Recovery at Home
Recovery at home after surgery may require certain dietary and environmental restrictions, recommended rest and limitations to physical activities, and other dos and don'ts as recommended by a physician or surgeon.
Post-operative recovery at home should promote physical healing and rest and recovery from the stress of surgery. For patients who undergo orthopedic surgery, the home recovery period will also involve rehabilitation to regain diminished musculoskeletal functioning. Emotional
When patients are discharged from either an ambulatory surgical facility or a hospital, they will receive written instructions from their physician on restrictions and recommendations for their post-operative recovery at home. A nurse will usually review these instructions verbally with the patient and answer any questions and concerns. They may also call one or up to several days after a surgical discharge to follow up on how the patient is feeling and answer any questions about home recovery.
Restrictions and recommendations outlined in home recovery instructions may include:
- Driving restrictions. A patient may be prohibited from driving for a period of time due to functional limitations or to medication that impairs driving ability.
- Work restrictions. Depending on the nature of a patient's job, they may be required to stay off of work or request alternate duties until recovery is complete.
- Social restrictions. Patients at high risk of complications from infection, such as an organ transplant patient, may be advised to avoid anyone with a cold or flu and to stay away from crowds or social gatherings during the initial recovery period.
- Medication recommendations. Prescription and/or over the counter drugs may be recommended on an as-needed basis for pain and nausea. Other drugs may also be required.
- Dietary limitations. Certain types of gastrointestinal procedures and other surgeries may require a restricted diet during the recovery period. Alcohol may also be prohibited, particularly if pain medication has been prescribed.
- Ambulation recommendations. The doctor will note if the patient should refrain from lifting heavy objects, climbing stairs, having sex, or participating in other potentially strenuous activities.
- Exercise recommendations. If movement, stretches, or exercise is encouraged as part of recovery, that fact will also be noted.
- Incision care. Patients are instructed on how to care for their incision and educated on signs of infection (i.e., redness, warmth, swelling, fever, odor).
- Home care needs. Some patients may require a visiting nurse or live-in health aid for a period of time as they recover from surgery.
- Adaptive equipment. Assistive or adaptive devices such as crutches, a walker, prosthetics, or bed or bathroom hand rails may be necessary.
- Follow-up with physician. A patient may be instructed to call the doctor's office to schedule a follow-up appointment. They should also be given criteria for warning signs and symptoms that may occur with their procedure, and when to call their physician if they do appear.
- Other required medical appointments. If a patient has undergone orthopedic surgery or another procedure that requires rehabilitation, he may need to see a physical therapist to regain range of motion, strength, and mobility. Depending on the type of surgery performed, the expertise of other medical professionals may also be required.
The postoperative period is also a time of emotional healing. Patients who face a long recovery and rehabilitation may feel depressed or anxious about their situation. Providing a patient with realistic goals and expectations for recovery both before and after the surgery can help them avoid feelings of failure or let down when things do not progress as quickly as they had hoped. Realistic recovery expectations can also prevent a patient from doing too much too early and potentially hindering the healing process.
Certain life-altering surgeries, such as an amputation or a mastectomy, carry their own set of emotional issues. Counseling, therapy, or participation in a patient support group may be an important part of post-operative recovery as a patient adjusts to their new life.
Discharge recommendations for home recovery are typically explained to the patient before they are allowed to leave the hospital or ambulatory care facility. In some cases, the patient may be required to sign paperwork indicating that they have both received and understood home care instructions.
Depending on the surgical procedure they undergo, a patient may be taught some home care techniques while still in the hospital. Physical therapy exercises, incision care, and use of assistive devices such as crutches or splints are a few self-care skills that may be demonstrated and practiced in an inpatient environment.
A physical and emotional support system is also a crucial part of a successful home recovery. Faced with restrictions to movement, driving, and possibly more, a patient needs someone at home to assist them with the daily tasks of independent living. If family or friends are not nearby or available, a visiting nurse or home healthcare aid should be hired before the patient is discharged to home recovery.
Following home care instructions can help to speed a patient's recovery time and ensure the safe resumption of normal activities. Several studies have indicated that women may have a longer postoperative recovery time than men. In some cases, the familiar, comforting home environment may even speed the healing process or improve the degree of recovery. One study of patients 64 and older undergoing hip surgery found that patients who were allowed to undergo rehabilitation at home had significantly better outcomes than those who underwent rehabilitation as hospital inpatients. On average, the former had better physical capacity and independent living skills when assessed six months after surgery.
Some studies have also indicated that gender may have an impact on the success and speed of post-operative home recovery. A 2001 study in the British Medical Journal found that women recovered from surgery at a 25% slower rate than men. Further research is needed to determine exactly why this gender gap exists, but the authors did hypothesize that both anatomical and physiological differences could be a factor.
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Klippel, John H., ed. All You Need to Know About Joint Surgery: Preparing for Surgery, Recovery, and an Active New Lifestyle. Atlanta: Arthritis Foundation, 2002.
Trehair, RCS. All About Heart Bypass Surgery. Philadelphia: Oxford University Press, 2003.
Golub, Catherine. "Ready Yourself for Recovery: Tips for Preand Post-Op Nutrition." Environmental Nutrition 24 (November 2001): 2.
National Association for Home Care and Hospice. 228 Seventh Street SE, Washington, DC 20003. (202) 547-7424. <http://www.nahc.org>.
Visiting Nurses Association of America. 99 Summer Street, Suite 1700, Boston, Massachusetts 02110. (617) 737-3200. <http://www.vnaa.org>.