Breathing exercises

To reduce the risk of developing a lung infection, practice the techniques below daily before surgery:

Coughing

  1. Sit down and take a deep breath in. (If you have obstructive pulmonary disease, such as emphysema, take a shallow breath in.)
  2. Forcefully cough, covering your mouth with the crook of your arm.
  3. Repeat 10 times daily.

Deep breathing

To keep your lungs clear and stay relaxed, lie down or sit and do the following:

  1. Breathe in through your nose slowly and deeply. If unable to breathe through your nose, inhale through your mouth. (If you have obstructive pulmonary disease, such as emphysema, take a shallow breath in.)
  2. Exhale slowly through pursed lips, similar to blowing out the candles on a birthday cake. Be sure to use proper technique:
    • Don’t hold your breath.
    • Place your hand on your stomach to confirm:
      • Breathe in: Your stomach should move out
      • Breathe out: Your stomach should move in

Once you get into the rhythm of this exercise, close your eyes and visualize a place/scene that relaxes you.

Activities of daily living (ADL)

Tips for getting around

For the next few weeks, you may have to stop and think about how to do certain activities that previously were automatic, like getting into bed or out of a chair. Soon they will become natural again. In the meantime, follow these guidelines to help you during your recovery period:

If using a standard walker (without wheels)

  1. Stand inside the walker.
  2. Grasp the side handles securely with elbows slightly bent.
  3. Move the walker in front of you, advancing it until your arms are straight.
  4. Place all four walker legs firmly on the ground.
  5. Take a small step forward with the more painful or weaker leg.
  6. Step forward with the opposite leg. Do not move your feet past the front of the walker.
  7. Advance the walker and repeat.

If using a rolling walker (with wheels)

  1. Stand inside the walker.
  2. Grasp the handles securely with elbows bent.
  3. Move the walker in front of you and start walking, staying inside of the walker (similar to pushing a shopping cart.)

Do not
Use the walker to pull yourself up to standing position.
Push the walker too far ahead. Try to keep your body upright and avoid leaning forward.

Transitioning to a cane

If using a rolling walker, transitioning to a cane typically happens one to two weeks following surgery. If you are working with a physical therapist, that person will let you know when the time comes and give you direction regarding using a cane. If you are not working directly with a physical therapist, contact your surgeon’s office for direction regarding readiness and guidelines for use.

Stair climbing

Going up stairs with a cane

  1. Hold hand rail in one hand and cane in the other.
  2. Step up with stronger leg to the first step.
  3. Step up with weaker or more painful leg, bringing the cane with you. Both feet and cane will be on the same step.
  4. Repeat.

Going down stairs with a cane

  1. Hold hand rail in one hand and cane in the other.
  2. Step down with the weaker or more painful leg to the first step, bringing the cane with you.
  3. Step down with stronger leg. Both feet and cane will be on the same step.
  4. Repeat.

Getting out of a chair

Chair with arms

  1. Scoot forward to the front edge of the chair.
  2. Place both feet firmly on the floor.
  3. Place both hands on the arms of the chair.
  4. Lean forward slightly and push up from the chair using both hands.

Chair without arms or a sofa

  1. Scoot forward to the front edge of the chair/sofa.
  2. Place both feet firmly on the floor.
  3. Place both hands on the chair.
  4. Lean forward and push up using both arms.

Toileting

Depending on your abilities, a raised toilet seat may make it easier for you to get up and down.

Sitting down on the toilet

  1. Take small steps toward the toilet and turn until your back is to the toilet. Do not pivot.
  2. Back up to the toilet until you feel it touch the back of your legs.
  3. If using a commode with arm rests, reach back for both arm rests and lower yourself onto the toilet.
  4. If using a regular or raised toilet seat without arm rest, keep one hand on a stable surface while reaching back for the toilet seat with the other.

Getting up from the toilet

If using a commode with arm rests, use the arm rests to push up. If using a regular or raised toilet seat without arm rests, place both hands on your thighs and push off your thighs. Balance yourself before you start walking.

Getting into the bathtub using a bath seat

Place the bath seat in the tub facing the faucets.

  1. Walk toward the bathtub and turn until you can feel it touch the back of your legs. Be sure you are in front of the bath seat.
  2. Reach back with one hand to grasp the back rest of the bath seat.
  3. Slowly lower yourself onto the bath seat.
  4. Lift your legs over the edge of the tub, using a leg lifter for your weaker or more painful leg if necessary.

Take care to keep your incision dry until instructed otherwise.

Getting out of the bathtub using a bath seat

  1. Lift your legs over the outside of the tub.
  2. Scoot to the side of the bath seat.
  3. Hold onto the seat with one hand.
  4. Slowly push off the tub seat.
  5. Balance yourself before continuing to move. Using a bath seat, grab bars, long-handled bath brushes and a handheld shower can make bathing easier and safer. Keep in mind, however, these items are not typically covered by insurance.

Getting into bed

  1. Gently lower yourself to a sitting position on the edge of the bed.
  2. Slowly bring your legs up as your torso lowers to the bed on your side.
  3. Keep your knees bent as you gently log roll onto your back.

Getting out of bed

  1. While on your back, slowly bend your knees up.
  2. Reach across your body with your arm to grab for the edge of the bed as your knees come down into a side-lying position on the bed (log rolling).
  3. Gently push yourself up to a sitting position.

Getting into the car

  1. Move the front passenger seat all the way back to allow the most leg room.
  2. Walk toward the car and turn.
  3. Back up to the car until you can feel it touch the back of your legs.
  4. Place your left hand on the dashboard of the car, reaching for the back of the seat with your right hand. Do not hold on to the car door as it may move.
  5. Lower yourself down onto the seat, being careful not to hit your head.
  6. Turn frontward, leaning back as you pivot.
  7. Return car seat to its upright position.
  8. Make sure you use your seat belt. We want you to arrive safely. If your car has fabric seat covers, place a plastic grocery bag on the seat to help you slide once you are seated, and remove bag after seated in the car.

Getting out of the car

Reverse the previous instructions for getting into a car.

Using a reacher or a dressing stick

Putting on pants or underwear

  1. Sit down.
  2. Put your weaker or more painful leg in first.
  3. Use a reacher or dressing stick to guide the waist band over your foot.
  4. Pull your pant leg up over your knees so the pants are within easy reach.
  5. Repeat for your stronger leg.
  6. Once both feet are through your pants, stand up slowly.
  7. Pull your pants up the rest of the way.

Taking off pants or underwear

  1. Back up to the chair or bed where you will be undressing.
  2. Unfasten your pants and let them drop to the floor.
  3. Push your underwear down to your knees.
  4. Reach back for the bed or the chair and sit down gently.
  5. Take your stronger leg out first and then the weaker or more painful leg.

A reacher or dressing stick can help you remove your pants from your foot and pick them up off the floor.

Using a sock aid

  1. Sit down.
  2. Slide the sock onto the sock aid with the toe completely tight at the end.
  3. Hold the cord and drop the sock aid in front of your foot. It is easier to do this if your knee is bent as much as possible.
  4. Slip your foot into the sock aid.
  5. Straighten your knee, point your toe and pull the sock on.
  6. Continue pulling until the sock aid releases. It is better to wear lace or Velcro shoes, or well-fitting slip-ons. Do not wear high-heeled shoes, backless shoes or flip-flops.

Using a long-handled shoehorn

  1. Sit down.
  2. Using a reacher, dressing stick or long-handled shoe horn, place your shoe in front of your foot. It is easier to do this if your knee is bent as much as possible.
  3. Place the shoehorn inside the shoe against the back of the heel, with its curve matching the curve of your shoe.
  4. Place your toes in your shoe.
  5. Step down into your shoe, sliding your heel down the shoehorn.
  6. Pull out the shoehorn.
  7. Repeat with your other foot.

To schedule an appointment with an orthopedic specialist at Main Line Health, call 1.866.CALL.MLH (225.5654) or use our secure online appointment request form.