At-Home How-To

To reduce the risk of developing a lung infection, practice the techniques below daily before surgery:

Coughing

1. Sit down and take a deep breath in. (If you have obstructive pulmonary disease, such as emphysema, take a shallow breath in.)
2. Forcefully cough, covering your mouth with the crook of your arm.
3. Repeat 10 times daily.

Deep breathing

To keep your lungs clear and stay relaxed, lie down or sit and do the following:

1. Breathe in through your nose slowly and deeply. If unable to breathe through your nose, inhale through your mouth. (If you have obstructive pulmonary disease, such as emphysema, take a shallow breath in.)
2. Exhale slowly through pursed lips, similar to blowing out the candles on a birthday cake. Be sure to use proper technique:
   • Don't hold your breath.
   • Place your hand on your stomach to confirm:
     • Breathe in: Your stomach should move out
     • Breathe out: Your stomach should move in

Once you get into the rhythm of this exercise, close your eyes and visualize a place/scene that relaxes you.

Hip precautions (if required by surgeon)

When you see this symbol remember to do the activity within the limits of hip precautions, according to your surgeon's instructions.

Successful recovery after hip replacement has a lot to do with how you move your body. Here are some movements you should always avoid if you are having a posterior surgical approach for your hip replacement:

DO NOT

• Bend past 90 degrees at hip/waist
• Stand, sit, or lie with your legs/toes turned in (keep toes pointed forward)
• Cross legs or ankles

If you have an anterior surgical approach to your hip replacement, here are movements to avoid:

DO NOT

• Step backwards with the surgical leg (hip extension
• Stand, sit, or lie with your legs/toes turned outward
• Cross legs or ankles

For the next few weeks, you may have to stop and think about how to do certain activities that previously were automatic, like getting into bed or out of a chair. Soon, they will become natural again. In the meantime, follow these guidelines to help you during your recovery period.

If you had a bilateral joint replacement, it helps to designate one of your legs as the "operated leg"—the one you are having more pain with. Whenever you see this icon remember to think of your more painful leg. This will help you move your body safely as you follow the activity instructions.

If using a rolling walker (with wheels)

1. Stand inside the walker.
2. Grasp the handles securely with elbows bent.
3. Move the walker in front of you and start walking, staying inside of the walker (similar to pushing a shopping cart.)

DO NOT

Use the walker to pull yourself up to standing position.

Push the walker too far ahead. Try to keep your body upright and avoid leaning forward.

If using a rolling walker, transitioning to a cane typically happens one to two weeks following surgery. If you are working with a physical therapist, that person will let you know when the time comes and give you direction regarding using a cane. If you are not working directly with a physical therapist, contact your surgeon's office for direction regarding readiness and guidelines for use.

Going up stairs with a cane:

1. Hold hand rail in one hand and cane in the other.
2. Step up with non-operated leg to the first step.
3. Step up with operated leg , bringing the cane with you. Both feet and cane will be on the same step.
4. Repeat.

Going down stairs with a cane:

Chair with arms

1. Scoot forward to the front edge of the chair.
2. Place both feet firmly on the floor.
3. Place both hands on the arms of the chair.
4. Lean forward slightly and push up from the chair using both hands.

Chair without arms or a sofa

1. Scoot forward to the front edge of the chair/sofa.
2. Place both feet firmly on the floor.
3. Place both hands on the chair.
4. Lean forward and push up using both arms.
5. As you push up, reach for the walker and grasp the handles one arm at a time. DO NOT use the walker to pull yourself up to standing position.

Depending on your abilities, a raised toilet seat may make it easier for you to get up and down.

Sitting down on the toilet

1. Take small steps toward the toilet and turn until your back is to the toilet. Do not pivot.
2. Back up to the toilet until you feel it touch the back of your legs.
3. If using a toilet with armrests, reach back for both armrests and lower yourself onto the toilet.
4. If using a regular or raised toilet seat without armrest, keep one hand on a stable surface while reaching back for the toilet seat with the other.
5. Slide your operated leg out in front of you when sitting down, as needed.

Getting up from the toilet

If using a toilet with armrests, use the armrests to push up. If using a regular or raised toilet seat without armrests, place both hands on your thighs and push off your thighs. As you push up, reach for the walker and grasp the handles one arm at a time. Balance yourself before you start walking.

Place the bath seat in the tub facing the faucets.

1. Walk toward the bathtub and turn until you can feel it touch the back of your legs. Be sure you are in front of the bath seat.
2. Hold on tightly to the walker and reach back with one hand to grasp the back rest of the bath seat.
3. Slowly lower yourself onto the bath seat, keeping the operated leg in front of you while sitting down, as needed.
4. Move the walker out of the way, keeping it within reach.
5. Lift your legs over the edge of the tub, using a leg lifter for your operated leg(s) if necessary.

Take care to keep your incision dry until instructed otherwise.

1. Lift your legs over the outside of the tub.
2. Scoot to the side of the bath seat.
3. Hold onto the seat with one hand and reach for the handle of the walker with the other hand.
4. Slowly push off the tub seat and reach for the other handle of the walker.
5. Balance yourself before continuing to move.

Using a bath seat, grab bars, long-handled bath brushes and a handheld shower can make bathing easier and safer. Keep in mind, however, these items are not typically covered by insurance.

1. Walk toward the bed and turn.
2. Back up to the bed until you feel it on the back of your legs. You will need to be positioned near the top third of the bed.
3. Reaching back with both hands, sit down on the edge of the bed.
4. Move the walker out of the way, keeping it within reach.
5. Scoot back toward the center of the mattress.
6. Scoot your hips around so that you are facing the foot of the bed.
7. Lift your leg onto the bed while scooting around. (If this is your operated leg , you may use a leg lifter or cane to assist you.)
8. Keep scooting and lift your other leg onto the bed.
9. Scoot your hips toward the center of the bed.

1. Scoot your hips to the edge of the bed.
2. Sit up while lowering your legs to the floor.
3. If necessary, use a leg lifter or cane to assist you.
4. Remain seated on the edge of the bed.
5. Use both hands to push off the bed. If the bed is too low, place one hand on the walker while pushing up off the bed with the other. Balance yourself before reaching for the walker.

1. Move the front passenger seat all the way back to allow the most leg room.
2. Walk toward the car and turn.
3. Using your walker, back up to the car until you can feel it touch the back of your legs.
4. Place your left hand on the dashboard of the car, reaching for the back of the seat with your right hand. Do not hold on to the car door as it may move.
5. Lower yourself down onto the seat, being careful not to hit your head. Keep your operated leg straight out in front of you, as needed.
6. Turn frontward, leaning back as you lift the operated leg into the car.
7. Return car seat to its upright position.
8. Make sure you use your seat belt. We want you to arrive safely.

If your car has fabric seat covers, place a plastic grocery bag on the seat to help you slide once you are seated, and remove bag after seated in the car.

Reverse the previous instructions for getting into a car.

Putting on pants or underwear

1. Sit down.
2. Put your operated leg in first.
3. Use a reacher or dressing stick to guide the waist band over your foot.
4. Pull your pant leg up over your knees so the pants are within easy reach.
5. Repeat for your non-operated leg.
6. Once both feet are through your pants, stand up with the walker in front of you.
7. Pull your pants up the rest of the way.

Taking off pants or underwear

1. Back up to the chair or bed where you will be undressing.
2. Unfasten your pants and let them drop to the floor.
3. Push your underwear down to your knees.
4. Sit down, keeping your operated leg out straight, as needed.
5. Take your non-operated leg out first and then the operated leg.

A reacher or dressing stick can help you remove your pants from your foot and pick them up off the floor.

1. Sit down.
2. Slide the sock onto the sock aid with the toe completely tight at the end.
3. Hold the cord and drop the sock aid in front of your foot. It is easier to do this if your knee is bent as much as possible.
4. Slip your foot into the sock aid.
5. Straighten your knee, point your toe and pull the sock on.
6. Continue pulling until the sock aid releases.

It is better to wear lace or Velcro shoes, or wellfitting slip-ons. Do not wear high-heeled shoes, backless shoes or flip-flops.

1. Sit down.
2. Using a reacher, dressing stick or longhandled shoe horn, place your shoe in front of your foot. It is easier to do this if your knee is bent as much as possible.
3. Place the shoehorn inside the shoe against the back of the heel, with its curve matching the curve of your shoe.
4. Place your toes in your shoe.
5. Step down into your shoe, sliding your heel down the shoehorn.
6. Pull out the shoehorn.
7. Repeat with your other foot.