Elevation of your hand above your heart is extremely important. Keeping your hand at eye level is good. This will significantly speed up your recovery and return to function. For most procedures range of motion of your shoulder and elbow is important to prevent stiffness, however specific instructions will be provided. Unless you had tendon surgery, full finger extension (completely straight) and flexion (full fist) promotes tendon gliding and early functional activities. This should be performed several times a day at least unless otherwise directed. Please see specific postoperative instructions.
Analgesia (pain medication)
You will have pain after surgery and that must be expected. Pain varies and depends upon the individual patient as well as the surgical procedure performed. Medication will not eliminate the pain but will make it more tolerable. Side effects of pain medications such as sleepiness, fatigue and nausea may occur. You should not drive when taking narcotic or judgement altering medications. Elevation and ice can help control the pain and swelling. Pain medication should be used as needed and specific instructions will be provided. Narcotic (Opioid) prescriptions will be given to you to help with postoperative pain control. Opioid pain relievers can help with short term pain. There are risks and side effects that should be reviewed prior to taking these medications. Narcotic prescriptions may be given to you prior to surgery if you are seen perioperative or they can be mailed to you. They must be filled within a week of the day written, otherwise the pharmacy will not fill them. However, you must not use or lose them prior to surgery and that is your responsibility. Filling the prescription prior to surgery will eliminate stopping and delays on the way home from surgery. Usually they are given at the time of surgery and can be filled on the way home. Remember to ask for NON childproof caps if there is no one to open them for you. However, they must be kept in a safe place away from children. If you have specific preferences or problems, please inform us. Medication will not eliminate the pain but will make it more tolerable. Side effects of medications - sleepiness, fatigue and nausea - may occur. If you have specific preferences or problems please inform us. Remember you should not drive for 24 hours after anesthesia that includes any sedation. Also you canot drive while taking narcotics or judgment altering medications. (See Living with an Injured Hand)
If you had a "block" for anesthesia or local anesthesia was injected, you may have minimal pain when you leave the ambulatory surgery area. This can be a considerable advantage. However, the block or anesthesia will wear off and you should be prepared. You should be at home in a comfortable environment with your prescription medication available. As the block or anesthetic wears off (when you will start having some tingling in your fingers) take the pain medication so you do not get "behind". It is much more difficult and unpleasant to catch up. Once your pain is under control usually a day or two, depending on the specific procedure (occasionally it can take one to two weeks) you can take the medication as needed. Over the counter medication can also be used. If you are normally allowed to use nonsteroidal anti-inflammatory medication (Link see above Preoperative Pain Control Considerations), they can be used in addition unless directed. Remember to take them with food and if gastrointestinal (GI) symptoms arise, please discontinue them. Also NSAI medications may interfere with bone healing. Therefore they should be limited if bone healing is neceassry for your recovery. This includes fracture healing, healing of fusions or bone ingrowth for prosthesis. If questions arise please check with the office.
It is not unusual to have some nausea or even vomiting after surgery. This is secondary to your reaction to the anesthesia and pain medications. If this has been a significant problem in the past, please inform the anesthesia team and us so that steps to minimize this can be taken. This cannot always be eliminated. Usually it does pass over 24 hours and hospitalization is not required. Occasionally specific medication must be provided either by mouth if you can tolerate this, by suppository or by injection. Small amounts of liquid should be given frequently. If this becomes a significant problem please let us know immediately. Stopping the pain medications may help this.
Postoperative appointments are usually scheduled prior to but may be scheduled after surgery. If scheduled prior to surgery they must occasionally be changed because of your individual needs. However, an appointment should be arranged by the working day after surgery. Therefore if there is any doubt, please call. You may be asked to bring splints that were used prior to surgery, if in doubt please ask or bring them.
If you have any questions or concerns, please call the office. A physician is available 24 hours a day for emergent problems. Hand Surgical Associates physicians can not return calls to phone numbers which will not accept blocked numbers. Therefore, if you want a return call from your physician, please allow your phone to accept blocked numbers. Increasing pain, numbness, tingling, excessive swelling and fever are all reasons to call emergently. For non-emergent problems and medications refills, please call during working hours. Medication including narcotic prescriptions will not be renewed during non-working hours or weekends, so please plan accordingly.
Hopefully this will make your recovery from surgery smooth.