Where and when is my surgery?
At your pre-operative visit you will be given location and time of arrival for your surgery.
- No food or drink after midnight the night before your surgery
- Stop all diuretics and ace inhibitors 1 day before your surgery
- Please stop all anti-inflammatories (Advil/ibuprofen, Aleve/naproxen, aspirin), multi-vitamins, fish oil, and any herbal supplements 5-7 days prior to surgery
- Pain Medication: At the preoperative appointment a prescription will be given for post-operative pain management. Prior to the surgery you may take an extra strength Tylenol as it does not thin your blood. Pain management will be dependent on the surgical procedure. Explanations will be given at the pre-operative discussion. Below are examples of potential pain medications that may be given.
- Percocet (Oxycodone)/Vicodin (Hydrocodone): take 1-2 pills every 4 to 6 hours as needed for pain. Do not take additional Tylenol as both Percocet and Vicodin have Tylenol. Excessive Tylenol can lead to liver problems.
- Toradol (Ketorolac): A strong anti-inflammatory given for 3 days following certain procedures. If given, please take 1 tab 3 times per day for 3 days only. If you have kidney disease, please discuss with your primary care physician prior to taking this medication.
- Nausea: Occasionally, one may develop nausea following anesthesia or from the narcotic medication. Zofran (Odansetron) and Phenerganare anti-nausea medications. You may take one tab every 6 hours as needed for nausea.
- Itching/Sleeping: Both anesthesia and narcotic pain medication may cause itching in certain individuals. If this occurs, take an over-the-counter Benadryl. This medication also can help with difficulty sleeping.
- Throat Soreness: If your throat feels sore following your intubation, an over-the-counter throat spray or lozenge(ie, Cepacol) will help to alleviate this discomfort.
- Constipation: Narcotic pain medication may cause constipation. If this occurs you may pick up an over-the-counter laxative or stool softenerto be taken as directed.
Can a nurse and therapist come to my home after surgery?
If home health care is deemed necessary for your surgical procedure, it will be arranged prior to your surgery date or in the hospital following your surgery. This entails nursing to help change your wound dressing. A therapist will be asked to come to your home. An aide will assist with sponge bathing if necessary. It will be requested that they come for ten visits to assist with your rehabilitation.
If you have a long term care policy you may qualify for an aid for extended hours.
- Bruising: An expected occurrence following any surgical procedure.
- Swelling: This is normal following any surgical procedure. The swelling may gravitate down the entirety of the arm, including the hand and fingers. This is especially common in arthroscopic procedures, where saline is used to flush the area during the surgery to ensure a clear visual.
- Ice Packs/ Heat Pads: It is our experience that icing the shoulder following a surgical procedure helps to alleviate some of the discomfort. Icing is very useful to help with inflammation. Following your procedure, you may ice your shoulder as often as you wish. Once you have begun to rehabilitate your shoulder, you may choose to alternate between heat and ice. Heat relaxes the muscles, allowing for an easier stretch. It is always good to stretch following a hot shower for this reason. Following your exercises, placing an ice pack on your shoulder may help to decrease any inflammation that may have occurred. There is no specific regimen on how often one should ice or heat their shoulders.
- Sleeping: It has been told to us by previous patients, that a reclining chair offers the most comfortable position to sleep in. This is information that we gladly pass on to our patients in an effort to make your post-operative period as comfortable as possible. However, this is not required for the surgery. If your procedure requires the use of a shoulder immobilizer, this must be slept in.
- Shoulder Immobilizer/Ultra-slings:If your procedure requires the use of a shoulder immobilizer or ultra-sling, this is to be worn at all times, including sleeping, with the exception of bathing, dressing, or doing your specific exercises.
- Arthroscopic Surgeries:Two (2) days following the surgery, you may remove your bandage and place waterproof Band-Aids over the incisions. You may shower at this point, carefully dry the operated area and replace the Band-Aids.
Open Surgeries: Please do not get the incision wet until sutures are removed ten (10) days following the surgery.
- You should not drive if you are currently taking any narcotic pain medication.
- If your surgery requires the use of a shoulder immobilizer driving is not recommend for the immobilization period. Usually 6 weeks.
Do I need to take antibiotics post-operatively before procedures?
- Dr. Malarkey recommends that for a minimum of two years following joint replacements, you should take antibiotics prior to any invasive procedure to prevent the possibility of an infection.
- Teeth cleaning, dental work, colonoscopy, cystoscopy, urinary catheterization, surgery, or any procedure requiring a tube to be placed within your body all require antibiotic prophylaxis.
- Most often the dentist/provider should prescribe you with an antibiotic prior to procedure based on the following guidelines.
Dental, Oral, Genitourinary, and Gastrointestinal Procedures:
- Amoxicillin 2.0 g 1 hour before procedure
If you are unable to take Amoxicillin, the following antibiotics are recommended:
For dental and oral procedures:
- Cephalexin 2.0 g 1 hour before procedure
- Clindamycin 600mg 1 hour before procedure
For genitourinary and gastrointestinal procedures:
- Ciprofloxicin 750 mg 1 hour before procedure
Caring for your incision
Your dressing should be changed daily or every other day with a dry piece of gauze, unless directed otherwise. Do not remove the steri strips or dermabond. Do not place any lotions or creams on the wound. Avoid excessive sun exposure, as this may cause permanent changes in the appearance of the wound