Post Op Instructions
FEVERS: It is not unusual for bleeding inside a joint to cause a fever to 101° or 101.5°. This will be accompanied by a warm feeling in the knee as well as discomfort. If you have repeated fevers of 101.5° or higher 48 hours or later after surgery, then you should contact our office immediately. This could indicate an infection. Other signs of infection would be redness around the wound or purulent material draining from the wounds. It is unlikely for evidence of an infection to show within the first 48 hours following surgery. Abnormal swelling or a red appearance of the wounds accompanied by fever after the first 48 hours is worrisome and you should call the doctor.
STITCHES: Usually, your stitches are buried beneath the skin and do not need to be removed. On occasion, your body may have some difficulty dissolving the stitches in which case you may occasionally see a stitch pop up, usually after several weeks. Usually the stitch can simply be plucked at this point. If there is any redness around the stitch, it should be treated with triple antibiotic ointment. If you wish, simply call the office and come in to have one of the nurses or one of the doctors take a look at it.
SWELLING: Swelling is fairly normal, especially early on after the surgery. It can cause quite intense pain, especially as the numbing medicine wears off. If the pain does not resolve with cool compresses, such as the cryo cuff and pain medication, then you should call the office.
RETURNING TO WORK: If you are not confident about your ability to do your job or return to work safely, then call the office and we will provide whatever documentation you feel necessary to validate your absence from work.
PAIN MEDICATION: If you have pain, take your pain medicine. Some people require very little pain medicine and some require a great deal more. You may take as much as two pain pills every three hours provided you are in a great deal of pain. If you are not in pain, this is not a safe amount of medicine to take. If you require more than two pain pills every three hours and have tired to rest and have using cold compresses and are still in pain, then you should call the doctor on call. Do not take any other home remedies or illegal drugs or alcohol in attempts to relieve the pain. This could be fatal.
FOLLOW UP APPOINTMENTS: In most cases, you should see your doctor and have the wound examined within two weeks of your surgery. The exception is knee and hip replacements which are generally seen 4 weeks after surgery. If you feel it is necessary, then certainly call and see the doctor earlier. In the meantime, if you require assistance at home, we can arrange to have the Visiting Nurse Association provide you with nursing care or physical therapy at home if you are having trouble getting along. This can be arranged by simply calling our office. You should not drive until your pain has decreased to a level where you do not have sharp pain pains when moving, and when you are off of narcotic pain medicine (Darvocet, Vicoden, Percocet, ect.).
DRESSINGS: You may remove all the dressings and bandages except the paper tapes protecting the wounds, after four days. If you feel safer with an ace bandage or some protection over the wounds, then feel free to cover them with Band-Aids or whatever dressing, loosely wrapped, that you desire. In general, keep the wounds clean and dry and do not pick at them. The chief role of dressings is to protect wounds from curious fingers.
CRUTCHES: You may require a cane, a walker or crutches to walk. If you need this support, then use it. Many ACL patients need to be on crutches after surgery. Most meniscus repair and arthroscopy patients in general, do not require any support but occasionally they feel more comfortable with crutches or a cane. If you think that you may need them after surgery, we can provide them to you at your preoperative visit. If you subsequently need them, call the office.
RUNNING OUT OF MEDICINE: Oxycodone is a Schedule 2 narcotic – it is the active medicine in Percocet and Roxicet. It cannot be legally renewed over the telephone. There are several other strong pain medicines that can be telephoned in to your pharmacy if you run out of your Oxycodone. Please telephone the office during working hours between 9am and 4pm, Monday through Friday to obtain more medication. If you require Oxycodone, you will need a written prescription. If a slightly less strong medication will suffice, then it may be telephoned to your pharmacy. This must be done during normal working hours. You cannot expect the on call physician, who does not know you personally, to phone narcotic medications in for you. If you need these medications and appear to be running low, then you should call during the day, during the week and if it is medically indicated, then your doctor will renew your prescription or prescribe something else. Sometimes these calls are not answered until the next business day, so please try to plan as far ahead as possible if you think you may run out of medicine.
WHEN IN DOUBT: Call the doctor on call at (302) 832-6220. There may be some emergencies or surgeries that take precedence, but he will return your call. Please leave the telephone number where you can be reached.