Inpatient Shoulder Surgery

Go to Surgery Guidance for more information.

• Keep your operated shoulder/arm in a shoulder immobilizer/sling as instructed for immobilization, support, and comfort. (Refer to the sling guide from your doctor’s office for how to properly take it on and off.)
• Keep your operated arm elevated above your heart when sitting or lying by using a pillow or wedge under it to reduce pain and swelling.
• Do not actively lift your operated arm to the side, away from your body, or overhead. Do not reach behind and push yourself up with your operated arm. Follow your doctor’s instructions for activity and therapy.
• You may use your hand and wrist for simple activities, such as brushing your teeth, combing your hair, and feeding yourself.
• You may loosen/temporarily remove the sling/immobilizer to allow your elbow to straighten a few times a day to prevent elbow stiffness.
• Using your sling or wedge protects the surgical repair. Follow your doctor’s instructions for when you can discontinue wearing the sling or if your doctor will allow you to take it off for brief periods daily. When the sling is removed, check your skin for irritation from the sling.
• During your recovery, your major focus will be to get your strength and function back. Plan your activities to be spread throughout the day and include rest times. Increase your activity (for example, walking) slowly and steadily.
• Use your pain level as a guide; for example, stop an activity if the pain level goes over your tolerable/acceptable level of pain.
• Most patients find it more comfortable to sleep in a recliner chair or to use pillows or a wedge to elevate their upper body in bed.

Follow your doctor’s instructions about driving.

• During your recovery, even with the use of pain medication, you may have some pain at the surgery site. You may also have the same type of pain you had before surgery.
• If you have pain that becomes unacceptable, more than mild pain, take your prescription pain medication as instructed. As you heal, you will notice you will not need to take as much pain medication or as often, gradually taking less and less. You do not need to finish taking all of the prescribed pain pills.
• To decrease pain and swelling, frequently apply an ice pack to the surgical site. Use a thin cloth between the skin and ice pack and use for 20 minutes at a time. If you have an ice machine, follow the directions while using it.
• Oral narcotic pain medication has been prescribed for the first few days. Use only as directed. Do not combine these medications with alcoholic beverages. We recommend that you take your pain medications routinely for the first 24-72 hours. Mild dizziness is not unusual with these medications. Be careful when walking and climbing stairs. Do not drive while taking narcotic pain medications. Narcotic pain medications can be dangerously addictive; try to gradually reduce your intake and wean off of them as soon as reasonably possible. If you have minimal to no pain and do not feel that you need to take the narcotic medication, it is perfectly fine to not take it and only take Tylenol and/or an anti-inflammatory instead.
• In addition to the narcotic pain medication, it is strongly recommended that you also take Tylenol (Acetaminophen) at the same time to optimize your pain control and reduce the need for narcotic pain medication. You may take a maximum of 3000mg of Tylenol total over 24 hours (1000mg of Tylenol every 8 hours). If your narcotic pain medication also contains acetaminophen, make sure you calculate this into your daily total. Do not take Tylenol if you have been told by your primary care physician not to or have liver disease.
• If you can tolerate taking an anti-inflammatory medication, it is very helpful to also take an anti-inflammatory medication in addition to the narcotic painkiller AND the Tylenol. DO NOT TAKE ANTI-INFLAMMATORY DRUGS IF YOU HAVE BEEN TOLD NOT TO BY YOUR PRIMARY CARE DOCTOR, IF YOU HAVE ULCERS, A HISTORY OF BLEEDING, OR KIDNEY FUNCTION PROBLEMS. Choose only one type of anti-inflammatory drug listed: Ibuprofen (Advil, Motrin, Midol) 600mg three times a day until not needed OR Naprosyn (Aleve) 500mg twice a day until not needed. Do not take these if you are currently taking Celebrex or any other type of anti-inflammatory drugs. Do not take anti-inflammatory medication if you are on a blood thinner medication (for example, Coumadin, Xarelto, or Lovenox).
• If you have nausea or an upset stomach, it is best to stop the narcotic and try Extra Strength Tylenol (1000mg of Tylenol every 8 hours). If your pain is such that you need to continue the narcotic, you have been prescribed a medication called Zofran, which will help reduce nausea.
• You may restart your Aspirin if you normally take it as an anticoagulant. Otherwise, do not take Aspirin unless specifically told to do so by your doctor.
• Please note if you are currently taking birth control pills and starting an antibiotic, your birth control may not be as effective. While taking any antibiotics, and for one month after completing your antibiotic prescription, we recommend using a back-up method of birth control.
• *Refills of narcotic pain medications will only be given during normal business hours per your doctor’s approval. By law, all narcotic prescriptions must be hand-signed by your doctor and cannot be called into a pharmacy.
• When your pain level has subsided to the point where you no longer need narcotic pain medication, it is strongly recommended that you safely dispose of your leftover medication, if you have any. You can find specific instructions on how to do so safely on Dr. Jurek’s website by clicking on “Surgery Overview” and selecting “Narcotic Disposal.”

• Prevent infection by washing your hands or using a hand sanitizer gel often.
• Avoid touching your incision with your hands.
• Do not apply lotion, cream, or ointment to the incision.
• Check your incision daily for bleeding, change or increase in drainage, redness, or swelling. Report any changes to your doctor’s office.
• If your incision is closed and dry, you may leave your incision uncovered without a dressing/bandage. If you have small white ‘steri strips’ in place, leave them on until they fall off.
• If your incision is draining, keep it covered with a dry dressing and change it daily or when it becomes wet with drainage.
• To change your dressing (have someone assist if available):
  • Wash your hands with soap and water; dry them well with a clean towel.
  • Remove the old dressing (if you have small white ‘steri stips,’ leave them in place).
  • Cover the incision with a new dressing. Be careful not to touch your incision area or the part of the dressing that touches the incision.
• If you had a drainage tube that was removed, there will be a separate, small opening near your incision. If this site is draining (leaking fluid), follow the same dressing change instructions as for your incision and change daily. Report any changes in this drainage to your doctor’s office.

• You are allowed to shower with your dressing in place when you feel ready.
• The dressing covering your surgical incision is waterproof and may be left in place until your first postoperative follow-up visit. It is OK to get the dressing wet in the shower. If it inadvertently becomes saturated in the shower, finish showering with the dressing on, remove it once you are out of the shower, allow your skin to air dry, and replace it with dry, sterile dressings.
• Avoid soaking the incision in water (no hot tubs, bathtubs, or swimming pools).

• Some pain medications may cause constipation. Signs and symptoms of constipation include: loss of appetite, abdominal pain, cramps, bloating, nausea and/or vomiting, and no bowel movement for several days or passing hard stools.
• If you have not had a bowel movement before leaving the hospital, take an over-the-counter laxative when you get home (such as Dulcolax). Ask your pharmacist for advice if needed.
• To help relieve constipation while taking prescription pain medication, you can:
  • Eat foods high in fiber
  • Add foods with a natural laxative effect (such as prunes or apricots) to your diet
  • Drink plenty of fluids
  • Take an over-the-counter stool softener daily (such as Colace)
• If stools are too loose stop taking the stool softener.
• If more than two or three days go by without a bowel movement, use over-the-counter laxatives (mentioned above).

• Sudden chest pain, difficulty breathing (this may appear as shortness of breath or as pain upon taking a deep breath), confusion, coughing up blood.

• Significant swelling in your shoulder or arm that doesn’t improve after elevating your arm overnight.
• Increased pain, warmth, and tenderness in your arm or shoulder.
• An increase or change in bleeding, redness, swelling, or drainage from your incisional area.
• Any change in sensation of your arm (e.g. increased numbness, tingling, or pain).
• Flu-like symptoms (e.g. nausea, general body aches, or temperature over 101.5 degrees).
• Intolerable pain (unable to sleep or concentrate on a conversation) not relieved by pain medication, cold therapy, and rest.
• Significant swelling, pain, warmth, or tenderness in the calf of either leg that you have not had before surgery.
• Taking strong pain medicine when not needed/necessary can result in dangerous over-sedation. Signs and symptoms of over-sedation from taking too much pain medicine (e.g. when your pain level is still tolerable or acceptable) include drowsiness, excessive sleepiness, slow breathing, slurred speech, impaired thinking, confusion, and impaired motor coordination. If any of these symptoms develop, stop taking the pain medicine and call your doctor.

• In the future, any time when you have surgery, dental work, or develop an infection of any kind (e.g. bladder, tooth, ear, respiratory), you MUST notify your surgeon, dentist, or doctor if you have had an artificial shoulder joint replacement. In these situations, antibiotics are often used to prevent artificial joint infections. Call your doctor’s office if you have any further questions or concerns.