Dr. McClung’s Sugery FAQ’s

July 26, 2016

Thank you for choosing Beacon Orthopaedics and Sports Medicine and Dr. McClung for your care. We are excited to get you back to being pain free and active again!

Once you’ve met with Dr. McClung and decided that surgery is the best route for getting you back to a pain free lifestyle, our surgery scheduler will be getting in touch with you within a couple of days to schedule your surgery and go through what needs to be done prior to your procedure. You will need to see your primary care physician or an urgent treatment center within 30 days of surgery for a preoperative history and physical exam. This ensures that it’s safe for you to undergo general anesthesia and will assess any risks prior to your surgery. This will be reviewed by Dr. McClung’s team and also by our anesthesiologists. You will also need to get some minor bloodwork and a urinalysis and depending on your medical history and your age, an EKG may be done. All of this must be done by the Friday prior to your surgery or your surgery may get rescheduled.

Our team of preoperative nurses will also be contacting you within a week of your surgery to go through your medical history and medications. This is a great time to clarify any questions you may have about continuing or stopping any medications.

Our patient advocate will contact you regarding the cost of your surgery. She contacts your insurance company and will inform you of any upfront costs you may need to pay before your surgery can be done. She can answer any financial questions you may have.

You will receive a call from the surgery center 24-48 hours prior to surgery with the specific time you must arrive. We cannot guarantee any surgical times before this 24-48 hour period.

Things to do and not to do the night prior to your surgery

• Do not eat or drink after midnight – only small sips of water with the medications you have been instructed to take.
• Do not drink alcohol, including beer, wine and liquor. Stay well hydrated.
• Do not smoke or chew tobacco
• Brush your teeth but be mindful not to swallow the water.
• Do clean the surgical area with antibacterial soap, such as Dial
• Do not bring anything of value with you to the surgery center – leave your jewelry at home.

On the day of surgery

• Bring your insurance card, driver’s license and a copy of your Advance Directives if you have them
• Bring your CPAP if you have one
• Wear something comfortable
• Bring your crutches or your sling on the day of surgery.
• Bring your glasses, contacts or hearing aids.

What to expect on the day of surgery

Your procedure will be done at our outpatient surgery center (or Good Samaritan Hospital or Christ Hospital if your insurance or health status requires it to be done at a hospital). Once you have checked-in, you will be taken to the pre-operative holding area. Here, you will have a nurse that will start your IV and prepare you to go into the operating room. You will meet your anesthesiologist and Dr. McClung will also be there. Depending on your procedure, you may receive a peripheral nerve block, this will help reduce post-operative pain for the first 12-24 hours. You will be given a mild sedative in the pre-op holding area for this procedure to be done.

You will be under a general anesthesia during your procedure. You will need a responsible adult to accompany you to the surgery center to make sure you get home safely, you will not be able to drive. This person will also be the person that Dr. McClung will speak to once your procedure has been completed.

Home care after surgery

Keep your incision clean and dry. Do not change the dressing, it will be changed at your post operative appointment with Erinn or Dr. McClung on the day following surgery or at your physical therapy appointment. It’s important to keep the wound clean and dry to avoid risks for infection. Do not submerge in water (bathtub, hot tub, lake, pool, river, etc.) until at least 2 weeks post operatively. You may shower, be sure to cover the incision sites with waterproof bandaids and change them once you’re done showering. If the site gets wet, pat it dry and cover with a dry dressing. Do not put any ointments or creams on the incision sites.

You can help control pain postoperatively with ice. You can use ice bags at home and leave them on for 20 minutes every hour as needed. If you purchased an ice machine pre-op, you can leave it on the surgical site for 1 hour at a time.

Take the medications prescribed to you post-operatively as prescribed. Do not take them more frequently or with any other sedatives or sleep aids. If you have questions regarding this contact us or your pharmacist. Sometimes pain medication can be constipating. You can take over the counter stool softeners or laxatives for relief. If this doesn’t work, please let us know.

If you experience any of the following post operatively, call the office immediately:

• Temperature greater than 101.5 degrees
• Bright red blood through your dressing
• Increased drainage, redness or foul-odor from the wound
• Swelling or pain in the calf or foot
• Difficulty breathing or chest pain

Here are some frequently asked questions; if you continue to have questions after reading through these, please call our office.

I’ve met with Dr. McClung and we’ve decided that the best option for me to get better is surgery, now what?

• Our surgery scheduler will be in touch with you within 1-2 days to discuss when your surgery can most appropriately be scheduled. Dr. McClung operates at our outpatient surgery center on Thursdays. If your procedure needs to be done at a hospital, we will schedule it when it’s most convenient.

What do I need to do prior to surgery?

• You will need to see your primary care physician or an urgent care physician prior to surgery to for a comprehensive physical exam to ensure that you are healthy enough to undergo general anesthesia. We will also require you to get some lab work and possibly and EKG before surgery. This must be done within 30 days of surgery and NO LATER than the Friday prior to your surgery. This allows appropriate time for Dr. McClung and an anesthesiologist to review your preoperative testing and resolve any issues without having to postpone your surgery. If you fail to get this done in a timely manner, we may have postpone your surgery for the following week.

• The forms you need to take to your physician are HERE. Your physician will fax them to our office.

• If you see a specialist (eg. Cardiologist) we will also need clearance from them.

Can I take all my medications before surgery?

• Please make sure you provide an accurate list of medications you are taking to our surgery scheduler. This will avoid any confusion on the day of surgery. Some common medications that must be stopped 7 days prior to your surgery are:
  • Anything containing aspirin
  • Blood thinners such as:
    • Plavix (clopidogrel)
    • Pradaxa (dabigatran)
    • Eliquis (apixaban)
    • Xarelto (rivaroxaban)
  • Anti inflammatories such as:
    • Advil or Motrin (ibuprofen)
    • Aleve or Naprosyn (naproxen)
    • Voltaren (diclofenac)
    • Celebrex (celecoxib
    • Meloxicam (Mobic)
    • Lodine (etodolac)

I take other medications for my diabetes, high blood pressure or for my heart, do I take those on the day of surgery?

• One of our preoperative nurses will be in touch with you prior to surgery to go over your medication list with you and instruct you on which medications to take and which ones to hold off on. Generally you should not take any diabetic medications on the day of surgery unless instructed to do so by your primary care physician. Most blood pressure medications, beta blockers and anti-seizure medications are ok to take on the morning of surgery. If you have any questions regarding your specific medications please contact our office or ask the preoperative nurse that will be contacting you.

Where is my surgery going to be at?

• Most of our surgeries are done at our ambulatory surgery center and are done outpatient. If your insurance or anesthesia determines that it must be done at a hospital, we will schedule you at either Christ Hospital or Good Samaritan.

What time is my surgery?

• The exact time of your surgery will be determined 1-2 days in advance. One of our nurses will contact you with a time to arrive. You will be asked to arrive 2 hours prior to your surgery time.

Can I drive myself to surgery?

• You must have a responsible adult accompany you on the day of surgery. This person, with your approval, will speak to Dr. McClung after surgery and will be responsible for getting you home safely. You may require assistance at home for several days after your procedure.

When will I start physical therapy?

• Depending on the surgery that you are having done, you may start within 1-2 days post operatively. Sometimes Dr. McClung or his PA, Erinn will see you in the office one day post operatively in order to determine when your physical therapy will start.

I can’t sleep at night, what can I do to help me get a good night sleep?

• Its not uncommon to have trouble sleeping for the first few nights post operatively. If you’ve had shoulder surgery, try sleeping in a recliner or propping yourself up with a couple of pillows in bed. It’s best to sleep at a 45 degree angle for the first few nights.

When can I drive?

• You can drive after surgery once you are off pain medication. Typically patients don’t drive for 1-2 weeks after surgery. If you’ve had surgery on your right leg or if you have a manual transmission, you must be cleared by Dr. McClung to drive.

When can I take these white socks off?

• Once you are up and moving around pretty regularly (at least once every 1-2 hours with the exception of sleeping) you can remove the stockings. The stockings help reduce swelling and help circulation to prevent blood clots.

Can I shower yet?

• You can shower with help within a day or two of surgery. If you are to be non weightbearing on one of your legs, you must keep your weight off that leg for your shower. Sometimes a plastic lawn chair in the shower or a shower chair can be helpful. Be sure to cover your incision with a waterproof bandage and change it once you’re done.

When can I go swimming/take a bath/go in a lake/go in my hot tub?

• Your incision must be completely closed before you get in water. If you’ve had an arthroscopic procedure, this is usually about 2-3 weeks. If you’ve had an open procedure, this can be longer.

How much time will I need off work?

• If you’re having shoulder surgery, this can vary considerably. If you have a desk job, sometimes you can return within a week. If your job requires manual labor, it can be 4-6 months before you are back at work.
• If you’re having knee surgery, there is some variability with returning back to work. If you do manual labor or spend most of your day on your feet, as long as your surgery doesn’t require you to be non weightbearing, you may need 2-3 weeks off work. If you mostly sit at a desk, you can sometimes return to work within a week.