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Post Op Instructions

UPON DISCHARGE

If you are having surgery at the Main Campus, you will be supplied with either crutches or a walker upon your discharge; whichever you are most comfortable with. If you already own crutches or a walker, you may bring it with you to avoid this additional charge.

If you are having surgery at the Ambulatory Surgery Center on Second Avenue, please bring crutches or a wheelchair with you as indicated in your surgery letter.

You will leave the hospital in a dressing similar to a cast, which consists of a splint, wrapped in gauze and wrapped again in an ACE bandage. THIS CANNOT GET WET. Should your dressing get wet, please call the office immediately as this must be changed.

You will be given pain medication upon your discharge. New York State law now requires all controlled medications to be electronically sent to the pharmacy of your choice. Please confirm with the nursing staff that the pharmacy in your chart is valid and up to date.

You may begin taking your pain medication as directed when you arrive home. If you wish to delay the start of your pain medication it is suggested you start taking it when the feeling begins to come back (similar to when dental Novocain begins to wear off).

  1. DO NOT PUT ANY WEIGHT ON THE OPERATIVE LEG. Between the operative date and the 1st post operative appointment, Dr. Drakos requires you to remain non-weight bearing and non ambulatory for 22 out of 24 hours of the day. This means you may get up to use the bathroom and get something to eat, but not much else, all while not putting any weight on the operative leg.

  2. DO NOT GET THE DRESSING WET. The dressing in which you leave the hospital should remain untouched until you return for your 1st post operative appointment unless otherwise instructed by Dr Drakos. Should the dressing get wet, please call the office immediately to arrange for a dressing change.

  3. KEEP THE OPERATIVE FOOT ELEVATED. Dr Drakos also advises that you keep the operative leg elevated if there is swelling and discomfort present. This helps in reducing swelling, pain, throbbing and the risk of infection.

  4. KNEE WALKERS/KNEE SCOOTERS ARE PROHIBITED UNTIL AFTER THE FIRST POST OPERATIVE APPOINTMENT. You should use crutches, a walker or a wheelchair during the first two weeks post operatively.

WHAT TO EXPECT

There is some discoloration associated with surgery and is to be expected. Any severe changes in color (eg: toes turning blue or red) or temperature (eg: very hot or very cold) should be reported to the office immediately to be addressed. If you are in any way concerned or unsure if what you are experiencing is normal, do not hesitate to contact the office. If it is after hours, the service will be able to reach either the doctor on call or Dr Drakos if necessary. The anesthesia block that will be administered prior to your surgery may last as long as 48 hours. If the numbness lasts longer than 48 hours, please call the office.

The risks, benefits and alternatives to surgical intervention were discussed at length during the visit. Specific risks discussed included: infection, wound breakdown, numbness and damage to nerves, tendon, muscle, arteries or other blood vessels. The possibilities of persistent pain and discomfort were also mentioned. Also discussed was the possibility of fracture, malunion, nonunion, and painful or broken hardware which may ultimately have to be removed. Medical complications related to the patient’s general medical health including deep vein thrombosis, pulmonary embolus, heart attack, stroke, death and other complications from anesthesia were discussed as well. We will take steps to minimize these risks by using sterile technique, antibiotics and DVT prophylaxis when appropriate and following the patient postoperatively in the clinic setting to monitor progress. The benefits of surgery were discussed including the potential to improve the current clinical condition through operative intervention. Alternatives to surgical intervention include continued conservative management which may yield less than optimal results in this particular case.

BETWEEN SURGERY DATE AND 1ST POST OP APPOINTMENT

If you have any questions about how you will manage at home after your surgery, the Hospital for Special Surgery has a Post Operative Discharge Planning Department to help you. It is staffed with nurses who are able to help assess your needs and what type of post-operative assistance you may qualify for. Please contact Noreen Curran at 212 606 1787 for assistance.

Whether or not you use any or all of the following devices is entirely up to you.

During your first two weeks post surgery, you may want to use a foam wedge to help keep the area elevated, and a cast bag or a shower stool to assist when bathing. These items are not reimbursable by insurance. Should you wish to use any of these items, you may purchase them from a local vendor. Neither Dr Drakos’ office nor the Hospital for Special Surgery supplies this equipment.

During your first two weeks post surgery, you may want to use a wheelchair and/or a commode. These items MAY be covered by insurance; you should check with your carrier directly and ask about your DME (durable medical equipment) coverage. If you are interested in using a wheelchair or commode, please let Dr Drakos’ office know and we will provide you with the required prescription(s) and letter of medical necessity. If prior authorization is required by your carrier, the vendor supplying the device is responsible for obtaining it.

Dr. Drakos does not allow for the use of knee walkers/knee scooters until after the first post operative appointment which is approximately 2 weeks after your surgery date. If you will be interested in using a knee walker/knee scooter after that timeframe, please let the office know as soon as possible so that the appropriate planning can be done. We use a company called Knee Walker Central who will check your benefits and contact you within 2 business days to let you know what – if any – out-of-pocket costs may be associated with the knee walker/knee scooter.