Latest / The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement / Episode 105: Getting Up After a Fall (What to Check Before You Try to Stand)

Transcript

Episode 105: Getting Up After a Fall (What to Check Before You Try to Stand) · The Total Knee Success Podcast: Your Essential Resource for Navigating Total Knee Replacement

• 0:00
  If someone is with you when you fall, ask them
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  to bring the phone, move anything dangerous out
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  of the way and call for help when needed. Pulling
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  you up by the arms can hurt your shoulders and
• 0:10
  throw the helper off balance. That can leave
• 0:12
  two people on the floor, which helps no one.
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  Are you ready to get back to what you love after
• 0:19
  knee replacement? The Total Knee Success podcast
• 0:22
  is your trusted guide with practical tips, evidence
• 0:26
  based strategies and no fluff. It's not personal
• 0:29
  medical advice, just solid education to help
• 0:32
  you manage pain, regain mobility, and get back
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  to living the life you love. Let's dive in. Welcome
• 0:40
  back to the Total Knee Success podcast. I'm Michelle.
• 0:44
  Marathon was carrying a folded towel from the
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  laundry room when her slipper caught the edge
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  of a rug. She landed on her side between the
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  doorway and the wall. Her first impulse was to
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  get up before anyone found her there. Then she
• 0:57
  realized that she felt unsteady, her wrist hurt,
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  and she could not remember whether her head had
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  touched the wall. Marilyn's story represents
• 1:07
  situations people can face after a fall. Her
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  story will help us look at what comes before
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  trying to stand, especially when you've had a
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  knee replacement and feel uncertain about getting
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  up or moving onto your knees. This is the first
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  episode in a four -part series on falls, balance,
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  and everyday independence. Today we're staying
• 1:27
  with the minutes immediately after a fall. The
• 1:30
  next three episodes will cover balance changes,
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  fall prevention, and the added challenge of carrying
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  everyday items. By the end of this episode, you'll
• 1:39
  know how guidance from the National Institute
• 1:41
  on Aging, or NIA, and the Centers for Disease
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  Control and Prevention in the U .S., CDC, can
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  help you decide what to check, when to call for
• 1:52
  help, and when a floor -rise strategy you practiced
• 1:54
  ahead of time may be appropriate. This episode
• 1:58
  provides general education. Your symptoms and
• 2:01
  the circumstances of your fall, if you do fall
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  and hopefully you do not, determine what kind
• 2:06
  of help you need. Serious symptoms or an unsafe
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  situation require emergency help. The companion
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  article will link directly to the government
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  guidance I'm using today. Marilyn stayed on the
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  floor for a moment and took several slow breaths.
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  That pause was the first good decision she made.
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  NIA guidance begins the same way, remain still
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  briefly, breathe, and decide whether you are
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  hurt before attempting to get up. The guidance
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  was written for older adults in general, so we
• 2:36
  will also consider how a knee replacement may
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  affect your options. Adrenaline can push you
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  toward immediate action, while pain, dizziness,
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  or confusion may take a moment to register. First,
• 2:48
  notice whether you know where you are and what
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  happened. Think about whether you lost consciousness
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  or struck your head. Severe pain, heavy bleeding,
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  an arm or leg that looks out of position, chest
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  pain, shortness of breath, one -sided weakness,
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  trouble speaking, or difficulty staying awake
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  requires emergency help. Persistent dizziness,
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  faintness, or severe pain when you try to move
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  an arm or leg also calls for help. Take the pressure
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  to stand out of the decision. Your first job
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  is to notice what is happening and respond safely.
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  The CDC advises an older adult who falls and
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  hits their head to see a doctor right away. Head
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  injuries can be especially serious for someone
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  taking a blood thinner, and internal bleeding
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  may be present even when the skin looks normal.
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  Treat a possible head impact seriously when you
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  cannot remember the moment. Tell the emergency
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  dispatcher or medical professional that your
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  head may have been involved. Describe your symptoms
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  and share the names of any blood thinners or
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  antiplatelet medicines you take. Marilyn had
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  three pieces of information. Persistent dizziness,
• 3:57
  wrist pain, and uncertainty about a head impact.
• 4:02
  Together, those were enough for her to stay down
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  and call for help. She used Siri to make the
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  call because her iPhone was on the counter. She
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  told the dispatcher that she had fallen, might
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  have hit her head, felt dizzy, and had pain in
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  her wrist. She also mentioned her knee replacement
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  and her medications. Then she followed the dispatcher's
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  instructions. One call spared Marilyn from a
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  series of exhausting attempts to stand and reduced
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  the chance of a second fall. Her dizziness and
• 4:31
  possible head impact made staying down the right
• 4:33
  choice. A quick test beforehand can show whether
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  you could call for help from the floor. Walk
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  through the rooms you use most and notice where
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  your phone usually is. A charged phone in your
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  pocket, a medical alert button, a voice assistant,
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  or a smartwatch can give you a way to reach someone
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  without standing. Common options include Siri
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  on an iPhone, Alexa on an Echo device, and emergency
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  features on a smartwatch. Siri can help place
• 5:02
  an emergency call on compatible Apple devices.
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  By default, Alexa does not call 911, although
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  it can call an emergency contact you have set
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  up. Some Apple watches offer fall detection,
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  which can ask whether you need help after a hard
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  fall and may contact emergency services if you
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  remain unresponsive. Features vary by device,
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  settings, connection, and service plan. Set yours
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  up ahead of time and test it from different rooms
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  while you are safely seated or close to the floor.
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  Spending a long time on the floor can contribute
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  to pressure injuries, dehydration, and other
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  medical complications. A reliable way to reach
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  someone can shorten that wait and give you a
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  safer choice when your symptoms suggest that
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  you should stay down. The dispatcher sent help
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  and Marilyn was evaluated for the possible head
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  impact, dizziness and wrist pain. Once she was
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  home, she tested Siri from the bedroom, bathroom,
• 6:01
  laundry room and kitchen. The other side of the
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  laundry room was the weak spot so she changed
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  where she kept her phone. Her plan now worked
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  in an additional part of the house just beyond
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  where she had actually fallen. The NIA advises
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  asking for help or calling for emergency help
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  when you're hurt or unable to get up. If you
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  need emergency help, call 911 in the United States
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  or Canada, 000 in Australia, 112 in the European
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  Union, or 999 or 112 in the United Kingdom. Emergency
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  numbers can vary outside those regions. so know
• 6:37
  the correct number where you live or travel.
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  If you're alone, move into a comfortable position
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  when you can do so safely and wait for help.
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  A dispatcher can guide the next step based on
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  what you report. Now consider a different situation.
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  You have paused, you remember the fall, you're
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  confident your head stayed away from the floor
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  and furniture, and your assessment finds comfortable
• 7:00
  movement, steady awareness, and none of the urgent
• 7:03
  symptoms we just covered. At that point, getting
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  up may be reasonable, provided the movement fits
• 7:09
  your abilities and your medical guidance. The
• 7:12
  NIA describes a general floor rise sequence.
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  Roll onto your side. Pause while your body adjusts.
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  Move toward hands and knees. Crawl to a sturdy
• 7:22
  chair. Bring one foot forward. Rise slowly and
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  turn to sit. Your hand placement, strength, chair,
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  and comfort with kneeling need to be worked out
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  in person before a fall. After a knee replacement,
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  your ability to use the NIA sequence depends
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  on several things. You need enough comfort on
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  your hands and knees, arm strength, knee bend,
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  balance and control to bring one foot forward
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  and rise beside a chair. Your skin sensitivity,
• 7:48
  other joints and any injury from the fall also
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  affect your options. The chair needs to stay
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  put when you lean on it. A rolling desk chair,
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  lightweight folding chair, towel bar, open cabinet
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  door or furniture that slides can lead to another
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  fall. the closest object may be a poor choice
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  once you've put your weight through it. If you
• 8:08
  want to know whether the NIA sequence works for
• 8:10
  you, ask your physical therapist or another qualified
• 8:13
  professional to help you try it before you ever
• 8:15
  need it. This is especially helpful after knee
• 8:18
  replacement or when kneeling, balance dizziness,
• 8:21
  osteoporosis, or another joint causes concern.
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  Together you can find out which leg works best
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  in front, how your knee handles a padded surface,
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  whether your arms can help, and which chair in
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  your home is actually sturdy enough. After Marilyn's
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  medical team said floor rise practice was appropriate,
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  her physical therapist helped her try the NIA
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  sequence beside a heavy chair. They used padding
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  and took their time. Marilyn learned that placing
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  her stronger leg forward gave her the best control.
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  She also learned that her low decorative chair
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  slid too far too easily to be useful. Marilyn
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  left knowing which movements worked for her and
• 9:00
  where the strategy stopped being safe. She could
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  recognize the difference between a situation
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  that might allow her practiced floor rise and
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  one that called for help. You can learn this
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  strategy in similar pieces. One approach called
• 9:13
  backward chaining begins with the last part near
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  the chair and adds the earlier parts over time.
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  Research suggests that this may help some older
• 9:21
  adults learn to rise from the floor. Having a
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  physical therapist or another qualified professional
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  nearby lets you find out what works for your
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  body in a safer setting. If someone is with you
• 9:32
  when you fall, ask them to bring the phone, move
• 9:35
  anything dangerous out of the way, and call for
• 9:37
  help when needed. Pulling you up by the arms
• 9:40
  can hurt your shoulders and throw the helper
• 9:42
  off balance. That can leave two people on the
• 9:45
  floor, which helps no one. A dispatcher or trained
• 9:48
  responder can guide the next step. Once you're
• 9:51
  seated, take another moment before walking away.
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  Dizziness, pain, swelling, or trouble putting
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  weight on your leg may be easier to notice now.
• 9:59
  Contact your orthopedic or medical team after
• 10:02
  a direct landing on your operated knee or when
• 10:05
  you develop new pain, swelling, limping, or loss
• 10:07
  of function. Tell them how you landed, whether
• 10:10
  your head was involved, and what changed afterward.
• 10:13
  If you fall more than once, caught yourself before
• 10:16
  falling several times, or notice the same situation
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  repeating, tell your medical team. Those details
• 10:22
  can help them decide whether to look more closely
• 10:23
  at your balance, walking, medications, vision,
• 10:27
  blood pressure, footwear, or home hazards. This
• 10:30
  follows the CDC's steady approach. We'll focus
• 10:34
  on balance in episode 106, and we'll talk about
• 10:37
  a larger fall prevention plan in episode 107.
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  Marilyn made three useful changes after her fall.
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  She removed the loose rug. began keeping her
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  phone with her and practiced a floor rise with
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  her physical therapist nearby for safety. She
• 10:52
  also understood that the right response depends
• 10:55
  on the fall. Dizziness and a possible head impact
• 10:58
  still mean help comes first. For more education
• 11:02
  about rebuilding your walking after surgery,
• 11:05
  my book Walking Like Yourself Again After Knee
• 11:07
  Replacement is linked in the show notes. You
• 11:09
  can also join the free Total Knee Success Insider
• 11:12
  Newsletter for new episodes and carefully selected
• 11:15
  knee replacement I have a special request. Think
• 11:19
  of someone who can benefit from this episode
• 11:21
  and share it with them. You might save them a
• 11:24
  lot of trouble. The companion article to this
• 11:28
  episode will include links to the National Institute
• 11:30
  on Aging's post -fall guidance, the CDC's information
• 11:34
  about falls and head injury, and CDC study resources.
• 11:39
  You can read the original government guidance
• 11:41
  and keep it available for yourself or someone
• 11:43
  who helps you. In episode 106, we'll look at
• 11:46
  why balance can still feel altered after knee
• 11:48
  replacement. We'll connect joint position awareness,
• 11:52
  vision, the inner ear, foot and ankle input,
• 11:54
  hip control, reaction time, and fatigue, and
• 11:57
  show why balance involves more than leg strength.
• 12:01
  Thanks for joining me. I'm Michelle, and this
• 12:03
  has been the Total Knee Success Podcast. This
• 12:09
  podcast is for educational purposes only. Discover
• 12:13
  more at TotalMeSuccess .com and be sure to subscribe
• 12:17
  and share because every step forward takes you
• 12:20
  closer to living the life you love.