First 7 – 10 days

You need to make an appointment to see Dr. Maffet 7 – 10 days post surgery.  Whatever date is convenient for you in this time period.  Dr. Maffet will discuss the details of the findings of the procedure at that time.   He will let your family know postop in the waiting room if there are any specific, different things that need to be done in this first 7 – 10 days.

Wound care

Leave the bandage on the first 48 hours.  It is not unusual for some drainage to appear through the bandages.  You can reinforce it with some gauze pads or change the dressing if necessary.  After 2 days, you can take the bandages off.  Leave the steri-strips in place until the first postop visit.  Do not use any ointments directly on the wound.  Keep the wound area dry until the first postop visit.  Showers can be taken as long as the wound and bandages stay dry.  Plastic bags, Saran wrap, or partial showers can accomplish this.  No immersion in water until 3 weeks out.

Sling / Shoulder immobilizer

One of these will be provided for support of the arm in the postop period.  They are typically for your comfort and don’t have to be on 24/7 unless you are told otherwise.  It is a good idea to use liberally the first 7 – 10 days and then for comfort after that.  It is a good reminder to you and everyone around you to be careful.

Cold Therapy

Use the cold therapy or ice for 30 minutes every 2 hours until the first postop visit.  A cold therapy device will be issued to you if your insurance covers it.  If not, an ice pack or bag of frozen peas may suffice.

Medications

A local anesthetic is injected at the operative site to help with pain the first 6 – 12 hours.  You wil be given Norco as a pain medication.  You can take that every 3 – 4 hours for any initial postop pain.  Remember, it takes less pain medicine to keep the pain controlled than it does to get it under control after it kicks in.  I would recommend taking regularly at least the first 48 hours.  Common side effects of Norco are nausea, drowsiness, and constipation.  Phenergan 25 mg can be used for uncontrolled nausea.  I recommend using the stool softener Colace 100 mg twice a day for at least the first week postop.  Dulcolax can also be used for constipation.

I will also prescribe a prophylactic antibiotic, Keflex, for 2 days postop.  Just take them untl they are gone.  For those with allergies to Keflex, I use Clindamycin instead.

For repair situations such as labral repairs or rotator cuff repairs, I don’t like using oral anti-inflammatory medicines for the first 3-4 months.  These include Motrin, Advil, etc.  Check with me before taking these.

Exercises / Physical Therapy

I want you to come out of the sling a couple times a day to move your elbow so it doesn’t get stiff.  For most shoulder arthroscopy procedures you can start the Basic Shoulder Exercises as soon as you can.  Okay to give it 24-48 hrs to settle down some before starting.  The basic idea is to passive preserve you range of motion so it doesn’t get stiff without putting too much stress on the shoulder too soon and keeping it inflamed. There is a balance between the two that varies between patients.

I typically won’t start any Physical Therapy until at least the first postop visit and ususally longer if the Basic Shoulder Exercises are going well.  For most surgeries involving a repair, formally Physical Therapy starts at 4-6 weeks postop.

Activity Level

This is a common question.  A good guide is that if you can do it with your sling on, it is okay.  If your shoulder is staying sore, you may be doing too much too soon.  The passive range of motion exercises are a minimum.  Other things may need to wait until your postop inflammation settles down.

Driving is a common question.  Again, if you can do it in a sling than okay.  No driving while taking narcotic medications.  Remember, the time when you can driving and when you should drive may not be the same.

Emergency Calls

Please make phone calls for medication refills during normal office hours.

Call 281-690-4678 for any uncontrolled pain, temp > 101, unusual redness or drainage from the wound.  Either Dr. Maffet, or his Physician Assistant, or On Call Physician will get back to you.

Any acute emergency please call 911 or go to the emergency room to be seen.