Distal Biceps Repair

Robert C. Mason, M.D.

Helpful Hints & Important Precautions for Patients

Diet:

 

  • You may resume clear liquids and light foods after surgery (jello, soup, etc.)
  • Progress to your normal diet as tolerated as long as you are not nauseated.

 

Medications:

 

  • Before surgery you will 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 from the nerve block wears off. The length of time the nerve block lasts varies pending on the patient and type of nerve block completed by the anesthesiologist.
  • The first medication I use is Percocet (Oxycodone/Tylenol), which is a strong narcotic pain medication. 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 6 hours but if the pain is severe, it can be used every 4 hours.
  • Common side effects of these medications 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 can also prescribe an anti-nausea medication called Zofran (Ondansetron) if you know you have or are concerned you may have persistent nausea after surgery.
  • I strongly recommend you take an over-the-counter stool softener such as Colace 100 mg (1 tablet) twice a day and/or a laxative such as Sennokot or Sennokot-S, 1 tablet nightly to avoid constipation.
  • Take over the counter Benadryl one half hour before your narcotic if you experience itching.
 
  • You may also take over the counter Ibuprofen or Aleve to help with post- operative pain control and help transition off narcotics. You can take Ibuprofen (800mg three times daily) or Aleve (440 mg (2 tabs of 220 mg, twice daily).
  • 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 4000 mg of Tylenol per day.

 

Bandages & Sling:

 

  • If Dr. Mason places you in a hard splint this should be kept clean and dry until your first post-operative visit.
  • If Dr. Mason does not place you in a splint but a soft dressing it is okay to remove this in 3 days and shower over the butterfly bandages (steri-strips).
  • You will have a sling placed after surgery.

 

Washing & Sling:

 

  • If you are in a splint this should be kept clean and dry and left in place until your first post-operative visit.
  • If not placed into a splint then beginning on the third day after surgery it is OK to shower as long as the incision is kept dry with plastic wrap. Remove the wrap after showering.
  • Do not take a bath until after the first post-operative visit.
  • It is OK to go into a swimming pool after the first post-operative visit, but no lakes or ocean until two weeks after surgery.
  • You will have a sling placed after surgery. The only time you are allowed to remove it is during showering and during shoulder, elbow and wrist exercises.

 

Ice & Activity:

 

  • One important goal following surgery is to minimize swelling around your surgery site. The best way to achieve this is with the frequent application of ice. This is most important the first 48 hours following surgery. The ice pack should be large (like a big zip-lock bag or bag of peas) and held firmly on the area of your surgery. Apply for 15 minutes every hour while awake if possible. Look for signs of frost-bite if left on too long.
  • I encourage you to move your wrist and fingers as much as possible as this will improve your chances of an early recovery and decrease your chances of developing stiffness.
  • You may return to sedentary work only or school in 3-4 days after surgery if your pain is tolerable.

 

Sleeping:

 

  • Many patients have difficulty sleeping after elbow surgery. You may find that sleeping in a slightly upright position (ie reclining chair) with a pillow under your
 

forearm will be your most comfortable position. Make sure to have your pain under control before you sleep.

 

Hand Therapy:

 

  • The goal of hand 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 hand therapy after your first post-operative visit.
  • Depending on the strength of your tendon, I will place you in a brace and discuss restrictions with your hand therapist.

 

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 two weeks 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

 

Call our office for any concern (757-827-2480). If you feel it is a medical emergency, call 911 or go to an emergency room.