Go to Surgery Guidance for more information.

1. Do not drive, operate machinery, or consume alcohol or tranquilizers for 24 hours or for as long as you take narcotic pain medicine.  Do not make important personal or business decisions or sign legal documents for 24 hours.
2. Rest today and not do anything too strenuous - you may feel tired from the anesthesia and pain medicine. Be in the care of a responsible adult.
3. Begin with clear liquids and light foods to eat, then progress your diet as tolerated. It is usually best to avoid heavy, greasy, or spicy food the day of surgery. Narcotics cause constipation, so increase the amount of fluid (especially water), fiber, and fruit in your diet. Examples of over-the-counter medications to prevent constipation or for constipation are Metamucil, Citrucel, Colace, or Docusate Sodium (DSS). If you are constipated after surgery, over-the-counter liquid magnesium citrate, taken as directed, can be used.
4. It is essential to eat some food every time you take narcotic painkillers (even in the middle of the night). Otherwise, you are more likely to get nauseated. Usually, a few crackers, applesauce, or banana will suffice.
5. Some anesthetics can cause urinary retention. If you are having trouble emptying your bladder or haven't urinated for eight hours after an anesthetic, be sure to call your doctor's office - no matter what time of day or night.
6. YOU CAN ALWAYS REACH DR. JUREK (OR THE DOCTOR ON CALL) BY PHONING 206.386.2600. AFTER BUSINESS HOURS, THE ANSWERING SERVICE WILL CALL THE DOCTOR FOR YOU.

1. You can be as active as desired during the postoperative phase, excluding the use of the surgical arm. Avoid any activities that could put you at risk of falling.
2. If you have been given a sling or shoulder immobilizer, use it for support and comfort. Make sure you remove/loosen your sling a couple of times per day to flex and fully extend your elbow to avoid stiffness.
3. DO NOT actively lift the operated arm away from the side of your body unless instructed to do so.  Slight elevation to wash under your arm is okay.
4. Avoid lifting, pushing, or pulling with the operated arm/hand. You may use your hand and wrist for simple activities and remove the sling to flex and extend your elbow.
5. You may passively move your arm and shoulder gently with your other arm to help prevent stiffness and swelling.
6. Elevation of the operative area also will help reduce pain and help with sleep. Don’t lay flat; elevate your head and shoulders with pillows. You may apply an ice pack to your operative site every hour for about 20 minutes to help reduce pain and swelling (not necessary during the night while sleeping).
7. Leave the surgical dressing in place until follow-up with Dr. Jurek if possible. If present, leave the steri-strips (skin tape) in place. If the dressing becomes soaked with blood, you may change the dressing or use Band-Aids to cover the incision(s).
8. The dressings covering your surgical incisions are waterproof and may be left in place until your first postoperative follow-up visit. It is OK to get the dressings wet in the shower. If they inadvertently become saturated in the shower, finish showering with the dressings on, remove them once you are out of the shower, allow your skin to air dry, and replace them with dry, sterile dressings or Band-Aids.
9. DO NOT soak in a bathtub or hot tub until your stitches are removed (if necessary) and your incisions are fully healed (this is usually a minimum of 2 weeks after surgery).

1. 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 reduce your intake and wean off of them as soon as reasonably possible.
2. 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.
3. It is usually okay to mix anti-inflammatories with narcotic painkillers. If you can take these drugs, this may be beneficial for pain control. DO NOT TAKE ANTI-INFLAMMATORY DRUGS 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.
4. You may restart your Aspirin if you usually take it as an anticoagulant. Otherwise, do not take Aspirin unless specifically told to do so by your doctor.
5. 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 backup method of birth control.
6. *Refills will only be given during regular 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.

1. FOR DIFFICULTY BREATHING OR CHEST PAIN, CALL 911.
2. Excessive drainage or bleeding from your incision that has not stopped by 20 minutes of direct pressure.
3. Excessive swelling not relieved by rest, elevation, and ice.
4. Feelings of flu-like symptoms (nausea, general body aches, or temps over 101.5 degrees for >24 hours).
5. Any sign of infection to your incision (increased redness, heat, hardness around your operative site, or pus-like drainage).
6. Intolerable pain (unable to sleep or concentrate on a conversation) not relieved by your meds.
7. Continued nausea and vomiting.
8. Any rash, welts, or hives (many people itch with narcotic usage and an antihistamine such as Benadryl will usually make this stop - itching by itself is not an allergy.  Itching with hives or a rash is an allergy).
9. Increasing calf or thigh pain, accompanied by swelling.
10. Any progressive numbness or decreased sensation in the operated extremity not relieved by immobilization and rest.

If your follow-up appointment has not already been scheduled, please call Dr. Jurek’s office on the next business day to schedule your appointment to be seen approximately 7-10 days following surgery.

Answers to many postoperative questions may be found under Surgery Guidance. Information on how to adjust the shoulder immobilizer is located in the Brace Information section.