Rocky Mountain Orthopaedic Discharge Instructions:Total/Partial KneeReplacement

Jeffrey M. Nakano, MD(ONLY the checked items pertain to you.)

Surgery Pain/Medications:

Expect some discomfort after surgery, even with pain medications:______.

__ Take acetaminophen (Tylenol, APAP) 1000mg three times a day (scheduled) for the next 1 – 4 weeks

__ Do not take extra acetaminophen (Tylenol) while taking the prescribed narcotic pain medication (the pain medication already has acetaminophen in it).

Take the prescribed pain medication for break-through pain.

Take stool softeners (like Colace 100 mg twice a day) while on narcotic pain medication, if it makes you constipated.

Resume your regular medications as usual except ______.

See your medication discharge reconciliation form for further instructions.

Take a multivitamin and an iron supplement once daily for 1 month.

Please call the office (242-3535) between 9:00am and 3:00pm Monday - Friday for prescription refill requests (refill requests on weekends and after hours will be denied).

Blood Clot Prevention:

Pump your feet and ankles up and down often to encourage blood flow and stimulate the muscles.

Wear your support stockings on the operated leg(s) for 3 weeks during the daytime. May remove at night.

__ AFTER you are off Coumadin (warfarin) / Lovenox (enoxaparin) /Arixtra, take one aspirin81 or 325mgdaily for at

least 3 months, if you can tolerate it.

__ We have prescribed ______, take it as directed: ______.

Please call242-3535immediately if you develop symptoms of a blood clot (increasing pain or swelling in your calf, tenderness or redness above or below your knee) or symptoms of a blood clot that has traveled to your lung (sudden shortness of breath, chest pain, localized chest pain with coughing, coughing up blood).

Bandage / Incision Care:

If your dressing becomes soiled, you may change it using sterile supplies, change at least daily.

If your incision was closed with Dermabond(glue) no dressing is needed.

If the incisionis dry (not draining anything), it is okay to shower with it uncovered, otherwise leave the bandage in place and change it after you get out of the shower.

If you have staples or stitches, they will come out 10-14days after surgery. Do not soak incision in bath or hot tub for 3 weeks after surgery.

Please call, 242-3535, if you develop any signs of infection (spreading redness, tenderness, drainage, pus), increasing drainage, or any drainage that persists beyond ______.

Activity:

__ May bear weight as pain allows, progress from walker, to cane, to no external support as long as you are safe. Avoid limping

__ Touch down foot for balance only, use walker.

Walk intermittently during the day. Avoid sitting for prolonged periods of time.

Ice (if it helps) and elevate your knee for 20-30 minutes 4-6 times a day and after activity.

Avoid situations that increase your risk of falling and use appropriate assist devices during such activities as climbing or descending stairs, showering or bathing, getting in and out of cars.

Do NOT sleep with a pillow under your knees or keep your knees bent all day long. Work on straightening the knee.

Continue to do the exercises taught to you by the Physical Therapist when you are at home.

No smoking or using tobacco products.

Post-op Appointments / Questions:Please call Dr. Nakano (970-242-3535) with any concerns or questions

We will want to see you in the clinic 10-14 days after surgery: ______. Please call today (242-3535) to confirm the appointment. __ Call Dr. Nakano on ______to report condition (970-242-3535).

Follow up with physical therapy on ______. ___St. Mary’s Life Center ___ Other: ______

__ Coumadin (warfarin) Therapy: __Got to Coagulation Management (Coumadin)Clinic on:______.

___ Go to ______on ______. ___ Call Dr. Nakano (242-3535) for further Coumadin orders on:_____