Pain Management
Reva's corner:
It is normal to think "why did I do this?" the day you wake up from
the surgery or even the next day as you start to recover, but that soon transforms
into "Why did I wait so long?
Pain is an inevitable part of surgery - but it is manageable. Your nurses
will check on you often to gauge your level of discomfort, but if you're experiencing
pain, don't wait for their next visit. Use the call light on the bed to alert
your nursing team that you need pain medication. If your current pain medication
isn't helping, tell your nurse.
Don't try to tough it out. Once pain feels out of control, it actually responds
less well to medication. The best time to ask for pain management is BEFORE
the pain becomes too intense to handle.
 Remember
that fatigue decreases your tolerance for pain, so avoid becoming overtired.
Pace your activities to allow for rest periods, returning to bed to rest between
therapy sessions whenever possible. If you're not sleeping well at night,
inform your nurse. Your doctor may prescribe medication to help you sleep
more comfortably.
Patient-Controlled Analgesia. Patient-controlled analgesia
(PCA) provides optimal pain relief during the days following surgery without
the use of injections. You'll intravenously receive a continual, small dose
of pain medication. A small, computerized pump also allows you to self-administer
an additional amount of medicine as needed. All you have to do is push a
button.
Increasing Muscle Strength. Strengthening your muscles is key to
rehabilitating your knee, so physical therapy starts soon after surgery.
A physical therapist (PT) will visit you during your hospital stay to review
essential exercises and adaptive equipment, let you know what to expect
from your first therapy session, and answer any questions.
You'll begin ambulation (walking) and other exercises soon after surgery.
In most hospitals, therapy is performed twice a day. The exercises are
designed to help improve circulation and maintain and increase muscle
strength, and the PT will vary your ambulation distance, exercise progression
and stair instruction depending on your tolerance. You may also begin
occupational therapy at this time.
Your therapists may ask one of your family members to observe your therapy
sessions. By helping them better understand the exercises and adaptive techniques,
they'll be better able to assist you safely at home. If you're planning
on going directly home after your discharge, the therapist will help your
make final arrangements for necessary home equipment and home health services.
Unfortunately, therapy is likely to be initially painful. Take pain medicine
30-40 minutes BEFORE your therapy sessions. Doing so allows it to begin
working before therapy starts and will improve pain control. Also take pain
medication BEFORE any activities that cause discomfort such as walking,
getting up into a chair, or bathing. It's important to be comfortable enough
to participate in therapy and other activities that prevent complications
and speed your recovery.
Body Alignment. Believe it or not, proper body alignment actually
helps lessen pain. The nursing staff will help you change position and turn
at frequent intervals to maximize your comfort. Don't try to turn on your
own immediately following surgery, however - ask for help whenever you want
to shift position.
Pain Medications. There are several types of anti-pain medications:
narcotic and non-narcotic pain relievers, muscle relaxants and anti-inflammatories.
They can be administered through injections, in pills or via an IV tube.
Your doctor may even prescribe a combination of medications for optimal
results. If the medication does not successfully control your pain, alert
your nurse.
The most common side effects of pain medications are an upset stomach, nausea,
constipation and drowsiness. If an upset stomach is a possible side effect,
always take the medication will something to eat or drink: milk, juice or
crackers are ideal.
Some pain medications may cause constipation, so it's important during your
hospital stay to eat and drink bowel-friendly foods. Choose HIGH FIBER foods
from the hospital menu, such as leafy vegetables, fruits, and whole wheat
and bran products. Fruit juices, especially prune juice, may also be helpful.
It's also a good idea to drink at least 5-6 glasses of water every day.
If you haven't had a bowel movement in 3 days, please inform your nurse.
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