Your Instructions for a Successful Surgery.

 

Your surgery has been scheduled and you may be wondering how can I best prepare for this surgery and what can I do to participate in my recovery.  Well, we have some suggestions.

 

Enclosed is a simple checklist you can use to help prepare yourself for your upcoming surgery.  All of these do not need to be checked off prior to surgery and some suggestions may not apply to your specific case. 

Risks and Benefits

___Understand the risks and benefits of the proposed procedure.  If you have not already had a discussion with your surgeon regarding this, please contact us and we are always willing to answer any questions at anytime.

Inform Your Loved Ones

___Inform your family members, friends or your significant other(s) about your upcoming procedure so they can help you prepare for your recovery.

Check With Your Primary Care Doctor

___Discuss your plans for the surgery with your primary care physician.  Have your physician contact us if there are any concerns.

Fulfill Your Prescription

___Take the enclosed prescriptions to your favorite pharmacy to have them filled prior to your surgery.  Do not take these before your surgery unless instructed.

Obtain Something to Cool You Down

___Purchase or borrow a method to cool down the extremity we will be operating on.  Most of our patients find that a few simple bags of frozen peas (we recommend 4 of the larger bags) work very well.  Other options include using a pair of the blue gel bags and other patients use a cooling unit they purchase over the internet.  The choice is up to you, since all work equally well. 

Obtain Crutches if Needed

___If you are scheduled for a lower extremity surgery, please see the enclosed prescription for a pair of crutches.  If you have never used crutches, please also see the enclosed prescription for “crutch training.”  You can obtain the crutches from most pharmacies (call before you go) or from a medical supplier in your area (we use either Koch’s Orthotics in Brighton (ph- 810-494-5210) or Advanced Medical Solutions in Howell (ph- 800-248-2229).  For crutch training, you can contact Saint Joseph Mercy Rehabilitation Services in Howell (517-545-6230) or Brighton (810-844-7544).  Please allow at least one week prior to your surgery to schedule for this training.   Bring your crutches with you to your surgery.

Arrange for Transportation and Care

___Make sure you schedule your transportation to and from the hospital or outpatient surgical center.  The hospital will not allow you to leave the hospital by yourself.  Arrange for someone to be with you for at least the first 24 to 48 hours after your surgery.  This is to ensure that you have a comfortable and safe recovery.

Do Not Eat or Drink Before Surgery

___Make sure you do not eat or drink anything for at least 6 hours prior to your scheduled surgery.  This includes smoking, candy and gum.

 

 If you have any further questions regarding your upcoming surgery, please feel free to call us anytime.

Happy Healing,

 

 

Edward G. Loniewski, DO

 

Post Operative Instructions

Now that you have just finished your surgery, you and your loved ones may be wondering what you should be doing to help you in your recovery.  Here are just a few tips.

 

1.)   For the first 24 hours after your surgery

·       Do not drive a car or operate any machinery which requires your full concentration.

·       Do not drink any alcohol or take any recreational drugs.

·       Do not sign any legal papers or make any major decisions.

·       Have someone stay with you and help you with some of your daily activities.

 

2.)   To reduce your discomfort after surgery

·       Keep you’re your leg elevated above your heart continuously for the next 48 hours.  Please see the enclosed picture for an idea of how to accomplish this in your own home.  One of the best methods we have found is to use the larger cushions from a couch and place this on your bed.  Place your leg on the top of this cushion while you lie flat on your back.  Your leg must be higher than your heart.  Sitting up in a lazy-boy type chair is counterproductive since your leg is now lower than your heart.

·       Keep your leg cool. This means icing the leg down continuously for the next 48 hours.  Our patients report that one of the easiest methods to accomplish this is to purchase 4 large bags of frozen peas from your local grocer.   Use one or sometimes two of these bags (depending on the size of your leg) at a time over the top of your leg directly over the dressing.  The cold from the peas will gently cool through your dressing and/or cast and keep swelling and pain down to a minimum.  The bags need to be rotated back into the freezer about every 90 minutes depending on the outside temperature.  You can rotate the already chilled bags back onto your covered leg to keep your extremity continuously cooled.  If you have loss of feeling or notice significant blanching of the skin, please discontinue the ice.  However, if you keep the ice over the dressing and it does not touch your skin, this should not be a problem. Another option is to use the blue gel packs used in coolers or to purchase a cryotherapy unit such as the Polar Care Cub or the Iceman from a medical supplier.  All of these works equally well ands the choice is yours.   Another useful tip provided by one of our patients is to place a cooler next to your bed at night filled with the frozen peas or blue packs.  Place one or two of the bags over your knee and set your alarm for approx 2 hours later. When the alarm sounds, just reach over and pull out one or two more of the peas and place them on to your knee and place the others back into the cooler.   This method keeps your extremity cool and free from inflammation and allows you to have a more restful night.

 

·       Take your medication continuously for the first 48 hours.  When you first arrive home, take the pain medication prescription according to the instructions so when the anesthesia wears off, your pain is minimal.  Repeat the dosing according to the directions for the first 48 hours and than you may want to take the medication only when you need it.

 

3.)   Taking Care of your incision(s)

 

4.)   When to Call.  Please notify us of any of the following symptoms.  Call our office anytime.  If your symptoms are increasing suddenly and you do not here from us right away, report to the nearest emergency room for evaluation and treatment.

·       Any of the above symptoms in section 3

·       Coldness, numbness or a sustained blue color to your extremity

·       Sudden onset of calf pain

·       Sudden onset  of shortness of breath

·       Chest pain

 

 

Frequently Asked Questions (FAQ’s)

 

1.)    How long of a recovery can I expect?

·       The answer is not universal, since each person is a unique individual with varying degrees of severity of their condition and each person responds differently to treatment.  However, on average, most of our patients recover from a scope of the knee between 7-10 days.  Some people take longer and others shorter, but this is just an average. If you have a high demand job, you may require a longer recovery period.  During your first post-operative visit, your return to your full activities will be discussed.

 

2.)    When can I drive?

·       Once again, this is not a universal answer, and each person recovers at different rates.  However, most of our patients can drive within one week from the surgery.  We do not recommend that you attempt to drive while under the influence of narcotic medication or during the first 72 hours when you have the large bulky dressing on your leg.  Once this is removed, you can take a short test drive with someone else by your side.  It is recommended you have someone drive you to an empty parking lot and take a short test drive to determine if it is safe for you to drive.  Remember, that your decision not only affects your safety, but the safety of your passengers, and the other people on the road.

 

3.)    How long do I need the crutches?

·       If you had a normal arthroscopic procedure, crutches are optional.  Unless you are instructed otherwise, you may only need to use the crutches or a cane until your muscle strength is strong enough to safely ambulate.  For most of our patients this is within the first 24hours.  We have provided you with a prescription for a pair of crutches and, if needed, crutch training.  We suggest you use them for your own safety and wean yourself off them when you feel confident and safe in your ambulation.

 

4.)    Will I need physical therapy?

·       Enclosed, you will find a set of easy to complete exercises recommended to help you regain your strength and stability.  An overwhelming majority of our patients easily complete these exercises in the comfort and convenience of their own home without the need for a visit to a physical therapist.  On your first post-operative visit with us, we can discuss your progress and make further recommendations.

 

5.)    What about notes for work /school or my disability insurance?

·       All of the paperwork needed to document your disability can be completed by discussing this with our staff prior to your surgery.  For some disability carriers, we have to do make some phone calls, research your chart, and find the appropriate codes.  Because this requires a tremendous amount of time and effort from our staff, we will require a small fee. Please make sure you give all of these requests directly to our staff, since paperwork given to the physician just delays the process.  A simple form is also required to complete your request.  This can be obtained through any of our staff members.

 

We appreciate the opportunity to help you in your recovery.  We are always available for any questions or comments you may have since our primary objective is to provide you with the best of care.  Feel free to talk with any of our staff.  We are here to help.