Early Preparation for Surgery

Transcription

1 Early Preparation for Surgery

2 Being prepared includes: Understanding Osteoarthritis Setting Goals Physical Activity Home Safety Nutrition & Weight Management Pain Management

3 People who are prepared for surgery have Better hospital experiences Fewer complications Smoother, faster recovery

4 What is Osteoarthritis? Breakdown of cartilage May cause joint pain, stiffness & swelling Typically affects weight bearing joints

5 Anatomy 101 Hip X-Rays NORMAL Pfizer 2004 The Arthritis Society OSTEOARTHRITIS

6 No bending past 90º L -shape No crossing the legs No twisting See p.10 Before, During and After Hip Precautions; For 3 months post-op

7 Anatomy 101 Knee X-Rays NORMAL OSTEOARTHRITIS Pfizer 2004 The Arthritis Society

8 No pillow under knee No squatting No kneeling No twisting See p.18 Before, During and After Knee Precautions; For 3 months post-op

9 Setting Goals

10 SMART Goals Specific Measureable Action-based Realistic Timely

11 SMART Goal Setting I am going to start exercising more VS. I am going to walk around the park for 10 minutes, 3 times a week This month, I am going to do water exercises for 20 minutes, once a week

12 Tips to succeed Write your goals down Post them where you see them Share your goals with friends and family Have a back up-plan

13 Physical Activity

14 Benefits Strong muscles less joint stress Joint mobility Endurance Weight control

15 But it hurts! Start small, increase gradually Break up the activity (2, 3, or 4x/day) Minimize joint stress Water Exercise bike Walking aids Respect your limitations

16 Avoid over-doing it 2-hour pain rule Extra joint pain for more than 2 hours after the exercise - you probably did too much, too fast! Slow down and do less next time Apply ice or heat to relieve symptoms

17 Move It! Gentle movement, 5 to 10 repetitions Stretch leg muscles, 20 30s hold Watch PreHab exercise videos Range of Motion, Stretching

18 Strength Arm and leg muscles 8 to 15 repetitions Watch PreHab exercise videos Arm Strength, Thigh muscle Strength

19 Balance

20 Fitness Options Arthritis Society programs: Water Works, Joint Works Community Centers / Pools Physiotherapy clinics Knee Replacement Exercise Guide (OASIS website) Physical Activity Line (PAL)

21 Additional Reading (and a break) Heal Your Knees: How to Prevent Knee Surgery and What to Do If You Need It Klapper & Huey Heal Your Hips: How to Prevent Hip Surgery and What to Do If You Need It Klapper & Huey Total Knee Replacement & Rehabilitation; The Knee Owner s Manual Brugioni & Falkel

22 Home Safety Be prepared

23 Home Set-up Install stair railings, grab bars Remove clutter, tripping hazards Seats 2 above knee Foam cushion, bed blocks Move frequently used items to waist-height

24 Bathroom Equipment Raised toilet seat Bath stool or bench Grab bars Rubber bath mats

25 Other Equipment Crutches Walker Long-handled reacher Long-handled shoe horn Elastic shoe laces Sock aid

26 Where can I get equipment? Medical supply stores - Rent or purchase - Check for coverage through medical plan Local Red Cross locations: - Equipment on loan for up to 3 months - Need a signed equipment form

27 Nutrition and Weight Management

28 Nutrition is important because A healthy body supports healing A healthy immune system fights infection

29 Weight Management Each extra pound = 4-6lbs of stress on joints Need for weight loss: High BMI Waist circumference

30 Set a SMART goal Overweight? Do not lose more than 3 lbs /wk Regular exercise Long-term changes in eating habits Limit calories from fluids Look at what causes you to eat

31 Underweight? Risks of being underweight include: Poor bone health Weak immune system Low energy levels Nutrient deficiencies Consult a dietitian

32 Canada s Food Guide Vegetables & Fruit 7-10 servings Grain Products 6-8 servings Milk Products 2-3 servings Meat & Alternates 2-3 servings Be aware of serving size! Consider vitamin/mineral supplements

33 Vegetables and Fruit 7-10 servings/day Provides energy, fiber, vitamins, minerals, antioxidants Choose(more often): dark green, orange and red vegetables orange and red fruit

34 Grain Products 6-8 servings/day Provides carbohydrates, fibre, vitamins, minerals Choose whole grains, high fibre, low fat

35 Milk Products 2-3 servings/day Provides protein, carbohydrate, vitamins, minerals, calcium Choose low fat

36 Calcium & Vitamin D Promotes bone healing Vitamin D; decreases risk of falls, hip fractures, cancer Aim for: mg calcium IU vitamin D

37 2-3 servings/day Supports muscle building, healing Meat and Alternates Sources: Fish, eggs, meat, poultry, tofu, peas, beans, lentils, nuts and nut butters.

38 Protein and Healing Protein needs increase 20-50% for healing Achieve this by eating: 3 servings of meat/meat alternates 3 servings of milk products

39 Iron and Surgery Low hemoglobin = anemia Fatigue, light-headed, weak Low iron stores may delay replacement of blood loss Choose iron-rich foods Discuss iron supplements with your doctor

40 Prevention is key Constipation Fiber: grams/day Fluids: 8 cups (2L)/day Exercise Take extra precautions before/after surgery

41 Resources Health Link BC or dial

42 Pain Management

43 What medication is right for me? Talk to your Doctor or pharmacist about: Pain level Risks, side effects Drug interactions

44 Medications for arthritis pain Multi-modal analgesia Acetaminophen (Tylenol Arthritis Formula) Lowest risk Non-Steroidal Anti-inflammatory (NSAID) Nonspecific NSAIDS Advil (ibuprofen), Voltaren (diclofenac), Naprosyn Affects blood pressure, stomach lining Stop 5 days preop Cox 2 Inhibitor (Celebrex) no platelet effect, doesn t have to be stopped

45 When should I take medication? Pre-medicate Smaller dose to prevent Larger dose to treat Take regularly Review with pharmacist or GP

46 Supplements and Surgery Some supplements and medications affect blood clotting Suggested to stop supplements 2 weeks before surgery, talk to your doctor or Pre-Admission Clinic

47 Time to quit? The single best thing you can do to improve your health Hospital no-smoking policy New strategies to help quit; Champix (prescription) acupuncture

48 Alcohol Use Tell the hospital staff if you drink daily Suddenly stopping alcohol use may lead to withdrawal symptoms Withdrawal will impact your rehab!!

49 What s next? Pre-op Education 1 3 weeks before surgery Pre-admission Clinic up to 2 weeks before surgery * Richmond residents do not attend group Pre-op; Home Care PT will contact you directly

50 Resources OASIS website OASIS Primary Education The Arthritis Society Arthritis Info Line: OrthoConnect

51 Summary People who are prepared for surgery tend to have a positive experience Set some SMART goals: Exercise Home safety, equipment Nutrition Weight management Pain control

52 Questions?