Post Operative Information

Medications 

Rush Fisher, MD, or his physician assistant (PA), will give you a prescription for medication upon discharge from the hospital.  Please follow the instructions for administration closely, and call us if you experience any problems taking these medications.  If you are taking antibiotics, take them until the bottle is completely finished.

We do not refill medications by telephone. All medication refills must be done in person at a scheduled visit with our physician assistant. The only exception to this rule will be for patients who are within 90 days of surgery and for physical therapy refills.

If you are within 90 days of surgery, please leave the following information: your first and last name, with the correct spelling, your phone number where you can be reached, your pharmacy name and phone number, the name of your medication and the dosage. According to Delaware state law we cannot refill any prescriptions before they are due. 

Note: Do not take arthritis medications (NSAIDS) or aspirin for at least 3 months after all fusion surgeries. These include Advil, Aleve, Celebrex, Daypro, Feldene, Motrin, Naprosyn, Felafen, and Voltaren.

 

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Follow-Up Appointments

Unless otherwise indicated by your physician, your first post-operative appointment will be approximately 6 weeks following your surgery.  Please call the Christiana Spine Center at (302) 623-4144 between the hours of 9:00 to 4:00, Monday through Friday to schedule your follow-up appointment.

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Incision Care 

Check your incision at least twice daily for the first two weeks for any sign of infection.  These signs include increased warmth or redness to the area, swelling, drainage or unexplained increasing pain in the incision not relieved by bed rest or local application of ice, 5 to 10 minutes, 3 times a day.  Small, punctate irritation or inflammation at the ends of the wound is most likely a reaction to the suture material.  These reactions are benign and will resolve as the wound heals.

For cervical operations, vitamin E oil may help fade the scar.  Apply vitamin E (200 IU or 400 IU) directly to your cervical incision once or twice daily.  Vitamin E oil can be applied directly from the capsule onto the neck wound.  Please give the wound at least one week to heal prior to the first application.

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Dressing Changes 

You may change the dressing the day after you return home.  A small amount of reddish-brown drainage is not unusual for 1 to 2 days.  Please report any other type or amount of drainage to our office.  We may begin you on an oral antibiotic if the drainage persists.  The dressing may be discontinued 24 hours after the incision stops draining or spotting.  Showers may begin two days after the drainage stops.  You may take tub baths 2 weeks after surgery or 6 weeks after fusion surgery.

Steri-strips (adhesive skin closures) should be kept on the incision until 6 to 10 days following surgery.  You may shower as the protocol for your particular surgery permits, remembering to gently dry the incision area and Steristrips.  It is common for the edges of the strips to loosen and curl.  Simply clip the frayed edges but leave the strips on for 6 to 10 days unless they are so loose they are obviously no longer functional.  In this case, you may gently lift off the strips but do not pull or jerk to remove them.  Apply vitamin E oil to neck wounds, otherwise keep the incision clean without the use of other creams or ointments.

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Pain Expectations 

After a lumbar fusion, you will have occasional low back pain for 3 to 6 months with gradual resolution.  After cervical surgery, you will have predictable muscle pain for up to 6 weeks post-operatively.  A sore throat often occurs after intubation for anesthesia.  After all surgeries, inflammation is a natural process of healing.  We cannot and do not want to block this process.  Please know we can take the "edge" off your pain, but we cannot stop all your pain.  With each day that passes, you will get stronger and oftentimes must simply be patient as the healing process begins.  You need to be encouraged by the "good days" as the "bad days" get further apart.

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Post Operative Procedures

Call our office immediately if you:

1. Have drainage and/or odor from your wound.
2. Have increased redness/swelling at the incision site, or unexplained increasing incisional pain not relieved by bed rest.
3. Have fever greater than 101 with sweats or chills.
4. Have new or unfamiliar pain or weakness in the arms or legs.
5. Have difficulty with urination or bowel movements.

General Information during your first 6 weeks after surgery:

• Activity, especially walking around your home, is encouraged.  Try to do so at least 4 times daily.
• Do not do heavy housework, such as bed making, vacuuming or laundry.
• If using stairs is necessary, go slowly and use the handrail.
• Do not twist, bend or lift anything over 10 lbs.  If you return to a sedentary job, you must abide by these restrictions.  A letter can be faxed from our office stating these restrictions.
• No special exercises are necessary.  Continue the abdominal and leg isometrics you were doing in the hospital.
• An increased intake of water, 6 to 8 glasses per day, will help clear your body of anesthetics and excess pain medication, and will increase the ease of bowel movements.
• With the use of narcotic pain medications, simple constipation is common.  Increasing your intake of fiber with a daily supplement such as Metamucil is often helpful.  Avoid extended use of stimulant laxatives.
• Avoid sitting in chairs and sofas that are low to the ground and avoid sleeping on a mattress with the height not equal to that of your mid-thigh.  This makes transfer in and out of bed easier.
• For discectomy patients, try not to sit longer than 15-30 minutes during a 4 hour time, and shorten those periods if soreness develops.  This soreness is generally muscular in origin, and can often be helped with alternating local application of heat or ice.
• If you have a lumbar fusion, wait until after the first post-operative office visit (6 weeks) before having any sexual activity.  Otherwise, you may resume normal activity after 2 weeks.
• Do not drive until after we have seen you at your first post-op visit, unless otherwise approved by your physician.  Riding in the car is acceptable, but long car rides (2 hrs.) are discouraged.
• Spine fusion patients cannot smoke for 6 months after surgery.  You must also avoid nicotine products (smokeless tobacco, gum and patches) and avoid exposure to smoke from other smokers.
• REMEMBER, spine fusion patients are to avoid use of NSAID's (arthritis medications) for at least 3 months after surgery.  Consult your physician prior to resuming these medications.
• Braces or corsets are to be worn at all times when out of bed.  Cervical collars are to be worn in the shower as well.  Remember to change and clean the cervical pads daily.  At your first post-operative visit, you will be given further instructions.  If you have a halo, halo pins must be cleaned twice daily with 1/2 strength hydrogen peroxide and water using cotton swabs.
• If your surgery included the use of spinal implants (rods, plates, screws, etc.,) be sure to inform any physician planning other surgery for you in the first 6 months.  This includes any dental surgery or deep dental cleaning.  We suggest that your physician or dentist use the American Heart Association Guidelines for antibiotic prophylaxis.