WOUND CARE: - A sterile surgical glue (Dermabond) was placed over the incisions (under the bandage) at the time of surgery. Dermabond can be removed after the 1st post op appointment. - Keep incision site clean and dry. - Avoid use of topical creams, ointments or lotions for first 2 weeks. - Keep site covered with gauze dressing and change the dressing daily. - May shower the day after discharge (remove dressing to shower). Pat area dry. - Do not soak incision in water such as in a bath, hot tub or swimming pool for 3 - 4 wks. - Ice packs for 20 minutes to incision and back 4 -5 times a day will help with swelling.
MEDICATIONS: - We will give you a prescription for pain medication upon discharge from the hospital. - If you need a medication refill after surgery, call the office at (512) 509-0235 between 8am – 4pm, Monday thru Thursday. It may take 24 hours before script is ready. - Medication refills are not given after hours or on the weekends. - Take all medications as prescribed. - Call your physician or ask the pharmacist any questions about medications or if you are unable to take the prescribed medications. - DO NOT drink alcohol or drive a motor vehicle while taking pain medications. - Pain medications cause constipation. Recommend regular use of over-the-counter laxatives and stool softeners (Surfak or Colace) on a daily basis while taking any pain medications. - DO NOT take Ibuprofen, Aleve, Mobic or any NSAID following your spine surgery. These medications interfere with fusions and bone healing. - If you were taking Coumadin (Warfarin) or Plavix before surgery, you can resume blood thinners 5-7 days after surgery. - You may re start your baby Aspirin the day after. - You may substitute Tylenol (Acetaminophen) for your pain medication; however, no more the 4,000 milligrams in 24 hours because it can cause liver damage. Please note that most narcotic pain medications (i.e. Norco) have Acetaminophen combined with them.
DIET: - Recommend a liquid diet (jello, soup, broth, etc.) after surgery. May advance to a normal diet if passing gas and no nausea or vomiting. - A sore throat and hoarseness often occur after intubation and anesthesia. - Drink plenty of cold fluids and/or eat ice chips to decrease a sore throat and swelling. - Take a stool softener daily with full glass of water.
ACTIVITY: - Walk daily. Walking is your physical therapy for the first 6 weeks after surgery; start slowly and increase distance and frequency of walks as tolerated. - Continue to use your incentive spirometer every hour while awake after discharge. - Practice deep breathing exercises daily. - Wear the back brace when out of bed walking or sitting in a chair as directed. - Use a walker or cane for balance for the first few weeks.
RESTRICTIONS: - No lifting, pushing or pulling > 10 lbs. (a gallon of milk is approximately 10 lbs.) - No repetitive bending over at waist. - Avoid repetitive bending or twisting, - Avoid strenuous activities or vigorous pounding (i.e. heavy housework, yard work, running or boating). - Avoid sitting in a recliner because the position will increase swelling in the lower back region. - Avoid spending all day in bed. Take short naps during the day if needed. - No driving for 2 weeks after surgery. We will discuss further at 1st post op appointment. - DO NOT use tobacco products for at least 6 months after a spinal fusion surgery. Even small amounts of tobacco use can interfere with fusions and bone healing.
FOLLOW-UP: - 1st appointment will be in office in 2 weeks after surgery with PA Rudi Dimas. - 2nd appointment will be in office 6 weeks after surgery with Dr. Mark Santman. - X-rays will be performed for all lumbar spine FUSIONS at each visit; please show up 30 minutes early to have films done prior to appointment. - For any questions or concerns, call the Nurses Line for the Orthopedic Spine Surgery Department at (512) 509 0235.
CALL THE OFFICE: - Signs of infection such as: fever > 101 degrees, chills and night sweats. - Bleeding or continuous drainage from the incision. - Redness or heat around surgical incision. - Increasing back or leg pain not controlled with prescribed pain medications. - Difficulty with urination or bowel movements. - Neurological deterioration to include new pain or weakness in the legs. - Severe headaches.
GO TO ER FOR THE FOLLOWING: - Nausea and vomiting. - Abdomen pain. - Respiratory distress or difficulty breathing. - Chest pain. - Leg swelling, pain or signs of a blood clot.