Preparing for surgery
Home Preparation
Surgery is taken seriously, and your health and safety are most important: DO NOT be afraid to ask for help. It is best to make arrangements with friends and family well in advance of your surgery to help with household activities:
Childcare
Housework
Meals
Transportation
Practice single-handed skills beforehand:
Dressing & undressing
Using the toilet
Brushing your teeth
Showering
Prepare ahead of time for the first few days after surgery:
Open & lightly reseal cans, bottles & medications you might need
Buy no-cut meats or ready-made meals to heat and eat
Helpful Items to Have
In the shower and bathroom: DO NOT ALLOW THE SPLINT/DRESSING TO GET WET
Plastic bags with rubber bands or tape to cover the dressing. You can use garbage bags or the bag the newspaper comes in. There are also commercial “cast covers” available from CVS/Walmart/Amazon etc.
Shampoo/conditioner/toothpaste with flip tops
Consider an electric razor
Dental floss with a “Y” handle
In the Kitchen
Rubber jar opener mat
Electric can opener
Paper plates and cups
In the Bedroom
Back Scratcher
Large sleeve shirts and tops
Sports bra or camisole
Choose clothes without buttons, fasteners in back or drawstrings
Pre-op
1. Nothing to eat or drink after midnight the day before your surgery except certain morning medications as instructed by the pre-admission surgery center/hospital phone call (with a small sip of water). Coffee, candy, mints, gum, and smoking/tobacco products are NOT permitted.
2. A surgical staff-member will call and screen you by phone to determine if you need to come in for pre-admission testing. Please ask the staff on the phone or at preadmission testing if any medications should be taken the morning of surgery. If you were instructed to take certain medications the morning of surgery, take them with a sip of water only. Medications for the following are commonly included: high blood pressure, heart, asthma, seizure, and reflux/stomach. If you have asthma, please bring any inhalers with you on the day of surgery. Please bring a list of medication allergies and all medications you are currently taking.
3. If you are a diabetic, please follow the specific instructions given to you at the time of your pre-admission testing.
4. No jewelry, body piercings, makeup, nail polish, hairpins, or contacts should be worn on the day of surgery. Please leave all valuables and money at home or with a family member.
5. Please wear loose-fitting, comfortable clothing. Keep in mind that a bulky dressing or splint may be placed on your hand, making it difficult to put your arm through a narrow sleeve.
6. Discontinue non-steroidal anti-inflammatory medication (NSAIDs – such as Aleve, Advil, Motrin/Ibuprofen, Mobic) and Vitamin E for 5-7 days prior to surgery. These medications can cause excessive bleeding. Tylenol is acceptable. Herbal medicines and diet pills should be stopped 2 weeks prior to surgery.
7. If you are taking aspirin or other blood thinning medications such as Plavix or Coumadin, you must contact your prescribing physician and obtain permission or clearance to discontinue the medication, and instructions on how/when to stop the medication before surgery.
8. If you are taking immunosuppressive medicines such as those prescribed for rheumatoid arthritis or lupus, contact your prescribing physician and obtain instructions on how/when to stop the medicine before surgery, and how/when to resume the medicine after surgery.
9. You will be notified what time and where to arrive prior to your surgery.
10. You must have a responsible adult available to take you home after surgery. YOU CANNOT DRIVE YOURSELF HOME. A bus, cab, or Uber driver is not considered a responsible caregiver.
11. Contact the office at (772)288-2400 if you develop any signs of infection such as fever, sore throat, painful urination, etc. or have any other questions or concerns.
Post-op
Dressings
You will have a bandage or dressing over the operative site. Unless specific instructions have been given, you are to leave the dressing on, do not change it, until your first postoperative appointment. Some dressings include casting material to help immobilize the extremity.
DO NOT GET YOUR DRESSING WET!
The bandages are placed in a sterile and specific fashion to protect the operative area. Once at home, if you feel your dressing is too tight, comes off, or accidentally gets wet, please contact Dr. Lekic’s office at (772)288-2400.
Activity
For the first 72 hours at least, elevate the operated extremity above the level of your heart to help avoid post-operative swelling and accompanying pain. While resting, place your hand/arm on several pillows, or while sitting at a table, rest your elbow on the table with your hand pointed to the sky. Try to balance your activity, allowing time for rest. If a sling is provided it is primarily until you regain strength after anesthesia or for occasional comfort while up and about. The sling does not allow for proper elevation and tends to cause stiffness in your elbow/shoulder if worn excessively. We encourage you to also move any fingers that are not immobilized all the way straight and into a full fist to help minimize finger swelling and stiffness. Do not squeeze anything, just a gentle pumping motion to push the fluid out of your fingers.
Pain
If you receive an anesthetic nerve block, your hand or arm may be numb for several hours, sometimes even the next day. You should make sure to pick up your pain medications before your surgery. Rest and elevation is one of the most important factors for pain control. Take your pain medication only as needed, but do not wait for the pain to become out of control. The most severe pain occurs as the nerve block wears off. Even if you are not having pain but feel the hand “waking up”, take your pain medicine so that it will be working when needed.
Pain medication may cause lethargy, nausea, and/or constipation. A prescription to reduce nausea (Zofran or ondansetron) and constipation (Colace or docusate) have been provided. Also, you have been given a pamphlet with alternatives to narcotic pain medications so that multimodal pain management is utilized to decrease the risk of becoming dependent on narcotics. Make certain you understand which pain medications to take and when.
Follow-up
You will be seen approximately 1 – 2 weeks after surgery depending on the procedure. Check your discharge sheet for specifics. If you are still uncertain, call Dr. Lekic’s office. Stitches will usually remain in for 10-14 days. Pins may remain in for 6 weeks or more. Your recovery may require additional appointments with an Occupational Therapist (OT).