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How to Properly Ice and Elevate

ice-and-elevation-protocol

Post Ortho Surgery Frequently Asked Questions

Post-Operative Questions Related to Pain:

  • Pain following surgery is typical. Normal surgical pain can be described using many terms: aching, throbbing, sharp, shooting, stabbing, tingling, cramping, etc.
    1. How often should I take my pain medication?
      • It is recommended for at least the first week to take pain medication as prescribed.
      • It is difficult to catch up to pain if it becomes out of control.
      • Pain medication also assists with making activity and exercises less painful.
    2. What is this sharp, shooting, tingling pain I feel? (often at night)
      • This is most likely nerve pain as nerve re-growth is occurring.
      • When we sleep, this is a perfect time for our body to rest and heal.
    3. Why do I hurt behind my knee?
      • You are most likely feeling muscle strain or stretching to the muscles behind your knee when in an extended position.
      • This feeling can also happen when you are in an elevated position and there is no support under the knee. Refer to ice/elevation picture to ensure you have proper positioning of pillows in a “stair-step” fashion or discuss with your physical therapist at your next visit.

Post-Operative Questions Related to Drainage:

  • Drainage can occur following surgery. It can increase with activity at times. Drainage can be limited by properly icing/elevating. If you have small amounts of increased drainage, this is not of immediate concern and can be addressed at your next home health visit.
    1. Help! My bandage is saturated, what do I do?
      • First, do not panic! The bandage most likely needs removed to assess drainage and be replaced with a new bandage.
      • Immediately call EnTrust Home Health using number found on pink sticker of your admission folder.
      • If you can take a picture of your bandage using your phone, go ahead and take one and have it ready to send via text message. The clinician on-call will likely ask for a picture if possible.

Post-Operative Questions Related to Fever:

  1. Why do I have a fever? Should I be concerned?
    • Running a low-grade fever following surgery is common, especially if it is <101.
  2. How can I assist with breaking a low-grade fever?
    • Stay hydrated! If you have not been already, increase water intake.
    • Use incentive spirometer per protocol – 10 breaths every 2 hours.

Pain Medication Side Effects Questions:

  1. How can I stop this awful nausea/vomiting I have?
  • Sometimes, pain medication can cause an upset stomach, especially if you are taking medication on an empty stomach.
  • We encourage eating a small snack prior to taking pain medication as this often helps reduce nausea.
  • If you already know you are prone to getting sick when taking pain medication, it helps to take something else that can help reduce nausea and/or vomiting.
  • Often times, your surgeon will also prescribe you another medication to reduce side effects that may occur when taking pain medication.
  • Check prescription labels for this information.

Post-Operative Questions Related to Physical Therapy:

  • “Motion is Lotion”: physical therapists (PT) often use this term to help describe the importance of initiating movement and exercise following surgery.
  • Early movement improves outcomes and limits future joint stiffness or immobility.
    1. Okay, but how often should I exercise? What about walking – can I walk too much? How can I know if I’m overdoing it? Here are some simple tips to help get you started:
  • Follow your PT’s direction on which exercises to begin.
    • Perform exercises 2-3 times daily.
    • Be sure to complete exercises to the point of mild discomfort. Do not push into extreme pain levels!
  • When first returning home, get up and walk short distances about every hour.
    • Short distances include household distances such as using the bathroom, getting a drink/food from the kitchen, or doing a short lap up/down hallway.
    • After the first week, your PT will assist with giving direction on increasing walking distances as appropriate.
  • After exercise, walking, or other activity, this can sometimes increase discomfort and even swelling to the surgical site.
    • To help reduce pain and swelling, be sure to rest, ice, and elevate properly immediately following exercise or walking.

I haven't had a bowel movement in several days, what can I do?

  • If you are into more natural remedies, try the following: increase water intake, eat high fiber foods, and drink warm prune juice.
  • For those that prefer over the counter remedies, purchase Colace (docusate sodium) or Miralax, which are both stool softeners that can be found at any local pharmacy.

I just feel so itchy and I can't stop scratching, what will help?

  • Another common side effect of pain medication is itching or feeling as if “your skin is crawling.”
    1. Please check your prescriptions for Promethazine or Vistaril, these are commonly prescribed preventatively. If you do not have a prescription for the pre-mentioned, feel free to call our office and we will contact your surgeon.
    2. If your surgeon did not prescribe anything, an over-the-counter alternative that would be okay to use is Benadryl.

How do I know if I have a blood clot?

  • Majority of blood clots manifest in a combination of 4 things:
    1. Significant increase in swelling
    2. Significant increase in redness
    3. Significant increase in pain with inability to gain relief, specifically to the calf of your leg.
    4. Increase in fever at 101.3 or greater.
  • Keep in mind that the following occur as a normal inflammatory response related to surgery and do not always indicate a blood clot: pain, swelling, redness, warmth, and limited mobility. Call our office if you continue to have concerns and we can contact your surgeon if necessary.

Woah! I have significant bruising all up and down my leg, is this normal?

  • Majority of the time, even significant bruising is common following surgery.
    1. Surgery causes small blood vessels to leak under the skin that causes bruising. Depending on where this occurs, bruising can travel up or down your leg.
    2. Significant bruising can be reduced by properly elevating following surgery and limiting sitting up with your legs hanging down.