Helpful Tips for Post-Operative Elbow, Hand and Shoulder Surgery

28 May 2015 Joel Goode , , , , , , ,

You have just had hand surgery, elbow surgery, or shoulder surgery. These are some helpful hints and frequently asked questions that may help with your recovery and manage your pain.* By staying ahead of your pain and swelling, you do not have to catch up. Remember, an ounce of prevention is worth a pound of cure!

Pain Management

  • Begin taking prescription pain medication given to you the same day of your surgery, BEFORE you go to bed. If you have received a nerve block, there is a good chance you will still be comfortable before you go to bed. However, the block will eventually wear off. Take your pain medication before the block wears off/before you go to bed.
  • The pain can be more manageable if you stay ahead of your pain, and not chase your pain.
  • Itching is a side effect that is quite common to experience after using narcotic pain medication. If you are itching, try over-the-counter Benadryl as directed. This may help to alleviate the itching.
  • However, if you are having difficulty breathing, swelling of the lips, face and/or throat, or a new rash, this may indicate a serious allergic reaction. You should stop taking the medication and alert your doctor or seek prompt medication attention.
  • As for use of anti-inflammatory medication, such as ibuprofen, Aleve, Motrin, etc., after surgery, this depends on your physician preference. Please check on your discharge instructions or ask your physician before or at the time of your surgery.

Nausea/Constipation

  • It is also not uncommon to experience nausea, constipation and sometimes drowsiness with narcotic pain medications.
  • Nausea is a common side effect either from the anesthetic or from the pain medication prescription itself. Make sure you take the medication with food to help prevent nausea.
  • The medication can also slow down your gastrointestinal tract and lead to constipation. If you experience constipation, try eating foods with high fiber, prune juice, and/or over the counter stool softeners (Check with your local pharmacists about stool softeners, if you have any questions).
  • If these are happening, cut back on the amount of pain medication you are taking or stop taking the medication. Contact your physician.
  • Do not drive while you are taking pain medications. They may enable your full capacity. Do not drink alcohol, use illicit drugs, drive or make any important decisions while taking pain medication.

Swelling Control

  • Swelling is one of the things that contribute to your post-operative pain.
  • After your surgery, keep your hand elevated, unless specified not too.
  • If you have had shoulder surgery, elevation of your hand may be difficult. In this case, getting a squeeze ball and making a fist repetitively can help to pump the swelling away from your hand.
  • Elevate your hand above the level of your heart, especially 3-5 days after surgery.
  • Below are some photos showing correct ways to elevate your hand.
  • Ice is an excellent anti-inflammatory and helps control pain and swelling. Apply ice to the surgical site as tolerable (unless specified otherwise). If the discharge information specifies not to ice, then please do not do so. This may be the case in some situations.

Positions to elevate your hand following surgery:

Exercises/Therapy

  • If you have had surgery on your shoulder and/or wrist/hand, it is important to start exercises the day of surgery by making a full fist and straightening your fingers. However, if your surgery was to repair a broken finger, or specified otherwise, follow specific instructions given to you.
  • You may be referred to a formal therapist at your follow-up appointment or subsequent appointments. Therapy is determined by your health care provider and individualized for your specific case.

Dressing/Cast and Sling

  • Do NOT remove your dressing, unless you are told to do so. This will be removed and/or changed at your first post-operative visit. Keep bandage clean and dry.
  • Do NOT get your dressing wet. Protect it with a plastic bag when you shower.
  • If your dressing is too tight, you may loosen the ace/bandage, and split the dressing down on one side; however, do NOT remove the entire dressing/splint.
  • If you are placed in a sling for a shoulder surgery, keep arm in the sling (as pictured below). Do not actively move the operative shoulder, unless told otherwise. You may gently move your hand, wrist and elbow.
  • Seeing blood on or through your bandage occurs and should not be worrisome unless excessive and expanding. You can try to apply some pressure to the area or reinforce the dressing to prevent further bleeding. If excessive and does not stop, call your physician or seek medical attention.
  • If you dressing is off, and while your incision is healing, please refrain from applying any antibiotic cream or ointment to the incision area. Keep clean and dry. Regular antimicrobial soap and water while washing is preferred.

Correct placement of arm sling following shoulder surgery:

Long-Term Management and Expectations

  • After a traumatic injury and/or elective surgery, it is common to experience swelling for several months. Typically, the process will gradually improve over the next 12 months! Try not to get discouraged, because the swelling will most likely improve with time.
  • As time progresses after surgery, the amount of activity will be determined by your physician/health care provider.

*There are many surgeries that are performed on the upper extremity (including surgeries for rotator cuff tear, carpal tunnel syndrome, and trigger finger) with many different post-operative instructions. The information above may not always pertain to you if you were told otherwise on your discharge paperwork and/or by your physician.

Written by Joel R. Goode, MD and Lauren King, PA-C, with contributions by Liz Cakmarstitt, MA

Post-Operative Foot & Ankle Helpful Hints

28 May 2015 Doctors, Eric Anctil , , ,

You just had surgery on either your foot or ankle, or possibly both. These are some helpful hints from Tucson Orthopaedic Institute’s foot doctors to best manage your pain, swelling and discomfort after the procedure. Any procedure is a big procedure, so please do all that you can to take the best care of yourself after the surgery to ensure the best possible outcome.

1. Pain Management

  • Begin taking prescription pain medications given to you the same day of your surgery, BEFORE you go to bed.
  • If you had a nerve block performed, there is a good chance that you will feel fine before going to bed. However, there is also a good chance the nerve block will wear off while sleeping, so start taking the prescription medications before you go to bed.
  • The pain will be better controlled if you start to treat it (i.e. taking prescription medications) before it begins, instead of trying to manage the pain after it has started.

2. Swelling Management

  • Swelling after surgery can significantly contribute to post-operative pain, especially with foot and ankle surgery.
  • By elevating the foot and ankle as often as you can for the first several weeks after surgery, the swelling can be greatly reduced, and the painful symptoms can be improved, significantly.
  • When elevating, elevate the affected foot and ankle above the level of the hip:

 

Ideal (foot/ankle higher than hip)

Not Okay (foot/ankle level with hip)   Not Okay (foot/ankle lower than hip)

3. Ice/Ice Packs/Etc.

  • Ice is also a good adjunct to help with pain and swelling.
  • If the discharge information you received from the surgery center mentions it is okay for you to ice the area of your surgery, then do so for 15 minutes every 1 to 2 hours. Frozen bags of vegetables also work well for this.
  • If the discharge information does not say it is okay for you to ice, then please do not do so. This may be the case if you had surgery on your toes. In this case, only keep your foot elevated as mentioned above, and avoid placing any ice/ice packs/etc. onto the area.

4. Nausea

  • You may have also been given a prescription medication for nausea (i.e. phenergan 12.5 mg)
  • Nausea is common after surgery. Nausea can also occur with the prescription pain medications you were prescribed, as many of them have a tendency to slow down how quickly things move through the stomach and intestines.
  • Many patients may not need this medication, but if you are prone to nausea, it is also a good idea to take this prescription medication the night of your surgery, before you go to bed.

5. Long-Term Symptom Management and Expectations

  • It is very common for the toes/foot/ankle to remain somewhat swollen for several months after surgery. Typically, this process will gradually improve over the course of an entire 12 months! So, if you do continue to have some swelling even 3 to 6 months after your surgery, there is still a good 6 to 9 months of time where this will improve. Don’t be discouraged. Instead, continue to keep the foot elevated as mentioned in #2, above, as often as you can.
  • As you make progress from your day of surgery, the amount of weight bearing you will be allowed to do will change. As this weight bearing increases, there will very likely be an increase in the amount of swelling and discomfort you have with the surgical side. To best control the discomfort and swelling, do any of the following, or a combination of the following:
    1. Place less weight on the surgical side.
    2. Spend less time, over the course of the day, placing weight on the surgical side.
    3. When you are not weight bearing, continue to keep the extremity elevated as mentioned above.
    4. Apply ice to the affected area as mentioned above.

**Important Note: DO NOT initiate weight bearing until you have been instructed to do so.

To learn more about this article, or to make an appointment with a Tucson Orthopaedic doctor or specialist, please contact the East office.

Written by Eric P. Anctil, MD and Matthew W. Byers, PA-C

Search

+