These can be found at durable medical goods suppliers and other local retailers.

Tonya Johnson, owner of Payne Street Pottery, had rotator cuff surgery in early 2017. She knew she wouldn’t be able to tie and untie her own shoes, so she purchased elastic laces to make getting her shoes on and off much easier. She also bought a steering wheel spinner from Amazon that cost around $12 that she says was “a very good idea for driving with one arm.”

Accessibility and Safety

After you’ve purchased the items you think you will need for recovery, it is important to consider where you are going to keep those items in the home to make them easily accessible.

It might be a good idea to put a Lazy Susan on the kitchen counter so all medications, cups, and utensils are easy to retrieve without bending or stooping.

Having two or more stashes of bandages and other hygienic

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items on every floor of the home is also a good idea.

Finally, if you are recovering at home alone, keep a cell phone close by at all times. It is important to have one’s home as recovery-friendly as possible, but it is equally important to be able to ask for assistance when and if you need it.

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The Dos and Don’ts of Recovery ESPECIALLY FOR CATARACT, FOOT, JOINTS AND ORAL SURGERY

By Carrie Vittitoe

We all know we should follow our doctor’s orders when patients can begin driving after their first post-operative check-up. preparing for and recovering from any kind of surgery, Rubbing the eye after surgery is a but that is often easier said than done. If we heal quickly, definite don’t, as is getting dirt or debris in the eye. So you get a pass for a day or we may push our bodies too fast, too soon. If we feel two from dusting and working in the yard. rotten, we may not do our rehabilitation work as often Foot Surgery Dr. Alan Mauser of Louisville as we should. In order to help us recover successfully, Podiatry says the most common foot surgeries are to treat ingrown toenails, four Kentuckiana surgeons offer the dos and don’ts of bunions, and hammertoes. Surgery recovery from cataract, foot, joint, and oral surgeries. for an ingrown toenail is performed Cataract Surgery

Dr. Brennan Greene with The Eye Care Institute says, “Most people are surprised about the speed of recovery from cataract surgery and the low impact it has on their daily activities.”

Cataract surgery is the removal of the clouded lens from the eye and its replacement with an artificial lens. The surgery is usually quick and requires very little preparation. Greene says, “With modern cataract surgery, a

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patient’s normal medications can still be taken before and after surgery, and this includes blood thinners.”

Following cataract surgery, Greene advises his patients not to engage in strenuous activity or heavy lifting for seven days, and he has patients wear a protective shield over the affected eye while sleeping for that week. He usually sees patients for a post-operative check the day after surgery and then once or twice over the next month. Most

in the office under local anesthesia, and Mauser says, the patient can wear shoes right off the bat. Bunion surgery is more complicated because it “involves breaking bone and resetting or repositioning bone with a pin, screw, or plate,” Mauser says. Likewise, hammertoe surgery is more difficult because “you have to remove a portion of the bone and put the bone ends together so the toe stays straight.”

Recovery for bunion and hammertoe surgery takes six to eight weeks on Continued on page 10 >>>

<<< Continued from page 8 average and requires that the patient put no weight on the affected foot.

Mauser says he advises patients to use whatever mobility device works best for them, whether it be a knee scooter, wheelchair, or crutches. Once patients begin to put weight on the foot, they often wear a fracture boot, which both protects and cushions.

Mauser instructs his patients to keep their foot elevated and put ice on it, and he prescribes a narcotic pain medication, although its actual use varies from person to person depending on their ability to tolerate pain. The biggest no-no he sees patients do during their recovery is putting weight on the foot.

Not only can this impede healing, it is just painful. “If they overdo it, they’ll know it,” he says.

Joint Surgery

Dr. Joseph Greene with Norton Orthopaedic Specialists says the recovery process with hip surgery is usually easier than knee or shoulder surgery. However, all of these surgeries generally require at least of month of recovery. Most patients who have hip or knee surgery use a walker right after surgery and then gradually transition to a cane.

Patients are given extensive education on what to do and not to do during their recovery period from joint surgery. Greene advises his patients to avoid certain positions so that the joint doesn’t become dislocated during recovery. Although his practice uses the anterior approach to hip surgery, which in general has less risk of joint dislocation, there are certain positions to avoid as a precaution, he says.

The biggest no-no in recovery is to stop attending physical therapy in the early stages. Greene says some patients who undergo knee surgery develop a limp prior to surgery because they are in pain, and they will maintain those limping habits because they have lost muscle mass. He stresses that “patients should become pretty religious about doing their home exercises.” It is critical to keep the joints moving and not let scar tissue form.

Oral Surgery

Dr. Kenneth Livesay with East Louisville Oral Surgery & Dental Implants, PLC says the most common oral surgeries are often age-dependent.

Younger patients typically have wisdom teeth removed or dental extractions, while patients over age 60 often have

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dental extractions, implants, preprosthetic surgery (to remove bone), or biopsies.

Surprisingly, implants are almost to the point of drive-through service, he says, and most patients don’t even need to take pain relievers. The recovery time for extractions really depends on the number of teeth extracted and their nature. Patients who have wisdom teeth removed are seen by Livesay about a week after the surgery, while implant patients are usually not seen for a few months after surgery to allow bone to begin growing in and around the implant.

Livesay instructs his patients to

limit strenuous activity for five days following surgery and to avoid drinking from straws, especially if they’ve had an extraction. Proper healing requires that a blood clot form over the area where the bone is exposed, and activity or suction can dislodge that clot and lead to dry socket which leaves underlying nerves exposed and is very painful.

For the first 24 hours after surgery, patients should use ice packs on the facial area near the extraction to control swelling , keep the head elevated, and do nothing in the mouth that might dislodge the clot (like brushing teeth). Warm salt water rinses and a soft diet are also important.

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How to Keep Your Spirits Up after Surgery

By Megan S. Willman

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n January 2017, Katrina Uhl told her surgeon she was ready for 360° Spinal Fusion surgery. The pain in her back, a genetic condition made worse by age and activity, was preventing Katrina from sleeping, working, and enjoying precious time with family.

“We love to hike together, and I could no longer do it. No one ever says ‘I can’t wait to have back surgery,’ but I knew it was time,” Katrina says.

After three nights in the hospital, Katrina returned home and faced a lengthy recovery. For the first month, she was not allowed to bend at the waist or knees. Family took off work and school to help, but Katrina vividly remembers the sense of helplessness on her first day home alone. “I couldn’t get dressed or eat. I called school and asked my daughter to come home and help me,” Katrina says.

Even with supportive family and friends, Katrina faced long and painful days. To stave off the depression doctors had warned about, and to give herself a positive distraction, Katrina turned to her students at Floyd Central High School. As the only teacher of AP Psychology at the school, Katrina not only missed her students but worried that her absence might put them behind for the AP testing that takes place at the end of the school year. “After the first couple of weeks, I figured out a way to teach from home,” says Katrina. Using the wonder of technology, Katrina logged onto her computer each day, and her classroom substitute teacher would set things up for the students. She was able to keep the kids up-to-date on their coursework, answer their questions, and keep herself focused on something other than her pain. “It gave me a reason to get up and brush my teeth. I even put on make-up most of the time,” says Katrina.

Recovering after surgery poses an array of physical and mental challenges for patients, and without proper attention can lead to anxiety and depression. Cheryl Ades, a licensed social worker and therapist in Louisville, says that we may delay healing “if we shove our feelings down and ignore them.” Medical procedures, even when elective, are frightening. Cheryl encourages us to use the time at home to examine our priorities and evaluate the changes we may need to make in our lives. “This is a great time for reflection and can be a lovely wakeup call if we let it be.”

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Katrina and Cheryl offer these suggestions to make recovery more bearable:

Meditate.

Try something new.

If you’ve never done it before, try a free app on your phone or look up easy techniques on the internet.

A great starting point is to focus on your breathing and try to relax.

Massage therapy, aromatherapy, and restorative yoga are excellent tools for building meditative practices.

Use this time to learn something that interests you: Learn a language for free at Dualingo.com; make your own music with the GarageBand app; pick up a few easy card tricks by watching YouTube; learn to knit, or start a journal.

Ask for and take the help you need.

This is a great time to write a letter, connect on Facebook, or call someone you’ve been meaning to contact for ages.

Let your friends bring food, visit briefly, and take care of tasks around the house.

It is OK to schedule these visits so that everyone doesn’t show up at once.

Get in touch with long-lost friends.

Clear some clutter.

Enjoy guilt-free TV and movies.

You have an excuse to binge-watch any movies or shows that you love or have always longed to see.

Sort through one drawer each day, organize your photos, or make a list of projects to do around the house whether it’s a “honey-do” list or things you want to do yourself when you feel better.

Nestle in with a good book.

Enjoy a spa day.

Catch up on your reading. Audio books are always a good option, as is having a friend or grandchild read to you.

Give yourself a manicure, pedicure, or facial at home. Better yet, have someone else come do it for you.

Get your Vitamin D.

Focus on the positive.

For some patients, walking is a daily requirement. Whenever possible, do it outside to brighten your spirits. Enjoy time sitting on your patio or deck.

Keep your furry friends nearby.

Research shows that pets aid in the healing process. Enjoy extra time with your faithful friend.

Set attainable daily goals that help you build confidence in your return to good health. Make a list of things you look forward to doing and the people with whom you want to share them. Focus on the positive aspects of your recovery, and for those days when it’s hard to think of any, have a friend or family member on call who can help you.

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WISE AND WELL

By Mark Kaelin

Stretch and strengthen

“Meeting with a physical therapist before your procedure for prehab can make a huge difference in your recovery,” says Patrick Myers of ProRehab Physical Therapy. He says individuals who engage in this type of training regularly report less pain and typically return to normal activities at a faster rate than those who don’t.

Prior to surgery and during recovery, you might find that you just can’t get all those errands completed. That’s where Carolyn Wolf of On the Go Personal Assistants can help. “I can handle your to-do list so you can focus on getting well,” Wolf says.

What to bring

When the day of your procedure arrives, travel light! “Patients need their insurance card and insurance information, a photo ID, and a form of payment,” says Veselsky. If you’d rather not carry a checkbook or credit card, most facilities will take your payment information over the phone during pre-registration.

Walk it off

Staying active before surgery has a positive impact on how you feel and how you heal. “If arthritis and joint pain are interfering with your walking, the AlterG treadmill might help you work around these issues,” says Myers. The treadmill is designed to limit how much weight you have to support by as much as 80 percent, reducing joint stress and pain.

Billing basics

When you’re in the physician’s office, meet with the surgery coordinator and write down the names of every person involved in your treatment, including the anesthesiologist, surgeon, pathologist, and even the lab where your samples and blood work might be taken. “Review this list with your insurance company to ensure all the partners are in your coverage network,” says Karen Veselsky of KentuckyOne Health.

What about the dog?

Just because you’re down and out doesn’t mean your dog is.

Hiring a pet sitter is one way to ensure your pet stays happy, healthy, and out of your hair while you’re recuperating. Long walks, scheduled play time, potty breaks, and transporting pets to veterinary appointments are just some of the services most pet sitters offer.

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Get help with your to-do list

Let someone else do the cooking

Alleviating Anxiety “Feeling anxious before surgery is perfectly normal,” says Dr. Gary Petiprin, counseling psychologist at Bellarmine University. However, side effects like irritability, poor concentration, and lack of sleep can interfere with your recovery. Petiprin recommends employing diaphragmatic breathing, progressive muscle relaxation, and positive self-talk to reduce anxiety symptoms. “All these methods help, and thanks to YouTube it’s fairly easy to learn how to do them,” Petiprin says.

Louisville Metro’s Meals on Wheels Program provides meals to homebound individuals over the age of 60. To learn more about this program and see if you might qualify, contact Ashley Mitchell at 502.574.6325.

Make your health a priority

Bad habits can interfere with your recovery. If you’re burning the candle at both ends, set a bedtime and stick to it. If your diet’s not the best, clean it up by stocking your pantry with healthy food instead of junk food. If you smoke, quit. Smoking raises your blood pressure and reduces oxygen to your tissues, both of which can impede healing.

Dietary supplements and surgery

Ginkgo biloba, ginseng, valerian, and echinacea are just a few of the supplements Americans take in hopes of improving their health. Unfortunately, many of these can cause complications during surgery. Discuss your supplement use with your physician beforehand and mention it again when you pre-register for your procedure.