Post-Op Instructions for the Shoulder

DIET

• Begin with clear liquids and light foods (jello, soups, etc.)
• Progress to your normal diet if you are not nauseated as tolerated

WOUND CARE

• Maintain your operative dressing, loosen bandage if swelling of the elbow, wrist, or hand occurs
• It is normal for the shoulder to bleed and swell following surgery - if blood soaks onto the bandage, do not become alarmed - reinforce with additional dressing
• Remove surgical dressing on the second postoperative day - if minimal drainage is present, apply waterproof band-aids over incisions and change daily
• To avoid infection, keep surgical incisions clean and dry - you may shower by placing waterproof bandaids over incisions. Please remember to change band-aids daily
• NO immersion of operative arm (i.e., bath)

MEDICATIONS

• Pain medication is injected into the wound and shoulder joint during surgery - this will wear off within 8-12 hours
• Most patients will require some narcotic pain medication for a short period of time - this can be taken as per directions on the bottle
• Common side effects of the pain medication are nausea, drowsiness, and constipation - to decrease the side effects, take medication with food - if constipation occurs, consider taking an over-the-counter laxative
• If you are having problems with nausea and vomiting, contact the office to possibly have your medication changed (email or call Dr. Cole's Physician Assistants: Kyle Pilz: kpilz@rushortho.com or Natalie Podboy: npodboy@rushortho.com 312-432-2379)
• Do not drive a car or operate machinery while taking the narcotic medication
• Ibuprofen 200-400mg (i.e., Advil) may be taken in between the narcotic pain medication to help smooth out the postoperative "peaks and valleys", reduce overall amount of pain medication required, and increase the time intervals between narcotic pain medication usage

ACTIVITY

• When sleeping or resting, inclined positions (i.e., reclining chair) and a pillow under the forearm for support may provide better comfort
• Do not engage in activities which increase pain/swelling (lifting or any repetitive above shoulder level activities) over the first 7-10 days following surgery
• Avoid long periods of sitting (without arm supported) or long distance traveling for 2 weeks
• NO driving until instructed otherwise by physician
• May return to sedentary work ONLY or school 3-4 days after surgery, if pain is tolerable

IMMOBILIZER

• Your sling with supporting abduction pillow should be worn at all times (except for hygiene and exercises)
• Maintain your elbow position against the pillow and even with your side or in front of this position to minimize stress on the repair

ICE THERAPY

• Begin immediately after surgery
• Use icing machine continuously or ice packs (if machine not prescribed) every 2 hours for 20 minutes daily until your first postoperative visit - remember to keep arm supported while icing

EXERCISE

• Begin pendulum exercises 24 hours after surgery - complete 3-4 sets of 10-15 reps per day
• While maintaining your arm against the pillow but out of the sling, begin elbow, wrist, and hand range of motion 24 hours after surgery. Complete 3-4 times per day until first postoperative visit
• If rotator cuff repair is done with a biceps tenodesis, do not perform elbow range of motion actively
• Formal physical therapy (PT) will begin after your first postoperative visit and you will be given a script for this at that time

EMERGENCIES**

• Painful swelling or numbness
• Unrelenting pain
• Fever (over 101° - it is normal to have a low grade fever for the first day or two following surgery) or chills
• Redness around incisions
• Color change in wrist or hand
• Continuous drainage or bleeding from incision (a small amount of drainage is expected)
• Difficulty breathing
• Excessive nausea/vomiting

**If you have an emergency after office hours or on the weekend, call 312-243-4244 and you will be connected to our page service - they will contact Dr. Cole or one of his fellows if he is unavailable. Do NOT call the hospital or surgicenter.

**If you have an emergency that requires immediate attention, proceed to the nearest emergency room.

FOLLOW-UP CARE/QUESTIONS

• Kyle Pilz, PA-C, or Natalie Podboy, PA-C (Dr. Cole's Physician Assistants) will call you on your first day after surgery to address any questions or concerns. If you have not been contacted within 48 hours of surgery, please email or call Kyle or Natalie directly (312-432-2379)
• If you have additional questions that arise at any time, whether for Dr. Cole, Kyle or Natalie, please send an email to Kyle (Kpilz@rushortho.com) or Natalie (Npodboy@rushortho.com) for the fastest reply. If email is not an option please call Kyle or Natalie directly (312-432-2379)
• If you do not already have a postoperative appointment scheduled, please contact the scheduling office during normal office hours (312-432-2599)

This web site also includes more postoperative information for specific procedures, which may be helpful for your recovery.

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