Preparing for surgery...on a budget

[lululocket]

Hi all,

I was writing a reply to Jamie who is prepping for an HTO, and decided that it was a topic which lots of people should contribute ideas to, so I am starting a thread. Given that I have been taking advantage of the time off to start a blog about personal finance, I have been thinking about the costs of all these gadgets recently. There is such a huge variation in what doctors prescribe, what insurance/NHS cover, that it can be difficult to know what to prioritise, especially if you are on a budget. If you don't prepare, you end up hurting yourself and ending up being off work for longer, being forced to pay for emergency takeaways, or wasting money on items which work, but you can't really afford given you only use them for a few weeks! Any option which is not free I've put in bold so that people can think spot them easily and, if they are on a budget, think about which ones are most important to them.

My experience has been with TTTs. Here are some of my ideas/what I wish I'd known the first time:

I'm walking through the PRICE steps

Protecting your knee

Trip hazards
- Clear up the house so that there are no obstacles. Areas that look fine to you now will seem scary and hazardous on crutches, so make sure that pathways are clear. Cost = Free.
Stairs
- Stairs are also difficult, especially going down. If you can sleep in a location that allows you flat access to a bathroom in the night, that will help. In the day, if you are on your own then can you get downstairs with a friend's help in the morning so that you can get anything you need without going near stairs? (My dad goes down backwards in front of me in the morning if I want to stay downstairs). Cost = Free.
Manoeuvring
- You can buy straps like this to help you lift your leg. http://www.allegromedical.com/bariatric-c6776/ableware-leg-lift-strap-p192647.html Cost = £7.
- Or you could improvise with a dressing gown or leather belt. Cost = Free.
Keeping clean
You will probably need to keep the surgery site dry for a period of time. You may have a long scar, which you must keep clean and dry to reduce the risk of infection. My OS uses mesh and things under the skin, with only a few stitches therefore required. However, until he takes the stitches out at the 2 week mark, keep things dry.
- There are lots of people on this site who use fancy cast covers to get in the shower, benches, and so on. I just don't have a shower. Much safer and less stressful. And cheaper! Buy some baby wipes to help out at first. Then just use a flannel and soap whilst you're in bed. The world will not end if you don't shower for a week or two. Cost = £0 - £5.
- To wash hair, I sat on a sofa and leant my head sideways over a table with a bin liner and the washing up bowl on top. My mum had to shampoo for me. Again, just do it once or twice in the first week, you'll live. Cost = Free.
- When you can get your knee wet, you will want to shower. If you have a stand up cubicle then just put a plastic garden chair in it to sit on. If you don't have one, borrow from a neighbour or buy a cheap one like this http://www.gardenfurnitureworld.com/p/Super_Elegant_High_Back_Stacking_Arm_Chair_in_White.htm Cost = £0 - £25.
- If you have a bathtub, you'll see products for transferring - I haven't had to deal with this, any ideas out there?

Resting your knee
Food
- You won't want to be cooking whilst you are on crutches. As you make your favourite foods in the lead up to surgery, make extra and freeze portions in ziplock bags so that you can just microwave them. Couscous is an easy alternative to rice and cheaper than those microwave rice bags. I'm sure others will step in with ideas here - I've moved back with my parents and my mum is taking care of me, which is great. When I was at university I had a few weeks on crutches and I remember eating toast, takeaways, pizza, and not much else, but it was terrible. I was also quite unhappy and I think I must have skipped lots of meals, I lost a stone (a bad thing at the time) and I have memory blanks. Don't do that! Cost = Free but takes time.
Stay in bed
- You will get more rest if you don't have to get up 10 times a day just because everything is out of reach. So organise! Clear a drawer beside your bed so that you can put essentials in it. Next to me currently I have medication, a phone, a laptop, magazines, DVDs, a book, tissues, pen and paper, TV remote etc. I also have a carrier bag over a bed post which might work if you can't get a drawer nearby. I set up an extension lead that I can reach from in bed so that I can plug my laptop in or recharge my phone without bothering anybody. Cost = Free.
- A tray that goes over your lap in bed is really helpful. This is one of the few things I invested in before my first surgery. Mine also doubles up to protect my knee from my cat so that she can't walk over it, which means I can let her on the bed. If you're working from home, this may also help you to work comfortably on a laptop http://www.argos.co.uk/static/Product/partNumber/6171995/Trail/searchtext%3ETRAY.htm Cost = £20.
Entertainment
- Loads of people advocate Netflix; I just got it on a free trial in the UK and the selection is pretty awful. We can get recent programs for free though from the main channels, so iplayer is fine for me. I also borrowed the odd box set from friends to tide me over. Cost = £0 - £6/month.
- Invite visitors! You will not want them immediately, but I've loved seeing a few friends in the past few days (I'm still in my first two weeks post surgery). Cost = Free.
- Skype. Arrange phonecalls to people you won't get to visit for a while! Cost = Free.

Ice and Compression
Here we get the first big potential cost
Ice only
- Buy a few of the flexible ice packs from physios and rotate them. http://www.sellesmedical.co.uk/store/product/54-Hot-and-Cold-Therapy-Pack-130-x-290mm- This will be easier if you have somebody who can get them from the freezer for you. It also means no ice at night. However my OS recommended using these for half an hour at a time a few times a day, so it may be fine. Cost = £15
Compression only
- The hospital gave me anti-embolism stockings which help with compression enough that I don't need anything else. These are pretty much essential because of DVT risks, so you will probably be given these, but you might want to buy a spare pair to change into (which I was also given). Cost = £15
Ice and compression
- Consider buying a cryocuff (or maybe an ice machine). I have never used one. I think that last time it might have helped, but this time I've been ok with just my ice packs, and the cost was too much for me. Some people swear by them. Cost of buying a cryocuff= £100-£150 if new
Elevating your knee
- Some people have suggested buying a beanbag. I've been able to manage by putting down a towel or two near the ankle, and then a pillow lengthwise on top so that it tilts up more near the ankle as it sits on the folded towels. Cost = Free.

I'm looking forward to more ideas from everybody else!

[colettefl]

I haven't got any tips as I'm still waiting for surgery but just wanted to thank you for your post.  It gives those of us preparing for first time surgery some really good ideas - thank you.

[mrschandrad]

I saw somewhere about putting a short stool in the bathroom. That way when you need to use the bathroom you have somewhere to rest your leg and you don't have to try and move it all over the place.

[LindaM]

Great ideas!  I hope this goes on to be a very successful thread.  I had some ideas and started a similar thread and thought it would be a good idea to share it with you so they are all available in the same place.  You can find it at:

The WAITING ROOM / General knee questions and comments (good for new threads) / Planning surgery? Some things to plan ahead before you go.

http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=58926.0

I also have one additional suggestion for during your early recovery- when I was having a lot of bruising and swelling after surgery my PT applied some physiotape and it worked like a charm.  It is available over-the-counter and there are instructions on youtube, but if you ask your PT they will probably do it for you.

Good luck 

Linda

[carty]

For SPORTS in recovery from surgery  .. or (as I have to do right now), from an activation of arthritis:


- thera band or stretch band, cost me 10 Euros: I use it for my knee exercises that I got from the PT as well as for any other body part. I can image it is easy to use, when sitting, as long as you can't stay, or even when laying in bed on the CPM. You can work as much as possible your upper body.
- small bumbbells: same as above.

- I also suggest, when you have to plan a long recovery to visit a course in stool exercises. Sorry, didn't find a translation for that. I mean, in many PTs in my country offer courses to do exercises for strength and flexibility sitting on a stool. It's like that: http://www.google.de/imgres?hl=de&client=firefox-a&hs=wwl&sa=X&rls=org.mozilla:de:official&biw=1280&bih=878&tbm=isch&prmd=imvnsb&tbnid=lVwxUlxJ0cEohM:&imgrefurl=http://www.schoeneweide-online.de/76917/102432.html&docid=ZRCluVWperXutM&imgurl=http://www.schoeneweide-online.de/mediac/400_0/media/DIR_76781/DIR_86332/DIR_103632/04210026.JPG&w=400&h=300&ei=YhR7T9iEDszXsgbq4b3DAQ&zoom=1&iact=hc&vpx=183&vpy=339&dur=1070&hovh=194&hovw=259&tx=147&ty=108&sig=107766110015420113182&page=1&tbnh=154&tbnw=184&start=0&ndsp=20&ved=1t:429,r:15,s:0
I plan to visit such a course, if I get surgery (which is most likely). I think one or two dates in such a course a sufficient to learn the exercises. Costs: 10-20 Euros. If you have pre-OP PT, you might ask for such a programm there and it will be for free.
I'm sure there is also something to find on the internet for free. I would prefer to ask directly for exercises, that take the special condition after my surgery into account.

- Also it is possible to perform martial arts punches and blocks when sitting. Tai chi quan is perfect, but I think any other martial art also does it. I know this, cause I know something about kung fu for handicapped people. Doing a row of blocks and punches, even sitting can be demanding enough, to have a feeling of sports.

This all will help me to stay as much in shape as possible, to fight boredom and is just for my sports geek self. I also think it will be good, because first laying  and sitting around a lot, then walking on crutches will go on you back and whole upper body. At least it does this to me even though I'm lightweight and athletic. The exercises will help me to stay in balance and cope better.


-another tip: If you have to walk on crutches to the supermarket (get yourself a big enough backpack) or to work and university, I would suggest to really walk all these ways on crutches and possibly with the brace you are getting BEFOR surgery. Especially so, if you have to rely on public transport. This way you can figure out possible obstacles that you do not even think about yet.

- arrange PT beforhand: In my country one waits 2-3 weeks for the first appointment. Bad if you are supposed to have early rehab or lymphatic drainage.

- if you plan to use a stationary bike or pezzi ball, buy it beforhand, so that you can use it right away, when you're ready without the hassle to get it delivered and assambled at that point. Probably you can also rent or borrow that stuff from a physiotherapy or from friends.
- alternativly buy a pedal exerciser. Costs just about 30 Euros and can be used with feet or even with hands to stay in shape as much as possible.


FOOD:
- look for food delivery from the supermarket: A supermarket chain here offers the service to buy all groceries, including fresh fruit, milk and meats on the internet and is delivering it to your door the same day for just 5 Euros charge. This is helpfull, if you life alone and can't go outside. Or when you can go outside, but have trouble carrying heavy loads. Once a week or every other week you might want to get the heavy stuff delivered.
Ask neighbours or friends to do that for you.

- What about a bar stool in the kitchen, to be able to cook simple things? (Never tried it myself, but my grandma was cooking that way, when she was not able to stay because of her arthritis.)
- Precook rice for several days. Then for a meal, just fry up some veggies with chicken or tofu in the pan, while microwaving the rice. Just takes some minutes. Also freez precooked meals, as was said. (I don't have such a big freezer).
Sandwhiches with salad is easy to make sitting.


- a remark for lifting the leg: This can be problematic, when knee is very irritated. I had just one simple scope in my life, but as far as I remember the knee was that much in pain and irritated, it would have not been possible to lift the leg like that. Reason is, you have your leg fixed on the foot in the sling and on your hip. With you immobilized muscles, you knee will dangle around from one side to another or up and down. And only the pain from the tibia pressed slightly to the femur was be horrible the first days. Only option is to grab you tigh with one hand and navigate you calve with the other hand. I think this is more save and less painfull.
When you are not allowed to flex you quads or lift your leg activly the sling method would be hazardous (e.g. on a cartilage transplant).