Lean at home, after my husband’s surgery

Post date: May 01, 2019 by Erica Lorie

Before becoming a lean healthcare consultant, I worked for many years as licensed physical therapist in the inpatient setting, specializing in post-operative recovery for patients following orthopedic surgeries and those who had suffered strokes and spinal cord injuries. Specifically, for my patients who had orthopedic surgeries, I assumed they were just fine to do their exercise program as prescribed. I advised them to stay ahead of their pain by keeping on a consistent pain medication regimen, to ice frequently, and to do their exercises two to three times a day. I never thought deeply about what happened after they went home from the hospital. Following protocols sounded simple to me, so I assumed that it would be for them as well; after all, the patients I treated were otherwise healthy overall and cognitively intact.

That was until my husband had a total hip replacement at the age of 49—and then my outlook on at-home recovery completely changed. At first, things were going great: Following his successful surgery, he was up out of bed after just a few hours and home within 24. It was amazing. And then reality set in. As the spinal tap and anesthesia wore off, his soreness quickly worsened. The medication he needed to manage his pain left him feeling nauseated, groggy, and tired. On the second night home, he woke me up in the middle of the night. He was in a lot of pain, needed help to get up to get water and an ice pack, and could not remember when he last took his pain medication.

I saw how hard it was for him, and it hit me that his recovery was not going to be as easy as we both thought, despite having me as his personal physical therapist. My lean practitioner instincts kicked in—and what I saw, even more clearly, was how valuable simple lean tools would be in helping him manage his recovery.

External set up was essential. Before leaving for work in the morning, I set up the different rooms of the house for him. In the bedroom, I made sure he had a “reacher” next to the bed so he could get what he needed. I also put a backpack next to the bed so he could carry what he needed from one room to the next. In the kitchen, there was water in a bottle with a strap so he could carry it while using his crutches. There were meals in small/light containers on the top shelf of the refrigerator so he could easily lift them and slide them along the counters. Close to his sitting area in the living room were the TV remote, crackers, dried fruit, and the phone. Before getting into bed, we ensured that he had two bottles of water, a fresh ice pack, and all his medications set up close at hand on his nightstand.

The scariest part for my husband was not remembering what he took for pain medications—so visual management and daily metrics to the rescue. We set up a dry erase board calendar where he could write what he was supposed to take each day and then mark off what he took, when he took it:


As he started to progress, I came home one day and, much to my delight, saw the strategy had carried over to him tracking his exercise program:


These changes took hold, and new habits formed. After years of unsuccessfully reminding my kids to stow their shoes and put their backpacks away, suddenly the fear of daddy (with his new hip) tripping on their belongings motivated them to use the shoe rack. And the backpacks were finally on the shelf instead of on the floor. Everything having a dedicated spot and always knowing where things were turned out to be a great help for the entire family.

In the time since, my husband, thankfully, has fully recovered. He has a new hip, and our family has newfound appreciation for lean practices that we still have in place to keep our household a little more efficient and safe.