All About Me
All About Me My name is _______________________________________________ I really like to be called: ______________________________________ My birthday is: _____________________________________________ I am ____ years old. The people I live with are: ____________________________________ My school is: _______________________________________________ I am in the_______ grade. My favorite foods are: ________________________________________ What I do best is: ___________________________________________ My favorite sport to play is: ___________________________________ My favorite games are: _______________________________________ My favorite activity is: _______________________________________ My favorite movie is: ________________________________________ Famous people I like are: _____________________________________ My favorite colors are: _______________________________________ My favorite pets are: _________________________________________ Something I hope to do one day is: ______________________________ Things that make me happy are: ________________________________ Things that I do not like are: ___________________________________ I am a ‘morning’ / ‘night’ person (please circle one). This is my _________ time in the hospital. I am here because: ___________________________________________ What’s really special about me (medical or non‐medical) is: __________________________________________________________ This notebook is all about you and your surgery. Please keep this for reference and bring to your appointments. 1 Before Place photo here After Place photo here 2 Clinic Location (please circle your clinic location) Le Bonheur Children’s Hospital – Orthopaedics Clinic Ground floor 848 Adams Ave. Memphis, TN 38103 (901) 287‐6767 Campbell Clinic Germantown 1400 S. Germantown Road Germantown, TN 38138 (901) 759‐3100 Campbell Clinic Collierville 1458 Poplar Avenue, Suite 100 Collierville, TN 38017 (901) 759‐3100 Campbell Clinic Midtown 1211 Union Avenue, Suite 500 Memphis, TN 38104 (901) 759-3100 Campbell Clinic DeSoto 7545 Airways Boulevard Southaven, MS 38671 (901) 759‐3100 3 Meet Your Doctor Derek Kelly, MD, is an assistant professor at the University of Tennessee‐Campbell Clinic Department of Orthopaedic Surgery and serves as the primary physician for the Clubfoot Clinic at Le Bonheur Children’s. Kelly completed his orthopaedic fellowship at Texas Scottish Rite Hospital for Children in 2008 and is a member of the Pediatric Orthopaedic Society of North America, Scoliosis Research Society and American Academy of Orthopaedic Surgeons. He currently serves as a University of Tennessee’s Surgical Subspecialty Orthopaedic Lecturer. He is a contributor to American Academy of Orthopaedic Surgeons’ Orthopedic Knowledge Update: Foot and Ankle. Jeff Sawyer, MD, is director of the Pediatric Orthopaedic Fellowship program at the University of Tennessee‐Campbell Clinic Department of Surgery, where he also serves as an associate professor. He serves as the American Academy of Orthopaedic Surgeons’ spokesperson for all‐ terrain vehicle safety and sits on the group’s Program Committee. He is also a member of the Vertical Expandable Prosthetic Titanium Rib (VEPTR) Study Group. Sawyer is a former instructor and visiting professor in Enugu, Nigeria, Abu Dhabi, United Arab Emerates and Malawi, Africa. He is also a former recipient of the Pediatric Orthopaedic Society of North America/International Pediatric Orthopaedic Symposium Traveling Fellowship. Sawyer also serves as a contributor to Campbell’s Operative Orthopaedics. David Spence, MD, is certified by the American Board of Orthopedic surgery and has special areas of interest in the role of hip surveillance in children with cerebral palsy and the long‐term outcome of patients with avascular necrosis following slipped capital femoral epiphysis. He completed his pediatric orthopaedic fellowship at Boston Children's Hospital and medical school at the University of Tennessee Health Science Center. William Warner, MD, is a professor in the University of Tennessee‐Campbell Clinic Department of Orthopaedic Surgery. He also serves as division chief of Orthopaedics for St. Jude Children’s Research Hospital and is chief of Orthopaedics for Mississippi Crippled Children’s Services. A former chief of surgery at Le Bonheur Children’s, Warner has also served as president of the Tennessee Orthopaedic Society and as a board member and trauma committee member of the Pediatric Orthopaedic Society of North America. He has served on the organizing committee for the International Pediatric Orthopaedic Symposium and the American Academy of Orthopaedic Surgeons Pediatric Update. He is also a contributor to Campbell’s Operative Orthopaedics. Leslie Rhodes, MSN, PNP‐BC, is a pediatric nurse practitioner in the division of orthopedic surgery. She helps manage inpatient care when doctors are in surgery and participates in all Le Bonheur orthopedic clinics including a weekly nurse practitioner clinic. 4 Understanding Scoliosis What is scoliosis? Scoliosis is different than poor posture. A normal spine, when viewed from behind, appears straight. However, a spine affected by scoliosis appears sideways. This is caused by a rotation of the back bones (vertebrae), giving the appearance that you are leaning to one side. The Scoliosis Research Society defines scoliosis as a curvature of the spine measuring 10 degrees or greater on an x‐ray. Curvature from scoliosis may occur on the right or left side of the spine, or on both sides in different areas. Both the middle and lower spine may be affected by scoliosis as well. 5 What causes scoliosis? In most cases, the cause of scoliosis is unknown. Scoliosis is more common in girls than boys. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, approximately four of every 1,000 children develop spinal curves that are considered large enough to need treatment. The American Academy of Orthopaedic Surgeons, in cooperation with the Scoliosis Research Society, describe three different types of scoliosis that can occur in children including: • Congenital – a type of scoliosis present at birth • Neuromuscular – a type of scoliosis caused by another condition such as spina bifida • Idiopathic – a type of scoliosis with no known cause Adolescent Idiopathic Scoliosis occurs in children from 10 to 18 years of age. This is the most common type of scoliosis and is more commonly seen in girls. What are the signs of scoliosis? The following are the most common signs of scoliosis. However, each person may experience symptoms differently. Signs may include: • difference in shoulder or shoulder blade height • head is not centered with the body • difference in hip height or position • when standing straight, difference in the way your arms hang beside the body • when bending forward, the sides of the back appear different in height 6 How is scoliosis diagnosed? In addition to a complete medical history and physical exam, x‐rays are the primary tool for diagnosing scoliosis. Once it is diagnosed, a doctor or nurse practitioner measures the degree of spinal curvature on the x‐ray. Other diagnostic procedures may include: • magnetic resonance imaging (MRI) ‐ a procedure that uses large magnets, radio frequencies, and a computer to produce detailed images of the vertebrae and spinal cord not able to be seen on x‐ray. • computed tomography scan (also called a CT or CAT scan) ‐ a procedure that uses x‐rays and computer technology to show detailed images of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x‐rays. 7 How is scoliosis treated? Specific treatment of scoliosis will be determined by your doctor or nurse practitioner based on: • your age, overall health, and medical history • the extent of your condition and how it is expected to progress in the future • your tolerance for specific medications, procedures, or therapies • your opinion or preference The goal of treatment is to stop the curve from getting worse. Treatment may include: • observation and repeated exams • bracing • surgery Le Bonheur Children’s Hospital and Campbell Clinic pediatric orthopaedic surgeons specialize in the spine and scoliosis. There are also clinics dedicated to the treatment of scoliosis. These clinics have doctors, nurse practitioners, residents, nurse coordinators, orthotists, and nurses trained to provide quality care, answer your questions, and provide patient and family‐centered care to you and your family. According to the Scoliosis Research Society, there is no scientific evidence to show that other methods for treating scoliosis (i.e., manipulation, electrical stimulation, and corrective exercise) slow down the progression of the disease. Long‐term outlook for a child or young adult with scoliosis The management of scoliosis is different for each child or young adult depending on your age, how curved your spine is, and the amount of time remaining for you to still grow. Scoliosis will require frequent exams by your doctor or nurse practitioner to monitor the curve as you grow and develop. If left untreated, scoliosis can cause problems with your heart and lungs. More information There is a tremendous amount of information available to patients and their families on scoliosis. Learning more about your condition can help you understand how to care for yourself. In the back of this guide is a list of suggested reading on scoliosis. 8 Scoliosis Surgery After meeting with your doctor or nurse practitioner and monitoring the curve of your spine for a while, you may need to have surgery. Scoliosis surgery is recommended when your spine has curved so much that other forms of treatment such as bracing and observation are not effective. You and your family, with the doctor’s help, will make the decision whether or not to have surgery. Once you have decided that surgery is best for you, your doctors and nurse practitioner will work with you to make the experience as easy as possible. Goals of the Surgery The goal of the operation is to stop the curve from getting worse. The operation may also partially straighten the curve (usually up to 50 percent) and decrease the visibility of the rib hump (the part of the back that is higher than the other). After surgery, you may still notice the curve (or the rib hump) on your back. This may improve slightly over the course of several months as the muscles and rib cage readjust. It is important to discuss your goals and expectations with your doctor or nurse practitioner before surgery. 9 About the Surgery Posterior spinal fusion with instrumentation is the most common scoliosis surgery performed today. The doctors and operating room staff at Le Bonheur and Campbell Clinic are specially trained to do this surgery and perform more than 100 of these surgeries each year. It is a major surgery, but most patients recover quickly and do well after surgery. Incision During surgery, a cut is made down the middle of your back. It can be fairly long, from just above your shoulder blades down to your waist. It is a very thin line and heals to about the size of a pen mark. Straightening After the cut is made, two metal rods are inserted into your back. The rods act like an “inside brace” and hold the spine in a straightened position while the bone heals. This also realigns the muscles and they stretch and move to adjust to the new position. Each rod is about as big around as a pencil, about eight to ten inches long, and shaped to match the normal profile of the back. The rods are made of titanium or stainless steel and secured to the spine using screws. Fusion After the rods are placed in your back, pieces of bone called bone graft are placed next to the rods. Spinal fusion is when the bone heals solidly, making all of the vertebrae into one solid piece. Once this occurs, the rods have finished their job. However, because removal of the rods would require you to undergo another major operation, they are usually left in your back unless a problem occurs. Growth The area of your spine that is “fused” will no longer grow and will not be flexible. The other untouched parts of your spine will continue to grow in the areas above and below the fusion and will retain flexibility. Sometimes people worry about losing growth. Actually, straightening your back through surgery may add one half to one inch to your height. 10 L R L R 11 Getting Prepared before Surgery Stay healthy To stay healthy, it is a good idea to stay away from people who might be sick with the flu or colds. You should also eat a well‐balanced and healthy diet. You should take a multivitamin with iron every day. Stay active It is important to stay healthy and active prior to your surgery. Any routine activities can be continued. Eating healthy and getting plenty of rest is important. By taking care of yourself, you give yourself the best chance of a successful surgery. Donate blood You may require extra blood during surgery. You may donate your own blood to use or use blood bank blood. If you choose to use your own, you may donate blood prior to surgery. If this is the case, you should take a multivitamin with iron beginning at least one week prior to the donation and continue until the time of the surgery. Notify school Parents need to inform the school of the upcoming surgery. Your physician will discuss with you how long you will be out of school. Most patients are out of school at least 2 weeks. Avoid certain medication Two weeks prior to surgery, you should not take ibuprofen, aspirin, Aleve® or herbal supplements (i.e., melatonin) in order to prevent potential bleeding problems. You may take acetaminophen (Tylenol®), if needed. Talk to your doctor or nurse practitioner if you have any questions about the medication you are taking. Maintain skin health Sunburn and insect bites can be uncomfortable any time, but especially uncomfortable when recovering from surgery. Please try to avoid these before your operation by using sunscreen and insect repellent. Arrange for accommodations If you live out of town, talk to the spine center coordinator about arranging a stay at the FedExFamilyHouse after your surgery date is scheduled. The FedExFamilyHouse is located 12 across the street from Le Bonheur Children’s Hospital and provides families a place to stay at no cost while their child is recovering. Pack for your visit You should bring loose fitting clothes to the hospital (which button down the front), slippers, and a bathrobe. Bring any special comfort items or electronics that you enjoy. Le Bonheur also has a child life department that will help you cope with your hospitalization. The child life specialist on your floor can provide for your psychosocial needs and can help with pain management. For more information on what to bring or how to prepare, please go to www.lebonheur.org and click on Your Visit. Prepare emotionally Going to the hospital can be a stressful experience for the entire family. You may understand the reason for hospitalization but may still be nervous. It is important to understand that it is okay to be nervous. Talk about your fears with family and staff. This will help validate your feelings and clear up misconceptions. Always feel free to write down questions and ask your doctor or nurse. You may also talk to a child life specialist who can offer information about what to expect. Surgery can be a stressful experience for parents, too. We encourage parents to take a break by taking turns staying at the hospital or having a trusted neighbor or friend fill in at times. It is important that parents get adequate sleep and take care of themselves in order to be helpful. Don’t be afraid to ask for any assistance that the staff may provide. If you would like resources on how to prepare for surgery, visit www.lebonheur.org and click on Your Visit. Day Before Surgery/Pre‐Operative Screening You will spend the day before surgery at Le Bonheur. You will start the day on the 2nd floor in the Same Day Surgery area. You will visit several areas of the hospital and the process can take most of the day. You will meet the pre‐screening nurse, and he or she will give you paperwork and talk to you about the day of surgery. The anesthesia nurse practitioner will also meet with you to answer any questions you may have about being sedated for the surgery. 13 You will go to the lab to have blood drawn to make sure it is safe for you to have surgery the next day. You will also need to leave a urine sample. If X‐rays are needed, they will be taken in Radiology. These tests are all used to make sure you a healthy enough for surgery. Day of Surgery Getting ready On the morning of your surgery, you will check in at the Surgery Check‐In Desk on the 2nd floor of Le Bonheur. Girls may want to wear pigtail braids to keep hair up (it’s hard to lie on a single ponytail in the back.) After you are called back to the surgery preparation area, you will meet several members of your care team including: • • Same day surgery nurse who will go over final information with you about your surgery Anesthesia nurse practitioner or anesthesiologist who will meet with you to make sure you are ready to go to sleep and give you some medicine to relax • Orthopaedic surgeon who will talk to you about the details of your surgery and answer questions • Resident or nurse practitioner who will answer questions • Operating room nurse who will verify details about your surgery • Child life specialist will meet with you and talk about any fears or concerns you might have • EEG technician who will place leads on your body to monitor stress on the spinal cord during surgery (the glue used to attach the leads is very sticky and can be hard to remove from your hair) You may hear the same information and answer the same questions more than once. This is to double check everything and make sure everyone on your team has the correct information about you and your surgery. Visiting Bunny Lane You will visit Bunny Lane to pick out a prize after surgery. Many patients choose video games or stuffed animals. Waiting At this time, families may wait in the 6th floor waiting room (Intermediate Care Unit), the 9th floor family room (Orthopaedics floor) or the waiting area on the 2nd floor. Surgery will take about four to six hours and the nurses will notify your family every hour or so about how things are going. 14 After Surgery Your room After your surgery is over, you will go to the Pediatric Intensive Care Unit on the 5th floor or the Intermediate Care Unit on the 6th floor. Once there, you will do things like turn side to side and eat ice and popsicles. The next day, you will be transferred to the 9th floor for the rest of the hospital stay. You will be in the hospital four to five days before going home. Your friends and extended family can visit you while you are in the hospital. What you will do While you are in the hospital, you will focus on feeling better and getting up and moving around. When nurses and doctors say it’s okay, you can eat, sit in a chair and walk. Please refer to your surgery plan in the back of this notebook for details on what will happen each day in the hospital. It is common for girls to start their menstrual period sometime during hospitalization (even if they have just finished one) due to the stress on the body from surgery. Periods usually return to normal within a few months. You may want to bring sanitary pads with you, tampons are not allowed after surgery. Pain Control After a major surgery, you will have some pain. It is important to work with your doctors and nurses to manage your pain and keep it under control. You will have a pain pump when you come out of the operating room and doctors and nurses can adjust both the type of medication and the dose to manage pain. You can work with your doctors and nurses before and after surgery so that you don’t have a lot of pain. We also have child life specialists who are experts in distraction methods to also manage your pain. We know that healing requires much more than just medicine. Each day we broadcast activities for our patients and their families on Channel 8, Le Bonheur’s own closed circuit TV channel. If you have good pain control, then you: Are more comfortable Get well faster Might go home earlier 15 Going Home After a few days in the hospital, you will feel well enough to go home. It’s normal to go home even before eating and bowel movements have returned to normal. Once you are home, you will feel better and be able to heal better in your own environment. When your doctor says it is okay to go home from the hospital, you will need to have an adult help you for about the first two weeks. It usually takes about six weeks before you feel like yourself. Try not to get discouraged if you do not feel very energetic. Gradually increasing your activities will help you feel better. Care of surgery site • • • • • Keep your bandage clean and dry. All of the stitches are under your skin. They dissolve on their own so they do not need to be removed. Small white strips of tape will also help hold the skin closed. Sponge bathe for the first few days, but do not use soap, oil or lotion on the scar until the doctor says it is okay. After you’ve been home for three days, you may remove the bandages and shower. Do not remove the white tape strips. They will fall off on their own over time. Avoid taking a bath or swimming until your doctor tells you it’s okay. For the first year, always put sun block on your scar when out in the sun. This is very important so that your scar does not darken. Activities Your doctor or nurse will review activities you can participate in. Some activities you will be allowed to do after you get home and before your follow up visit include: Walking (inside if the weather is bad) Hair combing, brushing teeth, etc. Climbing stairs Riding in a car (if it is necessary to take a long car trip, stop about every two hours to stretch) Some people are more comfortable standing or lying down rather than sitting. You should avoid: Bending over Twisting Lifting more than five pounds 16 Medication It may be necessary to take a prescription pain medicine for a few days after getting home. It is important to take the medicine as instructed to keep the pain manageable. Pain medicine can cause constipation, so be sure to drink plenty of fluids, eat fiber, and continue to use the stool softener given to you in the hospital. You may also use a mild laxative (such as miralax) or glycerin suppository if needed. Pain medication may also make your skin itch, but that will go away as you stop the medicine. School Most people are ready to go back to school after two or more weeks. Some prefer to start by going back for half days, or take time to lie down for a few minutes every couple of hours. Since there is a weight lifting restriction, you may be given a note requesting an extra set of books for home so all that you carry is a notebook. You will not be permitted to return to gym or physical education (P.E.) until cleared by your doctor. Additional Concerns If you ever need to have surgery or dental work done, be sure to tell your doctor or dentist that you have an implant in your back or that you’ve recently had surgery. Sometimes antibiotics will be prescribed to avoid infection from an additional procedure. Occasionally, some problems may occur regarding your incision site. If they do, call the doctor’s office and ask to speak with the nurse. Notify the nurse if any of the following occur: The scar is red, swollen, tender, or opening The scar has puss‐like drainage or a bad odor You experience pain, numbness, or tingling in the arms or legs that was not there before you went home You experience a fever develops of 101° or higher without any other apparent reason (i.e. cold, virus, etc.) 17 At Home These are guidelines for activities at home. Do not begin activity until given permission from your doctor. Ask your doctor before taking ibuprofen. Also, be sure to tell your doctor or dentist that you have a spinal implant prior to having any procedures such as teeth cleaning or surgery so antibiotics can be prescribed if needed. At Home Take a shower 3 days after discharge Remove dressings before showering Do not remove white tape strips; allow them to fall off Walk every day Eat well; get lots of rest Take pain medicine as prescribed Visit with friends Do schoolwork Return for follow‐up on ___________________ Activities allowed Walking Riding in a car Climbing stairs Lifting up to 5 pounds Activities NOT allowed No bending, twisting No driving No house work No sports or P.E. activities 6‐8 Weeks After Surgery Lifting up to 10 pounds Gentle bicycling Play lightweight musical instrument Light household chores Gentle swimming: no jumping, diving, or competitive swimming __________________________ __________________________ 3‐4 Months After Surgery Throw ball Shoot baskets Dance Vacuum Mow lawn Jog 6 Months After Surgery Tennis Soccer Golf Roller blade Drill team Cheerleading (no pyramids or tumbling) Limited amusement rides _______________________ 1 Year After Surgery Almost all activities, but check with your doctor 2 Years After Surgery Unlimited ‐ except below Important Restrictions Never football or gymnastics 18 Nutrition for Wound Healing Nutrition is very important for wound healing. Your child cannot heal properly if he or she is not eating the right foods. Your child’s body will need a lot of protein to heal. Make sure your child eats plenty of the following high‐protein foods: • • • • • • • • • • • • • Turkey Chicken Beef Fish Shrimp Tuna Eggs • • • • • • Cheese Yogurt Sausage Ham Meatloaf Macaroni & cheese Beans Peanut Butter Hamburger Cheeseburger Pizza Spaghetti with meatballs • Sandwiches: • Turkey • Roast Beef • Ham • Chicken breast • Grilled cheese • Tuna salad • Chicken salad What your child drinks is also very important. Your child should only be drinking milk (any flavor) or a nutritional supplement. Some supplements offered in the hospital include: Boost Kid Essentials, Boost, Resource Breeze, Gatorade Recover (contains protein), and Boost Pudding. Your child should NOT eat or drink anything listed below. The following items do NOT contain much protein and will NOT help your child’s wounds heal: • • • • • • • Juice Soda Sports Drinks o Gatorade o PowerAde Tea Lemonade Kool‐aid Fruit drinks • • • • • • • • Candy Potato chips Snack cakes Cookies Pretzels Popcorn Popsicles Pop‐Tarts • • • • • • • Brownies Doughnuts Pastries Cupcakes Fruit snacks Jell‐O Sherbet 19 Your Scoliosis Surgery Plan Before Surgery Spine Center Visit Talk to your doctor or orthopedic nurse practitioner Talk to your nurse Go to X‐ray if not already completed Fill out pre‐surgery paperwork Receive blood donation forms Talk to dietitian, social work, child life, physical therapy At Home Talk to your child’s school Talk to a support person Eat healthy foods Get exercise and plenty of sleep Take multivitamin with iron Two weeks before surgery Stop taking aspirin and ibuprofen Stop taking herbal medicines or supplements Stay away from sick people Avoid insect bites and sunburn Surgery Day Do not eat or drink Wake up early, get ready for surgery Check in at the Surgery Check‐In Desk on the 2nd floor See anesthesia team Meet surgery team Get electrodes hooked up for monitors Go to surgery and Bunny Lane Wake up in the Pediatric Intensive Care Unit or Intermediate Care Unit In ICU or IMCU Turn side to side Do breathing exercises Have vital signs checked often Report pain level to nurse Eat ice, popsicles, chew gum After Surgery Day Post‐Surgery Day 1 Transfer to 9th floor Eat ice, popsicles, chew gum Have lab test Do breathing exercises Have family help with a sponge bath Drink clear liquids once approved Sit up in bed and in chair Turn side to side Post‐Surgery Day 2 Do breathing exercises Have family help with a sponge bath Get rid of some tubes Drink full liquids and eat food once approved Sit up in chair 3 times Walk to bathroom Turn side to side Post‐Surgery Day 3 Do breathing exercises Have family help with a sponge bath Eat solid food as tolerated Sit up in chair Walk in the halls with help Participate in child life activities Post‐Surgery Day 4 Bathe yourself Wear regular clothes Have your bandage changed Walk in the halls with help Go to child life activities Wash your hair Learn about activities at home Prepare to go home 20 Selected Reading General Pediatric Conditions Pediatric Orthopaedic Society of North America http://www.posna.org/web/resources/patient.cfm American Academy of Orthopaedic Surgeons http://orthoinfo.aaos.org/menus/children.cfm Wheeless Textbook of Orthopaedics (Online textbook from Duke University) https://www.wheelessonline.com Campbell Clinic Website http://www.campbellclinic.com/pediatric‐spine Spinal Conditions (Scoliosis, Kyphosis, Spondylolysis, Spondylolithesis, Back Pain) Scoliosis Research Society http://www.srs.org/patients IScoliosis‐ commercial website dedicated to spinal care for children http://iscoliosis.com Spine Universe‐ commercial website dedicated to spinal care http://www.spineuniverse.com/displayarticle.php/article2799.html Scoliosis surgery Neuwirth, Michael, MD. The Scoliosis Sourcebook, 2nd edition. New York: McGraw Hill, 2001. Schommer, Nancy. Stopping Scoliosis: The Complete guide to Diagnosis and Treatment, 2nd edition. New York: Avery Penguin Putnam, 2002. For teens Deenie by Judy Blume http://www.curvygirlsscoliosis.com/ 21 Commonly Used Terminology Medical Terms CT/CAT Scan – Computed Tomography – Takes images that cannot be seen on a standard X‐ray. Multiple images are taken and compiled by a computer to create complete pictures of soft tissue, bone, and blood vessels. MRI – Magnetic Resonance Imaging – Takes images using a strong magnetic field to create computerized pictures inside your body. Chest Wall – The total system of structures outside the lungs that move as part of breathing; it includes the rib cage, diaphragm, abdominal wall, and abdominal contents. Rib Hump or Rib Prominence – When the spine curves abnormally and your back bones are forced to rotate. The spine’s curve and the displaced ribs become visibly noticeable. Tubes (often called Lines) I.V. – Intravenous line used to give pain medicine, antibiotics, and fluids. An IV is usually attached to a bag of fluids next to your hospital bed. Arterial Line – This line is used to measure blood pressure inside the arteries and can be used to draw blood samples. You can see the results from this line on your monitor. Foley Catheter – This is a tube that collects urine directly from your bladder into a bag hanging from the bedside. Doctors measure the urine volume to see how well your kidneys are working. Wound Drain – This drain is placed at the base of the incision. These flexible tubes drain air, blood, and fluid away from the surgery site and out of your body. Doctors and nurses will check the drains and record what is coming out several times a day. Monitors A computer screen above your bed may display the following information: Heart Rate – measures heart beats per minute. Respiration Rate – number of breaths per minute. Oxygen Saturation – measures the amount of oxygen in the blood. Blood Pressure Cuff – set on a timer to automatically check and record your blood pressure. Arterial Line Pressure – measures blood pressure and heart function 22 Notes: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ 23 24
© Copyright 2024