Appendix A Blank Intervention Information Sheet Orthopaedic Trauma Division POST OPERATIVE CARE INSTRUCTIONS Controlling Pain You can expect to have pain and swelling after an orthopedic injury or surgery and your narcotic pain medications will not control all of this pain. Swelling is a big source of pain and elevating your affected arm or leg to the level of your heart will help. It is important to know that swelling is normal for up to a year or more. You may apply ice packs wrapped in a towel several times a day if it helps to relieve your pain symptoms. Please do not take over-the-counter anti-inflammatories such as Ibuprofen or Naproxen as they can delay bone and wound healing. You will be given a prescription for pain medicine upon discharge from the hospital. Gradually increase the time between doses as the eventual goal is to discontinue the use of these within six weeks of your surgery. You might not be able to sleep very well the first few weeks due to decreased activity and pain medicine effects, but you can expect this to improve as your activity returns to normal. You may take over-the-counter Benadryl 25mg at night if needed to help you sleep. Constipation Constipation can be a problem because of the pain medicine and because you are not moving around very much. You can prevent constipation by drinking plenty of fluids and eating fresh fruits and vegetables. We recommend over-thecounter stool softeners for the first week or two to prevent this problem. Look for “Colace” or “Docusate” tablets and take twice daily as needed. Wound Care If you have a splint in place, then do not remove this. It should stay in place until your follow-up appointment. Do not get it wet (call the clinic if this happens). Be sure to keep pressure off your heel area. Place a pillow horizontally under your calf so there is nothing causing pressure under the heel. If you experience significant heel pain it may be necessary to have your splint/cast changed. Call the clinic for evaluation. Keep your incision clean and dry. Do not use creams or ointments. If you have stitches or staples, they will usually be removed at your follow up appointment if your wound is ready. You were given antibiotics before and after your surgery and will not need to take any additional antibiotics after discharge unless directed otherwise by your physician. A clear pink/red drainage is normal for the first week after surgery. If the drainage turns yellow/green and odorous, you have a fever greater than 101.5 or your incision becomes red and painful then you should contact the orthopedic nurse triage line. Activity and Exercises Continue to use your walker, crutches, braces or slings as you learned in the hospital. If you have questions about them, please call the clinic. You should continue elevating your injured extremity above heart level and continue the exercises that you were taught during your hospitalization. Performing exercises early and often will decrease your pain, improve your outcome and help you to heal faster. Even though your progress may seem slow and painful, doing the exercises often throughout your day is the best thing you can do to get back to your pre injury state. Deep Vein Thrombosis Prevention Upon discharge from the hospital you should have either received a prescription for a drug called Lovenox (Enoxaparin) or told to buy over-the-counter 325mg Aspirin to take every morning and every evening (get EC [enteric coated], they are easier on the stomach). These are both blood thinners and help to prevent you from getting a deep vein thrombosis also known as a “blood clot”. Problems/Questions If you experience any problems not addressed above or have questions about your recovery, you may call our nurse triage line at XXX-XXXX. This line is staffed Monday through Friday from 8:00am to 4:00pm. They can also assist in refilling pain medications if you are due for a refill. All requests should be called prior to 12:00 on Fridays to ensure we have enough time to process your request before the weekend. If you were prescribed Percocet, this medication cannot be refilled by phone. You must return to the clinic to pick up a prescription or you can be switched to Lortab which can be called into your pharmacy. Your injuries/Type of repair: _________________ _________________________________________ _________________________________________ _________________________________________ Your weight bearing restrictions: __________________________________________ __________________________________________ __________________________________________ Approximate healing time: ___________________ Blood clot (DVT) prevention: _________________