Rapid Recovery Book

Welcome to . . .

Kevin Mosier, MD

Brad Meister, MD

Rapid Recovery Joint Replacement Program

Annually, over 500,000 people undergo total joint replacement surgery. Primary candidates are individuals with chronic joint pain from arthritis that interferes with daily activities, walking, exercise, leisure, recreation and work. The surgery aims to relieve pain, restore your independence and return you to work and other daily activities. Total joint replacement patients typically recover quickly. Most patients will be ambulating the day of surgery. Generally, patients are able to return to driving in 2 - 4 weeks, dancing in 4 - 6 weeks and golf in 6 - 12 weeks. The Rapid Recovery Joint Replacement Unit has developed a comprehensive planned course of treatment. We believe that you play a key role in promoting a successful recovery. Our goal is to involve you in your treatment through each step of the program. This guide will give you the necessary information to promote a more successful surgical outcome. Your team includes physicians, physicians assistants, patient care technicians, nurses, orthopedic technicians, and physical and occupational therapists specializing in total joint care. Every detail, from pre - operative teaching to post - operative exercising, is considered and reviewed with you. The Joint Care Coordinator and your physician will plan your individual treatment program and guide you through it.

Your Guide to Recovery Is All Here

This Guide Book is intended to help you through your joint replacement surgery with a better understanding of what to expect before, during and after your surgery. We have divided the information into five (5) sections:

SECTION 1: PREOPERATIVE CHECKLIST SECTION 2: HOSPITAL STAY SECTION 3: POSTOPERATIVE CARE SECTION 4: EXERCISES SECTION 5: ADDITIONAL INFORMATION

Please read all the information carefully before your surgery. It is also important that you start your exercises. Please call Kerry Volmer, RN, Joint Care Coordinator, at (620) 820 - 5465, or one of our physical therapist at (620) 820 - 5238, if you have any questions, concerns or need additional information.

Please bring the book with you when you come for surgery and feel free to make notes in this book. It is yours to keep!

Thank You For Choosing Us!

Registration and Preoperative Class

 A special class is held every Monday morning for patients scheduled for joint surgery.  Prior to attending this class, you must have been medically cleared by your primary physician if you have significant medical problems.  You will be scheduled for this class 2 - 3 weeks prior to your surgery. This will allow you time to practice your exercises and make final preparations for surgery.  You will only need to attend one class.  Members of the “team” will be there to answer your questions.  It is strongly suggested that you bring a family member or friend to act as your “coach”. The coach’s role will be explained in the class.  You should leave this class with a better understanding of how your hospital stay will proceed.

Class Agenda

 Hospital Stay Presentation  Reviewing Your Exercises  Learn About Assistive Devices  Discharge Planning  Questions & Answers  Pre - Op Testing (Lab, EKG, Physical)

Infection Prevention

The prevention of infection starts before your surgery. The following are some things that increase your risk of infection.

1. History of MRSA or CRE . Make sure your doctor is aware if you have ever had any kind of infection that required long term IV antibiotics. 2. Smoking . Smoking affects the normal wound healing process and increases your risk of respiratory complications such as pneumonia. It is optimal to stop smoking 4 weeks prior to your surgery. 3. Poor hand hygiene . You need to wash your hands with soap and water or use alcohol gel before you eat, after visiting the toilet, using the commode or urinal, and before touching your incision. It is also important to use alcohol gel or soap and water after you blow and/or wipe your nose. It is good practice to ask any health care worker if they have washed their hands or used alcohol gel. 4. Not showering or bathing before your surgery . Make sure your skin is clean be- fore you come to the hospital for your surgery. Use either soap or antiseptic agents that have been provided or recommended by your physician. 5. Diabetes with poor control . It is very important to have good control of your blood sugar before, during and after your surgery. Tell your surgeon, physician assistant, anesthesia provider and/or nurse when you had your last Hgb A1C checked. High blood sugars increase your risk of infection.

Five Days Before Surgery: Stop taking Medications that increase bleeding

 Five days prior to surgery, stop taking anti - inflammatory medications such as aspirin, naproxen, vitamin E, etc.  All herbs should also be stopped five days prior to surgery.  You may continue Tylenol.  If you are on Coumadin, you will need special instructions for stopping this medication.  The joint care coordinator or anesthesiologist will instruct you about what to do with your other medications.

Preparing Your Home

 Chair with arm rests  Have all throw rugs picked up  Make arrangements for someone to care for your pets  Prepare frozen meals if you do not have someone to cook for you

Skin Preparation Before Surgery

Cleaning and preparing your skin before surgery is very important for the pre- vention of infection. It is very understandable as you prepare for your surgery you have a lot on your mind. To help prepare your skin, we are providing you with a checklist:  Shower or bathe using antimicrobial soap such as Dial or Hibicleanse for three (3) consecutive days. Wash your face and hair as you usually would. Do not shave your legs.  Use a clean wash cloth for your face and a second clean wash cloth for the rest of your body.  Use a clean towel after each shower. The area that will be operated on should be the first area that you dry off with the clean towel.  Wear clean night clothes.  Put clean sheets on your bed. Don’t let ;your pets sleep in your bed.  Do not put lotion or moisturizers on your skin.  The night before or the morning of your surgery, shower using the soap that was provided to you at the doctor’s office.

The Night Before Surgery

 Do NOT eat or drink anything after midnight, even water, unless otherwise instructed to do so.  NO chewing gum.  Drink plenty of fluids throughout the day until bedtime.  Take a good shower the night before or the morning of your surgery.  Do NOT shave your surgical leg.

Special Instructions

 You will be instructed by your physician or anesthesia provider about medications. If you normally take something for heart, blood pressure, or seizures, we ask that you take it with a small sip of water.  Do NOT take oral diabetic medication prior to surgery, but do take 1/2 of your normal morning insulin.  Makeup, dentures and contacts must be removed before your surgery.  Please leave jewelry, valuables and money at home.  Nail polish and acrylic nails may be left on.

Things You Need to Bring With You to the Hospital

 Copy of your advanced directives.  Driver’s license/insurance cards (for registration)  List of any new medications—including dosage, frequency and the time you take it.  Loose fitting casual clothes.  Your Joint Replacement Guide Book.

Transition to Home: Making the Discharge Plan

You need to think about your dismissal before you are admitted to the hospital. It is your right and responsibility to participate in your discharge planning. We will all be involved in your discharge plan: * Patient and Family * Program Coordinator * Surgeon

* Physical Therapist * Discharge Planner

Discharge Planning Options

 Home: Outpatient therapy may be recommended for up to 3 times per week.  Home with Home Health: Home Health comes to your home for Physical Therapy  Inpatient Rehab Unit: There is a screening process to see if you meet qualifications. It is Medicare regulated—not everyone will qualify  Skilled Nursing Facility: Stay at a Skilled Nursing Facility of your choice for longer care and therapy.

Our Discharge Planner will help you with insurance and authorizations. If you or your family would like to visit with our social worker or discharge planner prior to your surgery, please contact them at 620 - 820 - 5483.

It’s Surgery Day!

What to do:  Arrive at the Main Entrance of Labette Health at your scheduled time. Please do not be late.  Leave suitcase in the car until you are assigned to a room. What to Expect:  The nurse will check you in and then have you change your clothes.  You will go to the preoperative outpatient surgery area where you will prepare for surgery.  An I.V. will be started, your surgical site will be marked and the hair in this area will be clipped. Do not shave your own leg.  Your family may sit with you in the outpatient surgery area after the nurse is finished getting you ready. We ask that no more than two people be with you in the outpatient surgery area.  Your operating room nurse, as well as your anesthesia provider, will interview you.  You will be escorted to the operating room where you will see your surgeon, if you haven’t already visited with him.  Following surgery, you will be taken to the recovery room where you will remain for 1 - 2 hours.  Physical Therapy Team will visit you and get you up and ambulatory the day of your surgery. It is very important that you start your ankle pumps on this first day. This will help prevent blood clots.  You should also begin using the therapep and doing the deep breathing exercises.  Your evenings are free to visit with family and friends.

Pulmonary Services Department Pre - OP Therapep Information Sheet Post Operative PEP Therapy

What is Therapep? Therapep is a breathing exercise used after surgery for patients to encourage deep breathing to help prevent respiratory complications. Why do I need Pep Therapy? Your post - op recovery will require you to rest in bed at home or in the hospital. During your recovery time after surgery, you will not be as active as you normally are when you feel well. This inactivity allows the tiny air sacs of your lungs to become clogged with mucus or collapses creating a condition known as atelectasis. If you run a low grade temperature or remain inactive for along period of time without taking deep breaths and coughing frequently, you will develop pneumonia. How does Pep Therapy work? The Therapep device works by creating “back pressure” in the lungs to hold the airways and small air sacs open so that fresh air can get down into the lungs and mucus can be moved up the larger airways of your lungs so you can cough it out more effectively. If you or a family member play a musical instrument, then you will recognize the feeling of the “back pressure” created as you blow into a horn. How often should I do my Therapep Therapy? Your doctor will prescribe a frequency for you. We recommend that you do your PEP therapy every two hours (during the daytime) for the first two days after surgery. This will allow time for you to regain some strength and begin sitting in a chair and walking again. If your doctor prescribes respiratory therapy treatment for you after surgery, your PEP therapy will be done after your breathing treatment or in conjunction with your treatment. If you take treatments at home, you should use your PEP therapy with your home treatments as well. How do I do PEP Therapy The day of your surgery a respiratory therapist will instruct you on how to use the device before you go to surgery. We will also assist and follow your progress after surgery if you are admitted. The proper technique for PEP therapy is to do three sets of ten breaths or “blows” into the mouthpiece. Keep the blue column in the tower of the device between the two black lines during your exhalation. Start the device on level #6 and work your way up to level #1 or the most difficult level.

Pain Management

We take your pain very serious and we will do everything we can to make your pain tolerable after your total joint replacement.

We aim to manage the discomfort so that you can eat, sleep, move around and participate in therapy. You will not be pain free, but our goal is to make your pain level tolerable.

Preoperatively we will give you analgesics, during surgery we will give you a combination of medication that will have a numbing effect in your incision area and post - operatively we will give you pain medication in your IV and pill form. We will try to transition you to oral medication 24 hours after your surgery. It is important for us to know what pain medication is going to be effective for you. We have to stop giving IV narcotics to find out what is going to control your pain at home. You will go home with a prescription for pain medication, and we need to be sure that it is the one that is going to be most beneficial to you. Ice and positioning are also helpful with pain control. You cannot use too much ice after your surgery. We recommend that you use ice for at least 20 minutes every 2 hours for the first 2 weeks after your surgery. You need to put a cloth barrier between your skin and the ice pack. Sometimes it’s helpful to get up and go for a short walk to help relieve some discomfort.

Throughout your hospital stay, we will ask you to rate your pain on a pain scale. This same pain scale will be used in the recovery room and on the nursing units. The pain scale is a tool the nurses use to judge how effective your pain is being managed.

PAIN SCALE

Worst possible pain ever. You are not able to eat, drink, stand or relax.

10

Pain is very severe. You can’t concentrate on anything but pain. You can’t relax or sleep.

9-8

You are unable to move or use the affected side. You have difficulty concentrating or having a conversation.

7

Pain begins to cause you disability. You can’t function at full capacity.

6

Very limiting pain. Pain causes great difficulty moving or bearing weight.

5

Functionally limiting pain. Have discomfort but able to sleep, have a conversation, and/or walk.

4

3

Pain starting to affect ability to perform activities.

2

Pain does not restrict you from activity.

Slight discomfort.

1

0

No pain at all.

DAY 1 AFTER SURGERY

 Bath and out of bed by 6 am, seated in recliner in your room.  Your Surgeon and/or Physician’s Assistant will visit you in the morning.  Physical Therapist will assess your progress and get you walking with either crutches or a walker.  You must ask the Nurse for your pain medication when you need it. Meal times are ideal times for taking pain medication. Do NOT take pain pills on an empty stomach.  Be sure to take your pain medication before you go to therapy, while in the hospital and at home.  Group Therapy will begin at 9am and 1pm. Your Coach is en- couraged to be present as much as possible.  Visitors are welcome, preferably later in the afternoon or evening.  Occupational Therapist will instruct you on precautions and necessary assistive devices for home use.  Bath and out of bed by 6:00am.  Dress in your own loose fitting clothes.  Walk to group therapy at approximately 8:30am with physical therapist.  Group therapy will start at 9am. It would be helpful for your coach to participate in group therapy.  At noon, you will eat with the other patients, your coach and Rapid Recovery Team. There is no charge to the coach.  After lunch, you will have your second group therapy exercise session.  Most patients will be dismissed on day two but some will require additional days to help with medical issues and/or receive additional therapy. DAY 2 AFTER SURGERY

Day of Discharge

If you are going directly home:

 Someone responsible needs to drive you home.  You will receive written and verbal discharge instructions concerning medications, physical therapy, activity and follow - up appointments.  We will help you to arrange for any special needed equipment.  Most patients go to outpatient physical therapy within 1 - 2 days. You may go to the therapy department of your choice.  If you require home health services, we will arrange for this.  Some patients may need to go to an inpatient rehab or skilled nursing facility. These facilities are designed to help you transition into your home life.  We want you to be included in patient teaching during your family member’s hospital stay. We want you to feel welcome to participate in your family member’s care.  If you have special needs or questions, please direct them to any of our staff members. We will assist you in any way possible.  Hospital visiting hours are flexible based on the patient’s needs. Feel free to call the surgical floor at (620) 820 - 5316. Someone will direct your inquiry to the appropriate person.  Social Services can provide helpful discharge resources and can be reached at 620 - 820 - 5483. A Special Note for Family & Support Friends

Control Your Discomfort

 Take your pain medicine at least 30 minutes before physical therapy.  Gradually wean yourself from prescription medication to Tylenol. You may take two extra - strength Tylenol in place of your prescription medication up to four times a day.  Change your position every 45 minutes throughout the day.  Use ice for pain control. Applying ice to your affected joint will decrease discomfort, but do not use for more than 20 minutes at a time each hour. You can use it before and after your exercise program. A family size bag of frozen peas wrapped in a kitchen towel makes for an ideal ice pack. Mark the bag of peas and return them to the freezer to be used as an ice pack again later.  You may elevate your leg but you should place pillows down the length of your leg and not just directly under the knee itself.  Anti - inflammatory medication: Check with your surgeon before taking any NSAID medications such as Ibuprofen, Advil, Motrin, Aleve or Naprosyn.  Your appetite may be poor. Drink plenty of fluids to keep from getting dehydrated. Your desire for solid food will return.  You may have difficulty sleeping. This is normal. Do not sleep or nap too much during the day.  Your energy level will be decreased for the first month.  Pain medication that contains narcotics promotes constipation. Use stool softeners or laxatives such as Milk of Magnesia if necessary.  After a total knee replacement, your knee may swell for 2 - 3 months after surgery. Body Changes

POSTOPERATIVE CARE

Stockings

You will be asked to wear special white stockings. These stockings are used to help compress the veins in your legs. This helps to keep swelling down and reduces the chance for blood clots.  If swelling in the operative leg is bothersome, elevate the leg for short periods throughout the day. It is best to lie down and raise the leg above the heart level.  Wear the stockings during the day and take them off at bedtime.  Notify your physician if you notice increased pain or swelling in either leg.  Ask your surgeon when you can discontinue stockings. Usually, this will be done three weeks after surgery.  Keep your incision dry.  You may shower after surgery, unless instructed otherwise. After showering, towel dry off. Leave open to air.  If you have drainage from your incision, cover it with a sterile dressing.  Take your temperature if you feel warm or sick. Call your surgeon if it is higher than 101.5 degrees.  If you have house pets, you should cover your incision with a light dressing to prevent pet hair from getting in the incision. 1. Wash your hands. 2. Open all dressing packages (ABD pads, 4x4’s if needed, rubbing alcohol). 3. Apply liberal amounts of rubbing alcohol on incision. 4. Pick up the ABD pad by one corner and lay it over the incision. Be careful not to touch the inside of the dressing that will lay over the incision. 5. Use a large band - aide at the drain site. 6. Keep the dressing in place by wrapping it with an Ace bandage. If your incision has NOT been closed with visible metal staples, do NOT apply alcohol to incision and keep area clean and dry as possible. If your incision has been closed with metal staples (at least daily) Care for Your Incision

Recognizing & Preventing Complications & Infection

Signs of Infection:

 Increased swelling and redness at incision site.  Change in color, amount or odor of drainage.

 Increased pain in hip or knee.  Fever greater than 101.5 degrees.  A tapering low grade fever is common after joint replacement surgery.

Prevention of Infection:

 Do not touch your incision unless you are cleaning it.  Continue good hand hygiene. Always wash your hands before touch- ing your incision. Wash your hands with soap and water or use alcohol gel before you eat, after visiting the toilet, using the commode or urinal. You should also use hand gel or wash your hands after blowing your nose.  If you had a drain in place after surgery, clean the area where the drain was with rubbing alcohol twice a day.  You do not need to cover your incision unless your doctor tells your otherwise. If you have house pets and your incision has staples or stiches, you may want to cover your incision with a light dressing. If you have steri - strips (also called skin tapes or butterflies), do not pull them off. It is OK to get them wet but do NOT pull them off. If they start to curl up, have someone carefully trim them with a clean pair of scissors.  If you are diabetic, monitor your blood sugar.  Notify your family physician and your dentist that you have had a joint replacement. You will need to take prophylactic antibiotics when you have any dental procedure. This will need to be done for the rest of your life unless instructed otherwise.  It is very important that you take good care of your teeth.  Do not let any infection go untreated.

Blood Clots

Surgery may cause the blood to slow and coagulate in the veins of your legs, creating a blood clot. This is why you take blood thinners after surgery. If a clot occurs despite these measures, you may need to be admitted to the hospital to receive intravenous blood thinners. Prompt treatment usually prevents the more serious complications of Pulmonary Embolus. Signs of Blood Clots in Legs:  Swelling in thigh, calf or ankle that does not go down with elevation.  Pain, heat and tenderness in calf, back of knee or groin area.  If you have increasing calf pain or persistent increase in warmth, red- ness or swelling, please contact your doctor.  Blood clots can form in either leg.

Prevention of Blood Clots:

 Foot and ankle pumps  Walking  Compression Stockings

 Your surgeon will plan an anticoagulation regime appropriate for your case. Your nurse will review the prescribed medication and its dosage with you prior to discharge from the hospital. Written instructions will be sent home with you.

Pulmonary Embolus: An unrecognized blood clot could break away from the vein and travel to the lungs. This is an Emergency and you should call 911 if suspected.

Signs of Pulmonary Embolus:  Sudden Chest Pain

 Difficult and/or Rapid Breathing  Shortness of Breath

 Sweating  Confusion

Labette Health Rapid Recovery Exercise Program

Hip Precautions

To prevent dislocation of your total hip replacement:  Do not bend greater than 90 degrees at the hip.  Do not cross your legs at the knees.  Do not twist your leg inward.  Do not sit on low chairs without armrests, including sofas.  Your surgeon will specify how long you must follow these precautions. Other safety tips:  Be careful getting out of bed. Your therapist will review safe procedures.  Remove throw rugs and/or secure edges of area rugs.  Remove or move loose cords or secure to floor to prevent tripping.  Pets may be a tripping hazard when first returning home. You may need to find alternative care or keep them in a secure area.  Make sure areas are free from clutter and you have ample space in living area to move about safely with your walker or other assistive device.

Labette Health Rapid Recovery Exercise Program

Knee Flexion

 Sit or lie down.  With towel/belt around left heel, gently pull knee up with towel until stretch is felt.

 Repeat ten (10) times per set.  Do one (1) set per session.  Do three (3) sessions per day.

 Sit or lie down.  Place a rolled towel under ankle of operated knee.  Relax knee and allow to stretch straight.  Hold one (1) minute. Knee Extension Mobilization: Towel Prop

 Repeat three (3) times per set.  Do one (1) set per session.  Do three (3) sessions per day.

Labette Health Rapid Recovery Exercise Program

Best Stretch

 Use a chair or your walker for balance.  Place operated leg back, foot flat on floor.  Forward leg bent.  Keep shoulders, torso upright.  Squeeze bottom and slowly shift weight to forward leg until a stretch is felt in front of thigh on operated leg.  Hold 30 seconds.

 Repeat three (3) times.  Do three (3) sessions per day.

Standing Hip Abductor Stretch

 Stand facing walker.  Spread feet apart and shift weight toward uninvolved leg with knee bent to feel GENTLE stretch along inner thigh.  Hold 30 seconds.  Repeat three (3) times daily.

Labette Health Rapid Recovery Exercise Program

ANKLE PUMPS Bend ankles up and down, alternating feet.

SHORT ARC QUADS Place a large can or rolled towel under leg. Straighten knee and leg. Hold ___ seconds.

REPEAT: ___ Times

REPEAT: ___ Times

___ Times a Day

___ Times a Day

STRAIGHT LEG RAISE Bend one leg. Raise other leg 6 - 8 inches with knee locked. Exhale and tighten thigh muscles while raising leg. Repeat using other leg.

QUAD SET Slowly tighten muscles on thigh of straight leg while counting to 10 out loud.

REPEAT: ___ Times DO:

REPEAT: ___ Times DO:

___ Times Per Day

___ Times a Day

LONG ARC QUADS Straighten operated leg and try to hold it ___ seconds. Use ___ pounds on ankle.

GLUTEAL SQUEEZES

REPEAT: ___ Times

___ Times a Day

REPEAT: ___ Times

Labette Health Rapid Recovery Exercise Program Proper Techniques

STRAIGHT LEG RAISE

Bend one leg.

•

• Raise other leg 6 - 8 inches with knee locked. • Exhale and tighten thigh muscles while raising leg. • Repeat using other leg.

ABDUCTION

KNEE BENDS

Slide one leg out to the side.

•

• Keep kneecap pointing toward ceiling. • Gently bring leg back to pillow. • Repeat with other leg.

• Holding a chair for balance, slowly bend knees. • Keep both feet on the floor.

Labette Health Rapid Recovery Exercise Program

Walker Ambulation

1. Move walker forward 2. With all four (4) legs of walker placed firmly on the floor, step halfway into walker with operated leg. 3. Step forward with other leg, passing operated leg, as in a normal walking pattern. 4. Be mindful of your posture. Don’t stoop forward over walker. 5. You should try to walk 200 feet, 3 - 4 times daily.

STAIRCLIMBING “Up with the good”: Step up with non - operated leg first. “Down with the bad”: Step down with operated leg first.

You will practice this with your physical therapist.

Labette Health Rapid Recovery Exercise Program

Activities of Daily Living— Precautions and Home Safety Tips

IMPROPER METHOD

PROPER METHOD

Do not pull up on walker to stand!

Standing up from Chair. Sit in chair with armrests when possible.

1. Scoot bottom to front edge of chair. 2. Push up off armrests with both hands. If no armrests, place one hand

on walker while pushing off seat with other hand. 3. Balance yourself before placing hands on walker.

4. If you tend to lean forward, you may need to place operated leg slightly out in front of you to prevent bending too far at the hip.

TRANSFER: Wheelchair To Car (Unassisted)

General Tips

 Open the car door  Angle wheelchair as close as possible (leaving enough room for person to stand and pivot)  Remove feet from footrests, move foot rests out of the way, lock the brakes.  Put feet flat on the ground. Place the uninvolved foot slightly behind the involved foot.  If both legs are weak, put the stronger leg slightly forward.  Loops or other devices may be attached to car to assist movement. Reverse the procedure to return to the wheelchair

Lean forward, push down on armrest and come to a standing position. Balance, standing, for a few seconds.

Starting Position

Pivot on feet until the back of the legs are against the seat.

Slowly lower body into seat. Use the arms on the seat, if possible.

Lift each leg into the car.

Labette Health Rapid Recovery Exercise Program

Pursed - Lip Breathing

Pursed - lip breathing helps prevent shortness of breath. It helps you empty your lungs fully when you breathe out. The more air you breathe out, the more air you can breathe in. Practice the steps below. That way you will know how to do pursed - lip breathing when you need it.

1. Relax your neck and shoulders

2. Breath in slowly through your nose for 2 counts

1. Pucker your lips as if you are going to blow out a candle 2. Breathe out slowly and gently through your lips for 4 counts

Remember: Always breathe out for longer than you breathe in. Never hold your breath between breathing in and breathing out.

What is Occupational Therapy?

Occupational Therapists assist individuals to develop, recover, or maintain daily living and working skills with the goals of helping people live independent, productive and satisfying lives.

OT services typically include:

 Customized treatment programs to improve one’s ability to perform daily activities  Recommendations on home modifications  Recommendations and training for adaptive equipment  Family and caregiver education How will Occupational Therapy benefit me? Following a joint replacement, individuals may have difficulty with performing daily activities safely and independently—secondary to pain or surgical precautions. An occupational therapist will edu- cate and train the individual and/or family in the use of adaptive equipment and make recommenda- tions as needed in order to increase independence with activities of daily living (ADLs).

Modifications may be made to the following ADLs:

 Dressing  Bathing  Hygiene & Grooming

 Toileting  Eating  Walking & Transferring

 Sleeping  Homemaking  Sexual Activity

Possible Adaptive Equipment (AE) recommendations:

 Raised toilet seat  Shower chair or tub bench

 Sock - aid  Reacher  Shoe horn

 Bath sponge  Dressing stick  Elastic shoe strings

Where can I purchase these items and does insurance cover the cost?

Durable Medical Equipment (DME) businesses carry adaptive equipment. A list is provided in this manual. Each person’s insurance is unique, but often times these are an out of pocket expense.

Home Health Agencies

We have an obligation to list all agencies that have requested to be on our provider list.

You have the right to choose which agency you prefer, even if it is not on our list.

Labette Home Care

620-421-0739

Allen Co. Hospital Home Care

620-365-1000

Angel Home Care

620-325-3841

(Neodesha, Chanute, Pittsburg)

Chanute Hospital Home Health

620-431-2241

620-431-4000

Coffeyville Hospital Home Health

620-252-1507

Fredonia Hospital Home Health

620-378-2121, ext. 230

Ft. Scott Hospital Home Health

620-223-8090

Home Health Care Connect, Parsons 620-421-1073

Home Sweet Home Care

620-378-2067

Independent Strides Home Health, Parsons

620-423-3328

Miami OK Home Health

918-540-2577

Mt Carmel Hospital Home Health

620-231-3088

SEK Home Care

620-332-3215

Fredonia Home Town Health Care

620-378-3760

Durable Medical Equipment Suppliers

Access Medical 603 N. Broadway, Pittsburg 620 - 232 - 6245

Home Medical 2301 Corning, Parsons, KS 620 - 421 - 4239 Fax: 620 - 421 - 6404 Iola Pharmacy 109 E. Madison, Iola 620 - 365 - 3176 Lincare, Inc. 2411 Main, Parsons, KS 620 - 421 - 2774 Mercy Medical Supply 3120 S. Main, Joplin, MO 417 - 627 - 8424 Fax: 417 - 627 - 9286

American Home Patient 401 N. Broadway, Pittsburg, KS

800 - 231 - 3452 620 - 232 - 3452 Fax: 620 - 232 - 5803

American Medical Equipment 1401 W. 4th, Coffeyville, KS 800 - 530 - 5675 Fax: 620 - 251 - 8264

Apollo Medical Services 600 E. Main, Parsons, KS 620 - 423 - 0274 Fax: 620 - 423 - 8076

Mount Carmel Medical Equipment 200 E. Centennial, Suite 15, Pittsburg, KS

Apria Health Care, Ft. Scott 800 - 362 - 0887 Apria Health Care, Independence 620 - 331 - 5305 Bowen Pharmacy 1519 Main, Parsons, KS 620 - 421 - 4950 Fax: 620 - 421 - 9252 Care4All Home Medical 2 West 18th, Fort Scott, KS 620 - 223 - 4141 Home Care Products 629 S. Plummer, Chanute, KS 620 - 423 - 5459 Fax: 620 - 432 - 5553

620 - 235 - 0327 888 - 236 - 6700 Fax: 620 - 235 - 0773

Olson Medical 2515 Main, Parsons KS 620 - 421 - 2727 Fax: 620 - 421 - 2744

Reliable Medical Supply, Inc. 416 S. Huston, Altamont, KS 620 - 784 - 2580 Fax: 620 - 784 - 2583

Riggs Drug Store Chetopa, KS 620 - 236 - 7272

JOINT TEAM PHONE NUMBERS

Preadmission: 620 - 820 - 5464

Outpatient Surgery: 620 - 820 - 5396

Physical Therapy: 620 - 820 - 5885

3 North Surgical Floor: 620 - 820 - 5316

Labette Health: 620 - 421 - 4881

SEK Orthopedic Clinic: 620 - 421 - 0881

Drug Name

Used For

Side Effects

Zofran (Ondansetron)

Nausea/Vomiting

Headache/Diarrhea

Ducolax (Milk of Magnesia

Laxative

Rectal Bleeding

Bisacodyl (Biscolax)

Laxative

Rectal Bleeding

Restoril (Temazapam)

To Help Sleep

Drowsiness/Headache

Benadryl (Diphenhydramine Hydrochloride)

Itching

Drowsiness

Ancef (Cefazolin)

Infections

Anaphylaxis/Diarrhea

Cleocin (Clindamycin)

Infections

Pruritus/Diarrhea

Vancocin (Vancomycin)

Infections

Nausea/Abdominal Pain

Multivitamin

Supplement

Vitamin C (Ascorbic Acid)

Supplement

Feosol (Ferrous Sulfate)

Supplement

Nausea/GI Discomfort

Colace (Docusate Sodium)

Laxative

Rectal Bleeding

Flomax (Tamsulosin)

Urinary Retention

Headache/Dizziness

Lovenox (Enoxaparin)

Anticoagulant (Blood Thinner) Bleeding

Xarelto (Rivaroxaban)

Anticoagulant (Blood Thinner) Bleeding

Coumadin (Warfarin)

Anticoagulant (Blood Thinner) Bleeding

Aspirin (Acetlysalicylic Acid/ASA)

Anticoagulant (Blood Thinner) Headache/Dizziness

Dilaudid (Hydromorphone)

Pain

Sedation/Respiratory Depression

Toradol (Ketorolac)

Pain

Sedation/Respiratory Depression

Norco (Hydrocodone Bitartate/Acetaminophen)

Pain

Sedation/Respiratory Depression

Percocet (Oxycodone/Acetaminophen)

Pain

Sedation/Respiratory Depression

OxyContin (Oxycodone Hydrochloride)

Pain

Headache/Respiratory Depression

Celebrex (Celecoxib)

Pain

Diarrhea/Hypertension