Post-op Expectations

EXPECTATIONS FOR AFTER SURGERY

Dr. Baran will give you instructions specific to your individual surgery on the day of surgery.  Please follow these instructions! If you lose them, please contact

Dr. Baran’s office so that we can provide you another copy.

The following information provides a general guideline on what to expect after surgery.  While the complication rate after surgery is low, we ask that you carefully follow your specific post-operative instruction in order to help minimize the risk of complications.  

IMPORTANT PRECAUTIONS AFTER ANY ORTHOPEDIC SURGERY

• Keep incision clean, dry, and covered.  Follow your specific instructions for incision care.  
• Take medications only as prescribed.
• Elevate the operative extremity above the level of the heart to help control pain and decrease swelling.
• Carefully follow the weight bearing instructions that your doctor requests.
• Use any equipment that has been provided to you as instructed.
• Do not over-do-it!  Doing too much, too soon after surgery can prolong pain and irritation and inhibit motion.  
• Do not drive a car until you are off all narcotic pain medications and can safely operate the vehicle.   

CARE OF YOUR INCISIONS

• Leave the dressing in place as instructed after leaving the hospital.  This may vary depending on procedure, but do not remove the dressing prior to the time instructed.  If there is a question, please call the office.  
• There may be some mild bleeding or drainage at the incision sites for the first few days after surgery.  If this persists, contact Dr. Baran.
• If there are white tape strips (SteripsStrips), or purple glue (Dermabond) over the incision, leave this in place when you remove the dressings.  
• Do not touch or pick the wound or sutures.
• Do not place any creams, ointments, or lotions on the incisions.  
• Keep your incisions covered and dry until Dr. Baran instructs you otherwise.  

SIGNS OF INFECTION

• You should inspect your incision for signs of infection during dressing changes.  These signs include:  increasing redness, pain, swelling, and pus drainage. If you notice any of these signs please contact Dr. Baran’s office immediately.
• Some other signs of infection include:  high fever, night sweats or chills.  
• It is common to experience a mild fever in the first few days after surgery.  Some nausea and dizziness is also common.  Drink plenty of fluids, moving around (within your post-operative restrictions), and deep breathing will help these symptoms to resolve.  

SHOWERING

• Showering is generally allowed once you feel safe and so long as you can keep the incisions dry.  Do not submerge the incision (no baths, pools, ...etc.) until the it is for 3 weeks for non-joint replacement surgery and 6 weeks for joint replacement surgery, or until the incision is completely healed, whichever is longer.  
• Keep your incision dry when showering until instructed otherwise by Dr. Baran.
  • Cover with waterproof bandages or saran wrap.
  • Point the shower head away from your incisions.
  • Use a shower chair if you are unsteady on your feet.
  • Sponge bathe if needed.
• Remember:  do not place any creams or ointments on the incision, do not pick the incision or sutures and do not get the incision dirty.

BLOOD CLOTS

• Blood clots, also known as deep vein thrombosis (DVT), are a risk after orthopedic surgery.  Various measures to reduce the risk of blood clots after surgery include mobilization, ankle pumps, lower extremity compression devices, and blood thinning medications.  
• When sedentary, remember to move the ankle up and down to help keep the blood flowing.  
• Follow your specific instructions for medications after surgery.  
• Please call the office if you experience any of the following:
  • Large amounts of swelling
  • Cramps in the calf or lower leg
  • Difficulty breathing
  • Sharp/sudden chest pain

If you have a personal or family history of blood clots, please remember to inform the care team about this before your surgery and again on the day of your surgery!

NUMBNESS

• Some areas of skin numbness are very common after any surgery.  These areas typically become less symptomatic over time.  
• In some cases, numbness may be permanent but does not generally interfere with function.  

PAIN MEDICATION

• You will be given prescriptions for pain medication which should be taken only as prescribed.  
• Take these medications with food to help prevent nausea.
• DO NOT drive while taking these medications.
• DO NOT mix these medication with alcohol.
• Decrease the use of narcotic pain medications after surgery as soon as tolerated.
• Ice, rest, and elevation will decrease the need for stronger pain medication
• Remember to use Tylenol on schedule so long as your narcotic pain medication does not contain acetaminophen.  
• The goal should be to be off all narcotic pain medication no later than 2 weeks after surgery.

Prescription Requests and Refills

• Please call before you are out of the medication.
• Allow a minimum of 24 hours for a prescription refill request.  
• It is best to call Monday-Thursday.  
• Refills requests cannot be processed after hours or during the weekend.  
• If you are out of town, please allow enough time for the prescription to be mailed (5-7 days).  
• Narcotic prescription cannot be called in to your pharmacy.  

CONSTIPATION

Constipation can occur after surgery, and is commonly associated with narcotic pain medications.  To help prevent constipation:

• Drink plenty of water daily
• Take a stool softener (such as docusate) if you are taking any narcotic pain medication
• Eat food high in fiber (such as dried fruits), or drink prune juice.
• Stop using narcotic pain medication as soon as possible.

SLEEP

Normal sleep is difficult after surgery.  Try to avoid afternoon napping if you are having trouble sleeping at night.  If pain is keeping you awake, try scheduling your pain medications about an hour before bedtime.  For lower extremity surgery, keep the leg elevated at night on pillows.  For shoulder surgery, you may find it more comfortable to sleep in a “sitting” position in a recliner or propped up on multiple pillows.  

DRIVING

Driving after surgery is done at your own risk . You must be off all narcotic pain medications.  You must be able to safely operate your vehicle to prevent harm to yourself and others.  If you are in an accident, you could be blamed for your recent surgery.  Always practice in a large empty parking lot before returning to road driving.  BE CAREFUL!

RETURN TO WORK

Return to work after surgery is very depending on your surgery and the demands of your job.  Desk jobs can frequently be resumed quickly, while labor jobs will require a more prolonged time off.  Do not return to full duty until you are cleared by Dr. Baran.

WEIGHT BEARING

The amount of weight allowed after surgery depends on the specific procedure and you will be given instructions.  Common weight bearing precautions are described below:

• Non-weight Bearing:  do no place any weight through the involved limb.
• Touch-Down or Toe-Touch Weight Bearing:  you may touch your operated leg on the floor, but do not put weight on the extremity.  Allow just the ball of the foot to touch the floor for balance.  
• Partial Weight Bearing:  you may place up to half of your weight on the extremity.
• Weight Bearing as Tolerated/Full Weight Bearing:  you may place as much weight on the operated extremity as tolerated.  

PHYSICAL THERAPY

For most surgery, Dr. Baran will have you begin physical therapy after your first post-operative visit.  Specifics of physical therapy will be discussed at your first post-operative visit.  It is often necessary to schedule post-surgery physical therapy BEFORE surgery so to prevent a delay.

FOLLOW-UP APPOINTMENTS

You will be given instructions for scheduling your follow-up after surgery.  If you have questions, please call the office.  Remember, there is usually no charge for surgery-related visits within 90 days of the procedure, though there may be a charge for any prescribed equipment or x-rays.