Diet

  • Start with clear liquids (water, juice, Gatorade) and light foods (jello, soup, crackers). Progress to normal diet as tolerated if you are not nauseated.

  • Avoid greasy or spicy foods for the first 24 hours to avoid GI upset.

  • Drink plenty of fluids after surgery.

Anesthesia

  • If you received a nerve block before or after surgery to help with post-operative pain control, you may have numbness or inability to move the limb. Do not be alarmed as this may last 8-36 hours depending upon the amount and type of medication used by the anesthesiologist.

  • If you are experiencing numbness after 36 hours, please call the office.

  • When the nerve block begins to wear off, you will feel a tingling sensation, like pins and needles. It is important that you start taking the pain medication at that time to ensure that you stay ahead of the pain.

  • If your finger is cold, numb, or blue more than 6 hours after a finger procedure, please contact the office immediately.

Medications

  • Narcotic pain medicine (Oxycodone, Norco, or Percocet): The goal of post-operative pain management is pain control, NOT pain elimination. You should expect some pain after surgery. Constipation, nausea, itching, and drowsiness are side effects of this type of medication. You should take an over-the-counter stool softener (Colace and/or Senna) while taking narcotics to prevent constipation. If you experience itching, over-the-counter Benadryl may be helpful. Narcotic pain medications often produce drowsiness and it is against the law to operate a vehicle while taking these medications. Do not take additional Tylenol if the product already contains Tylenol.

  • Refill Policy: Due to the rising opioid addiction epidemic in the United States, refills of your narcotic pain medications will only be provided on a case-by-case basis. Please use these medications judiciously.

  • Anti-inflammatory (NSAID) medicine (Naproxen, Mobic, or Indomethacin): These provide both anti-inflammatory effects and pain relief. Do NOT take this medication if you have had an ulcer in the past unless you have cleared this with you primary care doctor. Take NSAIDs with food or antacid to reduce the chance of upset stomach.

  • DVT prophylaxis (Aspirin, Xarelto, Lovenox, or Coumadin): For most patients, activity alone is sufficient to prevent dangerous blood clots, but in some cases, your personal risk profile and/or the type of surgery you have undergone makes it necessary to take a blood thinner to help prevent blood clots. In patients who have undergone a shoulder replacement, Aspirin 81mg twice daily will be prescribed for 4 weeks after surgery.

  • Stool softener (Colace, Senna): These are available over-the-counter at your local pharmacy and should be taken while you are taking narcotic pain medication to avoid constipation. You should stop taking these medications if you develop diarrhea. Over-the-counter laxatives may be used if you develop painful constipation.

  • Please see Dr. Kaplan's helpful pain medication flowsheet. Tylenol and Anti-inflammatories can be very helpful to minimize discomfort and pain.

Ice

  • Icing is a very important part of your recovery. It helps reduce inflammation and improves pain control. You should ice several times each day for 30 minutes at a time, three to four times a day. Please make sure there is a thin piece of material (sheet, towel, or t-shirt) between the ice and your skin.

  • Ice as much as possible (30 minutes on, 30 minutes off, etc.). The more you ice during the first 2 weeks, the less pain, swelling, and inflammation you will experience.

  • If there is a hard splint in place, you can place the ice in an area where the splint ends or over the splint.

Dressings

  • If you have been placed in a hard splint, do not remove this until your follow up appointment. You may shower but cover the splint with a plastic bag and keep clean and dry. There are other commercially available shower bags available on Amazon or at your local drug store.

  • If you have been placed in a soft bandage, you may remove the dressing after 3 days. Do NOT remove the Steri-strips (white stickers) if present over your incisions. The Steri-strips may come off on their own, which is normal. After the bandage has been removed, you may cover the incisions with a waterproof bandage (Nex-care, Band-aid).

  • Do NOT apply any ointment or creams to the incision.

  • You may shower after the bandage has been removed (3 days). Pat the wound dry after showering and place a clean waterproof bandaid over the incision. It is very important that you keep the wounds clean until your first postoperative visit (10-14 days).

  • You may remove your brace or sling to shower, unless otherwise instructed. As your balance may be affected by your recent surgery, we recommend placing a plastic chair or bench in the shower to help prevent falls.

  • Do NOT take baths, go into a pool, or soak the operative site until approved by Dr. Kaplan.

Home Exercises

  • In some cases, you will given a document detailing home hand exercises to perform after surgery. You may start these home exercises right away. You can work on making a complete fist 10 times per hour.

  • If needed, physical or occupational therapy is just as important to your recovery as the surgery. You will be provided with a prescription for therapy at your first follow up appointment with Dr. Kaplan.

Driving and Travel

  • You may drive when you are (1) no longer taking narcotic pain medication and (2) no longer wearing a sling or splint.

  • Ultimately, it is your judgment to decide when you are safe to drive. If you have any specific questions or concerns, you may have to contact your insurance carrier or the DMV. If you are at all unsure, do not risk your life or someone else’s.

  • Avoid flights and long distance traveling for 2 weeks after surgery. It is important to discuss your travel plans with Dr. Kaplan.

Returning to Work or School

  • Typically, you may return to sedentary work or school 3-7 days after surgery if pain is tolerable and you are no longer requiring narcotic pain medication during work/school hours.

  • In conjunction with your input, Dr. Kaplan will determine when you may return to more physically rigorous demands.

  • If you require a note for work/school, please let us know.

What to Expect After Surgery

  • PAIN: We do everything possible to make your pain/discomfort level tolerable, but some amount of pain is to be expected.

  • WARMTH: Mild warmth around the operative site is normal for up to 3 weeks.

  • REDNESS: Small amount of redness where the sutures enter the skin is normal. If redness worsens or spreads it is important that you contact the office.

  • DRAINAGE: A small amount is normal for the first 48-72 hours. If wounds continue to drain after this time (requiring multiple gauze changes per day), please contact the office.

  • NUMBNESS: Around the incision is common.

  • BRUISING: Is common and often tracks down the arm or leg due to gravity and results in an alarming appearance, but will resolve with time.

  • FEVER: Low-grade fevers (less than 101.5°F) are common during the first week after surgery. You should drink plenty of fluids and breathe deeply.

Follow Up

  • A follow-up appointment should be arranged for 10-14 days after surgery. If one has not been provided, please call the office to schedule.

Notify Us

Most orthopedic surgical procedures are uneventful. However, complications can occur. The following are things to be aware of in the immediate postoperative period:

  • COLD/BLUE FINGER – If you have undergone a procedure in the palm or finger and your finger is cold, blue, or numb after 6 hours, please contact the office for further evaluation. We will likely ask you to take a picture of your finger and forward to Dr. Kaplan for review.

  • FEVER – Temperature rises above 101.5ºF or associated chills/sweats

  • WOUND – If you notice drainage more than 4 days after surgery, if the drainage turns yellows and foul smelling, if you need to change gauze multiple times per day, or if sutures become loose.

  • CARDIOVASCULAR – Chest pain, shortness of breath, palpitations, or fainting spells must be taken seriously. Go to the emergency room (or call 911) immediately for evaluation.

  • BLOOD CLOTS – Orthopaedic surgery patients are at risk for blood clots. While the risk is higher for lower extremity surgery, even those who have undergone upper extremity surgery are at an increased risk. Please notify Dr. Kaplan if you or someone in your family has had blood clots or any type of known clotting disorder. Signs of blood clots may include calf pain or cramping, diffuse swelling in the leg and foot, or chest pain and shortness of breath. Please call the office or go to the hospital if you recognize any of these symptoms.

  • NAUSEA – If you have severe vomiting, diarrhea, or constipation, or cannot keep any liquid down

  • URINARY RETENTION – If you cannot urinate the night after surgery, please go to the Emergency Room.

 

If any of these apply to you after surgery, notify us by calling (714) 456-7012 or message us on MyChart

Jesse Kaplan MD is an Orthopaedic Surgeon at UC Irvine (University of California, Irvine) in Orange County, California specializing in surgery of the hand, elbow and shoulder. He treats carpal tunnel syndrome, trigger fingers, ganglion cysts, dequervain’s, finger fractures, metacarpal fractures, scaphoid fractures, broken wrists, distal radius fractures, wrist fractures, thumb arthritis , CMC arthritis, hand arthritis, hand contractures, hand pain, hand masses, finger masses, nerve injuries, tendon injuries, finger and wrist joint replacement, Dupuytren’s disease, cubital tunnel syndrome, elbow fractures, elbow instability, tennis elbow, golfer’s elbow, elbow arthritis, elbow joint replacement, elbow arthroscopy, shoulder impingement, rotator cuff tears, shoulder arthritis, shoulder fracture, clavicle fractures, shoulder instability, shoulder arthroscopy, reverse shoulder joint replacement, total shoulder joint replacement, acromioclavicular joint arthritis, acromioclavicular joint separation.