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Frequently Asked Questions and Concerns

Questions are expected and welcomed after a surgery. To help answer some of these, here are some frequently asked questions and concerns that patients have. Please call our office regarding questions specific to your surgery.

If you are experiencing a medical emergency, please call 911 and proceed to your nearest emergency department.

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These medical emergencies include, but are not limited to, the following:

  • Chest pain, palpitations, or fainting

  • Shortness of breath, wheezing, or increased difficulty of breathing

  • New onset facial droop, slurring of words, or sudden loss of movement in one side of the body or one limb of the body

  • Severe headache that does not go away

  • If you have a concern about a blood clot: increasing swelling and cramping that does not go away even if the leg or arm are elevated above the level of your heart. If you have these symptoms and develop sudden chest pain or shortness of breath, please call 911.

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Other medical and surgical complications can occur. If during business hours, please call our office. For issues occurring after our offices are closed, please go to an urgent care or emergency department.

  • Persistent fever above 101.5F

  • Increased wound drainage with a foul smell or yellow, thick fluid

  • Excessive bleeding that has saturated your dressings

  • Urinary retention - If you cannot urinate after your surgery, please contact your primary care provider or proceed to an urgent or emergent care facility

Care for dressings, splint, and wounds after surgery are common questions. For specifics regarding care, please refer to the information packet you were provided for your surgery, discharge paperwork from the hospital, or by calling our office. The following are general guidelines for most circumstances:

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Splint/Casts: If you were discharged from our office or hospital with a hard cast or splint, please keep this clean and dry. If your splint/cast becomes wet it may require you to make an appointment with our office for changing this. A soaked splint or cast can lead to skin irritation, wounds, and infection if not treated appropriately. "Waterproof" covers can be used to avoid getting the splint or cast wet, but can still allow water in at the edges during showers. These covers will fail and allow water into the splint if submerged. Additionally, do not place anything down the splint/cast, for instance to scratch an area of your arm or leg.

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Adhesive dressings: Adhesive dressings are generally waterproof or water-resistant. You may shower with these dressings in place, but please pat them dry afterwards. If these dressings fall off or begin to allow water in, you may remove these dressings and leave the incision open to air. If this occurs, you may gently wash the incision with regular soap and water, but please do not submerge in water or scrub the incision. No need to replace with another gauze adhesive dressing unless there is wound drainage or personal preference. Otherwise please try to leave these adhesive dressings on until your first visit back after surgery.

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Soft, fabric (ACE wrap) dressings: This dressing can be removed on the first day after surgery. At this point you may begin showering and gently washing the incision with regular soap and water. Please do not submerge in water or scrub the incision. There is no need to replace with another dressing unless there is wound drainage or personal preference.

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Pools, hot tubs, swimming, etc: Do not submerge your incision in any water source until the incision has fully healed, even if covered by an adhesive water-resistant dressing. Generally, after 4 weeks the incisions is fully healed to allow for submersion in water.

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A low-grade fever (100.4F – 101F) is normal within the first week or two of surgery. This is typically not an indication of infection. This is your body’s natural inflammatory response to surgery, especially larger/major surgeries. I recommend taking Tylenol as needed to help treat the fever. If the fever is persistently over 101.5F or is associated with drainage or redness at the surgery site, then I recommend calling our office. If your fever is associated with other signs of a respiratory infection – coughing, wheezing, etc. – then I recommend evaluation by your primary care provider. If you are unable to reach our office, then evaluation by your primary care provider, urgent care, or emergency department may be appropriate.

Nausea and vomiting after surgery are common. This is typically because of anesthesia during your surgery and/or the use of opioid pain medications. Decreasing and stopping the use of opioid medications as soon as possible after surgery will help control these symptoms. Additionally, Zofran (ondansetron) or another anti-nausea medication will be prescribed for use at home. Please follow the directions listed on this medication.

  • Constipation is common after surgery and typically a side effect of opioid pain medications. Decreasing and stopping the use of these medications as soon as possible after surgery will help return normal bowel function.

  • I recommend drinking plenty of water during the day. Adequate fiber intake (25-30g of fiber per day for most patients) is also helpful – consider a fiber supplement if your normal diet does not meet this minimum. Most patients will be prescribed a stool softener (Colace/Dulcolax) which can be taken twice a day. If this does not relieve your constipation, you may also buy over the counter MiraLAX and take this according to the instructions, in addition to the Colace/Dulcolax.

  • Protein: Adequate amounts of protein after surgery are critical for your body to heal and recover effectively. Protein supplementation should be your number one focus after surgery, before any other supplements. I recommend consuming roughly 0.75g of protein per pound of body weight, especially within the first three months after surgery. Pre-made protein drinks – such as Ensure or Boost – or protein powders are easy and effective ways to make sure you are consuming adequate amounts of protein.

  • Vitamin D: Most people in this country are vitamin D deficient to some extent. Vitamin D is critical for adequate bone health, especially after surgery when we need bones to heal appropriately. Most of my patients will be prescribed a once weekly (50,000 IU) Vitamin D supplement to aid in their recovery.   

12-36 hours. As part of the multi-modal pain management, many patients will receive a nerve block by the anesthesia team the morning of their surgery. These blocks are effective at reducing pain during and after surgery, and they may also affect your ability to move operative arm or leg until the block as worn off. These blocks tend to last anywhere from 12-36 hours. As these blocks wear off, a sharp increase in pain is possible. Therefore, it is important that you start taking your prescribed pain medications as soon as you are discharged from the hospital, even if the block is still working and you have no pain. This will help decrease the risk of that sharp "rebound" pain when the block does eventually wear off.

  • You must be completely off opioid medication prior to driving and feel confidant to drive safely.

  • For surgeries on your arm: you may begin driving after you stop the opioid pain medications and you feel comfortable driving with your good (non-operative) arm. You must remove the sling while you are driving. 

  • For surgeries on your legs:

    • Right leg (braking leg) surgery: You must be out of any boot or cast prior to driving and have stopped your opioid pain medication. Additionally, you should wait 6 weeks after surgery to start driving. Most research indicates that it takes 4-6 weeks after surgery for your reflexes to recover enough to drive and brake safely.

    • Left leg (non-braking leg) surgery: Assuming you drive an automatic transmission vehicle, you may begin driving two weeks after surgery and once you have stopped your opioid pain medication. You may drive even if this leg is in a boot or cast. If you drive a manual transmission vehicle, you must wait 6 weeks for your reflexes to recover enough for safe driving.

Prescription refills or renewals can be requested by calling our office during normal business hours, Monday through Friday. Please allow up to 24 hours for requests to be approved and sent to your pharmacy. With increasing concerns about the opioid epidemic and increased monitoring of prescription drugs, narcotic/opioid pain medication refill requests will only be completed during an office visit on a case-by-case basis.

  • No. Extensive research has shown that for most patients and surgeries, antibiotics are not necessary after you have left the hospital and are not beneficial for preventing an infection.

  • For certain high-risk patients or surgeries, antibiotics may be prescribed on a case-by-case basis. The following patients or surgeries may benefit from a short course (2 weeks) of antibiotics after surgery:

    • Diabetes

    • Obesity (BMI > 40)

    • Inflammatory Arthritis (Rheumatoid Arthritis, Lupus, etc.) on Disease Modifying Antirheumatic Drugs (DMARDs)

    • Patients with prior prosthetic joint infections

    • Patients undergoing a revision joint arthroplasty

  • In 2024, the American Academy of Orthopedic Surgeons (AAOS) and the American Association of Hip and Knee Surgeons (AAHKS) published the following guidelines which I apply to all joint replacements (hip, knee, shoulder, and elbow):

    • Antibiotics are not necessary prior to invasive dental procedures. For patients with a total joint replacement (shoulder, elbow, hip, knee, etc.) routine use of antibiotics before any teeth cleaning or invasive dental procedures are not necessary. Routine use of antibiotics before an invasive dental procedure does not reduce the risk of a prosthetic joint infection. This recommendation is also supported by the American Dental Association (ADA)

    • Avoid undergoing invasive dental procedures within 3 months of a total joint replacement.

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