FAQs before calling the office: “Is this normal?”

I’m having pain after surgery – what should I do?

You will have pain after surgery, this is a big surgery and pain is NORMAL. The first 2 days are the hardest, but after that, your pain should slowly get better day by day.

IF YOUR PAIN IS NOT CONTROLLED (Do the following step by step):

1. First, make sure you have been taking all your scheduled medications as prescribed
2. Rest, Ice, and ELEVATE ELEVATE ELEVATE your surgical extremity above the level of the heart
3. Take an extra Ultram (Tramadol). You may take up to 2 tables or a total of 100mg of Tramadol every 8 hours during times of acute pain
4. Take an extra Oxycodone. You may take up to 2 tablets or a total of 10mg of Oxycodone every 4 hours during times of acute pain

I have bruising down my leg

• Bruising that travels down your leg – even into the foot! – is NORMAL after surgery. Severe calf pain (back of the leg) can be a warning sign for blood clots, but I expect most patients to have some purple bruising (just like a black eye) in their leg after any surgery

What is my incision supposed to look like?

• Joint replacement surgery requires an incision in the skin to perform the operation. This incision may look red, have some blood drainage (normal), and itch for the first few weeks after surgery. You may see up to ½ of the special beige dressing (called an “Aquacel”) stained with blood. If more than ½ of the dressing is stained, please notify our office.

Who should I call with questions after surgery?

• We have an incredible team of nurses who can answer your questions after surgery if this handout does not cover them (Phone#: ). If it is not urgent, you can also message Dr. Bremjit and his staff through MyChart, and he or a member of his team will respond to you as soon as possible.

Should I go to the Emergency Room?

• In general, we prefer you speak to someone from our team BEFORE going to the Emergency Room. The staff at the ER will not be familiar with you and may not be familiar with patients who have had a knee or hip replacement. There is always a provider on call with The Everett Clinic who you can speak to.

I’m having trouble sleeping, what should I do?

• Make sure your pain is well controlled throughout the day. Avoid taking naps during the day. Try to plan your activities as near normal as possible. If you still cannot sleep, try melatonin which is an over-the-counter natural sleep aid. You may sleep in any position that is comfortable. Just remember – after joint replacement surgery, it is normal to have difficulty sleeping through the night for up to 2 months!

Constipation

• Unfortunately, pain medicines may cause constipation postoperatively. It is best to continue drinking fluids regularly to help remedy these symptoms. Remember to take the stool softener twice daily until you are having a bowel movement every 1-2 days. If you begin to have loose or watery stools, discontinue this medication.
• If you have constipation despite using the stool softener, you can try these over-the-counter medications before calling our office:
  • Miralax powder: 17g mixed in water/juice/coffee, once a day
  • Senna (Ex-Lax): 8.6g orally, twice a day (once in the morning and once in the evening)
  • Milk of Magnesia (400mg/5mL): take 2-3 tablespoons by mouth, every 8 hours until you have a bowel movement

I no longer need any narcotic pain medications, what should I be taking?

• Once your pain has improved to the point where you no longer need the “heavy duty” narcotic pain medications like Oxycodone, or even Tramadol, you should still take some pain medication, specifically:
  • Meloxicam: Take for 6 weeks after surgery
    • This is an anti-inflammatory and will be the best medication to treat your discomfort after surgery. You should not add Aleve or Advil when you are taking this to reduce the risk of side effects
  • You can also take the Tylenol we prescribed or even Tylenol over-the-counter for pain
  • Even if you don’t feel you need it, you may need to continue taking the narcotic 1 hour before your physical therapy appointments!
• Physical therapy after a knee replacement is incredibly important and pain should not be what limits your knee range of motion. Make sure you appropriately have your pain pre-treated before all your PT appointments to get the maximum benefit.

Muscle soreness

• The muscles, not only immediately around the affected joint, but all of the muscles around the affected thigh/leg may be sore after surgery. It is not uncommon to feel soreness in your muscles for the first 6 weeks after your operation. Don’t worry! This will improve with physical therapy, the anti-inflammatory, and time.

Please call our office if you experience:

• Fever above 101.5F at least twice throughout the day. Fevers can be normal for the first 2 days after surgery as this is the body’s normal response to a big surgery.
• Increased drainage or swelling after it had previously slowed down
• Staining of the dressing with blood approximately 50% of the size of the dressing
• Persistent vomiting or difficulty passing urine
• Severe headaches
• Pain out of control with the medication regimen
• Inability to bear weight on your leg
• Severe insomnia
• Swelling in the calf (muscles in the back of your lower leg) which is accompanied by coolness or decreased sensation in the foot
• Confusion or disorientation – this is especially common in patients >65 years old who are on narcotic pain medications
• Call 911 with any shortness of breath or chest pain

**Medications can only be refilled Monday-Friday from 7:00am-4:00pm. Please plan your refills (especially before a long weekend) accordingly

**Call the office for refills and provide them with your date of birth, which medication(s) you need refilled, and your preferred pharmacy’s address