Shoulder Surgery Post-Operative Recovery Series:

Shoulder Instability

Day-by-Day Instructions

Shoulder Instability – Post Op Recovery

Everything You Need to Know from the Day Before Surgery through Starting Physical Therapy

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Day Before Your Surgery

Shoulder Instability

Your shoulder surgery is scheduled for tomorrow morning and I wanted to remind you of a few instructions you need to follow today – as well as for tomorrow morning to ensure everything goes smoothly for you:



Today

– Our facility should call you today and give details on the time of arrival and pre-op instructions.

Tonight
– Do not eat anything solid (food) after midnight. You may have clear liquids 2 hours prior to your surgery.  Below is a list of approved &d not approved drinks:

Approved – Gatorade, Apple / Cranberry juice, water, black coffee (NO MILK OR CREAM).

Not approved – Milk, cream, coffee with mild or cream, Orange juice.

Tomorrow AM
– We recommend that you take a shower with antibacterial soap the day of surgery.
– Wear loose and comfortable clothing.
– Small sips of water are okay if you need to take medication.

Arrival 
– Usually you will need to arrive at the surgery facility about 1.5 to 2 hours early.
– You will meet the anesthesiologist tomorrow before the surgery. You’ll also get to speak with me before. Write down any questions you may have.

Departure
– Someone will need to drive you home after the procedure and we recommend having someone available for at least 24 hours following the procedure.

Alternative Pain and Swelling Regimen (Homeopathic)
– As we are all aware, injuries and shoulder surgery are associated with pain and swelling. I personally use Motrin for inflammation & soreness, but I also use natural herbs to help with inflammation & healing. Many of my patients cannot take anti-inflammatory medication (NSAIDS) because of the side effects or allergic reaction to these medications.  Here are six natural anti-inflammatory supplements for you to consider.

Polar Ice Machine for Swelling / Pain
If you are getting an ice machine here are some instructions on its use.  If you are not getting the ice machine, bags of ice work very well.  If you are using ice bags, ice your shoulder for 30 minutes four times per day

The ice pad or ice bag should be placed over a t-shirt or a towel while your shoulder is asleep from the block.  

Do not have the “ pad” directly on your skin if you do not have feeling in your shoulder from the block.  One can get frostbite from the pad and not know it.  

Once the feeling in your shoulder comes back (the block has worn off) you can place the pad directly on your skin.  Use the ice machine as much as you would like for the next week. Here are some troubleshooting tips if you feel the pad is not getting cold:

  • Make sure that the cooler is full of ice and water.  The pump has to be underwater for it to work.
  • If the pump is on and the pad is not getting cold there may be a kink in the pad.  Try straightening the pad to allow the water to flow through.
  • If your machine just does not work there should be a phone number on the cooler.  Call the number and let them know what the problem is with the device.

Get some rest tonight, sleep well, see you tomorrow!

Common Questions

“When can I drive?”

You can drive as soon as you can drive one-handed and you are not taking narcotics.
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“How much pain will I be in?”

Everybody is different and some patients experience little to no pain while others will necessitate narcotics for days and/or weeks. There are multiple things that I will do with the pain block and intraoperative techniques that will minimize the pain.
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“I'm a little nervous”

Most patients are a little nervous before surgery. This is absolutely normal. Be assured that we have the best staff taking care of you and we treat all of our patients like family. FYI, I love my family.

“Can I eat or drink anything after midnight?”

Great question! Do not eat anything solid (food) after midnight. You may have clear liquids 2 hours prior to your surgery.  Below is a list of approved & not approved drinks:

Approved – Gatorade, Apple juice, Cranberry juice, water, black coffee (NO MILK OR CREAM).

Not approved – Milk, cream, coffee with milk or cream, Orange juice.

Day of Your Surgery

Your shoulder surgery is scheduled for this morning and I wanted to remind you of a few instructions you need to follow to ensure everything goes smoothly for you:



Today (Morning)
– Do NOT eat anything, unless you were indicated differently by the surgery center. You may have clear liquids 2 hours prior to your surgery.  Below is a list of approved & not approved drinks:

Approved – Gatorade, Apple juice,Cranberry juice, water, black coffee (NO MILK OR CREAM).

Not approved – Milk, cream, coffee with milk or cream, Orange juice.

– Take a shower with antibacterial soap this morning.
– Wear loose and comfortable clothing.
– Small sips of water are okay if you need to take medication.

Arrival 
– Please arrive at the surgery facility 1 to 1.5 hours early.
– You will meet the anesthesiologist tomorrow before the surgery. You’ll also get to speak with me before. Write down any questions you may have.

Departure from surgical center
– Someone will need to drive you home after the procedure.

Alternative Pain and Swelling Regimen That Is More Homeopathic
– As we are all aware, injuries and shoulder surgery are associated with pain and swelling. I personally use Motrin for inflammation & soreness, but I also use natural herbs to help with inflammation & healing. Many of my patients cannot take anti-inflammatory medication (NSAIDS) because of the side effects or allergic reaction to these medications. Here are six natural anti-inflammatory supplements for you to consider.

See you soon! 

DOs

  • Take a shower with antibacterial soap.
  • Wear loose & comfortable clothing.
  • Arrive early 1 – 1.5 hrs early.
  • Write down any questions you have for the anesthesiologist and/or me.

DONTs

  • Do not eat or drink anything this morning. You may have clear liquids 2 hours prior to your surgery.  Below is a list of approved & not approved drinks:

    Approved – Gatorade, Apple juice, Cranberry juice, water, black coffee (NO MILK OR CREAM).

    Not approved – Milk, cream, coffee with milk or cream, Orange juice.

Day After Your Surgery

I hope your shoulder is still nice and numbed up and that you are having a relaxing day and taking it easy. Here is some information that most patients find useful:

Pain

– If you are numb, I would recommend not taking the narcotics yet.
– If you start feeling pain tonight, turn up the nerve block and take a pain pill.
– If you have the digital nerve block, hit the “dose” button to give yourself more medication.
– If you have the On-Q nerve block, turn the dial on the catheter from “8” up to “10-14”. The longer you keep it on a higher number, the less the block will last.
– One of the side effects of the narcotics includes constipation so if you have trouble with this, start taking some over-the-counter stool softeners right away.

Diet

– Begin with liquids and light foods (jello, soup, etc.) and progress to your normal diet as tolerated. Consider our article regarding diet: Diet & Healing

Showering
– If you would like to shower today, go for it. Use the Glad “Press N’ Seal” over the dressing and catheter. Use tape to hold down the edges. Quick showers (up to 10 minutes) are okay.
– While in the shower, I recommend using a cheap sling from Walgreens to support the arm so that you don’t get your good sling wet.

Get some rest and relax.

DOs

DONTs

  • Do not drive or operate machinery.
  • Do not make important decisions or sign legal documents.
  • Do not drink alcoholic beverages.
  • Do not lift more than 2 pounds of weight.

Day 2 – After Your Surgery

Shoulder Instability

I know that you are wanting to get back into the swing of things, so here is a little more information about taking proper care of your shoulder.

Catheter

– The pain pump/catheter usually lasts around 2 to 2.5 days.
– Start taking your pain medications before you take the catheter out or it runs out.
– You will know that the catheter is running out because the bag with fluid will deflate and become flat. To take the catheter out, just undo the tape on your neck and pull the little clear tube. It will come out easily.

Sling
– If you want to take your arm out of the sling to relax it or let the elbow stretch out, that is OK. Just be seated and make sure that you rest it at your side.
– If your arm is completely asleep from the block, stay in your sling. You may come out of the sling if you are watching TV, reading a book, or just relaxing.
– If you want to go outside for a walk, please do so but in a sling. The same thing goes for a stationary bicycle.

Showering
– Shower today with the white dressing on.
– I recommend putting the “Press N’ Seal” on. Take the dressing off after your shower, but please leave the steri-strips on (the little white bandaids on your skin).
– After taking off the dressing, it is OK to leave the wound / steri-strips free and without anything on them. The steri-strips usually fall off around two weeks.
– For quick showers, continue to Press-N-Seal for two more days.

Keep taking it easy!

Please call us at (512) 583-4212 if you experience any of these:

  • Increased swelling or numbness
  • Unrelenting pain
  • Fever (temperature over 101 degrees) or chills
  • Redness around incisions
  • Continuous bleeding or drainage from incisions. A moderate amount of drainage is expected immediately after surgery.
  • Color change in arm or hand
  • Any other worrisome condition

Day 5 – After Your Surgery

Shoulder Instability

Your pain should be getting better. You should have an appointment in the next couple of days to discuss any issues you may have.

Narcotics

– Start using less narcotics. Most people find that during the day they can go to anti-inflammatory medication and Tylenol and save the narcotics for at night. As the pain continues to improve, wean off of the narcotics all together.

Don’t Worry
– You may start seeing bruising in the arm or chest area. This can be normal and it will get better in about one week.

Please call us at (512) 583-4212 if you experience any of these:

  • Increased swelling or numbness
  • Unrelenting pain
  • Fever (temperature over 101 degrees) or chills
  • Redness around incisions
  • Continuous bleeding or drainage from incisions. A moderate amount of drainage is expected immediately after surgery.
  • Color change in arm or hand
  • Any other worrisome condition

Day 7 – After Your Surgery

Shoulder Instability

I hope all is going well and you should be seeing improvements in your pain, swelling and overall energy.

No Exercises or Physical therapy yet – your shoulder is healing.

It’s really important for you to keep your arm in the sling when in public and when you are asleep. You can take your arm out of the sling when at home to relax or watch TV. 

Hang in there, stay positive, and allow your shoulder to heal properly!

 

Most Common Questions From Patients Around This Time

“Hey doc, when can I go back to work?”

If you can work in a sling, you can go back usually 5-7 days after the procedure. If you cannot work in a sling, talk with us at your first post-op visit.

Day 27 – After Your Surgery

Shoulder Instability

It’s been almost 30 days since your surgery. Your physical therapy begins in about 4 weeks!

Next Appointment

– When I see you in the office at your next appointment, I will give you a Physical Therapy prescription and you can get rid of the sling!

– Check out our list of the Best Physical Therapists in Austin – organized by location.

Medication
– If you are still needing pain medicine, make sure that you are taking anti-inflammatory medicine.

Most Common Questions From Patients Around This Time
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“Hey doc, when do I start Physical Therapy?”

When I see you in the office at your next appointment, I will give you a Physical Therapy prescription.

This resource has been provided by Edward Seade, M.D. as general information only. Additional information can be found by visiting our clinic. Please call for an appointment at 512-583-0219

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