Pain Management
- Keep your foot elevated above heart level. Make sure that your heel hangs free (“floats”). Avoid having your foot below your heart more than 15 minutes at a time for the first 2 weeks. Elevation is often the most important factor in your pain management.
- The numbing medicine in your foot can last several hours. Take pain medicine as soon as you feel it start to wear off.
- Medication to take for Pain:
- Take the following non-narcotic pain medicationsfor the first 4 weeks, or until you have no pain:
- Meloxicam 15mg once per day (with food)
- Acetaminophen 1000mg (two 500mg pills) three times per day
- Gabapentin 200mg (two 100mg pills) three times per day (do not drive while taking)
- Take your narcotic pain medicationonly if the above medications are not enough for your pain.
- Oxycodone 5 mg every 6 hours
- Narcotics commonly cause constipation. You have been prescribed a stool motility medication, Senna, to take WHILE taking the narcotic. Discontinue if you have diarrhea.
- Narcotics can cause nausea/vomiting. You have been prescribed an anti-nausea medication, Promethazine,to take as needed.
- Oxycodone 5 mg every 6 hours
- Take the following non-narcotic pain medicationsfor the first 4 weeks, or until you have no pain:
Example Pain Medication Schedule:
|
Medication |
Upon waking up |
Mid-day |
Just before bed |
|
Meloxicam 15mg once per day |
One 15mg tablet |
||
|
Acetaminophen 1000mg three times per day |
Two 500mg tablets |
Two 500mg tablets |
Two 500mg tablets |
|
Gabapentin 200mg three times per day |
Two 100mg tablets |
Two 100mg tablets |
Two 100mg tablets |
|
Oxycodone 5mg every 6hrs as needed |
No more than every 6 hours IF the above medications do not sufficiently control your pain |
||
Repeat as needed. Wean off narcotics (oxycodone) first.
DVT prophylaxis:
IF you are instructed to be non-weight bearing, you have been prescribed a medication (either Aspirin or Xarelto) to help prevent blood clots after surgery. Blood clots are also called deep vein thrombosis (DVT).
Beginning the day after your surgery take either:
- Aspirin 81mg twice daily
or
- Xarelto (rivaroxaban) 10mg daily
Dressing and/or Shoe
- Keep your dressing dry and clean. Do not take it off until your postop appointment.
- DO NOT change the dressing/splint. If there is a problem with the dressing (too tight/loose, gets wet, etc.) please contact Dr. Natsuhara’s office.
- Wear shoe or boot 24 hours/day. Do not remove!
- Wear shoe or boot when out of bed. OK to remove for shower/bath and sleeping
Activity
- NO weight bearing. Use knee scooter or wheelchair for mobilization.
- Touch down weight bearing only. Ok to put pressure on heel for transferring or to maintain balance while using crutches or walker.
- Heel weight bearing only.
- Weight bearing as tolerated.
Showering/Bathing Instructions
- DO NOT get your dressing wet. For showers, you can use an over-the-counter cast cover or wrap a washcloth around the top of your dressing and then cover it with a plastic bag and tape it to your leg.
- DO NOT soak the incision (no tubs, pools, baths, etc.) until you have approval from Dr. Natsuhara.
- When showering, you may need a chair in the shower for balance, as well as someone to help you; falls in and around the shower are common.
- Showering without a covering is allowed after your sutures have been removed. You may let water and soap flow over the incision and then pat dry, but do not rub near the incision.
Medications
- Ok to resume home medications as directed
- Take pain medications as prescribed. Take with food to avoid nausea.
- Do not drink alcohol while on narcotic pain medication.
- For medication refills/questions please contact Dr. Natsuhara’s office or send a message through the Sutter My Health Online portal.
First Postoperative Visit
- Your first postop visit will be 2 weeks after surgery.
- The incision will be evaluated for suture removal.
- Further instructions for incision care, showering, etc. will be provided at that time.
- For questions regarding postop appointment scheduling, please contact Dr. Natsuhara’s office or send a message through the Sutter My Health Online portal.
Contact Dr. Natsuhara’s office (209) 948-3333, option 2 or go to the Emergency Room for:
- Temperature over 101.5° F
- Increasing pain, unresponsive to pain medication or elevation
- Excessive redness or swelling in your foot
- Dressing problems – excessive bloody drainage, looseness or tightness, or if dressing becomes wet
- Develop pain, swelling, warmth, or discoloration of your calf
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