For a smooth recovery, do your homework before surgery:
- Talk to your employer about your plans to return to work with restrictions or part-time at first.
- Respect the healing process; it takes time. Let the inside of your shoulder settle down while you restore mobility.
For the first 2-3 days:
Controlling the Pain: The novocaine inside your shoulder will keep it numb for 2 days after surgery.
- Pain Pump: See the attached brochure. The nurses at the surgery center will review details with you.
- The most important way to control pain is to properly support your arm.
- Do: Adjust the sling while standing up; gravity will help you and your upper arm will hang comfortably.
- Wear the sling when up and around, and while sleeping; you can take it off while sitting, resting or showering.
- Don’t: Wear the sling so tight that it hikes up your shoulder and puts pressure on the surgical site.
- Don’t be afraid that dressing and repositioning yourself will mess up the shoulder.
- How to sleep comfortably:
- Do: Sleep in a reclining chair, or with a large wedge-shaped pillow supporting your whole back.
- Keep a small pillow behind your upper arm to lift your elbow forward; rest your forearm on your tummy.
- Don’t: Try to lie flat; it’s not dangerous, but it will hurt. Don’t rest your elbow on an armrest, or anything that pushes up on the shoulder.
- Place a LARGE ice pack around your shoulder 20 minutes every 3-4 hours. Fill 2 gallon-sized zippered plastic bags with ice cubes, or buy several LARGE gel-packs that you can rotate through the freezer.
- Medication: Take your pain medicine (usually Hydrocodone [Vicodin] or Oxycodone [Percocet]) as prescribed for the first 2-3 days, then cut back as you feel better.
Switch to over-the-counter acetaminophen (Tylenol), 500mg, up to 2 tabs, 3 times a day after this runs out.
Anti-Inflammatories: Along with the pain medicine or acetaminophen, you can also take:
- Over-the-counter ibuprofen (Advil) OR naproxen (Aleve) according to package instructions.
- Your prescription anti-inflammatory medication as prescribed:_______________
- Do NOT take any anti-inflammatory medication because of your other medical issues
- Move your neck, elbows, wrists, fingers 10 times, 3 times a day. Squeeze a rubber ball to pump your hand.
- You can use your hand for light activities like holding a toothbrush or a pencil, buttering toast or light typing. Lifting 1-2 pounds with your elbow near the body is OK. Don’t overdo it.
- Gradually increase how much, and for how long, you use your arm…use your symptoms as a guide.
- Start your exercises on the first day after surgery. Begin slowly and you’ll improve day by day.
- Wear shirts that button up the front. Treat your shoulder with respect, but realize it’s not fragile.
Care of the dressing:
- For the first 2 days, leave the dressing in place. Tuck a dry washcloth under your armpit to absorb sweat.
- The dressing is waterproof, so you can take a shower even with the Pain Pump catheter in place.
- Some blood and novocaine might leak from the incision for a few days. Don’t be alarmed if it soaks through the bandage. Reinforce the dressing with extra gauze pads or a clean wash cloth if needed.
- On the second day after surgery, remove the dressing and slip out the Pain Pump tube. You may feel a brief sting; the tube will quickly slip out with a steady tug. Throw it away.
- Apply a light dressing to absorb any drainage from the hole where the Pain Pump was removed.
- You can leave the wound open to the air while resting; DO NOT REMOVE THE PAPER TAPES FOR 2 WEEKS. You can get the paper tapes wet in the shower briefly. Pat them dry and apply a light dressing to protect the tapes under your clothes.
For the next 3-14 days:
- Switch from ice to warm compresses if it feels better.
- You can cut your pain medication dose as you feel better: cut the pills in half, or take them less often.
- You might have a lot of bruising around your shoulder and chest. Warm compresses and gentle exercise will help.
- It’s OK to drive after 1-2 weeks IF you can safely control your car. Use common sense.
The priority is to restore your range-of-motion without resistance.
At your 2-week postop visit:
- We’ll check your range-of-motion. You should be able to: lift your arm almost overhead (with help from your other arm!), reach your hand to your back pocket, and be comfortable lifting 3-5 pounds near the body.
- Most patients start PT at 2-6 weeks postop to add more aggressive exercises to restore function.
- We’ll talk about your plans to return to work, and what you can expect from your shoulder in the future.
What are some problems to watch out for?
- Some patients get very constipated after surgery. If you are nauseated and/or don’t have a bowel movement within 2-3 days postop: drink plenty of water or fruit juice, try over-the-counter laxative like Senokot, go for a walk.
- You’re having extreme pain that’s not relieved with rest, proper positioning or your prescribed medication.
- You’re having a fever over 101.5, or your arm is hot, red and very painful.
- You’re having problems with prescribed medications, with the dressing, or with any issue about your recovery that can’t wait until your follow-up visit.
- Call the office: 585-271-4272 (or for emergencies after-hours: Dr. Siegrist’s cell phone 585-329-3308 or our answering service 585-723-6566).