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div class="bodycopy"> strong>blood draw/strong>: A blood drawing technician will draw your blood at 6 AM (will test for your red blood cell levelbr/>
- hematocrit - and possibly chemitry level). Ask your nurse about your hematocrit (should be above 30 and ifbr/>
the hematocrit is below 26 we may recommend a transfusion)br/>
On day three, a platlet level will also be measured as low platlets counts can occur as a side effect of Lovenox (blood thinner).br/>
Don't be afraid to ask the nurse about this. Usually after day 4, blood draws are no longer necesssary. br/>
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strong>vitals and monitoring: /strong>The nurse or aid will measure your vitals (temperature, pulse, blood pressure, andbr/>
respirations, as well as noting the oxygen saturation rate). It is normal to have an elevated temperature forbr/>
2-3 days after surgery. Temperatures after day 3, may represent a problem. It is unusual to require supplementalbr/>
oxygen at this point.br/>
br/>
strong>bath:/strong> Usually the patient can perform bathing activities.br/>
strong> diet: S/strong>hould be normal at this point. You should be out of bed for each meal.br/>
br/>
strong> tubes: /strong>All tubes should be removed at this point.br/>
br/>
strong>physical therapy:/strong> The physical therapy service will pick up where they left off on day three. Most patients are navigating downbr/>
the hallway with assistance and are starting to walk on stairs.br/>
strong>CPM /strong> The therapists will show you how to increase the range of motion about 10-20 deg a day. On day 4, you should get the COMbr/>
up above 110 deg. When in bed, the patient should keep the CPM for at least 50% of the time. If the machine helps you sleep, feelbr/>
free to keep this running during the night.br/>
br/>
strong>blood clots: /strong> The nurse will give you a shot in the abdominal fat to prevent blood clots (Lovenox). Ask her to teach you how tobr/>
give these shots as they are often given for a week or two at home. Rember to ask the nurse about the platlet count as this can dropbr/>
with Lovenox shots. You are encouraged to move your feet back and forth for two minutes every 30 min (2 min during each TVbr/>
commercial). This will also help prevent blood clots.br/>
br/>
strong>hospitalist:/strong> The hospitalist will continue to see you on a daily basis. He may change around some of your home medications.br/>
br/>
strong>wound dressing: /strong>Typically, the wound dressing is left alone for several days unless there is bleeding.br/>
br/>
strong>bowel movement:/strong> If you have not had a bowel movement, then you will be given 1 tsb of milk of magnesia (MOM) every 6 hoursbr/>
until there is a BM. If the MOM is not successful, then we will recommend a fleets enema.br/>
br/>
strong>discharge planning: /strong>You need to start thinking about how you will function at home. The discharge planner will introduce herselfbr/>
and will help you think through the transition to getting back home. In most cases, patients will go straight home rather than going to br/>
a rehabilitation center. Before the patient goes home, a home physical therapy consult should be initiated. You may need special br/>
occupational therapy items such "pick up sticks and shoe horns", elevated commodes, hospital bed, and home nurses aid and therapy. br/>
Typically you will go home with a CPM. br/>
strong>blood clots:/strong> You must decide on a plan for preventing blood clots. Most patients elect for a few weeks of subcutaneous Lovenox.br/>
strong>first postoperative visit:/strong> Before you are discharged you should be given an appointment for to see your surgeon within 3-5 days.br/>
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/div>br/>hr/>br/>br/>br/>Last updated by Clifford R. Wheeless, III, MD on Saturday, March 1, 2008 7:41 pmbr/>
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