SHOULDER SURGERY INFORMATION
Do not eat or drink anything after midnight of the night before your surgery. Do not apply deodorant in the morning of your surgery under the arm of the shoulder that will be operated on. If you are having out-patient surgery and going home after your surgery, make sure you have someone who can drive you home later in the day.
What to expect after arthroscopic shoulder surgery?
It is normal to have swelling and discomfort in the shoulder for several days or a week after surgery. Apply ice bags or use the Cryocuff/Polar Care device you may have been given to control swelling. Ice should be applied 20-30 minutes at a time, every hour or two; put a thin towel or T-shirt next to your skin if using ice in a plastic bag. Icing is most important in the first 48 hours, although many people find that continuing it lessens their postoperative pain. As an alternative to ice, you may try a package of frozen vegetables. It refreezes between applications and can be easily molded to the contour of your shoulder.
If you had a nerve block, the local anaesthetic may keep your shoulder numb for several hours. You will be given a prescription for powerful pain medication when you are discharged from the hospital. If you find you do not tolerate it well, call our office and we will try another one. Begin the pain medication at the first sign of discomfort. If you wait until you are in pain, you have waited too long and the pain cycle will have started. It will now take longer for the pain medication to work.
Many patients find that lying down accentuates their discomfort. You might sleep better in a recliner, or propped up in bed. A pillow placed behind your elbow may also help. PUMP YOUR HAND AND MOVE YOUR WRIST AND ELBOW TO KEEP THE BLOOD CIRCULATING AND PREVENT STIFFNESS. You should come out of the sling at least three times a day to move your elbow.
CAUTION -- if you have had a SLAP repair, do not actively flex your elbow. This will threaten the repair. You may hold the hand of your operated extremity with your other hand and allow the arm to extend gently and then use this hand to flex your operated arm back up again. Please avoid active elbow flexion.
Keep the postoperative dressing clean and dry. Unless it becomes wet or too tight because of swelling, leave the bandages in place for at least two days. TWO DAYS AFTER YOUR SURGERY, REMOVE YOUR BANDAGES. Cover incisions with Band-Aids to keep from snagging the sutures on clothes. You may shower then, but try to keep the incisions dry for the first 10-14 days. Do not wet your incisions directly (bathing or swimming) until at least 2 weeks postoperatively.
The sutures will be removed at your first postoperative visit 7-14 days after surgery. We would like to see you back in the office 7-14 days after surgery. If you don't have your first post-operative visit scheduled, call our office to make one.
If you have an arthroscopic reconstructive procedure such as an instability repair, labral repair, or rotator cuff repair, your arm will be in a sling for up to six weeks. You can remove the sling to go in the shower; however, keep your arm at the side and do not use it actively. Do not move the arm out to the side. You can type on a computer with your arm at the side and you can bend your elbow to feed yourself (UNLESS YOU HAVE HAD A SLAP REPAIR). Otherwise keep the sling on. After about six weeks, we will prescribe a physical therapy program appropriate for your shoulder. It often helps to call before surgery to make an appointment with your physical therapist.
Be in the care of a responsible adult. Abstain from drinking alcoholic beverages and from smoking. You may eat a regular diet, if not nauseated. Drink plenty of non-alcoholic, caffeine-free fluids. Do not make important decisions or sign legal documents. Plan to take a few days off work. If you had a subacromial decompression or distal clavicle/acromioclavicular (AC) joint resection, you can remove your sling on the morning after surgery. Follow guidelines above for keeping the incision dry.
Rotator Cuff Repairs: The tendon repair needs six weeks to heal so active motion of the shoulder is not permitted during this time. Therapy may begin after your first visit to us and will be passive motion performed by the therapist. You will need to wear your sling for up to six weeks. After this period you will begin a program of active motion and, eventually, strengthening.
Arthroscopic Release of a Frozen Shoulder: Patients may remain in the hospital for a day or two in order to have pain control by intravenous medicines or by a catheter that numbs the nerves down the arm. You should arrange in advance for your physical therapy to start immediately on discharge from the hospital. This is important so as not to lose any motion gained by the arthroscopic release. You should start to use your arm right away and not wear your sling. Therapy is usually ordered for every day (five days/week) for the first two weeks and then adjusted by us after your first office visit.
Total or Partial Shoulder Replacement for Arthritis or Fracture: Therapy may or may not begin immediately on leaving the hospital. You will be instructed if you can do pendulum exercises on your own and you may see a therapist in the hospital for therapy. This depends on the type of surgery you have. You can use your arm from the elbow down but no active motion of the shoulder until ordered by us. We will review this with you on your first visit after surgery.
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