Pain medications work the best when they are taken early. The medicine may take 30-60 minutes to work, so you should take it when the pain starts. This is especially true if you had a block as part of your anesthesia. If you are ready to go to bed and still have no pain, consider taking one pill and setting an alarm for 5-6 hours later to take another one. Do NOT let the pain get ahead of you; it takes a long time to catch back up.
Pain Medication Refills
Medications are refilled Monday through Friday from 8:30 am to 4:30 pm. Please call your pharmacy to request the refill. The on-call physician will NOT refill medications.
The incision should be kept clean and dry. It may have slight redness or warmth. There may be slight clear or bloody drainage, which stops in a day or two. Please call the office during normal office hours if the drainage persists or if the redness is increasing. It is normal to have bruising around the surgical site.
Normal redness around incision
Leave the bandage on unless your physician tells you differently. If it becomes soiled or if there is drainage on the dressing; call during normal office hours to come in for a dressing change. If it is not during office hours, you may reinforce the dressing with gauze sponges and tape.
A low-grade temperature is common after surgery especially at night. Initial treatment is coughing and deep breathing. Use the incentive spirometer if you have one from the hospital. If the temperature is above 101.0 for several hours despite the above treatment please call the office or the doctor on-call.
Numbness and Tingling
This is common after surgery. It temporarily may be worse than before the surgery. Most importantly the numbness and tingling should not be progressive. If it continues to progress call the office or the on-call physician.
Narcotic pain medications can predispose people to constipation. Take Milk of Magnesia 2oz every night before bed until constipation resolves. If you are prone to constipation problems begin taking Milk of Magnesia 2 oz. every night before bed 3 days before surgery and continue after. Expect results 3 days after starting the medication. If constipations persist 72 hours after surgery, call the office.
Before surgery the skin is prepped with iodine and alcohol. This turns the skin yellow. It may take days to wear off. Acetone may help with removal but for infection prevention, it is best to just let it wear off.
Normal color after surgery prep
Appointment after Surgery
An appointment is needed about 10-14 days after surgery. Please call the office to schedule the appointment.
Fiberglass cast/ Splint: A fiberglass cast or splint hardens within 20 minutes. Do not rest your cast/ splint on a hard surface before this time as this may cause a dent in the cast, which could cause a pressure point on your skin. Do not get the cast/ splint wet or skin maceration (breakdown) can occur.
Keep the arm or leg elevated: Elevate the extremity on 2-3 pillows as often as necessary to prevent undue swelling. Keep your toes above the nose or hand above the heart as required to minimize swelling.
Skin care: No lotion, powder, or deodorant in or around the cast. Do not scratch under the cast/splint as this may irritate or damage the integrity of the skin. Do not insert any foreign objects underneath cast or bandage. To relieve itching under cast, use a hair dryer on the cool setting or over the counter Benadryl if no allergy to it or if it does not interfere with your current medications or conditions. Please do not remove any padding from the cast/splint.
Bathing: It is important to protect your cast/splint from water while bathing. Cover the cast/splint with a plastic bag and rubber band or tie the edges to your skin, creating a waterproof seal. If the cast should get wet, allow to dry, if dampness persists call our office.
Circulation: Move the fingers or toes back and forth 10 times every 1-2 hours to improve circulation and reduce swelling. Exercise the joints above and below the cast/splint to keep them from getting stiff. Ice can be placed on the cast/splint covered in a towel to reduce swelling and pain as needed.
Consult your doctor regarding your level of activity while in the cast.
Call our office immediately or go to Emergency Services if any of the following occur;
• Unrelieved severe pain or change in pain, circulation or sensation
• Numbness or tingling of the fingers or toes (slight numbness is normal)
• Increased swelling of fingers or toes
• Blue or purple discoloration or extremely cold fingers or toes
• Extreme tightness or looseness of bandage
• Body temperature above 101 or greater
• Unusual odors coming from the cast or bandage
• Cracks or soft spots in the cast
• Areas of wetness, dampness that do not dry and discoloration
Progressive Weight Bearing Program
Supplies needed: 1000ml saline or sterile water, house hold bleach, 4x4 gauze, 10cc syringe.
Instructions: 1000ml saline or sterile water, take out 30cc, replace with 30cc house hold bleach. Soak 4x4 in solution, squeeze out excess and apply to wound. Place dry 4x4 over wet. Usually change 3-4 times daily. When removing the dressing, pull off the wound, DO NOT SOAK IT OFF. You want the dressing to debride (pull off) bad tissue on the wound.
Swelling and Elevation
Swelling is very common after a fracture or surgery. It is best prevented by elevation and ice. Elevation must keep the surgical site above the heart. Think of it as a drop of water that must run down to the heart. For an example if you had knee surgery elevate the ankle higher than the knee and the knee higher than the heart.
Ice is also important. Apply ice bags or the pad for an ice machine to the surgical site. A towel may be used under the ice if it feels too cold. Apply ice for 30 minutes and then remove it for about 10 minutes. Repeat this sequence.
Ice and elevation are most important for the first 48 to 72 hours after a fracture or surgery.Exercise with heat and ice. Heat before exercises with a towel folded in half then heating pad on low for 20 minutes. Exercise, then ice knee for 30 minutes. This will help control pain and swelling.