We would like to see you in the clinic post-operatively at:
- One – Two (1-2) weeks – you will meet with Chad Ford PA at this visit for a wound check, range of motion check, possible x-rays depending on the surgery, and question/answer session.
- Six (6) weeks
- Twelve (12) weeks (dependent on type of surgery)
If you live outside Colorado or outside the USA, and it is not possible to see us in the office, we can arrange for a virtual follow up visit with you by email. If x-rays are needed, we would kindly ask that you email or mail them to us for review so we may contact you with the results/progress.
Please follow these instructions carefully. If you have any questions, please contact a member of Dr. Cunningham’s team: Chad, Erika or Victoria
The post-op dressing change is a vital part of your surgical process. You will be supplied with the needed materials and instructions prior to discharge.
Knee: The 1st dressing change for a knee surgery will occur 3 days after your surgery. The ACE bandage should be removed as well as all gauze and disposed of. Feel free to shower at this point. Please do NOT soak the knee in any bathtub, pool, hot tub, etc. until advised. The white tape strips over your incisions should remain on until your follow-up visit (or until 10-14 days).
- The Tubigrip (tan) sleeve is used to hold the gauze pads in place
- Change the gauze pads after EVERY shower until there is no further bloody drainage from the wound.
- DO NOT remove, or apply ointment to the tape strips over the incisions
- These will be removed at your first follow-up appointment
- If they fall off before your appointment, please reapply them with the extras provided to you
Shoulder: The 1st dressing change for a shoulder surgery will occur 3 days after your surgery. The bandage on your shoulder should be removed as well as all gauze and disposed of. The white tape strips over your incisions should remain on until your follow-up visit (or until 10-14 days). Place the waterproof bandages (Op-Sites) on top of the tapes, covering all incisions. Feel free to shower at this point. Keep your surgical arm by your side while showering and use the other arm to shower. You can bend over to allow your surgical arm to gently fall away from your body to wash under your arm. Please do NOT soak the shoulder in any bathtub, pool, hot tub, etc. until advised.
At the time of each dressing change, evaluate the incision for signs of infection. Signs and symptoms are:
- Purulent drainage
- Increasing redness surrounding the incision.
- Increased pain and swelling
- Fever or chills
If you have any questions or concerns please phone us immediately at 970-569-3240 or 970-668-3633.
Dissolvable: These look like clear fish line. They require no care. Some incisions may have suture “tails” or sutures at either end sticking out of the skin an inch or so. At the first post-op appointment, the “tails” will be clipped at the skin level. All suture material below the skin will gradually resorb. For out of town patients, suture tails can be done with fine scissors or small fingernail clippers.
Removable Sutures or Staples: If blue or black sutures or shiny metal staples were used to close your incision, they will be removed at 10-14 days from surgery by the clinic staff or your doctor at home. The staples need to be removed using a special staple remover. The sutures need to be removed using a sterile suture removal kit. Please do not try to remove them at home on your own unless instructed to do so.
- Keep the incision dry at all times for the 3 days
- Change gauze pads after each shower until there is no further bloody drainage
- Change the Op-Site (waterproof dressing) every 3 days for a shoulder surgery until there is no longer any bloody drainage.
Avoid baths, swimming pools for the first two (2) weeks.
Swelling reduction, pain reduction, and improving your range of motion are the primary goals in the first two (2) weeks following surgery.
The following will help you reach your goals:
Elevate your operative body part whenever possible. Elevation means the operative region is higher than your heart.
Ice the surgical site at least 3-4 times a day for 20 minutes at a time. You can ice more than this but be sure that your skin is not getting too cold (especially if you have had a nerve block and your sensation is compromised). You can use a motorized cooling device (arranged before surgery), ice bags, freezer wraps, or even frozen peas.
- When icing, have a protective layer between your skin and the ice.
- Be very diligent with your icing
- Check your skin to be sure it is not getting injured (frostbite) by the ice.
Ted Hose/Blood Clot Prevention
- TED hose are to be worn for the first two (2) weeks after surgery.
- Control swelling in the lower extremity
- Decrease the chance of blood clot formation.
Signs and symptoms of a blood clot:
- Pain (“Charlie Horse” Type)
- Swelling in calf and lower leg
(CALL IMMEDIATELY IF SYMPTOMS OCCUR). It is possible to get a blood clot in the non-surgical leg, so please wear the socks on both legs. You may remove them daily to wash and dry them, but please wear them as much as possible to gain full benefit.
You will be given specific exercises to follow at different time frames during your rehabilitation. Follow these instructions carefully. DO NOT ADVANCE or let your Physical Therapist advance your protocol beyond the normal time frames unless directed so by Dr. Cunningham.
A physical therapy prescription will be sent to the office that you have previously chosen. Please bring any protocol that was given in your post-op folder to your physical therapist on your first visit. If instructed to do physical therapy, you may begin the day after surgery or as soon as possible.
Following ALL knee surgeries you should have a physical therapy prescription sent to the office you have chosen.
Following shoulder surgeries (in particular rotator cuff repair surgeries), it is very likely that you will NOT have a physical therapy prescription in your folder. Many shoulder surgeries do not require formal physical therapy until 6-8 weeks following surgery dependent on the procedure. Your physical therapy prescription will be given to you most commonly at your 6 week visit.
Range of Motion
ROM exercises will help to decrease the amount of swelling and decrease the likelihood of scar tissue forming.
By two (2) weeks post-op your range of motion goals are:
Knee: Extension _______ Flexion _________
- Partial weight bearing: ______ for ______ weeks with crutches or walker.
- Non weight bearing/toe-touch weight bearing for ______ weeks with crutches or walker
- Weight bearing as tolerated with/without crutches or walker.
- A brace is / is not needed.
- The brace is set to limit you to _________ extension and _________ flexion while walking for ______ weeks.
- The brace should be worn at all times unless showering or icing the knee. If you are unable to sleep with the brace on, please discuss this with one of Dr. Cunningham’s team members. They may allow you to remove it while sleeping dependent on procedure.
- A sling is / is not needed
- Please have the sling on at all times unless otherwise directed. The only time you may remove the sling is to shower and perform your passive pendulum swings (~5 times a day for 5-10 minutes each time). Please sleep in your sling. You may need to sleep sitting upright in a recliner or propped up in your bed until you can sleep flat in bed comfortably.
You will be given prescriptions for medications at your pre-operative appointment. If you did not have a pre-operative appointment, these prescriptions will be given to you on your surgery day.
Your discharge medications may be as follows:
- MS Contin (Morphine Sulfate) / Percocet / Oxycodone / Vicodin / Norco / Dilaudid – ARE NARCOTICS that help control pain
These narcotic pain medications CANNOT be called into the pharmacy; a prescription must either be mailed to you or picked up in person in our office per law. Plan appropriately for refill request. Refills will not be authorized after office hours or on the weekend or holidays. Per our office policy, it may take up to 24 hours to authorize a refill request.
PLEASE DO NOT:
- MIX WITH ALCOHOL OR MARIJUANA
- DRIVE WHILE TAKING PAIN MEDICATION
- TAKE ANY ADDITIONAL TYLENOL IF ON VICODIN, PERCOCET OR NORCO.
No more than 3000mg or (3g) or Tylenol (APAP) per 24 hrs total.
- Valium (Diazepam) – is a Benzodiazepine for muscle spasms and helps to relieve anxiety and insomnia
- Flexeril (Cyclobenzaprine) – is a muscle relaxant use to decrease muscle spasms
- Aspirin – Take one 81mg aspirin daily for two (2) weeks following knee surgery to thin the blood unless otherwise advised. Please let Dr. Cunningham’s team know if you have ever had a blood clot or have a strong family history of clotting.
- Multivitamin– A daily Multivitamin should be taken to help ensure you get the correct nutrition to help your body heal after surgery.
- Colace (Docusate Sodium) – A stool softener than can be purchased over the counter to help relieve constipation which commonly occurs when taking narcotic pain pills. Over the counter laxative (MiraLAX, Milk of Magnesia) may also be used for more severe constipation.
- Zofran (Odansetron) – A nausea medication. Please follow instructions on bottle regarding how to properly take.
- Scopolamine patch – A nausea medication. It generally lasts 3 days long and is a patch that you should place behind your ear. Often, if you have a history of post-operative nausea, this is given prior to surgery. We ask that you put the patch on the night prior to your surgery. This will assist with decreasing your nausea following surgery.
OTHER MEDS: ______________________________________________________________________
*Pain medications cause constipation. Please drink plenty of fluids and take an over the counter stool softener!*
- Use as directed on the label.
- Take all medications with food.
- Please phone with any problems/questions.
**WE TRY TO AVOID ANTI-INFLAMMATORY MEDICATIONS FOR THE FIRST 6 WEEKS FOLLOWING SURGERIES FOR LIGAMENT OR TENDON REPAIRS, FRACTURE REPAIRS, OSTEOTOMIES.**
**If you have any questions or concerns please EMAIL US at firstname.lastname@example.org (or call us) at any time**
970-569-3240 or 970-668-3633
***For afterhours emergencies there is a physician and PA (Physician Assistant) on call with our office 24 hours a day 7 days a week. They can be reached by calling any of our office phone numbers and speaking with the answering service ***