Anesthesia
After undergoing a procedure that required a general anesthetic, you may feel a little off for a day or two. During that time, you should not: drink alcoholic beverages, make important decisions or engage in any potentially hazardous activities.
It is common to feel slightly nauseated after anesthesia. Start with a light, low fat diet until your appetite returns. It is common to have constipation after surgery secondary to the combination of inactivity, effects of general anesthesia, and narcotic medications. To prevent post-operative constipation, increase water and fiber to your diet. Remain as active as possible. If there are increasing difficulties with constipation, try Metamucil (2 TBS in a large glass of water) or use a stool-softener (such as Senokot or Colace). If you continue to have difficulties, please call your primary care physician.
Bathing and Wound Care
It is not unusual for some blood to show on the dressing or splint. If bleeding seems to be continuing and the area is larger than 2 inches, please call the office.
The dressing should cover the wounds and support the leg/ankle/foot but should not feel overly tight or uncomfortable. If the dressings seems too tight, please call the office or go the ER if after hours.
Cover the splint/dressings with plastic or use a plastic bag when showering. If the splint/dressing becomes wet it can be dried with a hair dryer or if too wet please call the office.
Do not remove your dressing or your splint.
Pain Management
A long acting local anesthetic is injected into the area of your incisions after surgery and usually wears off 6-12 hours later.
The interval for taking pain medication, as noted on your bottle (such as every 4 hours), is a minimum interval. You should not take the medication more frequently than instructed. You may take the medication less often (such as every 6-8 hours) if you are not in pain.
You have been prescribed a short acting narcotic pain medication (such as Percocet or Vicodin). This medication is taken to relieve pain but not to prevent it. You should not set your alarm clock to remind you to take your pain medication, nor should you take it on a set schedule if you are not hurting, as this can result in overdosing of the medication.
As long as you do not have ulcers or kidney problems, you may also use a NSAID (such as Ibuprofen or Aleve) in addition to or instead of the narcotic medication. An average sized adult may take three 200mg Ibuprofen every 8 hours or Naprosyn (Aleve) one pill 2x per day with food for a period of two weeks.
Ice and Elevation
You should go directly home from the hospital/surgery center and limit your activity for the remainder of the day.
Place ice packs on your foot or ankle (it will work even with the dressings in place) and change them as needed. Ice packs can simply be a bag of frozen vegetables or fancier ice bags from a surgical supply store. You will not feel much of the cold through the dressing initially but it will still help to decrease swelling and pain.
Elevation is the other best way to decrease pain and swelling. The leg will often throb when it is not elevated. Elevation can also decrease the risk of blood clots, by decreasing pooling in the leg. Work on moving your ankle/toes as this will keep the blood flowing in your leg.
Weight Bearing and Crutches
You are allowed to weight bear as able. You are encouraged to use crutches, a cane or a walker if you feel unstable when walking or standing. You may have been given a hard soled shoe or post op shoe which will make walking more comfortable.
Range of Motion
It is OK to move your knee and your toes. Your ankle and other joints of your foot may be immobilized in a splint, cast or dressing.
Physical Therapy
Most but not all patients will be sent to physical therapy in their recovery s/p surgery. When PT will be started will depend on the type of surgery you have had. The physical therapist will give you a series of exercises to work on the motion and strength of all of the muscles in your lower leg including your foot and ankle. The physical therapist will also chart the progress you make in your recovery.
Driving
After you are able to walk without crutches and without limping, your leg is mechanically able to perform the tasks associated with normal driving. Every patient is different in regards to their pain control/ability to concentrate/ability to recover strength after surgery. You must make your own determination as to whether you are safe to drive. It is often helpful to practice in a parking lot before heading out on the roads.
You cannot drive if you are taking narcotic pain medication.
Follow Up
You should have an appointment already scheduled to see Dr. Zell in approximately 7-10 days after surgery. This will be written on your discharge instructions from the hospital/surgery center. If you do not have an appointment, or if you need to change the date/time, please call Renee (Dr. Zell’s clinical coordinator) at 203-785-7720.
Reasons To Call The Office Before Your Follow Up:
- Fever greater than 101.5 (it is common to have a low-grade fever the first night or two after surgery)
- Redness or swelling that is spreading from the edges of the incision
- Pain that is severe and worsening and that is not relieved by rest, elevation and pain medication
- Chest pain, trouble breathing or shortness of breath (Call your primary care doctor or call 911)
The office phone number is 203-785-7720 for any questions or emergencies.
There is a doctor on call 24 hours per day. After hours, please call 203-785-2579 and the doctor on call will be paged. If you think you have an urgent problem that needs to be seen right away go to the emergency room or dial 911.