Hi, my name is Bethany. I'm a nurse here at Michigan, and I am providing this video for you so that if you are either having
surgery or you have just gotten finished with your neck or back surgery. Today
we're gonna go over several things. Physical therapy, occupational and
nursing will be working together to provide you all the instructions that
you need leading up to you going home from your surgery and what to do
afterwards. This has been recommended by your neurosurgeon. First Nursing is going
to go over many of the things that we are expecting you to do before going
home. We have to have your pain under control.
We have to get you up and moving
and physical therapy is gonna teach you these things. They're gonna teach you how
to get out of bed, get in and out of a chair, and occupational therapy will work
on things like getting up from the toilet, going to the bathroom, using a
shower and just things of daily living. Now let's begin. Our first goal here is
the restrictions you will have following your back or neck surgery. After your
surgery your neurosurgeon has stated that you cannot drive for ten to
fourteen days. This will be cleared for you on your follow-up appointment. You
can ride in a vehicle, you are expected to wear your seat belt, but you are
absolutely not allowed to drive. Now your back and neck precautions: You
can remember this like I do as a BLT sandwich.
No bending at the waist more
than 90 degrees. No lifting more than five pounds. Now five pounds is not
a lot — it's about a half gallon of milk. Remember your purses, your laptops, pots
and pans usually weigh more than five pounds, so be very careful with this. And
twisting: there's no movin' or groovin' after back surgery. You have to walk
nice and easy. Neck surgeries, yours is simply the same, the only difference is
the twisting at the waist now involves your neck, so be careful. Neck surgery
patients: the five pounds still applies. Physical therapy is going to explain
this in more detail shortly. All right so let's talk about some of the equipment
after back surgery. One of the things here is gonna be non-skid socks. The
nursing staff as well as the neurosurgeons are expecting you to wear
these anytime you get out of bed.
This is gonna help prevent falls and also keep
the infection rate lower. Many of the other things that you will have on are
not on the table. One for instance maybe a Foley catheter. Now nurses want to get
these out just as bad as you do. This Foley catheter has been placed by your
neurosurgeon so you have a little bit more time to rest before we get you out
of bed and take you to the bathroom. Once we can get you out of bed, we're gonna
take that Foley catheter out for you. One of the next things that you will have on
your legs, and you may have found these already, is these sequential boots. I tell
people these are much like leg massagers. these are very important.
These are here
held down by Velcro. It goes on the lower part of your leg, and it's gonna inflate
and deflate. This is going to help prevent blood pooling in your lower legs
promoting circulation and avoiding those dreaded blood clots. Anytime that you are
in bed resting, you are expected to have these on. I've heard many people don't
like them. The secret to not having these on is get up and walk and you can't be
attached to your bed. The next thing we have here is an incentive spirometer.
This right here is a very important tool. This is going to be for all neck
surgeries and back surgery patients. This right here is going to hopefully prevent
you from things like pneumonia.
We're gonna set a tab here on the side, and
this is your goal line. We want you to breathe into this every hour while you
are awake. You don't have to wake up at 2:00 in the morning. If you're
not awake, it can stay on the bedside table. This right here is your mouthpiece.
You're gonna put this in your mouth and you are gonna suck in and when you suck
in you're gonna fully inflate your lungs and hopefully this white bar here is
going to inflate and it's gonna go to your goal line. Don't be scared if you
start out at a very low level; this will improve. Let me demonstrate this for you.
I'm gonna put the mouthpiece in my mouth, I'm going to suck in, and I'm gonna try
to hold it there and watch this weight come up.
Here we go. As you can see even I did not hit my goal line on the first time. This is not a problem.
Keep trying. Get those lungs fully expanded, and prevent pneumonia. The next thing I want to talk to you about is a drain. Some of you guys will have a drain, and some of you will not. If you have something like this attached to your
gown right now: this is a drain.
You will not be going home with this, so don't let
it worry you. This drain is very important. It's going to help reduce the
swelling and the pain in your back. To do this, the neurosurgeon has taken this
plastic tube, which is fill of holes, and it's inserted just underneath the skin,
and it's gonna drain out all of that swelling. It's gonna go through this
tubing and it's gonna collect in this bottle. The nice thing is is the nurses
can come to this, we can open it up and we can dump it out. This is all the
bruising and swelling that would normally be by your incision in your back
or your neck.
So this is gonna help a lot with pain control, reduce the chances of
infection, and overall just make you a lot happier. Like I said, you will not go
home with this drain, which means the nurses are gonna watch and we're gonna
measure this. Before you leave, we are going to take this out. It's held in with
just one cute little stitch. We're gonna pull it out nicely, and there's no
special things that you have to do to your back where that was. Now the next thing I'd like to talk to
you about is exercise.
Because of those precautions that I mentioned before — no
bending no lifting and no twisting — there's not a lot of exercise that you
guys are approved to do. The only thing the neurosurgeon wants you to do after
your surgery is walk. Simply walking. Flat even surfaces, no treadmills, no
ellipticals, no mechanical devices at all. Just walking. The nice part about walking
besides it being good for your overall health is it's going to reduce the
chances of pneumonia, because it's gonna expand those lungs and it's also gonna
not allow that blood to pool in those calves, which means you're gonna decrease the amount of chance for blood clots. When you get home, we encourage you to
continue walking. This is your form of rehabilitation. Physical therapy will
talk about this shortly. The next thing I'd like to talk to you about is
pain control. Pain control is very difficult after surgery, so it's very
important for the nurse and the patient to communicate very well so we can get
your pain controlled and you to go home as quickly as possible. Each patient is
different.
Some of you may have very little pain. Some of you will be in a lot
more pain than your neighbor. This does not mean there's anything wrong with
your surgery or you had a worse surgery than someone else.
Everybody's body acts a little differently. The nurses are going to work
very hard to control your pain. We do this very shortly after surgery. We will
be providing oral pain medication right off the bat. We try to stay away from the
IV form as much as possible but we do have that available if absolutely needed.
Our goal is to make your pain tolerable. We cannot take your pain a hundred
percent away. We want you to be functional, and what that means to
nursing is we need to make sure that you can get up, that you can use the bathroom,
that you can eat, that you can communicate with us and your
neurosurgeon.
The nurse will be working to find a combination of pain
medications that work for you. The same medications will work for you will not
work for you as they would for somebody else. Therefore it's very important that
we communicate together to find the right combination. Now let me explain how
this scale works. The nurse is going to ask you, "On a 0 to 10 scale –10 being the
worst pain you've ever felt — what number would you give your pain?" Before you
think of this pain number, let me clear up a few things. Your pain cannot be
higher than a 10. Therefore your pain cannot be an 11 or a 15. Ten is the top of
the scale. Your pain does not need to be a 9 or 10 for you to receive pain
medication. if your pain is a 3 and it is not tolerable for you, and you need pain
medication, your nurse can provide that to you. The other misconception people
have is people say very often that they live with pain every day and that pain
is normally a 5 so they think by adding to that 5 they're coming up with an
accurate number.
We need you to forget the pain you had in the past and focus
on the pain you're having now. Otherwise your pain is going to constantly be in
that 9-10 range. We need you to think of this as a new day. This pain scale needs
to start at zero and end at 10. Now let me explain what the numbers mean. Zero to 0 is a very big range, so let me explain some of these numbers and you can fill
in the middle pieces. A 5 to a nurse is a pain level that if I asked you to get up
and go to the bathroom you could absolutely perform that task. You could
get up out of bed and you could walk to the bathroom ,but it's gonna be painful.
It's gonna be uncomfortable to the point that you are considering maybe I
don't really want to get up and go, but you can; that is a 5.
A 9 or 10 is for patients who are crying.
They are miserable.
These patients are not talking on the phone, they are not visiting with your
family or friends in the room. These patients are not dozing off and they are
not sleeping. These patients the nurse can typically see they are very
uncomfortable and we will work very hard at bringing that number down.
Lastly, the 0 to 10 or the 0 to 2 scale seems pretty obvious. These people are
pretty comfortable. You guys can get up.
You guys are walking the halls. You can
go to the bathroom. You don't really need any pain medicine right now. If your pain
is not controlled on oral pain medication, you will not be discharged
home until it is. If you need to go to a rehab facility or even a nursing home
facility at discharge to get this under control, we will be discharging you there.
We need to have your pain under control on oral pain medications before you go
home. Now one other question that those darn nurses are going to ask — and of
course it's not to annoy you but it's to give you the right pain medication — we're
gonna ask you, "Well what does it feel like? Tell us more about the pain." Now the
nurses aren't questioning if you have pain.
We know you just had surgery. We
expect you to have some pain. Different medications work differently on the body.
A sharp burning pain is going to require a certain form of medication. If you have
tight pain, pulling pain, muscle spasms, this requires a different pain
medication. If we don't give you the right pain medicine, we're not going to
get your pain under control. And that of course is our goal; to get
your pain under control before leaving. So it's going to be very important that
the nurse and the patient communicate well to get this accomplished.
Now many
of you probably want to know what you have to do to get
out of the hospital. You want to go home. So let me tell you. Walking: the nurse
needs to feel comfortable that you can walk when you get home. I have to make
sure that you can go from your vehicle into your home, from your couch to your
bathroom, from your couch to your bed, and so on. If you can't walk there I cannot
send you home there. I am NOT expecting your families to give you piggyback
rides to get you into your home. Next, you have to be able to urinate on your own.
Now I know that sounds kind of like a simple task, but many of you after having
a Foley catheter might have a couple hours if not a day or two where this is
a difficult task.
Before you go home, you will have this done. Next, you have to be
able to eat sometimes. The medicine we give you can make you a little bit
nauseated. We want to make sure that you can eat without throwing up. Pain: I've
mentioned the pain. We have to have this controlled on oral pain medications
before going home. The drain will be removed before going home.
If it's
putting out too much drainage, we will not pull it out until it's time. This is
going to help reduce that pain that I talked about, and it's very important.
Very shortly physical therapy will show you how to get in and out of bed
appropriately. This is going to be another task that will have to be
accomplished before discharge. If you cannot get in and out of bed safely, we
will have to practice this until you can. And lastly, you need to be
self-sufficient. And what I mean by that is there's many tasks that you can't do
that BLT prevents you from doing many things. But there are many things you can.
One of them of course is walking. You need to be able to get out of bed on
your own, which means you do not have somebody pulling or pushing you to do so.
This is an individual task.
Same thing with getting out of the chair
and walking across the room. Family members, be careful if you guys are
pulling and pushing these patients to get out of bed, you're gonna get hurt or
they're gonna get hurt. This is not recommended. Now the next thing I want to talk about is preventing falls. Preventing falls is very important. If
you don't ruin your surgery itself, it's gonna be extremely painful. I've been
told by some that it's very similar to having a charley horse in your leg and
amplify that by a whole bunch because it's in your back.
So from what I can see it's not very comfortable. So let's work on some tips
that we can do to prevent that one. Remove the excess furniture from your
house and the clutter you have from your walkways. Anything you're tripping over
now, you will likely trip on after your surgery.
Pick up throw rugs. Throw rugs on the floor are a very big trip hazard. Now I
do want some rugs in your house by your entrance doors, in front of your bathtub,
in front of your kitchen, see those are all fine, but pick up those pesky throw
rugs that are in front of your stairs in the middle of the rooms or anything that
can catch those feet and make you fall over.
Another thing that seems to get
people is extension cords. Now in the holiday season, we have a lot more
extension cords running in our house or outside our house for those pretty
lights. Those are very dangerous after a back surgery. You can trip on those and
fall. Be careful. Lastly, I like to mention using the
handrail when walking up and down the stairs. Be very careful tripping over stairs and falling down is going to be very painful. Another thing that I've heard about is
pets and kids. Now I don't want you to kennel your pets and I certainly don't
want to send your kids off to boarding school, so here's a trick that I have
heard that works very well. When you go inside the house, have your
responsible party go in first. You have an option of either holding the child's
hand or putting a pet in a room and shut the door. Then you as a patient can come
inside. You can sit safely in a chair and then
let go of the child or let the pet out of the room.
Typically it's about the
first 20 minutes or so that is the highest risk for a fall. They're excited,
they haven't seen you for a while. Just make sure you are seated safely to avoid
that fall. Now another thing that we need to make sure we do is we need to bathe
and we need to change our bandages. Your nurse will specifically instruct you
when you are able to shower after surgery. Some of you will have the
opportunity to shower within 24 hours after your surgery. Some of you will have
to wait 5 days. This is specifically set by your neurosurgeon, and you will be
told this upon discharge. No patient whether you are allowed to take a shower
24 hours after surgery or 5 days after surgery are allowed to swim, sit in
bathtubs, sit in hot tubs or use saunas until cleared by your neurosurgeon. All
of these will promote bacterial growth in your incision, and you are at
extremely high risk for infection.
Now bandages are to be changed daily
whether you are able to shower or not. You will be changing your bandage. These
bandages are very simple. It is a piece of gauze and a piece of tape. There are no creams. There are no ointments. There is no anything. It'll be gauze and tape and we will absolutely show you how
to do this before discharge. Just remember to wash your hands before and
after changing your bandage. Now one of the biggest things that you can do after
a surgery is to prevent infection. Now if you can imagine your brain and your spine
are kind of connected, so anytime you have an infection in your back that
involves your spine it involves your brain too, so we need to pay extra close
attention to prevent infection of this surgery. The first thing that you need to
remember is washing your hands.
When I say that you need to wash your hands, you
need to use soap and water. You need to have your hands scrubbed. This should
take about 20 seconds or longer. If you can remember to sing happy birthday
twice, you've about hit your goal. Change that bandage daily. Change your clothes
daily, and those clothes should be clean clothes, not something that you had in
the corner that you took off yesterday. if you have a brace you need to remember
that you need to have a clean shirt on first and your brace is to go over top
if you put that brace directly against your incision you have a very high
chance of having bacteria and infection in that location the next thing you can
do at your house is wash your bedding now this seems simple you should be
washing your bedding minimally twice per week this includes vacuuming your
mattress then you can put sheets back on your bed
unfortunately somebody will have to do this for you as this would break all of
your back precautions now many people don't realize but covering your
furniture also important we spent two thirds of
our time awake only one-third of our time sleeping our furniture does not get
cleaned as often as our bedding does so a good tip would be to place a clean
sheet over the area furniture that you sit and clean pillowcases over your
throw pillows this will allow a barrier between your back and bacteria now showering now once you're given the
clearance to shower there are still a few things you should keep in mind one a
wash cloth is a very good tool but you should have two during this time one for
a near your incision and there and another one for the rest of your body
you do not want to wash your feet and then wash your incision the same is true
about towels you should be using a clean towel every day this towel should not be
hung up over your shower rail dried and then reuse the next day you should have
a clean new towel and a clean new washcloth every time lastly and very
important about infection control is your pets many of you probably sleep
with your pets right now this is absolutely not recommended after your
surgery do not sleep with your pets their fur and their skin carry dirt and
bacteria that is going to get inside your incision and cause an infection
this is very important infections in your back and your neck are very painful
and depending on the severity can lead to permanent disability and death some
people require hospitalization in IV antibiotics for weeks please do your
part to prevent infections now one of the other things I'd like to talk to you
about is the signs and symptoms of infection and what to report so if you
have a fever greater than 101 degrees Fahrenheit if you have redness
puss or an odor coming from your incision this is a sign of infection if
your pain that was controlled is now extremely painful to the touch around
your incision this could possibly be a sign of infection family members if the
patient is now acting confused this is a sign of infection also it should seek
medical attention if you have any new numbness or tingling pain in your legs
or calves you should also call your neurosurgeons office now there are some
awesome signs and symptoms that you should report instead of to your
neurosurgeon to 911 this should be going to the local emergency room shortness of
breath difficulty breathing chest pain unable to urinate unable to move your
legs or your arms unable to speak or if you have swelling in one leg versus
another or one leg is completely cold or hot these are all immediate needs
attention we need to go to an emergency room and have this looked at now I'd
like to introduce you to physical therapy
you know Taryn will be talking to you about some of the things about getting
up and getting down and moving around hello my name is Tarun and I'm a
physical therapist assistant what I'm gonna be going over with you today
is first we're going to talk about the common causes of back pain next we'll
talk about braces that you may have the proper way to get in and out of bed up
and down out of a chair up and down the stairs as well as in and out of the car
ok so the first thing we're gonna talk about is common causes of back pain
incorrect posture plays a very big role in protecting your spine let's use for
example a secretary she works at a desk 40 hours a week
typing away in her computer and very common poor posture that you see in that
type of occupation is called the forward head posture and what that looks like is
where the chin comes forward and the shoulders tend to round in okay what
that actually looks like to your spine this is the side view when that happens
when you're increasing that curve the spine looks like so gravity is always
putting pressure down on our spine instead of that nice s and it's equally
distributing the stress of gravity when you increase that curve you're putting
the pressure right here at the base of the neck instead of equally distributing
it through the S curve another poor posture that you see in this type of
occupation is when you sit on your hips and what that looks like is your hips
come forward and you are again increasing the curve here this tends to
happen with people who have to stay in one position for a long period of time
and stand on their feet okay what that looks like it's more like so where you're
increasing this curve here we already talked about the curves a little bit but
this is what more of a natural curve or spine would look like here we have our
vertebrae most people know that this is the bottie of the vertebrae through here
now on the inside where you see a screw that's where your spinal cord is located
now that comes all the way down all the way through and off of your spinal cord
comes your nerves the yellow pieces that you see if you
look closely there's a little hole in between each vertebrae or the nerve
needs to sneak through that goes down to your arms down to your legs so for
example if you're having a pinched nerve that's where that happens where the
nerve has to sneak from the inside of your vertebrae of your spine down to
your arms and to your legs now if you can see closely these guys here these
sponges those are where your discs are at and that's exactly what it does for
your spine is it creates a cushion in between each vertebrae now when we talk about body mechanics
having good body mechanics is going to protect your back okay body mechanics
are the way that we move throughout our day that either puts more stress on our
back poor body mechanics or less stress on our back good body mechanics so for
example we all want to have good body mechanics so what you want to do
whenever you're carrying or lifting anything rule of thumb is to keep it
close to your belly button okay so let's say for example I'm going
to get groceries off of the counter instead of reaching out here for my
groceries away from my belly button this would be poor body mechanics you would
want to scooch the groceries to the edge of the counter depending upon how tall
your counter is how tall you are you may have to bend it your knees a little bit
grab your groceries keeping them close to your belly button and then carrying
them where you need to take them same rule applies with the laundry basket you
know keep the laundry right close to your belly button instead of twisted
over here on your hip whenever you're lifting anything up off
of the floor we've all heard make sure you lift with
your legs don't lift with your back now to demonstrate this when I go to bend my
knees down to the object I'm going to keep my back straight come down to the
object you want to bring the object close to your belly button first to keep
your back straight as you come up get the object bring it to you and keep your
back straight as you push up one mistake that some people make and
they think that they are that they are standing correctly and bringing the
object up correctly pushing with their pushing up with their legs is when they
bend down to the object they don't keep their back straight they keep their back
bent here push up with their back bent and then come up at the end you're still
lifting with your back and putting too much pressure and stress on your spine
okay now when we talk about decreased flexibility when we're talking about
protecting your back that kind of goes back in with correct posture again okay
ladies as we get older we have a tendency of rounding our shoulders the
pecs they have a tendency of getting tight okay
if you tighten this region they come in you tighten this region this tends to
happen gentlemen as they get older have more of a tendency of getting tight to
the hip flexor region through here you tighten this part and this starts to
happen okay so you can see how important just keeping yourself loose limber helps
in protecting your back and keeping good posture when we talk about lack of
physical fitness again that kind of rolls in with keeping yourself loose and
number if you're not a very active person if you have a very sedentary
lifestyle and your buddy calls you up and you need to go help him move be
honest with yourself know what you're capable of and what you're not capable
of okay know when you need to ask for help
and last part that I want to talk to you about is structural changes things that
happen with age they can cause back pain arthritis mr.
Gnosis a trauma or an
accident these are all things we don't have control over and protecting our
spine and protecting our back but the first things we just went over and we
talked about you have control over protecting yourself so that you don't
find yourself having more back pain and more surgeries in the future okay with
that said uncommon causes of back pain let's switch gears a little bit now okay
we're gonna talk about now that you've just had your surgery okay
the proper way for you to be laying in the bed is either laying on your back or
laying on your side you can put a pillow underneath your knees for comfort when
you're laying on your back you can put a pillow between your knees when laying on
your side for comfort that's that's fine we do recommend that you just put one
pillow underneath your head two or three pillows underneath your head it's gonna
flex your neck forward we want you in a nice neutral position your spine while
you're healing okay now you're gonna want to change positions frequently you
don't want to get in one position and not move for hours because that's gonna
increase your stiffness increase your stiffness you're gonna increase your
pain I tell my back patients that I want them to be shifting their weight moving
their body every 35 to 45 minutes so let's say for example that you're most
comfortable laying on your side let's say you've been there for 35 minutes
roll onto your back for a minute or two then roll back to your side where you're
comfortable this that moment of changing positions will help keep your stiffness
under control the worst thing you can do is lay in one position for long long
periods of time anticipating the pain being too scared to move because what's
gonna happen is you're gonna increase your stiffness you're gonna anticipate
the pain and guard and you go to move it hurts too much to move so you don't want
to move but the reason that you don't want to move is because you're not
moving you don't want to get in this cycle it's really hard to break that
cycle and get your pain back under control so don't be surprised if those
nurses are going to have you up have you moving from the very beginning okay now
next we're going to talk about the proper way to get in and out of bed
using a log rolling technique now we're going to review your back precautions
going back to the BLT no bending no lifting and no twisting so when we say
no bending we don't want you bending down like so down to your feet same rule
applies when you're laying in bed we don't want you bending straight up as
well no lifting more than five pounds and a gallon of milk a full gallon of
milk weighs eight pounds to put that into perspective and then no twisting
your shoulders and your hips they need to stay in alignment at all times
you're gonna be kind of like a robot for a little while if you need something off
the counter to your right your feet need to move with your shoulders like so next
we're gonna talk about getting in and out of bed and remembering our back
precautions Mary is going to join us to demonstrate so to get into bed using
what we call log rolling technique is we're gonna first have Mary come down
unto her side down unto her elbow notice that she keeps this shoulder forward so
that it doesn't fall back and she twists on her spine next what she's going to do
is bring her feet up into the bed and come down onto her shoulder once you're
in this position you're then going to roll in one motion onto her back again
her shoulders and her hips stay in alignment throughout the roll okay now
that she's on her back we're gonna review how to get out of bed the first
thing she's going to do is to bend up her right knee which is the opposite
knee that she's turning onto she's going to tighten her abdominal muscles keep
that tight and roll onto side once you're on your side she's
going to ring her her legs over the edge of the bed and pushing up with her arms
to bring herself up you're taking the load of the work off of your abdomen and
your back and giving it to your arms to bring yourself upright take your time
with the log rolling technique it's not fast and go at your own pace next I'm going to talk to you about the
proper chair to use after your back surgery you're going to want to find a
chair with a nice back support something that fits you nice and upright you're
going to feel more comfortable in that position
most standard recliners have a little bit of a dip and your bottom tends to go
down into that a little bit that's why they're so comfortable but actually
after you have your back surgery that's gonna pull right where you have an
incision it's not gonna be very comfortable I would never take your
recliner away from you forever this is just temporary maybe for the first
couple weeks so try to think about something that at home that you have
that'll work good a lot of people just use their dining room chair as long as
it has arm rests on it I like Queen Anne's chairs those types of chairs work
really nice try to avoid chairs that have wheels on them or they Rock it's
not the safest thing to be standing out from if it's gonna be moving on you
while you're trying to stand this type of chair that we have here works great
don't go out and purchase something again it's just temporary maybe a friend
or a neighbor might have a chair that you can borrow for a couple weeks with
that said I'm going to show you how to get in and out of the chair properly
after your back surgery the first thing you're going to do is back up to the
chair and feel it on the back of both of your legs now that I feel the chair
there I don't want to twist and look for the chair that's breaking my back
precautions that's why I want to make sure I feel it behind me next I'm going
to keep my back nice and straight and bend at my hips and my knees and find
the armrest with my arms lower myself down slowly you don't want to plop into
that chair that will be very painful and we'll never do that again if you do next
to scoot myself back into the chair you're going to want to use your arm
rests and bring yourself back like so or another option if that's too painful is
to walk your hips back and I'll show that all you do is just shift your
weight side to side and work your hips backwards like so now to get out of the
chair I'm going to come out as I came in I need to scoop my bottom to the edge of
the chair first again walking my hips forward once I get to the edge of the
chair I want to make sure I have my feet underneath me good to push with push
with my armrests and keep my back straight as I come up and down once you
get to this position some people walk up their legs you don't have to do that
that's just a little trick that might be helpful to you next we're going to talk
about how to properly go up and down the stairs most people have two to three
entry steps to get into their home hopefully you have a handrail on your
stairs if you don't have a handrail make sure that somebody's with you the first
couple times that you go up and down your stairs you just had surgery you
might be a little unsteady you want to take your time with your stairs and use
your handrail for safety the key with going up and down the stairs is to make
sure that you keep your back straight as you go up and down so you'll use your
handrail and keep your hand down by your hip we don't want you to be grabbing
your head to pull yourself forward we want you to keep your back nice and
straight as you go up and down you'll go up with
one leg at a time again use your handrail as your hip push and come up
when you go down the stairs again you want to keep your back nice and straight
you want to avoid this so keep your handrail ask your hip go down one at a
time keep your back nice and straight as you go down your stairs some people have a flight of stairs in
their home that they have to go up and down that's okay after surgery but we
don't want you to do that frequently throughout the day so for example if
your bedroom is upstairs and the rest of your home is downstairs come down in the
morning go back up at night if you need something upstairs in the meantime maybe
send somebody else up there we don't want you to wear yourself out lastly I'm
going to talk to you about the different types of braces this type of brace is
like a corset and this brace would be used for a lumbar surgery or a low back
surgery how this goes on is you let the the velcro out and this piece actually
goes over your abdomen there's a little yellow tab at the top and this is how
you know which way is up it just comes around your abdomen and velcros in on each side you have
some pull strings that you can pull to tighten from there these are helpful in
adjusting your brace when you go from the laying position to the sitting
position and then the standing position these do have a tendency to ride up
throughout the day you would just want to take the time to readjust and put the
brace back where it's supposed to go as far as physical therapy is concerned I
want to make sure that you know how to put your brace on and off properly
without breaking your back precautions you will get more instructions on how to
use this brace when it comes off you're just relaxing your strings and on
velcroing from there now I'd like to show you the brace for cervical
surgeries in the front notice the yellow circle this is the front of the brace
this is how you know which way is forward I'm going to use Mary to
demonstrate how this brace goes on on both sides you have a velcro strap on
either side you're going to take the velcro off and place the brace under
your chin velcro in your chin should be above the
brace and not tucked down inside like so very good to take the brace off again
just take the velcro off and slide it forward thank you Mary now not everybody
gets a brace after their back or neck surgery it depends on if your surgeon
has ordered one for you or not he may feel that your muscles may need a little
extra help and support while you're healing and in that case would order
your brace however in some cases your surgeon feels that he would like your
muscles to start and Rehab and work from the very beginning and in that case you
would not have a brace it's different from patient to patient your frequency
of the brace is also different from patient to patient your surgeon may say
that he wants the brace on for the first yeah three to four weeks sometimes six
to eight sometimes maybe just a week it's different from everybody and you
will know what what those the frequency is and how long he would like you to
wear it as well as how often would he like you to wear it in some cases he
wants you to have it on at all times and only off to shower for example or in
other cases only when you're up walking do they want it on when you're resting
in a chair or resting in bed you don't need it on so it's different we'll give
you those instructions and you will know that the last thing that I would like to
talk to you about is walking we want you to be doing lots and lots of walking
that is the form of exercise that it would like you to do I can't give you
exercises for your arms or for your legs we just want you walking the only
exception is for our cervical surgeries you can add shoulder rolls to help with
the tightness and the tension that you may have now how do you know if you're
doing too much well for example let's say that I had numbness and shooting
sharp pain down my right leg before I had my surgery I had my surgery it's
really much better and I'm going for my walk and let's say as I'm walking I
start to feel a little twinge down my butt cheek into the back of my
leg that's kind of weird and I walk a little more and I feel it traveling even
farther that's your body telling you that you're doing too much and you need
to slow it down you didn't ruin your surgery probably what's happening is
swelling is increasing and you just need to slow down everybody's different
listen to your body more frequent short walks is going to be better for you than
long long one or two walks okay so you want to keep it nice and short and to
your tolerance everybody is going to be different we want you to stay away from
treadmills let's say for example you have a muscle spasm while you're on the
treadmill and you need to stop the treadmill is not going to stop for you
that's why we would like you to stick to even surfaces don't go out hiking out
back we've all done that you step in a hole and you don't know it's there and
that shock that you get definitely don't want that we don't want you tripping on
anything so stick to the even surfaces not everybody gets physical therapy
after they've had a back surgery in the hospital if you're having difficulty for
example doing your log rolling or getting up and down out of the chair but
in most cases physical therapy is it needed so good luck to you hello my name is Mary and I work here at
my Michigan in the occupational therapy department now that you've heard
everything about the BLT no bending lifting or twisting you're probably
wondering how you're gonna be able to get dressed when you get home I have
some special equipment that will help you with this these are things that you
may want to consider purchasing ahead of time or after your surgery to make it
easier for you to get dressed such as a long-handled sponge which will
allow you to wash your feet after surgery and a long-handled shoehorn to
make it easier to put your tennis shoes on you may also want to consider what we
call a Reacher or a grabber this tool wheel will allow you to put your pants
on without bending over and breaking those precautions in order to put on a
pair of pants using the Reacher you will be in the seated position you can fan
the pants out in front of you and grab the front of the pants with the Reacher you're going to put one foot in and the
other without bending over you will have to pull the pants up using the Reacher
until you get your pants to where you can reach them without bending over once
you get your feet all the way through you can then stand up without bending
your back and pull the pants up you can also use the Reacher to help you pull
your pants down once you have them down and back in the skid seated position you
can use the Reacher to pull the pants off this will take some practice and
some patience this equipment can be purchased at any
medical supply store sometimes they will come as a kit which we refer to as a hip
kit because we use this equipment with our hip replacement surgeries sometimes
in the hip kit you will also have a piece of equipment called a sock aid
which helps you to put your socks on however the surgeons here at the
hospital have told us that this puts too many pounds of pressure on your back
therefore we don't want you using the sock aid until your surgeon has told you
you are allowed to the other piece of equipment you may want to consider is a
tub seat the tub seat will allow you to have a rest while you take your shower
it's also slippery and dangerous that you could possibly fall in the shower
you may want to consider a chair that has a back on it just for added support
if you do want a tub seat you will want to look for something that has
adjustable legs on it this particular model screws up and down
however there are models that have a push pin to make it tall enough you for
sure don't want to have anything that's too low where you're having difficulty
getting up and down or breaking your back precautions the tub seat will fit
into the tub and instead of having to step up and over the edge of the tub
this will allow you to back up reach for the tub seat lower yourself down keeping
your back straight you can then scoot your hips back and swing your hips or
swing your legs into the tub this makes it a safer option than trying to step up
and over then you're just going to reverse it to come out of the tub you
can then dry off and apply your brace if necessary the technique that we use to
get into the tub is the same technique that you're going to use for getting in
and out of the car when I go to get into the car I'm going
to have the seat back as far as it will go then I'm going to approach the car
the same way backing up to it feeling it on the back
of my legs reaching for the sea or the dashboard or both just not the
door because the doors gonna wiggle on me so I want to reach for something
that's sturdy again keeping your back straight have a seat
scoot your hips back if necessary and then swing your legs into the car you're
just going to reverse it to come back out keeping your back straight each time
you still need to wear your seatbelt so make sure that you're not crossing and
twisting your back but grabbing the seatbelt with your right hand and
crossing it over the other thing to think about is you may want to remind
your driver not to be a racecar driver because if you think about all the trunk
and stomach muscles you use when you go to it when you're accelerating and
decelerating you're going to want to avoid that in the car the other thing
they might want to avoid is potholes which is difficult in Michigan but you
might want to take main roads rather than backcountry roads the other piece
of equipment you may want to consider is a toilet riser the toilet risers
typically look like this just a donut which have a groove in it so they don't
slide off of the toilet these these toilet risers we can order for you right
here at the hospital if you do not have a tall toilet at your house you're going
to need a toilet riser to avoid breaking those back precautions same rules apply
keeping the back straight you want to just lower yourself down if you don't
have a countertop or a vanity next to you in your bathroom you may want to
consider something like this which is a toilet safety frame these two can be
ordered or purchased at any medical supply store just some other general safety tips to
think about once you return home after your surgery bethany already mentioned
that you want to pick up your throw rugs and the end the other trip hazards that
you may have at your home nobody wants to trip and fall after surgery other
things to think about is you're not going to return home and be ringing the
bell for service you definitely need to be getting up and moving around we
recommend that you get up and move around approximately every 30 to 45
minutes you already know the longer you stay in one position the stiffer your
back will feel or your neck Tarin talked about doing those shoulder rolls you
want to be up and moving so that you don't stiffen up the other thing to
think about is you did have major surgery so you are allowed to rest don't
plan on going home in cooking a five course meal for your family you need to
be prepared and have things that are easy to fix such as sandwiches or
throwing something in the microwave if you're the chief cook and bottle washer
in your house you might have to look at alternatives to meal preparation you
will be able to get things out of the refrigerator but again follow your back
precautions no twisting and getting things out and when you carry bigger
objects you can use the counter top to cruise along the other thing to think
about is your bigger chores such as laundry you won't be carrying the
laundry basket or getting things from the washer into the dryer you're going
to break your back precautions if you do that you certainly can stand or set and
fold laundry but you're going to need help carrying the laundry basket you
also won't be able to be running the vacuum orhan on your hands and knees
scrubbing the floor so you get out of chores for a little while all of these
things you will be able to get back to once you're back precautions are lifted
also with outdoor activities you need to think about having help with yard work
shoveling snow raking leaves any of those big yard chores out in the yard
that require you to be bending lifting or twisting so make arrangements for
assistance with that the other safety things you want to think about is such
as getting up in the middle of the night night lights are a good thing to have
since we all tend to walk like we're a little drunk when we're half awake you
will be on some pretty heavy pain medicines and you won't be too alert so
you'll want to make sure that you have a clear path and maybe even a lip a night
light the other thing to think about is you're not a prisoner in your home so
your family members or yourself you can leave the house but if they leave you
may want to have a cell phone or cordless phone with you just for safety
thank you for listening to our video on spying on your spine surgery I hope that
you've learned a little bit about your spine and ways to keep yourself safe
following your surgery the biggest thing that I want you to remember after this
is to follow your precautions remember that blt if you can follow
those precautions and be really patient until your surgeon tells you that you
are able to lift more bend and twist you will be better off in the long run thank
you you