“Hi, this is Dr. Silvester and today I’m going to talk to you about the importance of Post-operative Compliance. This video is for patients who are considering having surgery, or have had surgery in our office. I want to tell you that about half the successful outcome is our responsibility – making sure the surgery is done correctly and the fixations are in place, just doing the mechanical things of trying to make it successful. Half of the surgery’s success is your responsibility. That’s keeping the swelling down and doing the therapy that you need.
First thing that we tell all of our patients for most foot surgery that we do is, “Go home, lay down, and keep your foot elevated for 4-5 days.” What that means is the following:
Elevated means above your head is better than above your heart which is better than above your hip. If you have your foot below your hip – if you’re sitting and you think it’s elevated because you’re in a recliner, but your foot is below your hip, that’s still down, because water runs downhill. You just have to think of it like water. If you can put water on your foot, will it run down to your toe, or up your leg? The higher you put it, the faster it’s going to run downhill. What happens is, if you keep your foot elevated – it doesn’t swell up. The miracle that happens in that is that you don’t have a lot of pain. Most people think that the pain occurs because of the surgery. It’s really not the surgery that causes a lot of the pain. The majority of the pain occurs because of the swelling that occurs after the surgery because of the trauma that’s been done. If you can keep the swelling down, you can keep most of the pain down. So, that’s important. The first four or five days, go home, lay down, put your foot up.
There’s also – you want to pay attention to how the dressing feels. If it feels tight and feels like it’s not – let’s say you’re having pain and it feels like its too tight and the pain medication isn’t working, call us and let us know. Because it’s not good to have a dressing that’s too tight. You want to have it somewhat snug to keep the swelling down as well.
Secondly, we tell patients to keep their medications going. We have post-operative medications that we give patients. Some of them are antibiotics in some cases, and some of them have pain medication in some cases – go ahead and take them. The antibiotics you want to take according to instructions, and the pain medication – if you’re having any pain at all, go ahead and take them. If you’re not having any pain, you don’t need to. Pain medications – make sure you take them with a little food because they can make you somewhat ill – some people are sensitive to them and they can make you feel a bit nauseated, so take those with food.
Other thing is after a few days or weeks, after we take your stitches out and everything’s going well, if we give you exercises to do, it is extremely important that you do those exercises because they will help the mobility, keep the swelling down, and keep your pain down. A lot of people don’t understand that by moving a toe after surgery – let’s say you have a bunion surgery, if you start moving that toe regularly and frequently, the pain is less than if you just leave it sit, after a few days – after the skin incision has healed up.
I just had a lady – saw her in church yesterday – who’s a patient of mine that I operated on and she’s a little unusual in the sense that she’s a little more active than most of our patients, but she’s a young lady and a mother of four children and she ran two miles the day before I saw her and she’s about 4.5 weeks after her surgery. This is probably a little early, but because she’s been doing a lot of therapy, she feels good. Her foot doesn’t swell up, she’s comfortable, and she has it in a regular shoe. She’s very happy with her results.
I have other patients who don’t move their feet and won’t do their therapy because it hurts a little bit, who take months to get to that level. So it’s important to go through the therapy as you’re directed. If we advise it, if you live nearby, we like to do electrical stimulation post-operatively to our patients, and that helps them feel better in a much quicker way.
Basically, follow the doctor’s instructions. No matter what surgery you’re having, the doctor don’t tell you instructions just to make you uncomfortable or to make you miserable – we really want you to have the most pleasant experience post-operatively as you can, and by following those instructions, you can have a not only less pain post-operatively, but also a much more successful outcome for your surgery, and it does have a big effect. So keep that in mind if you’re considering surgery – the advice I give my patients, all of them, “If you cannot do the recovery, don’t do the surgery.”
Thanks for listening!”