Resources

This page contains several resources that are important for Dr. Schultz’ patients undergoing procedures, including pre- and post-op instructions. Dr. Schultz will be able to expand on these instructions based on the needs of individual patients, their specific procedures and their unique medical conditions.

Post-Operative Instructions 

1. Weight bearing status: Non-weight bearing on the operative extremity.

2. Activity: If you are in a splint or boot, it is ok to move your fingers and toes. This will help with swelling and decrease the risk of post-operative stiffness. Keeping your extremity elevated above the level of your heart for the first 24-48hrs will also be helpful for swelling and pain control. It is normal for your injury to continue to swell after surgery, especially if it has not been elevated during the day. Elevating at night should be helpful with this. Using ice can also help with swelling. It should not be applied directly to the skin as it can cause burns. Ice can be used for 20 minutes on, 20 minutes off fashion. It is normal for bruising to also get worse or move up/down the extremity after the surgery as your body deals with the swelling from the fracture/surgery.

3. Dressing: Please leave your dressing on until your clinic follow-up. Some minimal saturation of the dressing is OK. Please do not use any ointment under the bandage. 

4. Driving: No driving during the first week after surgery regardless of the operative leg/arm or while on narcotic medications. 

5. Showering: You may shower on postoperative day #2-3; however, do not wet the wound/dressing. Cover the area with tape and plastic wrap. Keep the wound dry at all times. Do not soak the knee/arm in water or go swimming in the pool or ocean until advised by the doctor (minimum 2 weeks). 

6. Follow-up: You should already have a 2- week post-operative visit scheduled. If not, call the office: 512-485-0544. Sutures/staples, they will be removed at this time.

7. Concerns: If you develop a fever (101.5), redness or drainage from the surgical incision site, please call our office to arrange for an evaluation. 

8. Pain medications: To minimize the amount of narcotic pain medications prescribed to each of our patients we utilize a multi-modal pathway for pain management. This means that several different medications each affecting a different pain sensation pathway will be prescribed. These include medications from various families of drugs: 1) a weak non-addictive opioid and 2) an anti-inflammatory which helps reduce pain and swelling. Tylenol (acetaminophen) may be taken as needed up to 4 grams (4000 mg) per day in addition to prescribed medications. A small amount of a stronger opioid for pain that cannot be controlled with the above combination will also be provided:

  1. Meloxicam 15 mg: take once daily, helps with inflammation and swelling as well as pain
  2. Tramadol 50 mg: take every 6 hours as needed for pain, low dose narcotic that is an excellent pain reliever especially when used in conjunction with meloxicam and acetaminophen
  3. Oxycodone 5mg: will be prescribed and can be taken up to four times a day if the above protocol does not relieve symptoms of pain (breakthrough pain)
  4. Aspirin 81mg daily: is also often prescribed to prevent blood clots. Take it once daily until prescription is complete. 
  5. Tylenol 500 mg: take 2 tablets up to 4 times a day. This is not prescribed but OK to take with above medications.

Nerve blocks

Once you have minimal pain, usually a couple days after surgery, you can stop the tramadol and oxycodone. Meloxicam helps with swelling and discomfort and usually is helpful to take until your first post op appointment, as is Tylenol. Many surgeries are done under local sedation and a block, meaning you will have a numb extremity anywhere from 12-36 hours after surgery. This is normal. Do not be alarmed if you cannot feel your operative extremity. The block usually wears off by 24 hours but can last longer. You should take tramadol before you go to sleep the night of surgery even if you are having no pain. This ensures that you have some measure of pain control if the block wears off while you sleep. As soon as you feel tingling or increased sensation of any type, not just pain, in the operative extremity, you should take another tramadol and continue to do so every 6 hours until the block has completely worn off. The day after surgery you should also take one meloxicam in the am, to help with pain. Once the block has fully worn off and you have full sensation in the operative limb, you can determine how much pain medication you still need and eventually stop taking it based on pain. Usually you stop tramadol first (and oxycodone if you needed it), followed by meloxicam, and finally Tylenol. A lot of patients find it beneficial to take meloxicam until the first post op appointment as it helps with swelling and discomfort.