At-home care after surgery

Follow these tips to help protect your joint and feel comfortable at home:

If you had a hip replacement:

• Don't lie on the surgical hip.
• Don't cross your legs at the knees.
• Don't bend at the hip or waist more than 90 degrees. Use a reacher to pick things up.
• Don't turn your feet excessively inward or outward when you bend down. Don't stand pigeon-toed.
• Don't sit on a low toilet or chair that would cause your hip joint to bend more than 90 degrees.
• Don't bend forward when getting out of a chair. Move to the edge of the chair and lift yourself up with your arms.
• When lying down, don't cross your legs or roll your surgical leg toward the other leg.
• When lying down, don't bend forward to reach for something.
• Wear shoes and slippers that provide good support.
• Sit in chairs that have arms.
• If your muscles begin to ache, cut back on your exercises but don't stop them altogether.

If you had a knee replacement:

• Don't keep the knee flexed or bent. That may shorten the knee muscles and make it difficult to fully extend the leg.
• When lying down, position a pillow under your ankles for support. Avoid putting a pillow under the knee, causing it to flex or bend.
• Continue using shoes with good support. Avoid wearing open-toe slippers or shoes without a back.
• Sit in chairs that have arms to help in getting up.

If you had a shoulder replacement:

• Don't roll the shoulder backward.
• Don't extend the elbow behind the body.
• Don't lift, push, pull or stretch with the arm.
• Don't support your body weight with your hand or arm.
• Support your elbow and upper arm with a pillow when lying down. Recliners may be the best choice for the first few days at home.
• Wear an immobilizer or sling until you follow up with the surgeon. You may remove it two to three times daily to move your fingers, wrist and elbow.

If you had a hip or knee replacement, you may experience swelling in your leg. Lie on your back and prop your feet up on pillows so that your feet are higher than your heart. Gravity will help drain the excess fluid. This is a good time to apply ice as well.

The white compression stockings you were given in the hospital will help keep the swelling down by compressing the veins in your leg and preventing fluids from pooling. They are also effective in preventing blood clots from forming. Most people wear them for four to six weeks after surgery. Your surgeon will tell you when you can stop. When using compression stockings, keep in mind:

• They should be worn during the day and taken off at night.
• To clean the stockings, handwash them in a mild detergent and let them air-dry overnight.
• Notify your surgeon right away if you notice any increased pain or swelling in either leg.

If you had a shoulder replacement, you may experience swelling in your arm and hand. It's usually less pronounced in the morning and grows throughout the day. To help reduce it, you can elevate your hand and forearm on pillows for 30 to 60 minutes during the day.

To help prevent swelling, avoid activities that leave your arm in a hanging position. If swelling is severe and accompanied by arm pain first thing in the morning, contact your surgeon.

If you're in pain, you're less likely to move or do your exercises. Inactivity can cause the joint to stiffen and slow your recovery, undoing all your excellent work during your hospital stay.

Try these tips to help you protect your joint and feel comfortable at home:

• Take your pain medication 20 to 30 minutes before you exercise. This will make moving the joint much easier.
• Control discomfort by applying an ice pack or a bag of frozen peas to the joint. Don't ice the joint more than 15 minutes per hour. Nonstop ice can cause tissue damage and slow the healing process.
• Change your position every 45 minutes.
• Avoid napping during the day so that you will be able to sleep better at night.

When you think you're ready to wean yourself off pain medications, try substituting extra-strength Tylenol in place of one dose of narcotic pain medication. Gradually increase the number of substitutions until you are no longer taking narcotics.

If you're taking a blood thinner, check with your doctor before taking any other type of pain reliever. Many common over-the-counter pain relievers may interact with your blood thinner and cause problems.

Taking care of your incision is the first step to preventing infection. Remember:

• Keep your incision clean and dry.
• Don't immerse your joint in water until your staples have been removed.
• When showering or sponge bathing, cover your incision with plastic wrap to keep it dry.
• Cover your incision with a light, dry dressing until instructed otherwise.
• Don't use any lotions, rubs or ointments on your wound unless directed to do so by your home health nurse or surgeon.
• Examine your wound daily and report any signs of infection.

Your dressing needs to be changed daily. If you have home health help or are going to a skilled nursing facility, the nursing staff will change the dressing for you. If you need to change it yourself, here's what to do:

• Wash your hands thoroughly with warm soapy water, rinse and dry.
• Assemble and open all new dressing materials.
• Remove the old dressing pads.
• Inspect the wound for any signs of infection, such as increased swelling, redness, yellow or green discharge, or odor. Report any abnormal findings to your surgeon.
• If the dressing has adhesive strips, uncover them and apply the bandage over your incision. If you're using tape to close it, pick up the dressing by the corner, apply it to the incision and apply tape on all four sides.
• Avoid touching any part of the dressing that will come in contact with your incision.

While it's healing, some redness, heat, swelling and bruising around your incision is normal. But call your surgeon if:

• The redness increases and pain does not subside.
• You develop a fever or night sweats.
• You notice any increase in drainage, the discharge changes color or an odor is present.
• You notice an increase in pain (not associated with normal exercise).

During the first two years after a hip replacement, you're more susceptible to infection. However, infections are possible for life. So always follow these steps:

• Notify your doctor before any procedure that may break the skin.
• When scheduling dental work, inform your dentist that you've had a joint replacement. Your dentist may give you antibiotics to take.
• If you see a new doctor, be sure to include the joint replacement in your medical history.

Changes in your daily routine, as well as taking narcotic pain medicines, can result in constipation. These steps can help keep your system moving:

• Eat fiber-rich foods, like grains, fresh fruits and vegetables.
• Drink plenty of water.
• Avoid liquids that contain caffeine, such as coffee and cola drinks.
• Avoid alcohol.
• Incorporate a daily walk or two into your exercise routine.
• Wean yourself off of narcotic medications as soon as possible.

If you do become constipated, use stool softeners or laxatives as needed.