POST OP-SHOULDER SURGERY INSTRUCTIONS

GENERAL

Following your operative procedure, you will be allowed to go home with the assistance of another individual. It is recommended that you have someone stay with you the first 24 to 48 hours after being given an anesthetic. It is normal to have some discomfort and/or pain in the first few days after this procedure. Every one responds to and describes pain differently, but in general the pain medications prescribed should be adequate to control your pain. Severe pain, or pain that is increasing over the course of the first few days, is a reason to contact the office ahead of your scheduled appointment.

 

OTHER REASONS TO CALL

FEVER: Greater than 101.5*F degrees. It is not unusual to have a low-grade fever (101 or less) in the first 24-48 hours after general anesthesia. However, fever that begins after, or lasts longer than 48 hours, is a reason to call.

NAUSEA: It is common in the first few hours after general anesthesia, and your physicians have taken steps to try and reduce the severity and duration. If severe nausea persists, or if it makes you unable to take your oral pain medications, please contact the office. It is recommended to eat a limited diet, with relatively bland food, for the first few days after surgery to reduce the chances of nausea.

SWELLING: It is related to accumulation of arthroscopic fluid in the soft tissues around the shoulder. It generally resolves over the first 24-48 hours. It may lead to saturation of the initial post-operative dressing. This dressing can be changed if needed and replaced with a dry dressing at 48 hours. It is also normal to see bruising down your arm from the effects of the surgical procedure. Fracture surgery and rotator cuff surgeries may have bruising. If you develop a hot, red, or excessively swollen shoulder or arm, or if you experience a feeling of cold or numbness or tingling after 18 hours please contact Dr. Berkman. Progressive swelling should be discussed with the office and may require a visit ahead of your scheduled appointment. For swelling in the hand lay on your back, point fingers to the sky for 1-2 hours.

 

CARE OF DRESSING/SHOWERING

Your shoulder was dressed in the sterile environment in the operating room. The dressing can be removed on the second day. Dressings and coverings are no longer necessary after three days. At this point you can look for any signs of infection ie., (fever, redness, drainage). You may take a shower after three days. The incisions do not need to be covered unless instructed by your doctor. Water may run over the area, but do not attempt to scrub or wash the area vigorously. Pat the area dry after the shower and apply a dry dressing if desired. Avoid creams, salves or ointments unless instructed to do so by your physician. Soaking the incisions in a tub, pool or hot tub is not permitted until instructed by your physician, generally 10-14 days post-operatively. 

 

ICE

During the first 48 hours, ice can be helpful to decrease pain and swelling and is especially important during the first 72 hours. Ice bags/packs should never be applied directly to the skin. They should be wrapped in a towel and applied for 20 minutes at a time. Generally a break of an hour or more between icing is recommended. If the skin becomes very cold or burns, discontinue the ice application immediately.

SLING

Your arm may be placed in a sling for comfort after surgery. IF YOU HAVE HAD A ROTATOR CUFF REPAIR, OR STABILIZATION OF FRACTURE DO NOT DISCONTINUE THE USE OF THE SLING UNTIL DIRECTED BY DR. BERKMAN. You will remain in a sling for approximately 4-6 weeks after rotator cuff repair or a stabilization procedure. You can start wiggling the fingers and moving the wrist (clockwise and counter clock wise) to maintain adequate circulation. Do exercises several times a day to begin elbow and wrist range of motion to prevent stiffness. Remember, however, that it is very easy to “over-do” in the first few days after surgery and any increase in pain or swelling usually indicates that you need to decrease your activities.

PHYSICAL THERAPY

Physical therapy will be discussed at your first post-operative visit. Therapy will be used to begin the recovery process and reduce stiffness. Rotator cuff repairs and Labral procedures will delay the start of physical therapy until approximately 4 weeks.

 

DRIVING AND ACTIVITY

Driving is not recommended until patients are off all narcotic medications. It is recommended that patients not drive until they have weaned from the sling, and have enough strength, mobility and the use of both hands to drive. Please avoid bending, lifting (7-10 lbs.), straining, exercise and air travel for 2 weeks. Most patients, within 2 weeks, can resume all regular activities.

 

MEDICATIONS

Your physician has prescribed a combination of medications in an attempt to make you as comfortable as possible in the post-operative period. No medications can take away all the pain of surgery, but a combination regimen is effective in reducing pain and inflammation.

****DO NOT WAIT FOR THE BLOCK TO WEAR OFF TO START YOUR PAIN MEDICATIONS. IT IS RECOMMENDED THAT YOU START THESE IMMEDIATELY WHEN YOU GET HOME TO AVOID A PERIOD OF SEVERE PAIN****

The following medications will be given to you at your History and Physical visit.This medication can cause stomach upset and should always be taken with food. Please inform your physician of any past ulcer or reflux history as it may alter this prescription. NORCO, is designed for pain control and should only be used as needed. Use the lowest dose possible to control pain. This medication can cause constipation and drowsiness and should best opped as soon as pain allows. If constipation occurs, try eating bran cereal (with 8-10 grams of fiber). If that doesn’t stimulate a bowel movement consider using alaxative (over the counter) such as Colace or Miralax and make sure you drink plenty of fluids. ASPIRIN (must take for 14 days) it serves as a mild blood thinner and may decrease the chance of blood clots forming.  CYCLOBENZAPRINE, is a muscle relaxant, it is used to treat muscle pain, spasms, and stiffness.KEFLEX (this medication is for one day only) and is used to help prevent infection.

 

EMERGENCIES OR CONCERNS

Contact us at 713-486-3550 or go to the nearest emergency room.

  • Pain worsens or does not go away after pain medication is taken.
  • Redness or swelling in your thigh or calf that will not decrease.
  • Difficulties moving your toes or extremities.
  • Develop a fever greater than 101.4 degrees.
  • If you develop chest pain, shortness of breath, loss of consciousness, new onset slurred speech call 911.

Please note that refills on pain medication will not be approved during evenings or on weekends.

 

 

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