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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 pain medication I use is either Percocet (Oxycodone/Tylenol) or Norco (Hydrocodone/Tylenol), which are strong narcotic pain medications. They will begin to work within 15 minutes after taking it with a maximal effect in one to two hours. Normally, Percocet or Norco are 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 or Norco to Tylenol as your pain subsides, but pay attention to the dosage as Percocet and Norco have 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 dressing consists of a large white fluffy dressing and absorbent pads that are held in place with an ACE bandage.
• Unless directed otherwise, remove this outer layer of dressing 3 days after surgery. Place a new absorbent pad or gauze and tape if there is any drainage, otherwise leave the incision open to air.
• Your incision is closed with non-absorbable stitches that will be removed at your first post-operative appointment.

Washing & Sling:

• You should be careful to keep the dressing clean and dry for the first 48 hours after surgery.
• 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.

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 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 15 minutes every hour while awake if possible.
• Remember we did not do any repairs so you cannot hurt your elbow by moving it. I encourage you to move your arm as much as possible as this will improve your chances of an early recovery and decrease your chances of developing stiffness.
• Work on touching your hand to your nose and ear to keep your flexion and use your other hand to gently push your arm into extension.
• You may return to sedentary work only or school in 3-4 days after surgery if your pain is tolerable.