PATIENT RESOURCES

Pre operative guidance:

Preparing for surgery
 
  • Inform the patient they will be in the hospital as little as the same day or overnight and sometimes as much as 5-7 days with rehab after leaving the hospital.  Your doctor will have discussed these issues with you prior to surgery.
  • Inform the patient they will receive further detail in a separate communication personalized to you.  
  • Pt is to be instructed to stop smoking If they are a current smoker, we advise that the patient quit smoking tobacco products at least 1 month prior to surgery. Nicotine, in any form, is a hindrance to bone fusion and healing. Because Nicotine is the source of the problem when it comes to healing and bone fusion, smoking cessation products such as Nicorette® gum or nicotine patches must be discontinued as well. Please discuss smoking cessation plans with your medical doctor. There are new medications available to help with this
  • Pt must BRING your CPAP machine with them to the hospital the morning of surgery.  
 
Instructions for medications prior to surgery
 
  • Patients  will be required to STOP any nonsteroidal anti-inflammatories such as Ibuprofen (Advil, Motrin), Naprosyn (Aleve), Celebrex, Mobic, Indocin, and Lodine 7-10 days prior to there surgery.  
  • Patients will need to be informed to STOP taking aspirin and any anticoagulants including coumadin and Plavix®, Lovenox®. Please check with your health care provider about when and how this should be done.  
  • Inform the patient to stop taking any herbal supplements and certain vitamins 10 days prior to surgery including but not limited to St. John’s Wort, Garlic, Ginseng, Gingko Biloba, Vitamin E and Vitamin C, as these tend to thin your blood.  
  • Diabetic patients should not take any oral hypoglycemic agents and insulin products the morning of surgery. Metformin (Glucophage) is the most vital to make sure to avoid.  
  • Patients should not take any diuretics the morning of surgery (i.e. Lasix, HCTZ) (Unless you have congestive heart failure).
  • Patients should not take any ACE/ARB the morning of surgery. These are classes of antihypertensive medications. Examples include Lisinopril, Lotrel, Captopril, Lotensin, Monopril, Prinzide, Atacand, Benicar, Diovan and Avalide. 

Discharge Instructions

Post Operative Guidance:
 
  • Patients should be informed we will have them up as soon as the same day but sometimes the next day.
  • We should encourage Patients to walk right away unless other specified guidance is given by a performing physician.  You may have a spinal brace to add support to your spine.
  • Patients are to avoid bending forward, twisting or lifting more than 10 pounds. They should brace themselves with their arm when spitting after brushing their teeth.
  • The external spinal brace should be worn at all times when up and about and when riding in a car.  
  • Brace may be off while laying in bed or resting comfortably in a chair or while showering.  
  • Patients may shower regularly the 2nd day after surgery unless instructed otherwise.  If Patient has a drain still in place, do not shower across the drain.  
  • Pain medications will have been sent to their pharmacy upon your discharge.  
  • If a patient has had a spinal fusion surgery they are to avoid use of Advil, Aleve, Ibuprofen or other NSAIDs on any regular basis for 3 months following surgery.  
  • Recommend Senna to avoid constipation. 


Surgical incision Healing
 
  • Inform the patient that if they notice any increase or change in drainage, redness, swelling, or have a fever of 101.5 or greater, to please call their surgeon’s office immediately at 918-401-1002 or go to the emergency room. 
  • The surgical incision may be closed with dissolvable sutures and steri-strips, staples or sutures. If they have staples or visible sutures, these will need to be removed 10 to 14 days after your surgery. 
  • Arrangements for a home care nurse can be made in the hospital by our home care coordinators. If they do not qualify for in-home care by your insurance company, we will need to make an appointment for staple/suture removal with the PCP or surgeon’s office. 
 
Surgical incision care 
 
  • While the patient is in the hospital, they will wear a dry gauze dressing. Once their incision is no longer draining, you may take off the dressing and leave the incision open to air.  
  • The incision should drain minimally.   Do not apply any ointments or lotions to the incision while it is healing.  
  • The patient may shower but THEY MAY NOT BATHE IN A TUB, SWIM OR USE A HOT TUB UNTIL YOUR INCISION IS HEALED AND UNTIL OR UNTIL THEY HAVE SEEN THE SURGEON. 
 
Sexual activity 
  • Patients can resume sexual activity when they are feeling up to it. 
  • they may find certain positions will be more comfortable than others. 
  • Caution and common sense are recommended and a safe rule of thumb for positions is if it hurts, then don’t do it. 
 
Driving 
  • Patients can drive when they feel up to driving and are not taking narcotic pain medications that make you feel impaired or after clearance by the surgeon. 
  • This is usually 2 weeks after a laminectomy and discectomy and 4 to 6 weeks after a lumbar fusion. 
  • Narcotic pain medications will delay the reflex time. It is advised to start with short trips first and get out of the car every 30 to 45 minutes to walk around and reposition. 
 
Return to work 
  • Naturally, you will feel tired and weak after surgery. You will begin to feel yourself after 2 to 3 weeks and improve over the following weeks. You should tell your employer you will be out of work for approximately 6 to 12 weeks but may be able to return earlier than that. 
 
Walking
  •  Walking is the best activity you can do for the first 6 weeks after surgery. Patients should start out slowly and work up to walking 30 minutes at least twice a day. Patients should not be surprised if they require frequent naps during the day.
  •  Between the narcotic pain medications the patient  will be discharged with and the stress on the body after having undergone surgery, it will be quite common to be fatigued. 
 
X-rays 
  • Patients need to  visit Envision imaging center or another nearby location prior to your post operative visit if you have hardware in place. 
  • It is important to obtain x-rays at the 6 week follow up appointment to evaluate healing. 
 
Physical Therapy 
  • At the 6 week follow-up appointment in the clinic, patients may be directed to https://www.spine-health.com/ for home therapies.  
  • Patients may also be given a prescription for outpatient physical therapy, depending on how well they have recovered so far. 
  • they may go to the physical therapist of their choice. Until that time, focus on walking and gentle stretching from the seated position.