Preparing for surgery

Once you and your doctor decide that surgery will help you, you will need to learn what to expect from the surgery and how to actively participate in the treatment plan for the best results. See Surgical FAQs for details specific to Rotator Cuff Repair, Anatomic Total Shoulder Arthroplasty, and Reverse Total Shoulder Arthroplasty.

Preparing mentally and physically for surgery is an important step toward a successful result. Understanding the process, and your role in it, will help you recover more quickly and have fewer problems.

Before Surgery

Before surgery, your doctor will perform a complete physical examination to make sure you don’t have any conditions that could interfere with the surgery or the outcomes.

• Depending on the surgery and your underlying medical conditions, preoperative tests and a visit with your primary care doctor or a specialist may be required.
• Discuss any medications you are taking with your doctor and your family physician to see which ones you should stop taking before surgery. If you are on blood thinners, you will need a clear plan on how to handle these before surgery.
• Typically, if you are taking aspirin or anti-inflammatory medications or any drugs that increase the risk of bleeding, you will need to stop taking them one week before surgery to minimize bleeding.
• If you smoke, you should stop or cut down your nicotine intake to reduce your risk of infection or poor healing.
• If you have diabetes, your glucose control leading up to, and in the first days to weeks after, surgery can have a critical effect on your risk of infection of poor healing.
• Have any tooth, gum, bladder or bowel problems treated before surgery.
• Eat a well-balanced diet.
• Report any infections to your surgeon. Elective surgery cannot be performed with an active infection anywhere in the body.
• Put items that you use often within easy reach before surgery, so you won’t have to reach up.
• Surgery and the medications given are very constipating. After surgery you are recommended to have a high fiber diet, stay hydrated, ambulate frequently, and use a stool softener. Staying “regular” before the surgery will set you up for success after the procedure.

After Surgery

General

• If you are having day surgery, remember to have someone available to drive you home.
• Use ice on the shoulder intermittently over the first 48 hours after surgery, then as needed.
• The combination of anesthesia, food, and car motion can quite often cause nausea or vomiting. After arriving home, wait until you are hungry before trying to eat. Begin with a clear fluids, then a light meal and try to avoid greasy food for the first 24 hours.
• Take your pain medicine as directed. Begin the pain medicine as soon the block begins to wear off. Well before you start getting uncomfortable andwell before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will be behind and may be uncomfortable until you catch up.

Caution: Narcotics are habit forming and have multiple side effects. Begin to taper your use as soon as you are able.

Activity

• For most shoulder procedures you will wear sling at all times, removing it only to shower, dress/undress, or for any prescribed exercises. Do not drive while in your sling and/or on narcotic medications.
  • When getting dressed/undressed, gently assist your elbow into a hanging position and lean over with your arm hanging down like a weight on a string if you need to access your armpit or slide on a shirt sleeve—do not raise your arm from your side against gravity
• Some shoulder procedures involve moving the arm immediately. Dr. G and his team will clarify based on your particular surgery.
• Move your fingers frequently to prevent swelling.
• Stay hydrated and walk frequently to avoid pneumonia, blood clots, constipation, and boredom.

Over the counter medications

• To prevent constipation: Stool softener of choice. A prescription for Senokot has been provided, but use whatever keeps you regular (Miralax, Colace, Dulcolax or Senokot).
• For pain: Tylenol should be used (as long as you do not have liver disease) for pain
• Blood thinner: Aspirin 325 mg daily for 6 weeks unless you are already on a different blood thinner (Coumadin, Xarelto, lovenox, etc.)

Wound care

• You may remove your dressing after two days, leave any steri-strips/sutures/staples in place. They will fall off on their own.
• You may shower 5 days after surgery. The incision CANNOT get wet prior to 5 days. Simply allow the water to wash over the site and then pat dry. Do not rub the incision. Make sure your axilla (armpit) is completely dry after showering.
• Keep incision out of direct sunlight until the scars fade (months)
• If garments irritate incision, feel free to cover with a band-aid or gauze

Diet

• Stay hydrated
• High fiber diet with extra fresh fruits and vegetables

Concerning Findings

If you have any problems:

• During business hours call the office:  
• After hours call and ask for the orthopaedic resident on call:  , option 0
• Concerning findings: Excessive redness of the incisions, Drainage for more than 4 days after surgery, Fever of more than 101.5° F