Snapping Scapula

1. DIET

• Begin with clear liquids and light foods (jellos, soups, etc.)
• Progress to your normal diet if you are not nauseated

2. WOUND CARE

• Maintain your operative dressing, loosen bandage if swelling of the elbow, wrist, or hand occurs
• It is normal for the shoulder to bleed and swell following surgery – if blood soaks through the bandage, do not become alarmed – reinforce with additional dressing
• Remove surgical dressing on the second post-operative day – if minimal drainage is present, apply band-aids over incisions and change daily
• To avoid infection, keep surgical incisions clean and dry – you may shower by placing a large garbage bag over your sling starting the day after surgery – NO immersion of operative arm (i.e. bath)

3. MEDICATIONS

• Pain medication is injected into the wound and shoulder joint during surgery – this will wear off within 8-12 hours
• Most patients will require some narcotic pain medication for a short period of time – this can be taken as per directions on the bottle
  • Primary Medication = Norco (Hydrocodone)
  • Take 1 – 2 tablets every 4 – 6 hours as needed
  • Max of 12 pills per day
  • Plan on using it for 2 to 5 days, depending on level of pain
  • Do NOT take additional Tylenol (Acetaminophen) while taking Norco
• Common side effects of the pain medication are nausea, drowsiness, and constipation – to decrease the side effects, take medication with food.
• If constipation occurs, consider taking an over-the-counter laxative
• If you are having problems with nausea and vomiting, contact the office to possibly have your medication changed
• Do not drive a car or operate machinery while taking the narcotic medication
• Ibuprofen 400-600mg (i.e. Advil) may be taken in between the narcotic pain medication to help smooth out the post-operative ‘peaks and valleys’, reduce overall amount of pain medication required, and increase the time intervals between narcotic pain medication usage.

4. ACTIVITY

• When sleeping or resting, inclined positions (i.e. reclining chair) and a pillow under the forearm for support may provide better comfort
• Do not engage in activities which increase pain/swelling (lifting or any repetitive above shoulder level activities) over the first 7-10 days following surgery
• Avoid long periods of sitting (without arm supported) or long distance traveling for 2 weeks
• NO driving until instructed otherwise by physician
• May return to sedentary work ONLY or school 3-4 days after surgery, if pain is tolerable

5. IMMOBILIZER

Your immobilizer should be worn at all times except for hygiene and exercise

6. ICE THERAPY

• Begin immediately after surgery
• Use icing machine continuously or ice packs (if machine not prescribed) every 2 hours for 20 minutes daily until your first post-operative visit – remember to keep arm supported while icing
• Motion Medical Ice Machine “Gameready”/Vasothermic device may be used.
  • Use unit as frequently as tolerated x 14 days
  • Unit is programmed hour on/hour off continuous of compression and ice alternating
  • If braced* – Loosen brace to avoid added pressure
• If issues with Vasothermic device, please contact Dr. Waterman

7. EXERCISE

• No exercises or shoulder motion until after your first post-operative visit unless otherwise instructed
• You may begin elbow, wrist, and hand range of motion on the first post-operative day about 2-3 times per day
• Formal physical therapy (PT) will begin after your first post-operative visit

8. EMERGENCIES

Contact Dr. Waterman or his nurse at 336-716-8091 if any of the following are present:

• Painful swelling or numbness
• Unrelenting pain
• Fever (over 101° – it is normal to have a low grade fever for the first day or two following surgery) or chills
• Redness around incisions
• Color change in wrist or hand
• Continuous drainage or bleeding from incision (a small amount of drainage is expected)
• Difficulty breathing
• Excessive nausea/vomiting
• **If you have an emergency after office hours or on the weekend, contact the same office number (336-716-8091 and you will be connected to our page service – they will contact Dr. Waterman or one of his fellows if he is unavailable. Do NOT call the hospital or surgical center.

**If you have an emergency that requires immediate attention, proceed to the nearest emergency room.

9. FOLLOW UP CARE + QUESTIONS

Post-Op Instructions