Peter Tsai, MD -- Emily Olson, PA-C
Phone: 541.207.0910 Fax: 541.738.2596
Post Operative Surgery Instructions:
Dressings/Wound
· After surgery you will be in a:
□ Splint
§ Depending on the type of surgery the splint may also incorporate your elbow to limit rotation.
§ This splint will stay on until your first postoperative visit with Upper Hand Orthopaedics or a hand/occupational therapist.
□ Soft dressing
§ This soft dressing will stay on for 5 days after surgery.
§ 5 days after surgery you may remove the soft dressing and wash/shower over the incision.
§ You will have sutures in the incision but it is okay to wash over them. DO NOT soak the hand in water, such as dish water, the bathtub or hot tub.
§ Let the incision dry out before putting a new dressing over the incision. It is okay to keep the incision open to the air in a clean environment. If you are out and about, keep the incision covered with a dressing or simply a band aid.
Activity
· Begin moving your fingers right after surgery, or as soon as your nerve block wears off. Try to make a full fist then fully straighten the fingers. This will help reduce stiffness and swelling. You do not need to try and squeeze a ball for exercise.
· You may have some or all of your fingers immobilized in a splint. If so, you do not need to try moving the immobilized fingers.
· Keep the hand elevated above your heart if it starts to swell or if you get throbbing pain.
· There will be pain and soreness in the wrist after surgery. This is normal.
· No lifting or strengthening with the hand or wrist right after surgery. Depending on your surgery, your activity will be progressed at the first postoperative visit.
Pain medications (full prescription policy at end of this document)
· A prescription for pain medication will be provided to you the day of surgery. The pain medication should be taken based on the scheduled dosage written on your prescription. However, once your pain begins to decrease you can also decrease the frequency of your medication. The first couple of days will be the most painful but you can expect the pain to continually decrease with time.
· Do NOT drive while taking prescription pain medications. Do NOT drink alcohol with prescription pain medications.
· IF YOU ARE ON A PAIN CONTRACT, YOU MUST INFORM US OF THIS INFORMATION
· Please allow 2 business days for the refill of pain medication unless requesting it at your postoperative appointment.
Follow-Up
· Your first postoperative visit will be scheduled 7-14 days after surgery for suture removal. At that time we will evaluate your operative site and take x-rays as needed.
· Our office will call you the day after surgery to check in and answer any questions. Please feel free to contact us sooner if you have questions or concerns.
· If your surgery occurs on a Friday, you can still call our office if you have any questions or concerns over the weekend and you will be connected to the on-call doctor.
Nerve Block
· Your hand / operative area may be numb for a few hours after surgery from the numbing medication. If you received a nerve block your hand may be numb for 24 hours from surgery.
· If you had a nerve block your arm will start tingling as the nerves wake up. Take the pain medication prescribed when this happens to stay on top of the pain. If your arm is still numb when you go to sleep, take your pain medication before bed because the block may wear off during the night.
**Insurance Information**
Surgery:
· Our office will contact your insurance company to determine if prior authorization is required for your scheduled procedure. If authorization is required, our office complete the prior authorization process.
· Our office will not be able to tell you what your insurance will pay for the procedure. We can provide you with procedure codes and our fees upon request, with which you can contact your personal insurance plan to discuss patient responsibility for surgery.
· Global Periods: The majority of surgical procedures include a 90-day global period. This means that your postoperative visits with our office are included in the cost of your surgery and not billed to insurance for the first 90 days. For most procedures, you will not have a copay for your visits for the first 90 days after surgery. Our office will make every possible accommodation to schedule your routine postop appointments within this global period. Your insurance will still be charged for any x-rays, splints/casts, or other supplies.
o If you have a staged procedure, there will be an additional charge.
o If you undergo a buried/deep pin removal in office after surgery, this is considered a separate procedure and not included in the global period.
· ***Certain procedures can be considered an exclusion (not covered benefit) on your individual insurance plan. Please check your specific patient benefit and plan documents to ensure your scheduled procedure is a covered benefit on your plan.
Physical / Occupational Therapy:
· Our office will contact your insurance company to determine if prior authorization is required for occupational therapy. If prior authorization is required, our office will complete the prior authorization process.
· If your plan requires a copay for therapy visits, this is unfortunately NOT included in your postoperative global period and is required at the time of each appointment.
· Most insurance plans have a limit on how many physical/occupational therapy visits you are allowed per year. Please check you specific patient benefit and plan documents to ensure you have therapy visits remaining on your plan.