Food
Start slowly. It's natural to want to eat a lot after surgery, but start with small amounts of your normal food, and eat more as your nausea improves.
Dressing
If you have a cast or splint, keep your dressing on until you return for follow-up. If you do not have a cast or splint, you may remove the dressing and shower (no bathing or soaking the incision) after 48 hours, then redress the incision with a clean dressing or a large Band-Aid.
Incision
Keep your incision dry for 48 hours. After that, you may remove the dressing and shower, but leave the Steri-Strips in place. You may let water run over the incision, but do not soak it in a bath, swimming pool, lake, or hot tub for three weeks. Keep a Band-Aid on the incision until it is no longer draining (about 7 days).
Weight Bearing
Check with the nursing staff about whether you are allowed to put weight on your operative leg. Most patients are not allowed to put weight on the foot for 2 to 6 weeks.
Activity
Stay as active as your pain and swelling allow — without putting weight on your foot. This helps prevent blood clots.
Blood Clots
My biggest concern after foot and ankle surgery is the formation of blood clots. To prevent them, stay active and take one tablet (81 mg) of aspirin twice daily with food for 2 weeks. If you or your family have a history of blood clots — or any other reason for increased clotting risk — you may need more aggressive treatment; please discuss this with Dr. Allred within 24 hours after surgery. What does a blood clot feel like? Blood clots usually (though not always) appear a few weeks after surgery. They typically cause new calf pain and new ankle swelling, and rarely cause shortness of breath. If you think you may have a blood clot, call the office immediately during office hours, or go to the ER after hours.
Swelling
The best way to control swelling is to keep your foot above your heart (sitting up in bed usually does not get your foot above your heart). Controlling swelling dramatically affects healing and complications. If you do not have a splint or cast, ice machines or reusable ice pads (search “ankle ice machine” on Amazon) can help reduce pain and swelling — I like them, but frozen peas work just as well. Be careful not to freeze your skin: use 20 minutes on and 10 minutes off, unless your machine has temperature settings that prevent freezing. If you have a splint or cast, ice machines don't work very well.
Physical Therapy
If physical therapy is needed or wanted, we will arrange it at your first post-op visit.
Medications
As noted above, I recommend aspirin for two weeks. For pain, alternate over-the-counter ibuprofen and Tylenol — for example, take regular Tylenol, then ibuprofen 2 hours later. Do not take more than the daily dose shown on the label for either one. While taking ibuprofen, I also recommend over-the-counter Pepcid or another antacid to help prevent a stomach ulcer. For prescription pain medicine (narcotics), see below. If you are also taking daily aspirin to prevent blood clots, take your ibuprofen at least 30 minutes after the aspirin — or at least 8 hours before it.
Narcotics
You may need narcotics for a few days, but the sooner you stop using them, the better you will feel. Refills are rarely needed. We do not refill these medications after hours or on weekends, and a refill takes about 72 hours, so please plan ahead. If you take narcotic medications regularly, you will need to make arrangements with your regular prescribing provider.
Post Operative Visits
Call to schedule an appointment about 2 weeks after surgery.
Precautionary Measures
- To prevent infection, you were given IV antibiotics before your surgery.
- To prevent blood clots, stay active. Walk around your living room once every hour while you are awake, and take aspirin 81 mg twice daily for 2 weeks.
- If you are taking narcotic pain medication (such as Percocet or Vicodin), you may need a laxative to prevent constipation. We recommend an over-the-counter stimulant laxative such as Senna. Narcotics slow the bowel down, and Senna works by stimulating it. Fiber-only products (like Metamucil) usually aren't enough on their own, since they add bulk but don't stimulate the bowel.
When to Call / Emergencies
Call the office or go to the ER if you experience any of the following:
- Incision opens
- Increased redness at incision site
- Pain uncontrolled by pain medicine
- Uncontrollable bleeding
- Fever > 101°F or shaking chills
- Difficulty breathing or chest pain
- New calf pain or ankle swelling
- Painful swelling
If this is a life-threatening emergency, call 911.
Don't know which number to call? Every clinic's emergency and daytime number is on one page — worth saving to your phone before surgery.