Post Operative Instructions Shoulder Surgery

1. Please keep your hospital dressings on.
   
   
2. A prescription for pain tablets will be provided by the hospital on discharge. Generally take Paracetamol regularly: 1 to 2 (500 mg) tablets three times a day will reduce the need for stronger mediation. For breakthrough pain eg. after exercise or at bedtime, take Oxycodone (tradename Endone or Oxynorm) 1 to 2 (5 mg) tablets twice but no more than three times a day. This is a narcotic prescription. Oxycodone should be taken sparingly. It may make you lightheaded and nauseous and should not be combined with alcohol or sleeping pills. You should not take anti-inflammatory medication (eg Naprosyn, Mobic, Voltaranetc) as well.
   
   
3. If a sling has been applied, please keep this on day and night to prevent tension and stress on the surgical repair. Learn how to apply the sling while you are in hospital. The sling should rest on the side of your hip, not resting on the front of your chest. It should support the weight of your arm. Your shoulders should be on the same level. The sling can be removed only for washing, dressing and gentle exercises. You should not attempt to drive a motor vehicle with the sling or sleep on the affected side. Initially you may be more comfortable sleeping in a recliner chair or slightly sitting up, rather than fully flat.
   
   
4. Gentle exercises will decrease stiffness of the shoulder and other joints in the upper limb. Do your exercises slowly and gently, to the point of discomfort never pain. Before exercising, warm up with a warm shower or hot pack. After exercising apply a cold pack. Do your exercises for 2-3 minutes twice daily.

Initial Shoulder Exercises include:

1. "Rock the Baby" Pendulum Exercise: Stand and bend forward at the waist. Support the operated arm at the elbow with your opposite hand. Lift the operated arm out of the sling. Use your opposite hand to support the weight of the operated arm at the elbow andslowly move your operated arm side to side and forward and back, then circle clockwise and anti-clockwise five times each. Only move as far or as fast as is comfortable. This will help prevent stiffness in the operated shoulder.
   
   
   
   
2. "Open the Door" Passive External Rotation: Elbow flexed to 90˚ and held by the side. Grasp wrist of operated arm with good hand. Gently rotate operated arm outward. Repeat fivetimes.
   
   

   Note: Initially the operated shoulder movements are passive by using the good arm. Active movements of the operated shoulder on its own accord should be avoided as these can damage the surgical repair. The same must apply during showering and dressing.
   

3. Gently bend and straighten your elbow five times.
   
   
4. Gently clench to make a fist and stretch your fingers out straight five times.
   
   
5. Make sure your posture is good and avoid slouching. Do some neck stretches and chin tucks.
   
   
6. In the first day or two after surgery – performing some general exercises will aid recovery. These include cough and deep breathing (to keep your chest healthy) and frequent short walks (to prevent deep vein thrombosis).
   
   

Mr Wang will review you at 7-10 days after surgery. Your exercises may be increased at this stage depending on the type and extent of surgery.

With regards to work, generally you would be off all work duties until you are reviewed after surgery.

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