Nicholas K. Sablan, M.D.

Achilles Repair

Post Operative Instructions after Achilles Tendon Repair.

Helpful Hints & Important Precautions for Patients

Diet

Medications:

Before surgery, you may be offered a nerve block, which helps greatly with pain control and decreases your need to take narcotic medications. It is important to begin taking your pain pills before this medicine wears off.
The first medication I use is Percocet (Oxycodone/Acetominophen), hich is a strong narcotic pain medication combined with Tylenol. It will begin to work within 15 minutes after taking it, wth a maximal effect in one to two hours. Normally, Percocet is taken 1 pill every 6 hours but if the pain is severe, 2 pills can be used every 4 hours.
Common side effects of the medication are nausea, constipation, itching, and drowsiness.

The best way to prevent nausea is to take the medicine with a little food, start with just one pill, and be patient while the medicine begins to work. Usually, after the first few doses the nausea will go away. I also prescribe an anti-nausea medication called Zofran (Odansetron) to be taken if you have persistent nausea after surgery.
You will also be given a prescription for Naprosyn strong anti-inflammatory medication. Take this twice a day with food in addition to the Percocet. Both medications will work synergistically in pain relief. Do not take it if you have a history of stomach ulcers or kidney dysfunction.
I strongly recommend you take an over-the-counter stool softener starting the day of surgery such as Colace 100 mg 1 tablet a day and a laxative such as MiraLAX to avoid constipation.
Take Benadryl one half hour before your narcotic if you experience itching.
Transition from Percocet to Tylenol as your pain subsides but pay attention to the dosage as Percocet has 325 mg of Tylenol in each pill. Patients with normal liver function should not consume more than 3000 mg of Tylenol per day.

You need to take 325mg Enteric Coated Aspirin once a day for the first 2 weeks after surgery to help prevent the formation of blood clots.

All non-narcotic medications will be called in to your pharmacy prior to surgery. Bandages & Sling:

Your post-operative splint should be kept clean and dry until your first post-operative visit.

Ice & Activity:

One important goal following surgery is to minimize swelling around your surgery site. The best way to achieve this is with elevation of your foot above the level of your heart. Try to avoid having your foot hanging down for extended periods of time.
I encourage the frequent application of ice. This is most important during the first 48 hours following surgery. The ice pack should be large (like a big zip-lock bag) and held firmly on the area of your surgery. Apply for 20 minutes every hour while awake if possible.

I encourage you to move your toes as much as possible as this will improve your chances of an early recovery and decrease your chances of developing stiffness.
You need to use crutches, a kneeling walker, or a wheelchair to get around.
You may return to sedentary work only or school in 3-4 days after surgery if your pain is tolerable.

Physical Therapy

The goal of physical therapy is to first assess how your body responded to the surgical procedure. They help you feel comfortable with your surgery and make sure you aren't afraid to start doing things. Your therapist will start range of motion and exercises on your first visit.

Follow up appointment:

We try to give all of our patients a follow-up office visit at the same time we schedule your surgery.
Typically, I want to see my patients in the office 5-10 days after surgery.

FOLLOW UP APPOINTMENT:

What to watch out for:

∞ Pain that is increasing every hour in spite of the pain medication

∞ Drainage from the wound more than 2 days after surgery

∞ Increasing redness around the surgical site

∞ Pain or swelling around your surgery

∞ Fever greater than 101.5 degrees.

∞ Unable to keep food or water down for more than one day