Seattle surgery center



HOME CARE INSTRUCTIONS AFTER MENISCUS REPAIR SURGERY

SARA JUREK, M.D.



24-HOUR PHONE NUMBER: 206.386.2600

GUIDELINES AFTER ANESTHESIA:

1. Do not drive, operate machinery, or consume alcohol or tranquilizers for 24 hours or for as long as you are taking narcotic pain medicine. Do not make important personal or business decisions or sign legal documents for 24 hours.

2. It is usually advisable to rest today and not do anything too strenuous - you may feel tired from the anesthesia and pain medicine. Be in the care of a responsible adult.

3. Begin with clear liquids and light foods to eat, then progress your diet as tolerated. It is usually best to avoid heavy, greasy, or spicy food the day of surgery. Narcotics cause constipation, so increase the amount of fluid (especially water), fiber, and fruit in your diet. Examples of over-the-counter medications to prevent constipation or for constipation are Metamucil, Citrucel, Colace, or Docusate Sodium (DSS). In the event that you are constipated after surgery, over-the-counter liquid magnesium citrate, taken as directed, can be used.

4. It is important to eat some food every time you take narcotic painkillers (even in the middle of the night), otherwise you are more likely to get nauseated. Usually a few crackers, applesauce, or banana will suffice.

5. Some anesthetics can cause urinary retention. If you are having trouble emptying your bladder or haven't urinated for eight hours after an anesthetic, be sure to call your doctor's office - no matter what time of day or night.

6. YOU CAN ALWAYS REACH YOUR DOCTOR (OR THE DOCTOR ON CALL) BY PHONING THE DOCTOR’S OFFICE. AFTER BUSINESS HOURS, AN ANSWERING SERVICE WILL CALL THE DOCTOR FOR YOU.

ACTIVITY:

1. Before you leave the surgery center, you will be instructed in the use of crutches. the instructions state to be non-weight-bearing, do not put any weight on your leg but it is okay to gently rest your toes on the floor when you are not moving. If your knee is braced, keep the brace on at all times.

2. Elevate your operative leg higher than your heart level when sitting or lying to help reduce pain and swelling.

3. You may find that icing your thigh just above your dressings helps relieve pain. Icing the knee directly usually is not as effective through the bulky dressing. If you are using an IceMan cold therapy unit, Dr. Jurek will apply the cold pad under your dressing to allow you to directly ice your knee. See Dr. Jurek’s website for further instruction.

4. To help prevent blood clotting in your leg, point and flex your foot and wiggle your toes throughout the hours while you're awake for a week or two following surgery.

EXERCISES:

1. It is very important to achieve full extension of your knee at least two or three times a day. This is to prevent permanent stiffness. Work to achieve full extension of your knee as soon as reasonably possible.

2. Start bending your knee gently on the first day of surgery.

3. The goal of the first week: Full extension and flexion as directed by Dr. Jurek.

4. Once your comfort level allows, perform isometric contractions of the thigh muscle (“quads”) and straight leg raises to maintain muscle tone. Try to do each exercise 10 reps 3-4 times/day.

5. You will receive further instruction at your first post-operative visit.

CARE OF INCISION AND DRESSING:

Following surgery you will have an ace wrap on your knee. Under the ace wrap are gauze bandages. On the skin are steri-strip bandages. There will also be a few sutures on the outside of the skin. The ace wrap is used to hold the bandages in place and apply compression to the knee.

1. DO NOT REMOVE YOUR DRESSINGS. This will be done at your first post-operative visit with Dr. Jurek.

2. Showers are okay. Cover the leg with a large plastic bag and tape securely to your thigh to prevent leaks.

3. DO NOT soak in a bathtub or hot tub.

DIET: Decreased activity and narcotic pain medications cause constipation. To prevent this, eat foods high in fiber and drink 6-8 glasses of fluid per day (water or juice). Foods high in vitamins and protein will aid in wound healing.

MEDICATIONS:

1. Oral narcotic pain medication has been prescribed for the first few days. Use only as directed. Do not combine these medications with alcoholic beverages. We recommend that you take your pain medications routinely the first 24 hours. Mild dizziness is not unusual with these medications. Be careful when walking and climbing stairs. Do not drive while taking narcotic pain medications. Narcotic pain medications can be dangerously addictive; try to gradually reduce your intake and wean off of them as soon as reasonably possible.

2. If your narcotic is Percocet (Oxycodone/Acetaminophen) or Norco (Hydrocodone/Acetaminophen), do not take more than 3000mg of Tylenol total over 24 hours, including the Tylenol in your pain medication, as the pain medication already has Tylenol (acetaminophen) in it. If you have nausea or an upset stomach, it is best to stop the narcotic and try Extra Strength Tylenol. If the nausea continues, you should contact your physician.

3. It is usually okay to mix anti-inflammatories with narcotic painkillers. If you are able to take these drugs, this may be beneficial for pain control. DO NOT TAKE ANTI-INFLAMMATORY DRUGS IF YOU HAVE ULCERS, A HISTORY OF BLEEDING, OR KIDNEY FUNCTION PROBLEMS. Choose only one type of anti-inflammatory drug listed: Ibuprofen (Advil, Motrin, Midol) 600mg three times a day until not needed OR Naprosyn (Aleve) 500mg twice a day until not needed. Do not take these if you are currently taking Celebrex, or any other type of anti-inflammatory drugs.

4. You may restart your Aspirin if you normally take it as an anticoagulant. Otherwise, do not take Aspirin unless specifically told to do so by your doctor.

5. Please note if you are currently taking birth control pills and starting an antibiotic, your birth control may not be as effective. While taking any antibiotics, and for one month after completing your antibiotic prescription, we recommend using a back-up method of birth control.

6. *Refills will only be given during normal business hours per your doctor’s approval. By law, all narcotic prescriptions must be hand-signed by your doctor and cannot be called into a pharmacy.

SYMPTOMS TO REPORT TO YOUR DOCTOR: 24-HOUR PHONE NUMBER: 206.386.2600

1. FOR DIFFICULTY BREATHING OR CHEST PAIN CALL 911.

2. Excessive drainage or bleeding from your incision not stopped by 20 minutes of direct pressure.

3. Excessive swelling not relieved by rest, elevation and ice.

4. Feelings of flu-like symptoms (nausea, general body aches, or temps over 101 degrees for >24 hours).

5. Any sign of infection to your incision (increased redness, heat, hardness around your operative site or pus-like drainage).

6. Intolerable pain (unable to sleep or concentrate on a conversation) not relieved by your meds.

7. Continued nausea and vomiting.

8. Any rash, welts, or hives (many people itch with narcotic usage and an antihistamine such as Benadryl will usually make this stop - itching by itself is not an allergy. Itching with hives or a rash is an allergy).

9. Increasing calf or thigh pain, accompanied by swelling.

10. Any progressive numbness or decreased sensation in the operated extremity not relieved by immobilization and rest.

FOLLOW-UP APPOINTMENT: If your follow-up appointment has not already been scheduled, please call Dr. Jurek’s office on the next business day to schedule your appointment to be seen approximately 7-10 days following surgery.

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