PRE-OP INSTRUCTIONS

(THESE ARE TO BE TAKEN AFTER SURGERY)

1. Advil (Ibuprofen): 2-3 pills to be taken every 8 hours as soon as you get home and have some food in your stomach.*

*If you have any history of kidney disease, stomach ulcers, or allergic reactions to the NSAID drug family, this drug should be avoided. Also, if you are taking any type of blood thinner OTHER THAN Aspirin, this drug should not be used.

2. Extra-Strength Tylenol (Acetaminophen) (500mg): 2 pills to be taken every 8 hours after surgery at the same time as your Ibuprofen. The goal is to have both Tylenol and Ibuprofen in your system at the same time to achieve the synergistic effect of combined drug therapy to reduce pain by suppressing different pain receptors. The combination also helps lower doses of narcotic work more effectively. *

*If you have any history of liver disease or elevated liver enzymes, or allergic reaction to Tylenol, this drug should be avoided.

***** IF YOU RECEIVED A NERVE BLOCK IT IS VERY IMPORTANT TO START TAKING YOUR IBUPROFEN AND TYLENOL, WITH 1 NARCOTIC PILL, AS SOON AS POSSIBLE. HAVING THESE MEDICATIONS IN YOUR SYSTEM WILL HELP WITH THE PAIN CONTROL TRANSITION WHEN THE NERVE BLOCK WEARS OFF. IF YOU DO NOT TAKE THESE PAIN MEDICATIONS, PAIN LEVELS CAN RAPIDLY ELEVATE TO A 10/10 ON THE PAIN SCALE. I RECOMMEND YOU START THESE ABOVE 3 MEDICATIONS WHEN YOU GET HOME AFTER YOU EAT. ONCE THE NERVE BLOCK WEARS OFF AND CAN GET A BETTER IDEA OF HOW MUCH NARCOTIC MEDICINE YOU NEED TO MANAGE PAIN THAT BREAKS THROUGH THE IBUPROFEN/TYLENOL COMBINATION.*****

3. Baby Aspirin (81mg): This drug is to be taken twice a day, at breakfast & dinner, for 4-6 weeks, depending on your surgery, to help prevent blood clots. You do not need to take aspirin if you are already on a blood thinner such as Coumadin, Xarelto, Eliquis, etc… You will restart these blood thinner medications the night of surgery.
4. Stool Softeners: While taking narcotics you are likely to experience constipation. I recommend taking Colace, 2 pills twice a day to maintain soft stools. I have also had good success with taking 1 cap of Miralax powder twice a day in instead of Colace or in addition to Colace (if you are prone to constipation).
5. Laxative of your choice: If you have not had a bowel movement within 2-3 days after surgery, I recommend you take a laxative such as Dulcolax or a laxative of your choice. Follow the instructions on the box.
6. Antihistamine: It is very common while taking narcotics to experience itching as well as hot/cold flashes. This is NOT AN ALLERGIC reaction but a side effect as the narcotic in addition to relieving pain also causes a histamine release. You can take an over the counter non-drowsy 24 hour-acting antihistamine such as Zyrtec, Allegra, Claritin, etc… to help with this itching. If symptoms still do not resolve or if you are having trouble sleeping because of itching or the narcotics are preventing you from falling asleep, feel free to take a dose of Benadryl in addition to the non-drowsy medication antihistamine.
7. For Wrist Fractures Only: Wrist fracture patients should take 500mg of Vitamin C, once a day, to help prevent chronic wrist pain.