These instructions are for open procedures (not arthroscopic), like total shoulder replacement, elbow surgery, open knee surgery, etc.
What to Expect After Surgery?
You may feel groggy, sleepy, have some discomfort and potentially be nauseous. You will need someone to drive you home from surgery and be with you for at least the first 24 hours following surgery. Please plan for this prior to your day of surgery.
Surgical Details
It is common to not remember much that happens following surgery due to the anesthesia. Thus, Dr. Takenishi will not explain surgical details with you the same day of surgery but he will talk to the person taking you home from surgery. Dr. Takenishi will go over the full details of your surgery at your post-operative visit.
Follow up Appointment
You should have scheduled a follow up appointment within 10-14 days following surgery. If you do not have any appointment, please call our office at 916-732-3005 to schedule your post-operative appointment.
What to Eat and Drink after Surgery?
After undergoing surgery, it is common to feel nauseous due to the anesthesia. Please start by eating plain foods (saltines, toast, etc) and drinking clear liquids. As you feel more normal throughout the day, you can increase the amount of food. We recommend avoiding dairy products within the first day or two after surgery because it may make you more nauseous and cause vomiting. Please remember to stay hydrated with water and clear liquids.
Bandages and Incisions
Please keep your splint on at all times. Do not get your splint and dressings wet.
Aftercare
Icing is very important for the first 5-7 days after surgery. You should ice as much as possible in the first few days following surgery. The splint is thick and may take some time for the ice to penetrate. Do not get the splint wet.
Swelling of your entire extremity is common after arthroscopic surgery. Elevating your extremity and using ice are important to minimize swelling, especially in the first 72 hours after surgery.
Numbness is common and expected over the surgery site and even within the entire extremity following surgery.
Bruising is common following surgery and you should not be alarmed. This can extend down the entire extremity due to gravity causing the blood to travel down the arm and fingers. The bruising can last for several weeks but will improve over time.
Weight Bearing, braces and slings
Do not lift/push/pull anything with the operative arm.
Keep the sling on and have your hand up as high as possible to help with the swelling.
You can remove the sling and prop your arm/splint up on pillows.
Start moving your fingers/wrist immediately.
Sleeping
Sleeping is often difficult within the first week of surgery due to the discomfort from the procedure and wearing a sling/brace. Please remember to wear your sling/brace while sleeping unless otherwise directed by Dr. Takenishi. This is to protect healing of the surgical site while you sleep and to avoid injury to the repair site while you are asleep. While wearing a sling, you may find it easier to sleep in a recliner or sleeping upright and supported by several pillows. If you have a knee brace on, please sleep with the brace and keep your leg elevated on pillows at night time. We do not recommend using sleep medications as they can have combined effects with narcotics affecting your ability to breathe.
Driving
We do not recommend driving after surgery until you can safely control your vehicle and you must be off all narcotics medications. You should not drive if you had surgery on the right leg as this affects your ability to accelerate/brake. If you had shoulder surgery and are in a sling, we do not recommend driving for at least 6-8 weeks. You should be out of your sling by the time you start to drive and be able to follow the DMV guidelines on holding the steering wheel.
Medications
Narcotic/Opioid: You were most likely prescribed a narcotic medication (ie. Norco, Percocet, etc). It is easier to manage your pain as it develops rather than attempting to “catch up” when the pain becomes severe.
The medications are typically prescribed 1-2 pills every 4-6 hours as needed for pain. For significant pain, take 2 pills every 4 hours in the first two days after surgery. After 2 days, your pain should improve and you should decrease the use and frequency of the narcotic. It is recommended to stop all narcotics as soon as your pain has improved. Prolonged use of narcotics can cause dependency, constipation, difficulty breathing, altered mental status and increased risk of falls. Do not drink alcohol or drive while taking narcotic medication.
Anti-inflammatory: As long as you do not have a contraindication (kidney problems, stomach ulcers, etc) you should be taking this medication along with the narcotic pain medication to help with your swelling and discomfort. Start this medication the same day of surgery and be sure to take it with food. You can take Naprosyn/Naproxen (Aleve) 500 mg two a day or Ibuprofen (Motrin) 800 mg three times a day. Only take one of these types of medications and always take it with food.
Blood Clot Medication: You may restart your blood thinner medications the next day after surgery. You may also be recommended to take aspirin 81 mg once a day depending on your procedure. Dr. Takenishi will provide this information on your discharge instruction sheet.
Nausea: The anesthesia medications used during surgery may cause nausea. Narcotics/opioids can also cause nausea. This is most commonly encountered within the first 24-48 hours following surgery. If encountered, please drink clear liquids to stay hydrated (water, Gatorade, 7-up, etc). If nausea is severe, you can take Zofran 4-8 mg every 8 hours. If you were not prescribed this medication and have significant nausea, please contact the clinic for a prescription. If nausea and vomiting become so severe that the patient shows signs of dehydration (lack of urination), please go to the local emergency room/urgent care.
Constipation: Narcotics/opioids can cause constipation. You should take Colace 100 mg twice a day while taking the narcotics. If you have not had a bowel movement in 2 days after surgery, you can try over the counter medication like milk of magnesia or magnesium citrate. These can be purchases at any pharmacy, grocery store or Target. If you still have not had a bowel movement after trying these remedies, please contact your primary care physician and notify our clinic.
Other Medications: You should resume all your normal home medications that you routinely take unless specified by Dr. Takenishi.
Questions or Concerns
You can also contact our office directly by using the Klara texting application. You can respond to the text messages sent by our office or your can initiate a new conversation by clicking on the purple “MESSAGE US” at the bottom of my webpage. www.sacorthosports.com
Greg Takenishi, MD
Sacramento Orthopedic Sports & Shoulder
Sacramento River Cats Head Team physician
San Francisco Giants Team physician
www.sacorthosports.com