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Pre-Operative Instructions

  • Discontinue Aspirin/NSAIDs/Blood Thinners 7 days prior to surgery
  • You have been prescribed medications including pain medication and a blood thinner (ie Aspirin or Xarelto). You can pick these up at the pharmacy prior to surgery, but DO NOT take until after your surgery.
  • Nothing to eat or drink after midnight the night before your surgery. It is okay to take essential medications with a small sip of water.
  • Please show up to the hospital or surgery center at the time instructed with the proper paperwork. This is often ~2 hours prior to your scheduled surgery time.

Post-Operative Instructions

Pain Management

  1. 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.
  2. The numbing medicine in your foot can last several hours. Take pain medicine as soon as you feel it start to wear off.
  3. Medication to take for Pain:
    1. Acetaminophen (Tylenol) 1000 mg every 6 hours, (purchase over the counter). Do not exceed 4000 mg (4g) acetaminophen in 24h period
    2. Ibuprofen/Advil 400 mg every 6 hours, (purchase over the counter)
    3. IF still in pain add on narcotic pain medication every 6 hours, (prescribed)
      1. Narcotics commonly cause constipation. You have been prescribed a stool motility medication to take WHILE taking the narcotic. Discontinue if you have diarrhea.
    4. It is often helpful to alternate above medications. Example medication schedule:

      8am: Ibuprofen/Advil 400mg q6

      10am: Acetaminophen 1000 mg

      12pm: narcotic pain pill (if needed)

      2pm: Ibuprofen/Advil 400mg q6

      4pm: Tylenol 1000 mg

      6pm: narcotic pain pill (if needed)

      Repeat as needed. Wean off narcotics first and as soon as possible.

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.


  • NO weight bearing unless told otherwise. Use knee scooter for mobilization.

**IF non-weight bearing, starting the day after your surgery take your blood thinner as prescribed (Aspirin OR Xarelto)

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.


  • 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 call Erica: 209.946.7134

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, call Sabrina: 209.946.7107

General Instructions

  • Driving: You must be off narcotic pain medication. If your surgery was on the leg you use to drive, then you must be cleared for full weight bearing
  • Swelling is very common after foot and ankle surgery. It often takes 3 months for the foot and ankle to begin to feel comfortable. Some amount of swelling can persist for 6-12 months.

Contact Dr. Natsuhara’s office , 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
  • Develop pain, swelling, warmth, or discoloration of your calf
  • Shortness of breath or chest pain
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