Microsoft word - lumbar decompression dc instructions.doc
TOWN CENTER ORTHOPAEDIC ASSOCIATES SPINE SURGERY Dhruv B. Pateder, MD POST-OPERATIVE DISCHARGE INSTRUCTIONS: LUMBAR DECOMPRESSION
2. MINIMALLY INVASIVE LAMINECTOMY/FORAMINOTOMY
3. OPEN DISCECTOMY/LAMINECTOMY/FORAMINOTOMY
I. ACTIVITY RESTRICTIONS until first follow-up appointment
A. Return to work will be discussed on an individual basis B. No driving while taking NARCOTIC medications C. You may slowly, progressively increase your activity as tolerated. While there are no specific restrictions, please increase your activity slowly and do not overdo it D. Most patients do NOT need a brace after surgery. If you are prescribed a brace, wear it as instructed by Dr. Pateder ALWAYS be mindful of good body mechanics as discussed with your physical therapist and/or Dr. Pateder before hospital discharge II. PAIN MANAGEMENT Post-operative pain is to be expected and will vary depending on several factors: the type of surgery, prior use of narcotic pain medications, and personal tolerance of pain. Given the individual variation of pain, your post-operative pain management will be discussed with us on an individual basis prior to discharge. A. After a lumbar decompression for leg pain, the nerve root may remain inflamed for several days to weeks. This is due to the fact that the nerve root was being compressed for an extended period of time and requires to “cool down.” You may be placed on a short course of steroids to help reduce this inflammation.
Furthermore, it is normal for you to have some spasms and aching pain in the back following surgery. These symptoms will resolve over time. B. If needed, you may take over the counter anti-inflammatory pain medication following surgery. The medications include: Motrin/Ibuprofen/Advil, Alleve/Naprosyn, Excedrin, Lodine, Relafin, Celebrex, Daypro, Vioxx, Bextra, Aspirin, etc. C. Narcotic medications will only be refilled during office hours. Please be aware of how many pills you have left so that you will not run out when the office is closed. III. INCISION CARE A. Unless otherwise stated, your incision(s) have been sutured from the inside with material that dissolves. Thus, there are no sutures or staples that need to be removed at a later time. Overlying the incision are Steristrips which are similar to the old “butterfly” bandaids. They provide extra support and will curl up and fall off by themselves (usually in 1-3 weeks). If a Steristrip is starting to come off and you can see that the incision under that strip is healed, you may go ahead and pull off that Steristrip. B. You will be sent home with a dressing over the Steristrips. You can remove the outer dressing on postoperative day number 2. Thereafter, you may shower and wash the Steristrips with soap and water. Gently dry the Steristrips until they start to come off as described above. Do NOT soak the incision by taking baths or sitting in a pool/hot tub until the incision is completely healed and the Steristrips have fallen off (generally 2-3 weeks). C. Healing tissue that will exist along your incision does not contain the pigment melanin that normally protects the skin against the sun. For cosmetic reasons, it helps to protect the incision from the sun by covering it with clothing or using sunblock (if exposed) with at least SPF 30 or higher for 6 to 12 months.
D. You may remove the TED hose upon leaving the hospital if you are walking independently. IV. CALL our office (703 435 6604), your private physician’s office or present to an emergency room IMMEDIATELY if any of the following occur: A. Fever (>101.5 degrees Farenheit), chills or sweats that occur beyond 2-3 days after surgery. It is NOT unusual to have a low grade fever (100.5 degrees Fareneheit) for 2-3 days after surgery B. Redness or swelling or warmth around the incision(s), NON-clear drainage from the incision, or increased pain in or around the incision
C. Any neurological change in the arms or legs such as new weakness or increased pain/tingling/numbness D. Persistent or increased difficulty swallowing or speaking E. Severe headaches that are different in nature to prior headaches and ones that are worsened with standing and better with lying down F. Abdominal bloating associated with persistent nausea and vomiting (often these symptoms will be accompanied with constipation or inability to have a bowel movement) G. Calf swelling, redness, pain or warmth as this can be a sign of a deep venous thrombosis (also known as a “blood clot”) H. Chest pain, difficulty breathing or cough V. FOLLOW-UP APPOINTMENT Please call immediately upon discharge to make a follow-up appointment with us in the office 7-14 after the day of your surgery. Let the office know that you are a post-operative patient and must be added on to the schedule. If there are any problems, please request to speak with Dr. Pateder or his assistant. ALWAYS FEEL FREE TO CONTACT US WITH YOUR CONCERNS & QUESTIONS AT 703 435 7704
The HANDLE® Institute 7 Mt. Lassen Drive, Suite B110 San Rafael, CA 94903 415-479-1800 CASE STUDY ADD, Autism, Central Auditory Processing Disorder, Sensory Processing Disorder in 14-year-old femalePresented by Peg Simon, certified HANDLE® Practitioner, from Judith Bluestone’s client notesThese case studies, each submitted by a Certified HANDLE® Practitioner, demonstrate outcomes ach
Personaggi Il Conte; La Contessa; Susanna; Figaro; Che-John Brownlee; Elisabeth Rethberg; Licia Al-rubino; Marcellina; Bartolo; Don Basilio;banese; Ezio Pinza; Jarmila Novotna; Irra Pe-Don Curzio; Barbarina; Antonio; Due Conta-tina; Salvatore Baccaloni; Alessio De Paolis;George Rasely; Marita Farell; Louis D’Ange-lo; Helen Olheim, Maxine Stellman. Coro eOrchestra del Metropolitan Opera