Preparation & Follow Up of Surgery

Pre-Surgery Instructions

1 Pre-Testing

  • A hospital representative from Pre-Admission Testing will contact you to discuss the policy for admission. If you don’t hear from the office one week before the surgery, you may call (718) 283-7300, to arrange the appointment yourself.
  • You may contact the Anesthesia Department, at (718) 283-8816, to confirm insurance coverage and any possible coinsurance you may have.
  • Contact your primary care doctor to fax our office a letter of medical clearance, within 30 days of the surgery.

2 One Week Before Surgery

  • 1 week before surgery, STOP taking of any platelet inhibitors or blood thinners (i.e. Bayer, Baby Aspirin, Excedrin, Anacin, Plavix, Aspirin, Coumadin, Heparin, Lovenox, etc.).
  • 1 week before surgery, STOP taking any anti-inflammatories (i.e. Naprosyn, Motrin, Aleve, Advil, Ibuprofen, etc.)

3 Day Before Surgery

  • Your doctor’s office will call you to tell you what time to come in for your surgery. If you haven’t heard from us by 1PM, please call (718) 283-7362.
  • Do not eat, drink, or smoke anything after midnight.

4 Day Of Surgery

  • Take any necessary medications in the morning with one sip of water if needed.
  • The hospital parking lot is located on 10th Avenue, between 47th and 48th Streets. Validate your parking ticket at the hospital to get free parking.
  • Minors (younger than 18 years of age) must be accompanies by a parent or legal guardian to sign the operative consent form.
  • After the surgery, you must be escorted/driven home by a responsible adult.

5 Surgery Follow-Up

  • Call our office, at (718) 283-7362, to make a follow-up appointment after the surgery.

If there is a problem and you need to reschedule the surgery, please notify our office at least one week prior to the surgery.

If you have any questions, please call the physician’s assistant or your doctor.

Post-Operative Instructions for Shoulder Arthroscopy

1 Call Dr. Choueka’s office at (718) 283-7362, or Dr. Edelstein’s office at (718) 283-8927 for :

  • Temperature above 102 ºF or severe chilling.
  • Persistent nausea or vomiting.
  • Severe pain not relieved by oral medication.
  • Excessive or persistent swelling and redness around the incision.
  • Excessive bleeding or draining on the dressing.

2 Dressing Gown

  • There will be a white dressing with a plastic covering on your shoulder.
  • It is waterproof, but do not soak it.
  • Remove it 2 days after surgery and take a regular shower.
  • Underneath you will see steristrips (brown strips). Do not remove the steristrips.

3 Ice packs to your shoulder for 30 minutes, 4 times a day for 3 days.

4 Arm sling

  • Wear the arm sling at all times.
  • You may remove it to take a shower and twice a day to move to move your elbow up and down.
  • Do not try to raise your arm.

5 Follow labeled instructions on your prescriptions.

6 Medication

  • Do not take your oral pain medication on an empty stomach.
  • Do not drink alcohol or drive while taking the prescribed pain medication.
  • Start taking your pain medication before your anesthetic block wears off.

7 If you have received general anesthesia:

  • Do not drive, drink any alcohol, and do not use any heavy equipment for 24 hours after your discharge from the hospital.
  • Do not make any important decisions (i.e. sign important papers) for 24 hours after your discharge from the hospital.

8 We strongly suggest that a responsible adult be with the patient for the rest of the day and also during the night for the patient’s safety.

9 Call us for a follow-up visit, at (718) 283-1362 for Dr. Choueka, and (718) 283-8927 for Dr. Edelstein. Your should be seen a week after surgery.

Post-Operative Instructions for Hand Surgery

1 Elevation:

Elevation of the hand is the extremely important after any surgery of the hand or wrist. The hand should be kept at a level that is higher than your heart and your elbow in order to cause fluid to drain from the hand. This will help to prevent swelling. A swollen hand will be painful and stiff. It is also important to work on ROM of your fingers after surgery. You should try to make a full fist and fully straighten your fingers ten times an hour after any hand surgery unless instructed otherwise. This motion will pump the fluid out of the fingers and thereby will prevent swelling.

2 Dressings:

Do not change the bandages or splint after surgery, unless your doctor instructs you otherwise. Your doctor will change it after your first post- operative visit. The bandages and dressings must be kept dry. Showering should be done with a large plastic bag over the hand and arm, securely taped just below the shoulder. By keeping the hand fully elevated, it is possible to take a brief shower without getting the bandages wet.

3 Pain Relief:

After an operation that has been done under a local anesthetic, or regional l anesthetic, it is common to experience numbness and tingling in the hand for eight to ten hours or longer. A prescription for a pain reliever will be given to you after the surgery, and we recommend that you fill the prescription, although you may not need this medication. In some instances Tylenol or Advil may be used. One should note that often the pain reliever given by your physician may include Tylenol in it; in these instances, one should not take Tylenol in addition to the prescription given. The most important aspect of pain relief after hand surgery is strict elevation of the hand.

4 Diet:

Start with light, non-greasy foods today. Gradually increase your diet as tolerated. Even if you only had mild sedation, you may be more susceptible to nausea.

5 Concerning symptoms:

If you notice that your bandages are completely saturated with blood, if you have a temperature above 101 degrees, if you have pain that does not decrease with pain medication or if your fingers become cold, numb or purple, or if you have any other concerns or questions, please contact Dr. Edelstein, at 718-283-8927, or Dr. Choueka, at 718-283-7362. Some blood on the bandages is not unusual; however, persistent bleeding is not normal. Many patients will have an elevated temperature for the first few days after surgery. However, a temperature above 101 degrees is not normal, especially if associated with chills or severe pain. Pain medication and elevation should help to “control” your pain; however, it will NOT take away all of the pain

6 Stitches:

Stitches are usually removed ten to fifteen days after hand surgery. Once the dressing is removed by your physician, he will instruct you on local would care including washing, applying bacitracin and eventually scar massage.

7 Hand therapy:

Hand therapy may be necessary after surgery for a variety of reasons such as making a special splint, regaining motion, managing scars, etc.

8 Contact us:

Contact the office today or tomorrow at 718-283-8927 for Dr. Edelstein and (718) 283-7362 for Dr. Choueka to schedule a post-operative appointment. After your surgery, your doctor will tell you what day to follow up.