First Days at Home
After discharge from the hospital, the following information will be important for recovery whether at home or in a care facility. Plan ahead to have help available at for at least the first week. You will need help bathing, shopping, doing housework, cooking, and getting dressed.
First Days at Home
After your discharge from the hospital, you will need some assistance for the first few days at home. During this time, your support team should plan to help with shopping, housework, and other activities of daily life.
Ice & Elevation
Swelling in the leg that you had surgery on is normal and should go down over time. Ice the area several times daily for 30–60 minutes. This will decrease swelling and help control your pain. We don't recommend putting heat on your leg since it can increase swelling.
Elevate your leg several times throughout the day by lying flat with your foot on three to four pillows, so your knee is above your heart. Do this for 30–60 minutes, four to five times a day (or as needed). This exercise helps reduce swelling and lowers the risk of blood clots for both hip and knee replacement patients.
To elevate your joint correctly, lie flat with your feet on three to four stacked pillows (hint: think toes above nose). This exercise helps reduce swelling and lowers the risk of blood clots for both hip and knee replacement patients.
If you had a total knee replacement, don't put pillows behind your knee.
Hip replacement patients should remember hip precautions (if instructed by physical therapy) while elevating.
Incision Care
Your dressing is sterile (clean). Don't remove it until your two-week appointment. Your dressing can get wet as long as there's a strong seal around your incision. If your dressing has loosened, cover it before showering.
Call our office if you have drainage that leaks or gets your clothes wet. You may send a photo to uocjointteam@utah.edu and, if necessary, we will make arrangements to change the dressing.
Bruising is normal and can take a couple weeks to go away. It is normal for the surgical area to feel warm, red, or slightly swollen. Be sure that you are icing and elevating as much as directed, at least four to five times a day for 30 minutes each time.
Blood Clot Prevention
Since you will be having joint surgery, you will be at risk for developing a blood clot. To prevent this, while you are in the hospital, we will place compression boots on your feet to circulate your blood.
Moving your ankles up and down (foot pumps) will circulate even more blood through your legs. Your doctor will prescribe one of two medications; a blood-thinning medication called warfarin (Coumadin®) or aspirin.
Your physician and a member from our thrombosis service will discuss using warfarin vs. aspirin and will determine which medication to prescribe based upon your health history and risk factors for developing a blood clot.
If your doctor chooses aspirin, you will take it for six weeks, twice daily, beginning after surgery. We also won't need to monitor your blood.
If you are prescribed warfarin, you will take this for four weeks after surgery. While taking this medication, you will need to have your blood tested regularly. Our thrombosis service will assist you in this process and help keep you safe while taking this medicine.
Warning Signs of Blood Clots
Warning signs of possible blood clots include:
- increasing pain in your calf,
- tenderness or redness above or below your knee,
- increasing swelling in your calf, ankle, and foot.
If you experience any of these symptoms, contact our office immediately:
University of Utah Thrombosis Service: 800-783-3735
Physical Therapy
In addition to any home health physical therapy or outpatient physical therapy sessions, you should continue to work on your physical therapy exercises independently. Your hospital therapist will teach you an exercise regimen, and you can also refer to the tabs in this binder, or discuss any questions that might arise with your home health therapist.
Nausea, Sleep, & Constipation
Nausea
Sometimes pain medication can make people feel nauseous or cause vomiting. If you are experiencing this problem, please let us know. There are several things we can do to help. The easiest thing to do is remember to take your pain medication with food and plenty of liquids.
Sleep Hygiene
Getting back to a normal sleep pattern after surgery can be difficult. If you are having trouble sleeping, try to avoid napping during the day. Elevate your leg in the early evening and do a quiet activity, and schedule your pain medication so you can take pain pills one hour before bed.
If you are still struggling to sleep, consider taking melatonin or Benadryl (diphenhydramine), an allergy medication with a side effect of drowsiness. Avoid sleeping with pets after surgery until your wound is healed.
Constipation
Because of the narcotic pain medications you will be taking after your surgery, constipation is a common complication. To help reduce the discomfort of constipation, we will prescribe all joint replacement patients a stool softener. We also encourage you to be proactive about your diet.
You should never go more than four to five days without a bowel movement (including the time you spent in the hospital). To avoid constipation and encourage a bowel movement:
- Drink plenty of water (minimum of 64 ounces per day).
- Increase fiber intake by eating dried and fresh fruit, whole grains, vegetables, bran, psyllium, apple juice or prune juice.
- Use stool softeners such as Colace, Metamucil or Miralax as needed.
- Use Fleet enema or a warm water enema.
- Depending on your pain level, consider decreasing or stopping your narcotic pain medication.
- Chew gum
Continued constipation can lead to emergency trips to the hospital. Contact us if you are concerned about the amount of time you have gone without a bowel movement.
Getting Back to Your Normal Activities
Return to Work
Most people return to work two to six weeks after their surgery, depending on the demands of their job. Desk jobs or other sedentary work can be resumed quite promptly, while work that involves significant lifting or other heavy labor are generally not resumed until six to eight weeks following surgery.
Returning to home directly from the hospital will help expedite your return to work.
Sexual Activity
You can resume sexual activity usually four to six weeks after surgery. Limit it to what you are able to do without pain. Hip replacement patients should remember all appropriate hip precautions, to avoid the possibility of dislocation.
Driving
You may begin driving two to three weeks after surgery as long as you are:
- able to move your leg as needed,
- follow your hip precautions while entering and exiting the vehicle, and
- do not take narcotic pain medication during the hours that you drive.
Please be a cautious driver. If an accident were to occur, you could be found at fault because of your recent surgery. We encourage you to practice driving in a large parking lot before proceeding to the road.
Follow-Up Questions From the Patient Support Team
To make sure your recovery is going well, our patient support team will be reaching out to you and asking questions like these:
24–48 Hours
- How are things going?
- How are you doing with your medications?
- Are you having any difficulties with getting or taking your medications?
Seven to Ten Days
- What's going well and what's not going well?
- How is your pain?
- How is your mobility-how are you getting around?
- Are you icing/elevating?
Day 30
- How are you getting around?
- And how's your pain?
Day 60
- Have you needed additional care since we last saw you?
90 Days/Three Months
- Are you still seeing improvements?