Helpful Hints & Important Precautions for Patients
- 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.
- 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:
- Your post-operative splint should be kept clean and dry until your first post- operative visit. Do not remove the splint.
- You will have a sling placed after surgery, which is for comfort only. Feel free to remove it when you like, but most people like to wear it during the first couple days to avoid shoulder and neck pain.
Washing & Sling:
- You should be careful to keep the splint clean and dry.
- You may take a bath/shower but will need to cover your splint to prevent getting it wet.
- After your first post-operative visit you will be placed into a hard cast.
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 wrist above the level of your heart. Try to avoid having your hand hanging down for extended periods of time.
- 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 fingers as much as possible as this will improve your chances of an early recovery and decrease your chances of developing stiffness. Perform six pack finger exercises as instructed. (see attached document)
- You only need to wear your sling for comfort.
- You may return to sedentary work only or school in 3-4 days after surgery if your pain is tolerable.
- Many patients have difficulty sleeping after wrist surgery. You may find that lying with a pillow under your forearm keeping your wrist/hand elevated will be your most comfortable position. Make sure to have your pain under control before you sleep.
- 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 will start hand therapy after your first post-operative 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 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.