Marvin R. Brown, M.D.
Phone: (210) 593-1400
Post Operative Instructions
- Follow up Instructions:
§ PLEASE!! Call our office at 593-1400 a day or two after surgery for an appointment
§ Unless told otherwise, the first routine post-op visit is usually 14-18 days after surgery
§ Call the office for an earlier appointment if you are having problems with the cast or pain is not controlled with medication and elevation.
§ Call for fever > 101.5, chills or sweats, persistent drainage or increasing redness.
§ PAIN MEDICATION is only refilled during normal clinic hours, Monday thru Friday!! The On-Call Doctor CAN NOT call in pain medicine on the weekend
§ Other Urgent Problems Call the office day or night at 593-1400 or the ORTHONOW clinic 804-5424 (Mon.-Fri. until 7:30 pm & Sat. 9:00 – 1:00 pm)
2. Activity:
§ YOU ARE TO BE AT STRICT BEDREST FOR THE NEXT 2 WEEKS UNLESS TOLD OTHERWISE. You should move from bed to sofa to recliner through out the day to prevent blood clots or back pain. DON’T STAY IN ONE PLACE !
§ Weight bearing status on the operated extremity (until follow up) will be: (As checked)
c NON WEIGHT BEARING
c Touch Down or Partial Weight Bearing
c Weight Bearing as Tolerated
§ If comfort allows, you may perform leg exercises (i.e. leg lifts, knee extensions.) while lying down
§ Crutches, Walker or Wheelchair will be prescribed as necessary to assist with ambulation
3. Pain Control: (SOME SWELLING AFTER FOOT SURGERY IS NORMAL!)
§ ELEVATING YOUR LEG on 3 or 5 pillows is the First thing TO do to REDUCE SWELLING (Sitting in a chair with your leg up is not adequate!)
§ For the first 48 hours take pain pills as they were prescribed AND before the pain becomes unbearable. After that, take only as needed to control moderate to severe pain.
§ Apply Ice to help control pain (Note HEAT INCREASES PAIN AND SWELLING)
§ DO NOT mix pain medicine with alcohol and do not operate a Motor Vehicle
IMPORTANT! Many Narcotics are combined with acetaminophen (Tylenol). The Maximum amount of acetaminophen that can be taken in 24 hours is 4000 mg.
4. Regional Anesthesia: (As checked)
c LOCAL OR FIELD BLOCK.
§ Marcaine and or lidocaine injected in or around the operative site
§ Will generally provide between 5-6 hours of local pain relief
c POPLITEAL BLOCK
§ Long acting marcaine injected around the nerve in the back of the knee
§ Provides approximately 18 hours of pain control
§ Will cause numbness to foot and toes and may cause some temporary motor weakness
§ Please be sure to take your pain pills as you notice a change in sensation to your foot
5. Wound Care (As checked)
c Bunionectomy:
§ Your dressing is part of the surgery and SHOULD NOT be removed!
§ A slipper cast may be applied and this must be kept clean an dry
c Soft Dressings: (Other than bunionectomy)
§ May be removed after 3 days
§ You may shower but do not soak your foot in water.
§ Clean incision with hydrogen peroxide and keep it dry, you may cover the incision with a dry gauze dressing.
§ Do not apply ointments (i.e. bacitracin, Neosporin, etc) to your incision.
§ Ace wraps may be removed and rewrapped at any time if they feel to tight.
c PINS:
§ Protect pins from being disturbed by placing a small piece of tape over it
§ Clean pin area by scrubbing with peroxide on a Q-tip at least twice daily
§ Pins will generally stay in place for six weeks and are routinely removed in the clinic
c CASTS or SPLINTS:
§ Cast must be kept clean and dry
§ When showering, use a CASTGARD sleeve or wrap and secure a folded hand towel around your leg just above your cast. Then cover with 2 plastic bags and secure the top with tape.
§ If your cast gets a little wet you can use a hair dryer on the cool or warm setting to dry it
§ If the cast gets very wet, you must call and come in for a cast change within 24hours to prevent serious skin breakdown.
c PAINBALL:
§ Local anesthetic medicine usually delivered to an operative site via a small indwelling catheter. (i.e. the Iliac Crest of the pelvis)
§ Should provide post op pain control for 3 days.
§ This small catheter is easily removed by the patient when they perform their first dressing change of the hip incision at 3 days post-op.
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Marvin R. Brown, M.D.
Marc Deschaine PA-C