Prepare for Surgery

• Start with clear liquids (water, juice, Gatorade) and light foods (jello, soup, crackers). Progress to normal diet as tolerated if you are not nauseated.

• Avoid greasy or spicy foods for the first 24 hours to avoid GI upset.

• Drink plenty of fluids to help prevent constipation.

• If you received a nerve block before or after surgery to help with post-operative pain control, you may have numbness or inability to move the limb. Do not be alarmed as this may last 8-36 hours depending upon the amount and type of medication used by the anesthesiologist.

• If you are experiencing numbness after 36 hours, please call the office.

• When the nerve block begins to wear off, you will feel a tingling sensation, like pins and needles. It is important that you start taking the pain medication at that time to ensure that you stay ahead of the pain.

• Narcotic pain medicine (Percocet or Norco): The goal of post-operative pain management is pain control, NOT pain elimination. You should expect some pain after surgery. Constipation, nausea, itching, and drowsiness are side effects of this type of medication. You should take an over-the-counter stool softener (Colace and/or Senna) while taking narcotics to prevent constipation. If you experience itching, over-the-counter Benadryl may be helpful. Narcotic pain medications often produce drowsiness and it is against the law to operate a vehicle while taking these medications. Do not take Tylenol products while on these medications, since they already contain Tylenol.

  • Refill Policy: Due to the rising opioid addiction epidemic in the United States, refills of your narcotic pain medications will only be provided on a case-by-case basis. Please use these medications judiciously.

• Anti-inflammatory (NSAID) medicine (Naproxen, Mobic, or Indomethacin): These provide both anti-inflammatory effects and pain relief. Do NOT take this medication if you have had an ulcer in the past unless you have cleared this with you primary care doctor. Take NSAIDs with food or antacid to reduce the chance of upset stomach. After hip arthroscopy, you may be prescribed a prolonged course of Indomethacin and Naproxen to prevent abnormal bone formation (heterotopic ossification) within the soft tissues of your hip.

• Anti-nausea medicine (Zofran): You may experience nausea related to either the anesthesia or narcotic pain medication. If so, you will find this medication helpful.

• DVT prophylaxis (Aspirin, Xarelto, Lovenox, or Coumadin): For most patients, activity alone is sufficient to prevent dangerous blood clots, but in some cases, your personal risk profile and/or the type of surgery you have undergone makes it necessary to take a blood thinner to help prevent blood clots.

• Stool softener (Colace, Senna): These are available over-the-counter at your local pharmacy and should be taken while you are taking narcotic pain medication to avoid constipation. You should stop taking these medications if you develop diarrhea. Over-the-counter laxatives may be used if you develop painful constipation.

• Icing is a very important part of your recovery. It helps reduce inflammation and improves pain control. You should ice several times each day for 30 minutes at a time. Please make sure there is a thin piece of material (sheet, towel, or t-shirt) between the ice and your skin.

• If you opted for one of the commercially available ice machines and a compression setting is available, you should use LOW or NO compression during the first 5 days. After that, you may increase compression setting as tolerated. If the compression is bothering you, then do not use compression.

• Ice as much as possible (30 minutes on, 30 minutes off, etc.). The more you ice during the first 2 weeks, the less pain, swelling, and inflammation you will experience.

• If you have a known diagnosis of RSD or CRPS, please discuss with Dr. Wang before using ice.

• You may remove the outer dressing after 2 days. Do NOT remove the Steri-strips (white stickers) if present over your incisions. The Steri-strips may come off on their own, which is normal.

• After the bandage has been removed, you may leave the incisions open to air. Alternatively, if you prefer to keep them covered, you may do so with Band-Aids, a light gauze dressing, and/or a clean ACE wrap.

• Do NOT apply any ointment or creams to the incision.

• You may shower after the bandage has been removed (2 days), but it is very important that you keep the wounds dry until your first postoperative visit (10-14 days). Covering them with saran wrap is often a very inexpensive and effective way to stay dry. There are a number of other water-repellent bandages available at your local pharmacy.

• You may remove your brace or sling to shower, unless otherwise instructed. As your balance may be affected by your recent surgery, we recommend placing a plastic chair or bench in the shower to help prevent falls.

• Do NOT take baths, go into a pool, or soak the operative site until approved by Dr. Wang.

• In some cases, you will given a document detailing home exercises to perform after surgery. You may start these home exercises right away.

• If needed, physical therapy is just as important to your recovery as the surgery. You will be provided with a prescription and recommended physical therapy facilities the day of surgery. You do not need to start formal physical therapy before your first post-operative visit unless otherwise instructed by Dr. Wang.

• After reconstructive knee surgery (e.g., ACL reconstruction), you can apply the neuromuscular electrical stimulation system (e.g., Kneehab XP) beginning on the third or fourth day after surgery. Dr. Wang recommends using the device for three 20-minute sessions per day, 5 days per week.

• You may drive when you are:

  (1) no longer taking narcotic pain medication

  and

  (2) no longer wearing a sling or knee brace on the right leg.

• Ultimately, it is your judgment to decide when you are safe to drive. If you are at all unsure, do not risk your life or someone else’s.

• Avoid flights and long distance traveling for 4 weeks after surgery. It is important to discuss your travel plans with Dr. Wang, as additional medications may need to be prescribed to help prevent blood clots if certain travel is unavoidable.

• Typically, you may return to sedentary work or school 3-7 days after surgery if pain is tolerable and you are no longer requiring narcotic pain medication during work/school hours.

• In conjunction with your input, Dr. Wang will determine when you may return to more physically rigorous demands.

• If you require a note for work/school, please let us know.

• PAIN: We do everything possible to make your pain/discomfort level tolerable, but some amount of pain is to be expected.

• WARMTH: Mild warmth around the operative site is normal for up to 3 weeks.

• REDNESS: Small amount of redness where the sutures enter the skin is normal. If redness worsens or spreads it is important that you contact the office.

• DRAINAGE: A small amount is normal for the first 48-72 hours. If wounds continue to drain after this time (requiring multiple gauze changes per day), please contact the office.

• NUMBNESS: Around the incision is common.

• BRUISING: Is common and often tracks down the arm or leg due to gravity and results in an alarming appearance, but is common and will resolve with time.

• FEVER: Low-grade fevers (less than 101.5°F) are common during the first week after surgery. You should drink plenty of fluids and breathe deeply.

A follow-up appointment should be arranged for 10-14 days after surgery. If one has not been provided, please call the office to schedule.

Most orthopedic surgical procedures are uneventful. However, complications can occur. The following are things to be aware of in the immediate postoperative period. If any of the following applies to you after surgery, please notify us immediately by calling 714-456-7012.

• FEVER – Temperature rises above 101.5ºF or associated chills/sweats

• WOUND – If you notice drainage more than 4 days after surgery, if the drainage turns yellows and foul smelling, if you need to change gauze multiple times per day, or if sutures become loose.

• CARDIOVASCULAR – Chest pain, shortness of breath, palpitations, or fainting spells must be taken seriously. Go to the emergency room (or call 911) immediately for evaluation.

• BLOOD CLOTS

• URINARY RETENTION – If you cannot urinate the night after surgery, please go to the Emergency Room.