OPEN ROTATOR CUFF REPAIR
Discharge Instructions
Operation:
Your operation was performed through a 2-3” incision on the
top of your shoulder. Your rotator cuff tendon, AC joint, and surrounding
structures were inspected under direct visualization, and the diagnosis
confirmed. Bone spurs and degenerative tissue were removed, and your
torn rotator cuff tendon was sewn back to its normal position on
your humerus bone. Additionally, the end of your collar bone may
have been removed if your AC joint was found to be degenerative.
Pain:
Upon discharge, you will be given a prescription for pain medication
that can be filled at either the hospital or a local pharmacy.
The pain medication can be taken every 3 to 4 hours as needed.
The medicine will help decrease the level of pain, but it is not
meant to completely eliminate the pain. Some pain is expected.
If you develop itching, skin rash, nausea or vomiting, please discontinue
the medicine and call the office. Additionally, narcotics can cause
constipation if used for an extended period of time. If this occurs,
you should decrease the use of the prescribed medicine, and increase
fluid, roughage and fruit intake in your diet. Please do not use
aspirin unless you have OK’d it with your surgeon.
The use of ice decreases both swelling and pain. You may apply ice
over your shoulder dressing for two to five days after surgery unless
otherwise instructed. If you were given an ice water shoulder wrap,
please follow the instructions provided.
Your surgeon may have inserted a pain pump into your shoulder. It
consists of a small catheter, or tube, located within the surgical
site, and connected to a fluid-filled container of local anesthetic
(usually marcaine). The pump will automatically deliver medication
directly into the surgical site for approximately two days. The catheter
will be removed at your first post-op visit in 2-3 days, or we will
provide specific instructions for you to do it at home.
Pain Pump:
You may have been sent home with a continuous infusion apparatus
for pain management. The pump works automatically. Please do not
pull or push on the pump or its tubing. One of the doctors at Valley Bone & Joint Clinic will remove this apparatus in approximately 48 hours
to 72 hours.
Dressings:
Your incisions have been closed with suture and skin tape, covered
with gauze pads and held in place with tape or a compressive wrap.
Additionally, your pain pump catheter is held secure under a separate
transparent bandage. It is not uncommon to notice bloody drainage
on your dressing during the first 24-36 hours after surgery. If
the drainage soaks through the bandage, simply reinforce it with
additional bandages as needed. Please remove the original dressing
in 3 days, and replace with sterile gauze and tape. The small incisions
can be covered with Bandaids. Please do not remove the skin tape
as they will fall off on their own.
Wounds:
The small incisions may be sore and you may develop bruising in the
area of surgery as well as down your arm and your chest over the
next several days. This will go away, and no special care is needed.
Bathing:
Although it is safe to shower or bathe in 2-3 days, please keep your
shoulder incisions dry until after your sutures are removed 10-14
days following surgery (try saran wrap or waterproof tape). Please
do not remove the skin tape, and change bandaids as necessary.
Do not soak your shoulder under water, and avoid hot tubs and pools
for two weeks.
Activity:
You should rest, relax and make arrangements to have someone stay
with you for at least 24 hours after discharge. Do not drive any
vehicle or operate mechanical equipment for 24 hours following
your surgery. Even though you feel normal, your reaction time may
be affected by the medication you have received. Returning to work
or school depends greatly on working conditions and school requirements.
Immediately following surgery, your arm was placed in a sling, or
shoulder immobilizer. It is strongly recommended that your arm remain
immobilized in the sling just as it was when you left the surgery
center. You may carefully remove the sling/immobilizer several times
a day to perform gentle shoulder and elbow exercises, as instructed.
You should not attempt to reach out in front of you, to reach overhead,
to push or pull yourself up with your operative arm, or to lift objects.
However, you are encouraged to move and exercise your hand and fingers.
This will decrease the swelling in your arm and ease your rehabilitation.
Diet:
Drink clear liquids (apple juice, ginger ale, broth, 7-Up, etc.).
Progress to your regular diet as you feel able. Do not drink alcoholic
beverages for at least 24 hours following your surgery. If nauseated,
wait 30 minutes and then begin drinking water or 7-Up in small
amounts. If clear liquids are tolerated, you may progress to solid
food. If nausea continues beyond 24 hours, contact the office.
Precautions:
If you develop a fever (temperature over 101°), unexpected or severe
pain, redness, or swelling, please contact the office for consultation
or examination. A low-grade fever is common after surgery. If your
temperature is elevated, drink plenty of fluids and try regular
Tylenol.
Follow-up: A post-operative visit with your surgeon or nurse will
be made approximately 3-14 days following surgery to check your wounds
and discuss your case. Physical therapy will usually begin three
to five days after surgery. Probably the most important thing to
remember about your shoulder surgery is that the post-operative rehabilitation
is as important as the surgery itself. For this reason, your surgeon
and therapists will monitor your rehab program closely, and if you
have any questions or concerns, please feel free to discuss the situation
with either of them.
Emergency Calls: If you have a problem of an emergency nature and
are unable to reach your doctor, call or come to Altru Hospital Emergency
Room (phone: 701-780-5280); or your nearest hospital or emergency
facility.
Special Instructions:
CONTACT YOUR PHYSICIAN (OR HIS ALTERNATE) IF YOU HAVE ANY PROBLEMS:
- Fever greater than 101 degrees orally or if at all questionable.
- Chills
- Excessive bleeding
- Separation of the incision
- Excessive swelling or tenderness
- Unusual drainage:
pus-like drainage (white, yellow, or greenish in color);
any excessive drainage
from the area; foul odor from the incision or dressing.
- Change in color around the area; excessive redness may indicate
infection
- Change in temperature around the area: unusual
warmth
- Increased pain in operative area
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