Home / Physician / Michael L. Swank, M.D. / Dr. Swank’s Frequently Asked Post-Op Questions

Dr. Swank’s Frequently Asked Post-Op Questions

Dr. Swank is a board-certified orthopaedic surgeon specializing in hip and knee replacements. He is a pioneer in computer-assisted and minimally invasive hip and knee surgery.

If you have any questions before or after your operation with Dr. Swank, please read some of our frequently asked questions below to see if we can answer any questions you may have.

These medical instructions are specific to Dr. Swank’s patients only. Please talk with your provider before following any of the steps below.

How long should I wear the compression socks after surgery?

You can stop wearing the compression socks TWO WEEKS from your surgery date. The purpose of the TED hose is to reduce or eliminate lower leg swelling. If, after removal, you experience a return of lower leg swelling then return to the hose for several days. Also, be a little more conscious of elevating (remember – toes above the nose). We do recommend wearing the compression socks on both legs; however, if they are really bothersome, you do not have to wear it on the non-operative leg. We do strongly suggest wearing on the operative leg for two weeks after surgery.

I am experiencing constipation after surgery. Is this normal?

Constipation after surgery is not uncommon. It is caused from the narcotic use during surgery and post-op. Here are some things you can do to ease constipation:

– Decrease/stop the narcotics as soon as possible

– Increase fluid intake – You need to be drinking at least 8 glasses (8oz) of water a day (Drinking enough water is extremely important in decreasing constipation)

– Use a stool softener (i.e. Colace 100mg 1 tablet two times a day)

– Add Miralax (Mix a full dose of Miralax in an 8oz glass of water 2-3 times a day)

When can I return to driving after surgery?

You may attempt to return to driving:

– When you are not using the narcotic pain medication during the day

– You are not heavily relying on a cane or a walker

– You have good Range Of Motion

– You have good Strength

– You are comfortable and confident returning to driving

– We suggest beginning in an empty parking lot and progressing from that point to quiet streets and lastly to highways.

When can I expect my lab and/or cultures to be ordered?

Certain labs and/or cultures may be ordered. These results do come to the office and will be addressed in a timely manner. If you get an abnormal lab or culture result, please give us 2-3 business days to address this prior to calling the office.

When should I order medication refills and what do I do if I run out?

Medications will not be refilled over the weekend. Please plan accordingly and contact the office BEFORE FRIDAY in order to get a refill and make sure you have enough medicine to last you through the week.

If you do run out of pain medication you can:

– Tylenol – make sure you are taking Tylenol 1000mg every 6 hours scheduled to decrease the pain. Max dose of Tylenol is 4000mg in a 24 hour period.

– Prednisone – double up on the prednisone. Take a prednisone tablet twice a day through the weekend

– Gabapentin – use this three times a day (morning, afternoon and then at bedtime) (Example: 1 with breakfast, 1 with lunch and then 1-3 at bedtime)

When can I return to taking Over-The-Counter Medications?

Dr. Swank would like you to hold any over-the-counter medications, supplements, and/or vitamins for 2 weeks after surgery. After 2 weeks from surgery it is ok to resume these medicines.

What should I do if my prineo is starting to come off/peel off?

This can happen with time and showering. Trim the loose ends or edges with scissors and leave the rest alone.

I’m having a lot of pain after surgery. Is this common?

IT WILL GET BETTER! It is normal to have a lot of pain after surgery. Day 2 and 3 after surgery tends to be the most painful for most patients. The pain will decrease with time, but there are some things you can do to try to decrease the acute pain:

ICE/ELEVATE

– Make sure your toes are above your nose (the extremity needs to be above your heart) in order to effectively elevate

– Increase your icing time – ice for 20 minutes 6-8 times a day

MEDICATION ADJUSTMENTS

– Oxycodone – it is ok to take 2 tablets every 4 hours at the beginning. Try to decrease the amount and frequency as soon as possible to conserve your prescription.

– Tylenol – make sure you are taking Tylenol 1000mg every 6 hours scheduled to decrease the pain. Max dose of Tylenol is 4000mg in a 24 hour period.

– Prednisone – this medication can be doubled (take twice a day) for a short time period to help decrease the pain

– Gabapentin – If you find this medicine is helping at night but you are still having a lot of pain during the day, the gabapentin can be used three times a day (morning, afternoon and then at bedtime) (Example: 1 with breakfast, 1 with lunch and then 1-3 at bedtime)

When can I return to swimming after surgery?

You can swim after surgery only after your incision is totally sealed. You incision must be completely sealed with no openings or scabs on it before soaking in any water. This typically occurs around 4 weeks post-op.

I am developing a rash around my prineo (mesh strip). Is this normal?

A rash around your mesh strip is not uncommon and often nothing to be concerned about. Some people will develop a rash/red itchy bumps that start to form around the dressing/knee. What to do if this is you:

– Keep area dry and clean

– DO NOT PUT ANY CREAMS ON THIS RASH

– Take Benadryl 25mg (1 tablet) every 6 hours to help with the rash and itching

– If on prednisone, start taking 2 tablets a day for 2-3 days. If you ran out of prednisone and Benadryl not helping, call the office for a refill of the steroid

I am developing blisters around prineo. Is this common?

This is not uncommon and often nothing to be concerned about. Blisters are often caused from increase swelling and pressure in the knee and under the skin causing a fluid filled sack to form on the skin. These blisters can be large and can rupture. This is not worrisome. What to do if this is you:

– Keep area dry and clean

– Pour hydrogen peroxide on the blister(s) two times a day

– Leave open to air if possible and in a clean environment

– If the blister(s) is draining/leaking – ok to cover with clean absorbent dressing

– Do not put any cream or topical medication on the area

– ICE AND ELEVATE! The issue is swelling – so ice and elevation will decrease the swelling and pressure causing the blister

What should I do if my wound is bleeding or draining?

This is not uncommon and not worrisome. Apply a compression dressing made up of absorbent material and pressure. For example: get gauze pads and wrap these tightly around the incision with an ACE wrap or coban tape. Leave this compression dressing on for 24 hours unless it becomes saturated then remove and re-apply. Also focus on elevating the extremity. If bleeding for longer than 7 days post-op please contact office.

Dr. Swank Surgical Patient Medication Instructions

Dr. Swank uses a multi-modal medication approach in order to control pain after surgery. Each one of these medications targets a different pain pathway/pain receptor in your body.

This is the standard regimen, however every patient is different and the exact medications you should be on will be discussed at your pre-op appointment. If you have already had your pre-op appointment, please refer to your medication page for specifics.

  • Aspirin 81mg – blood thinner (over the counter)
    • Take 1 tablet twice a day for 35 days after surgery
    • If you have a history of a blood clot or are already on a blood thinning medication you may be placed on a different medication
  • Mobic/meloxicam 15mg – anti-inflammatory
    • Take 1 tablet daily until gone (after surgery)
    • Do not use any other anti-inflammatory medication (Ibuprofen, Diclofenac, Advil, Aleve) while using Mobic
    • If your stomach gets upset while using Aspirin and Mobic together, you can take add Prilosec/omeprazole daily
    • If you are over 70 years old, you most likely will not be given this medication to be used post-operatively
  • Neurontin/gabapentin 300mg – sleep and nerve pain
    • Take 1 capsule the morning of your surgery
    • Take 1-3 capsules at bedtime
      • If 1 doesn’t work and you still have pain/trouble sleeping can increase the dose to 2 or 3 capsules at bedtime
  • Cymbalta/duloxetine 30mg – pain
    • Start this medication 5 days before your surgery
    • Take 1 tablet at dinner every evening
      • take 1 tablet morning of surgery
    • When you have 7 tablets left: wean off the medication by taking one capsule every other day until gone
    • This medication can cause nausea/lightheadedness/other side effects – if this occurs, stop taking the medication and let Dr. Swank know the day of surgery
    • If you are already on an anti-depressant or mood medication, you will not be placed on Cymbalta and are instructed to continue your anti-depressant you use at baseline
  • Oxycodone – pain
    • Starting after surgery, take 1-2 every 4-6 hours as needed (using as little medication as possible)
    • Add Tylenol 1000mg every 6 hours in addition to the oxycodone
    • People will often alternate oxycodone and Tylenol for best pain control
    • Do not drive while using oxycodone
    • You may want to take an oxycodone the night of surgery to decrease pain once the block wears off
  • Prednisone – steroid – pain
    • Take 1 tablet daily for 14 days
    • If this medication causes you to stay awake, take it in the morning
    • Start taking this medication the night of your surgery
  • Keflex – antibiotic
    • Take 1 tablet twice a day for 2 days (after surgery)
    • If allergic to Keflex, take Clindamycin

 

These medication instructions are for Dr. Swank’s surgical patients only. Please do not take these medications if they have not been prescribed to you.

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