home safety after hip surgery

  1. I'm hoping I can get some ideas from you experienced ortho nurses....

    I'm having an open dislocation hip surgery next month, and I live in a split-level house (need to climb stairs to get in the house). I'll be anything from 0 to 50% weight-bearing for a while, and I tried crutching on the stairs already and totally can't do it (they're steep and very narrow). I've been looking online for some kind of tools- temporary stairway handrails, steep temporary ramps, etc.- but haven't found anything that (a) would work, and/or (b) isn't prohibitively expensive.

    I also have 2 dachshunds that go out on-leash, and I'm not allowed to put in underground fencing (rental property), and can't get to the door to let them in the yard anyway. I do have a 2nd story deck in the back and the door is on the main level of the house. I'm thinking of putting a gate on the deck to block the stairs and laying down some piddle pads for the dogs to let them do their business there.

    Anyway- I can't come up with any other ideas to deal with the dogs, or for me getting in and out of the house. My husband works 12 hour shifts in a locked-down military facility and I won't be able to reach him easily, and he's not been given any time off to help me, so I'm going to be on my own for half of several days each week. We just moved to this town and live in a pretty remote area with few neighbors.

    I know I'll have PT, OT, nurses and case managers looking after me, but I'd love some suggestions for what I can put in place now, in case I need to order something. Plus, I like to be well-prepared, probably to a fault.

    Any suggestions, or places online I should look for ideas and/or tools? I'm much more nervous about safety at home afterward than I am about the surgery itself. I'd like to avoid spending a week in rehab, if possible- the hospital is 2 hours from home and I won't see my husband at all if I'm stuck there.
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    About rach_nc_03

    Joined: Nov '04; Posts: 376; Likes: 34
    clinical research nurse
    Specialty: PICU, Nurse Educator, Clinical Research

    11 Comments

  3. by   traumaRUs
    Hi and wanted to wish you luck. Is your hubby active duty? Would there be any help from Famiily Services. What about your church for meals, assistance and just some company? Home health to look in on you? Family member that might be able to spend a week with you? Community resources?

    Oh just thought of something else? Maybe stay with a friend in a ranch home?

    For the dogs - piddle pads work great for little dogs. I have an elderly (read can't hold it for long) westie-poodle mix. She stays in our laundry room with newspapers, food, water, doggie bed and I put up a baby gate too and she is fine there.

    I wish you the best. Please take care of yourself.
  4. by   rach_nc_03
    Quote from traumaRUs
    Hi and wanted to wish you luck. Is your hubby active duty? Would there be any help from Famiily Services. What about your church for meals, assistance and just some company? Home health to look in on you? Family member that might be able to spend a week with you? Community resources?

    Oh just thought of something else? Maybe stay with a friend in a ranch home?

    For the dogs - piddle pads work great for little dogs. I have an elderly (read can't hold it for long) westie-poodle mix. She stays in our laundry room with newspapers, food, water, doggie bed and I put up a baby gate too and she is fine there.

    I wish you the best. Please take care of yourself.
    Thanks for the good wishes, Trauma. Luckily, hubby is now officially OUT of the service, which means no more overseas jaunts (I had 4 surgeries while he was overseas, but none this big); bad news is no family services available.

    We don't go to church, and honestly don't know anyone here at all yet. My family can't help- parents are in their 70s and not in the best health, and his family can't come down because of work. I could kick myself for thinking this house would be a good idea! oop- better not- I'd hurt my stupid hip. :roll

    I have thought about posting an ad somewhere to hire a home health aide directly, or an LPN/RN, if I can afford one. I'm just worried insurance would take issue if something happened and I was injured while under the care of someone I'd hired on my own- I work for my health insurance plan, though, so I could probably get an off-the-record answer from someone on that.

    Actually, a friend at work is active in the jaycees in the next town over- I wonder if an organization like that could recommend someone? I'm a little hesitant to rely on someone without healthcare training, though- I'm six feet tall, and if I start to go down, you'd better know what you're doing, or I might take you down with me!

    Thanks for the suggestions, though- I still have a little time, so I might research the resources in our teeny community (7k people, I believe) to see what I can come up with. Keep your fingers crossed for me!
  5. by   rach_nc_03
    just thought of another question, but related to surgery- I know it's common to use epidurals along with general anesthesia, but are epidurals used in patients who've had spinal surgery? I had a discectomy/laminectomy in april. Don't want to ask for one if it's contraindicated.
  6. by   traumaRUs
    Sorry but that's too close for medical advice for me. I would ask your doctor.

    I'm trying to come up with other ideas. I almost would consider the stint at rehab because it would give you extra, intense rehab and get you back in fighting form sooner.
  7. by   emllpn2006
    Will your insurance plan cover any kind of home nursing care after surgery? Or maybe if your husband has worked at the facility for awhile maybe he could get some FMLA time I dont know how it works for government jobs but would not hurt to ask if you can afford him to not work for a week or so.
  8. by   rach_nc_03
    thanks for the suggestions.

    Sorry about the other question- I really wasn't trying to get medical advice- I certainly intend to ask my doctor, I just thought of it after reading a post on another board from a guy who had back surgery and was told that excluded him from getting an epidural. Before nursing school, I'd only heard of epidurals given during labor.

    The whole experience for asking others for suggestions on this makes me wonder if patients, as a rule, feel like they don't get enough information from healthcare providers before scheduled surgeries (in a lot of other situations, too, but I've never thought about this until it happened to me.) I mean, I have no ortho experience outside of nursing school, but I know a heck of a lot more than the average non-medical person would, so I know *what* I don't know, if that makes any sense. When I saw this surgeon (only once, but he's about the 6th person I've seen for this issue and it's my second hip surgery), he did a lot of tests, but spent maybe 2 minutes talking to me about the surgery. What I hope is that he felt like i must know a lot about it already, both because I'm a nurse and because I had a huge file I brought with me. I'd hate to think someone would come in without any prior understanding of these things and get pushed through as quickly as I did.

    I'm happy to report, however, that the person who spent the most time with me at my appointment was the nurse! I've also talked to a couple of people who've had surgery at this hospital, and they gave the nursing staff great reviews. (In fact, that's the first question I asked of them!) I also checked various websites for the quality ratings of the hospital, and it's top-notch.

    That's totally a tangent- sorry about that. I work as a clinical consultant for an insurance group, and I'm developing a program to educate members about what to look for and ask when they're going to have surgery, so I'm hoping this personal experience will help me provide practical advice.
  9. by   meownsmile
    Is there a neighbor child,, say jr high or high school that could come walk the doggies a couple times a day for you for a few bucks? I know my kids would have loved to do that for a few spending dollars when they were younger.
    Also,, with moving up and down the steps. Use your SEAT. You can sit on the 3rd or so step from the bottom,, and move yourself up the steps with the good leg, going down the same way,, go down a couple steps and sit back on the top step and lower yourself down to about the 3rd step where you can stand from a semi sitting position. Or a variance of this,, maybe try it a few times prior and see how it goes not using the operative leg.
    When i had foot surgery i found to carry things in the other room i used a bag and carried it in my teeth. Use a glass/plastic glass with a lid, drop it in the bag. Can carry your snacks, whatever too at the same time. Leaves your hands free for crutches or walker. I know these sound kind of stupid,, but ive found sometimes some of the most stupid ideas work like majic.

    Good luck, hope the surgery goes well.
  10. by   clichay
    Hello! I'm not a nurse but the wife of a hip joint replacement patient (3 years ago, actually). I was going to suggest using your seat, as well, but the reason I'm replying is to suggest that you have a look at a site called Hip Universe Support Group.

    http://groups.msn.com/hipuniversesup.../welcome1.msnw

    To post a question, you will have to get yourself a Hotmail account then apply to join but all you have to say is that you will be having the hip surgery and have questions.

    There have been quite a few members recently who have had PAOs or other hip surgeries other than straight THRs and they might have helpful info for you.

    I might add that I have been a member for 2 and a half years and I think it is a good group.
  11. by   Emmjay
    Not sure if you could possibly contact the physician doing your surgery and see if he/she can hook you up with the physical therapy /occupational therapy department at the hospital you are having your surgery. They oftentimes can do a home visit, and have great ideas for folks like you who have lots of stairs and such. I would also begin doing your standard hip exercises NOW if the doc says it's ok, and to try and build your upper body strength so using the crutches/walker won't be as tough. It will make your recovery much easier......
  12. by   nurseangel47
    Hi, and good luck with your upcoming surgery. Ouch! As far as the dogs are concerned, being a dog lover and working with them for a living at the moment, taking a break from nursing and doing something "fun" for a change!, I can recommend: a) kennel crates for them-will provide you, their mum, much needed time for rest and a break from being worried about their containment. b) boarding them at a decent kennel for the first week or so, c) having a pet sitter come by once a day to clean up their mess on the deck, feed and water them, walk them, let them out of their crates and play with them. Option c would be the least expensive. Good luck on their care as well as your own and a speedy recovery.
  13. by   amandarez
    I work on an ortho unit and the patients who are going to be getting any kind of joint surgery have to go to a class a couple weeks prior - they learn all about hip precautions, types of pain control, etc.....

    In addition, all of our patients have care management consults to arrange for either home health/pt or rehab. In general (at least at our hospital), unless the patient is fairly young, most hip replacements go to rehab after staying with us, they use walkers and are taught to navigate steps before leaving us. I would tell your surgeon that you are concerned about your home environment and ask for a consult for rehab.

    I absolutatly disagree with using your seat to move up and down steps. It flexes your hip more than 90 degrees which is a huge risk for it to dislocate. Again, tell your doctor and tell physical therapy that you have steps to navigate, they will teach you.

    I understand you don't want to be away from your husband if in rehab, but you have to put your safety first. If you aren't safe to be at home then you shouldn't be there. And believe me, at rehab you won't have much time to miss him - our patients have activities for about 6 hours a day.

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