FAQ

Pain Not Controlled

You will have some pain after surgery. The goal is to keep the pain tolerable and make sure you can walk around after surgery.

Prescription Pain Medications:

• Take any prescription medications as directed on the bottle.
• Narcotic (opioid) pain medication such as Tramadol, Norco, oxycodone, Percocet may be prescribed for SEVERE PAIN only.
• These medications are prescribed for 3 -10 days after surgery ONLY. Not for long term pain.
• Narcotics are never refilled by phone at our clinic.

 

Narcotic (opioid prescription) reminders:

• Take with a stool softener as they often cause constipation.
• Do not drive or operate machinery while taking.
• Can cause dependance and tolerance leading to addiction if taken long term or misused.
  
  

For extra pain control add in over-the-counter remedies such as:

• Tylenol (acetaminophen) 500-1000mg every 8 hours (do not take if you have cirrhosis or liver failure). IF* taking Norco or Percocet only take 500mg Tylenol every 12 hours, as they contain Tylenol.
• Motrin/Advil (Ibuprofen) 400-800mg every 8 hours (do not take if you have kidney problems or gastritis or stomach ulcers).
• ICE the painful area for 20 min at a time 3 – 5 times a day.
• Warm compress for 20 min at a time for 3 – 5 times a day (you can alternate ice and heat if it feels good).
  
  

Wound Care

Skin glue (Dermabond)  OR  Staples

• You may shower (remove gauze and tape first).
• Gently wash the surgical area with soap and water and pat dry. Do not scrub.
• You may place a clean gauze dressing and change daily if there is drainage from the wound.
• Do not submerge wound in a hot tub, pool or bath for 2 weeks after surgery.
• The skin glue will peel off after a few weeks, no not pull it off unless all the edges are peeling up.
• Staples should be removed in the surgery clinic 10-14 days after surgery.
  
  

Redness

• If redness is NEW or INCREASING
  •  use a marker to draw a line around it. If it continues to spread outside the line in the next 24 hours then call the clinic to be seen.  If it is the same or better then continue to monitor.
  • If redness is associated with worsening pain or fever then you should be seen in clinic.

Drainage

NEW or INCREASING drainage:

• CLEAR, CLEAR YELLOW, CLEAR PINK = serous fluid:
  Normal build up for lymphatic fluid that should clear after 1-2 days. Not generally concerning. If does not slow down after 2 days call the clinic to be seen.
• BLOOD:
  A few drops of blood on gauze or clothing is not concerning. Hold pressure with 2 fingers for 10min. If bleeding stops then no concern. If more bleeding or won’t stop you should be seen in the clinic (or ER if clinic closed).
• PUS (thick white or yellow/green or grey):
  IF this is new then you should be seen in clinic.
  
  

Open Wound

• Pack wound with gauze and saline as directed on discharge instructions. Gauze should be moist but not soaking wet.
• Wound vac: changes will be done in clinic or by wound care team.
  
  

Surgical or IR (Intervention Radiology) Drain “JP Drain”

• Strip the drains daily with your fingers to prevent clogging of tubes.
• Record the output at home daily & bring this log to your clinic appointment, this will help decide if the drain can be removed when you come to clinic.
• Discuss with Surgeon before drain removal by anyone (if drain placed by surgeon).
• Surgeon will manage drains placed under our care.
  
  

Activity

• Walk daily to prevent blood clots in your legs and lungs.
• You may go up and down stairs.
• Do not lift more than 10 pounds until:
  • Laparoscopic:  1 month after surgery
  • Open: 6 weeks after surgery
    
    

Constipation, bloating/tightness in stomach
(constipation = unable to have bowel movement)

• Narcotics/opioid pain medication (such as oxycodone, Tramadol, Norco, Percocet) this will usually make people constipated.
• Drink plenty of water daily (minimum 6 regular size cups a day, more is better unless heart or kidney failure).
• Take a stool softener daily with the medication. Examples of over the counter stool softeners are: Senna/Sennakot (strongest), Colace/docusate(mild) and Miralax (mild). Generic brand is fine for all of these. DO NOT WAIT UNTIL CONSTIPATED! IT IS ENCOURAGED TO TAKE DAILY UNTIL THEY ARE HAVING DAILY BM and/or STOP NARCOTICS.
• Patients can take an over-the-counter suppository or enema if they feel they are impacted ‘stuck’ with hard stool. Ask pharmacist for recommendation. Any brand is fine.  
  
  

Nausea/Vomiting

• One or two episodes can be due to pain medication, side effects of anesthesia medications.
• Stick with liquid diet or plain food such as crackers, bananas, plain rice if experiencing nausea.
• If persists for more then 12-24 hours AND you cannot hold down liquid then call the clinic.
• If nausea stops after 12 hours AND you can tolerate drinking water then can monitor at home,
  
  

Diarrhea

After bowel surgery BM can be very hard OR loose for a week or two, this is normal.

• Loose stool: make sure to stop any laxatives, BM should return to normal in 1-2 days,
• If patient can drink water and eat then monitor for 1-2 days,
• Concerning if: worsening abdominal pain/cramps, then  if they you may need to be seen or tested for C.diff (infection),