Your Post-Operative Recovery

Frequently Asked Questions

On return to the ward, the nurses will ensure you are appropriately looked after and that your pain is well controlled. Mr Lau will generally see you either that day, or the next morning prior to discharge, and update you on the operation, your progress and the steps going forward. A physiotherapist will usually see you prior to discharge to make sure appropriate rehabilitation is commenced.

This varies depending on your operation and your general health. Examples of length of stay include:

• Shoulder replacement – 1-2 days

• Shoulder arthroscopy (rotator cuff repair, stabilisation) – 1 day

• Elbow replacement – 1-2 days

• Elbow arthroscopy – day surgery

• Wrist fusions – 1 day

• Nerve releases (carpal tunnel, cubital tunnel) – day surgery

Rehabilitation after upper limb surgery can be very difficult, and it is important to have a physiotherapist help guide you through this process. There are many different approaches to rehab after surgery and Mr Lau has a number of protocols which will be tailored to your specific operation. It is important to abide by these as they allow a balance between early movement and strengthening with protecting your repair. Whilst in hospital, a physiotherapist will usually start your rehabilitation and give you guidance of what to do at home.

You will see a ward based physiotherapist prior to discharge from hospital, who should give you a number of exercises to do at home. After discharge, you are welcome to see your own physio if you are already seeing one you like. Alternatively, Mr Lau is able to refer you to physios who he works well with and who have experience with his post operative protocols.

Tips for sleeping after surgery:

• A reclined position is generally the easiest. Try a recliner chair or propped up in bed with lots of pillows/cushions. Generally patients will do better on an incline for 4-6 weeks. Don’t forget pillows for your shoulder as well

• Wear your sling at night for the first 4-6 weeks. It helps to protect the shoulder and limit movement

• Pillows are your friend. Elevate the arm as much as possible

• Time your medication including taking something long acting just before you sleep. Have pain relief next to your bedside within easy reach

• Ice before bed – can help reduce inflammation and improve pain

• Take it easy!

Keep the wound dry until it has healed – usually 10-14 days. There will be a waterproof dressing over the wound but  try to avoid getting it too wet in the shower. Avoid any spray on deodorants, lotions or talcum powder etc. until the wound has healed entirely. If the dressings start to lift away, you can buy additional dressings at your local chemist to reinforce or replace them. Generally, Mr Lau will see you at 2 weeks to check the wound in the rooms.

Wearing a sling is important to protect your shoulder during the early stages of post operative recovery. Generally, its use is divided into stages (this may change depending on your specific type of operation):

• 0-2 weeks: wear sling at all times. Can come off for hygiene only

• 2-6 weeks: wear the sling most of the time, but you can wean out of it for longer periods of time

• >6 weeks: sling only if necessary, out most if not all of the time

When out of the sling, ensure your elbow is supported with pillows or cushions. For shoulder replacement patients, do not allow the elbow to drop behind you as it risks dislocating your shoulder. A nurse of physio will help you fit the sling and make sure you know how to put your arm in the sling in a correct way. Unless specified, you should not need the body strap.

It is recommended you wear your sling at night for the first 6 weeks. Try to find a comfortable position, either on your back, propped up or on your side, and support the elbow/shoulder with cushions. Armpit hygiene can be difficult with a sling, and it is OK to come out of the sling from time to time to wash. Moist towels to wipe down the armpit can be helpful

The most common question is when can I drive after surgery. Legally, you must have full control of both arms at all times to drive, and therefore you cannot drive whilst wearing a sling. Most of the time, this means that after surgery, it is 6 weeks before you can drive, although this may change depending on your operation.

There are more detailed guidelines to specific activities in the post-operative protocols and patient information sheets. Alternatively, please ask Mr Lau if there is a specific activity you wish to do after surgery.