Nicholas K. Sablan, M.D.

Foot Surgery

Post Operative Instructions after Foot and Ankle Surgery 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) which is a strong narcotic pain medication combined with Tylenol. It will begin to work within 15 minutes after taking it with a maximal effect in one to two hours. Normally, Percocet is taken every 1 pill every 6 hours but if the pain is severe, it can be used 2 pills 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.
I strongly recommend you take an over-the-counter stool softener such as Colace 100 mg 2 tablets 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 will also be given a prescription for Naprosyn which is a strong anti-inflammatory medication. Take this twice a day with food in addition to the Percocet. Both medications with work synergistically in pain relief. Do not take if you have a history of stomach ulcers or kidney dysfunction.
Unless directed otherwise, 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.

Bandages & Sling:

Your post-operative splint should be kept clean and dry until your first post-operative visit.
You may shower but you must use a bag and tape to avoid getting the splint wet. If your splint gets wet you need to immediately return to the office to get it changed.

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 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 or a wheelchair to get around.
You may return to sedentary work only or school in 7 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.
You may start physical therapy after your first post-operative visit if directed by Dr. Sablan.

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