Tuesday, December 13, 2011

Fractured Tibia ~ Tips for home survival ~ from My brokenleg.com

A great list of advice from mybrokenleg.com 

Tips for home survival
You have just arrived home from the hospital. You are past the shock of "Gee, I broke my leg". "Now what?" you ask. The purpose of this page is to suggest solutions to some problems you are about to experience.
Why are we offering these tips? Frankly, this is one way for us to put some value to the pain and suffering that we have just passed through. And to send that value to someone who (probably) desperately wants it. A bargain for us all. So, here are our collective experiences with the solutions we have found.
Since this page was started in February 2003 we've had many reader tips.


Attitude

Relax when you get home, and be prepared to take good care of yourself. Prepare to be pampered. Don't do anything. Put your life as you knew it on hold. You are entering a road of recovery from a severe shock to the ole body. It is probably far more than you yet realize. Relax, even if you feel great and want to be off doing things and being busy. Relax. Give your body some time to do what it needs to do. I felt great after a few weeks and began doing more than I should have. Uh-uh. Don't do it. Listen to the words of wisdom from those who have gone before you in this "little misery."


Communication and safety

Certainly the single most important tool we have discovered to ensure the safety and comfort of both the patient and the care-giver is the use of personal two-way radios. They allow instant contact without the need for shouting and give the care-giver the ability range quite far without fear of being out of contact should a need or emergency arise. When powered by the newer long lasting nickel-metal-hydride batteries, these radios will last up to two days between recharge. The newest one hour type charger with two sets of batteries is highly recommended.
Have a friend make your house or apartment wheelchair safe by creating wheelchair paths around the main floor (bedroom, kitchen, bath) and remove all throw rugs which tend to make crutches precarious.
Always have a phone within easy reach and keep emergency numbers (including your MD’s) handy, just in case. If you have pain or questions about something related to your injury that you're not quite sure about don't be afraid to call your MD.


Drugs and kidneys

Hydrate constantly, beyond what is comfortable. The patient will object because of the necessity of frequent bathroom or urinal use. The body will find health much quicker and with considerable less discomfort if hydrated properly.
Synthetic pain killers can occasionally produce an allergic reaction. Watch for signs of body rash or other symptoms of a reaction. Initially, we recommend you chart medication by recording the type, dosage, and time taken. In a short time you find your tolerance for medications and the most effective combinations of medications. Do not trust your memory.
Most pain relief medications also bring with them an un-wanted side effect: constipation. Consider natural remedies such as high fiber and bulk foods like Taboule, herbal teas such as Laxative Tea, or over-the-counter commercial stool softeners.
Anger is often a product of prolonged pain and discomfort. "Tension Tamer Tea" from Celestial Seasons has saved our sanity more times than we can count. We keep multiple boxes on hand. This stuff WORKS! Don’t be home (with a patient) without it.
Restful Sleep. Ahhhh, can you recall what that felt like before the accident? Well, you can safely go there again thanks to the miracle of pharmacology. "Ambien 10mg" by prescription is your ticket to a great night sleep with no hangover. Cost of these baby's is a tad high but well worth it when you just NEED a good night sleep. See your MD for advice.


Clothing

Comfort wins out over fashion. Swelling and skin tenderness particularly in the area of surgical incisions will be minimized by the purchase of several pair of soft sweat pants that are clearly too large. If the sweat pants have elastic cuffs, feel free to snip the elastic to prevent pressure on the lower leg. The local Costso offers the "Fila" brand without elastic cuffs and very comfortable.
For those necessary visits outside the home where dressier apparel is desired, consider a pair of sports tear-away pants. While not inexpensive, they are an easy and somewhat dressier solution to everyday sweat pants. They’re ideal for visits to the doctor as he/she can easily examine your leg without requiring you to remove your trousers.
The sedentary nature of the healing process can slow your circulatory system to the point where it will be difficult for the body to maintain a comfortable temperature. The resulting feeling of terrible chills is very uncomfortable. Several warm zip-up style (not pull over) polar fleece house jackets are wonderful. Some types of sweatshirts (often with hood) have a single large pocket sewn on the front. A convenient kangaroo pouch for transporting objects while using crutches.
Balance and strength are at a minimum after serious injury, and the last thing you need is another fall. Purchase a supply of hospital style socks with the anti skid coating on the bottom. These will provide warmth and a sure footing. House slippers are often constricting due to elastic bindings. Slip-on slippers have a tendency to slip-off at the worst possible moment. Slippers are also nearly impossible for the patient to manage after surgery. Think safety. Knitted hospital "over-socks" are just the ticket for additional warmth without binding or putting additional pressure on the swollen foot.
Most of heat loss is through the head. A stocking cap will assure comfort during sleep and prolonged sitting. A loose sweatshirt with built in hood is another convenient piece of clothing.
Consider wearing a fishing type vest with lots of pockets to hold everything that you want conveniently nearby.


Temp/chills

Pain, whether medicated or not, will cause erratic sleep and sometimes prolonged bouts of sleeplessness. Lack of quality sleep will throw the body out of wack even more than the general level of pain and the side effects of pain relievers. Sleep loss can also cause the body to lose the ability to respond appropriately to temperature changes. You may experience deep chills and massive sweats. Sometimes only minutes apart. Be prepared to easily cast off clothing and absorb perspiration minutes after bundling up like an Eskimo.
Anything that will enable the patient to respond quickly to their own comfort needs will be a Godsend. For the long tedious days of chills while sedentary in a easy-chair, the purchase of a electric lap robe is highly recommended.
The purchase of a electric blanket for the bed will allow the patient to respond to their own temperature fluctuations without waking the care-giver.


Swelling

Ice is the body's best friend when it comes to swelling. Purchase or borrow a minimum of three medium or large ice gel-packs. Forget the small one... go for quality. You will often wish you had more of these wonderful anti-swelling aids.
Orthopedic socks are wonderful. Don't leave the hospital without an MD order for these. Better yet, get them before you leave.


Waste and Sanitation

Your most difficult physical challenges will be toileting and bathing. Plan carefully before attempting each transfer from a chair/toilet or chair/bath stool. Then think it through again. Safety First.
Some people like a raised toilet seat (extender). Most feel that a seat at the same height as your wheelchair to be safest.
An inexpensive plastic patio chair (you probably already have one) will make a great bath/shower stool. And unlike a shower stool, it has a back for good support. A fairly simple way to enter a conventional tub/shower is to place a second patio chair half-in and half-out of the tub. Transfer from your wheelchair to this chair, swing around and transfer to the bathing chair.
Frequent hydration means frequent urination. If you are a male, obtain twourine jugs: one for the bedroom and one for near the easy chair. If you are a female, you’ll soon be adept at transfers from your wheelchair to the toilet.
Sanitation is necessary for comfort and peace of mind. Purchase several of the small personal alcohol gel hand sanitizers available at the pharmacy.


Foods that promote bone healing and foods to avoid

These recommendations come via the nurse educators that work for a health sciences publishing company. We hope they help you with your dietary choices!
Foods to eat to promote the healing of broken bones:
  • Fat free milk (skim)
  • Defatted soy flour (at least 1/3 of a cup per day recommended) highest source of Lysine)
  • Calcium fortified orange juice (2 cups per day recommended)
  • Green leafy vegetables, collard greens 355 mg/cal/cup, Bok choy 250 mg/cal/cup, (Vitamin K)
  • Broccoli (200 mg/cal/cup)
  • Sesame seeds
  • Carrots (lightly cooked)
  • Pumpkin (canned or cooked)
  • Sweet potatoes
  • Squash
  • Oatmeal, shredded wheat, other whole grain low-no sugar added cereals
  • At least 97% or greater fat free chicken or turkey breast (I look for at least 99% fat free.) Substitute olive oil or canola oil for other oils, but still use sparingly. Also keep animal protein consumption down, it increases calcium loss.
  • Salmon and other fish, including the skin and fat (Research suggests this fat (EPA fat) has the ability to raise HDLs. 1-5 servings per week recommended)
  • Sardines
  • Tofu with calcium sulfate
  • Fresh fruits (especially apples) good source of boron to aid in calcium absorption
  • Dried fruits (unsweetened) especially apricots, dates, prunes
  • Low fat tomato sauces and pasta
  • Peanuts, walnuts, almonds in moderation
  • Grape juice
  • Grapes, especially red grapes
  • Grapefruit, especially pink
  • Bean and, chickpea dishes and dips (great source of boron to help increase calcium absorption)
  • Tomato salsas
  • Mineral water
  • Apples
  • Yeast
Remember the key to building your bones is not how much calcium you take in, but how much you absorb

Foods to consider avoiding:
  • 1%, 2% and whole milk and products
  • Meats with 96% or less fat
  • Red meats (Increases calcium loss)
  • Hydrogenated oils such as stick margarine, and when listed as an ingredient in foods
  • Food with high butter fat and other animal fats
  • Hot dogs, hamburgers
  • Salt (a major bone robber) or foods prepared with salt
  • More than one cup of coffee or other caffeine beverages a day
  • Sugar (a major bone robber)
  • Chocolate (a bone robber due to caffeine content)
  • Soft drinks due to high phosphorus content
  • Alcohol (it inhibits calcium absorption)
  • Carbonated Beverages
  • Caffeine (increases rate of calcium loss through the urine)


General

Vitamin E skin cream works wonders for minimizing the scars from surgery and the dry skin resulting from poor circulation.
If confined to a wheelchair, the patient will bless the day you purchase a "gripper." These wonderfully handy devices are used for reaching, grasping, and retrieving items out of reach. The device will be in constant use.
The words "wheelchair" and "comfort" cannot be used together. Draping a single towel over the chair will provide some comfort and a measure of absorbency during those instances of sweating and following bathing.
Well intentioned friends will often assume you are merely inconvenienced by your surgery. They may also assume you are clear headed, pain free, and able to take care of yourself and your surroundings. As you well know by now, that is a long way from reality. If friends say, "Call me if I can help," they mean it. Call them. Prepare and keep current a list of tasks with which you need help. When people ask if they can help, show them the list and ask them to select how they would like to help. Shopping, cleaning, taking out the trash. DO NOT MISS AN OPPORTUNITY WHEN HELP IF OFFERED.
You will probably have trouble sleeping in a flat bed. Make yourself at home in a comfortable recliner or easy chair. Place a dining room chair in front with a pillow to support your leg at a higher elevation than your body. Unlike the bed, the chair will give good support and prevent you from rolling side to side. Your quality of sleep will probably be much better in a easy chair or recliner.
Purchase a full body pillow for leg support once you graduate to sleeping in a bed. Trust me on this one, you will need the added leg support.
Crutches are dangerous. People will assume that you will get out their way. Do not underestimate the indifference of others to your condition.
You expect to tip for good service at a restaurant. People in the health care profession do not expect a monetary tip, but they do need for you to acknowledge great service. Thank you’s go a long way.
Circulatory problems can become acute due to the sedentary nature of the healing process. Another cause of pain can be the wheelchair itself. The front lip of the seat can put additional pressure on the legs and cause a circulatory blockage. Consider lowering the front wheel of the chair one notch to relieve the pressure on the back of the legs.
The perfect tool for those leg stretching exercises is the removable strap from a piece of carry-on luggage in your closet.
Muscles not in use tend to cramp. Add leg cramps to the list of ailments you will experience during your recovery period. A fabulous way to relieve those muscle cramps, tight tendon, and improve circulation is the use of a electric massager. The large rather clunky ones with an articulating head work very well on the foot and leg. A worthwhile investment for pain relief.
Assemble a few place-settings of dishes and glass ware on the kitchen countertop for easy access by the patient in a wheel-chair.
Keep a spare roll of toilet tissue on the back of each toilet.
Access to lower cabinets in the kitchen and bathroom can be a real problem for a chair bound patient. Consider temporarily removing some cabinet doors for ease of access. They can be quickly replaced when the crisis is over.
Most of our homes were not designed with ease of access for the wheelchair bound person. Doorways are a special problem. Knuckle scrapes can be reduced by simply removing doors from their hinges.
If you have pets you may find they will avoid you upon your return from the hospital. It may take awhile for you to loose that "hospital smell" and to be "scent recognizable" again. Your pets may choose to linger about your wheelchair. Always look around you before moving or backing the chair. A broken tail or leg on your pet could be the disaster that you just do not need.
Request a "disabled parking" authorization from you MD. He can often provide the form required by your state for the permit.
Learn to protect your leg while in your wheelchair. Approach corners slowly and learn to peek around corners before entering a room. Likely there is someone about to run directly into your leg. Ouch!
If you use a walker, clip a small bicycle basket to the front rail for easy carrying of items.
Use storage bowls with lids to transport food (yes, even hot soup) from kitchen to your resting place. Place in a bag and clip to your crutch or walker.
Easily transport items by strapping a small backpack to the back of your wheelchair.
A standard cooler chest close by your resting place can provide plenty of water, snacks, and a sandwich while alone during the day.
Once you "graduate" to crutches, carry a backpack. Everything is just so handy.
Learn how to scoot up and down stairs on your bottom while someone is providing supervision. TAKE IT SLOWLY!! THINK SAFETY FIRST!!
Find things to keep yourself occupied, especially during those first few weeks. Read, draw, do crosswords, play video games, have friends over, call someone, log on and surf the www, whatever. It is so important to keep a positive attitude going (especially in the beginning), and keeping busy can help.
Call all of your fiends with the request to borrow video tapes or DVD’s. The hours you spend in the chair or bed will just fly by when you have a host of entertainment from which to choose.