The following is a list of post-operative instructions for your convalescent period following surgery.  The guidelines listed below represent general instructions to follow upon your discharge.  Please remember that Dr. Bonnen may have specific “do’s and dont's” in your case.  These will be discussed with you prior to your discharge.  Apply these recommendations with common sense.  All restrictions apply until your follow-up appointment in 10-14 days, and may be modified by the doctor following that visit.

1. No lifting, pulling, or pushing objects over 15 pounds.  Avoid bending at the waist; rather, bend with the knees.  Avoid twisting motions.  For neck surgery patients, avoid any overhead work.
2. Your incision may have been closed with visible sutures, staples, or sutures beneath the skin.  Visible sutures and staples need to be removed about 10-14 days after surgery.  If your sutures are under the skin, you do not have to have these removed.  If you have Steri-strips on your incision, let these fall off by themselves.  You may trim the edges of the Steri-strips with scissors as they curl up.  Do not peel these off!  Leave the incision open to air, and do not apply creams, ointments, or powders to the incision.  It is ok to shower and blot dry your incision, but do not soak in a tub or pool for two weeks.
3. If you have a drain in place upon discharge, you will be instructed to open the drainage container and empty it twice daily.  Record the amount of fluid on a piece of paper.  Drains are usually removed 3-5 days after discharge, and you will be on an antibiotic medication when the drain is in place.  It will be removed once the fluid output has diminished.
4. Have a family member or friend look at the incision(s) once a day to observe for signs of infection.  These may include:
1. Pain and tenderness at the surgical site that persists several days after surgery.
2. Diffuse redness or heat at the incision
3. Excessive swelling
4. Drainage through the incision
5. Fever above 101 degrees.  A low-grade temperature is common after surgery, and is usually due to not taking deep breaths and/or being too inactive.  Staying out of bed, walking as much as you can, and taking deep breaths should bring down the temperature.  If the temperature persists, is over 101 or is associated with any other problems, call the office immediately.
5. Avoid neck or back strengthening exercises during this recovery period.  When you return for your follow-up appointment, an exercise program and/or physical therapy can be recommended if needed.
6. Walking is one of the best exercises to improve your overall fitness and endurance level.  Start with a few small trips a day and gradually increase the distance according to your tolerance.  Don’t try and do too much too soon.
7. Questions regarding your return to work will depend on the type of job you have, type of surgical procedure, and your general recovery.  All forms that you may need should be filled out prior to your discharge.
8. Do not smoke following surgery.  Smoking is the enemy of healing!
9. You may be given a prescription for pain medication prior to discharge.  Pain medication should only be taken if you have pain.  You may call your pharmacy for refills on these medications and the pharmacy will call our office for an approval.  Prescriptions are called in and refilled during office hours only.  You should begin tapering off your pain medication within 2 weeks of your discharge.  As soon as you are comfortable, take a non-prescription pain medication(i.e., Tylenol) for pain relief.  Do not take any anti-inflammatory (such as Advil, Ibuprofen, Motrin, Aspirin) until cleared by the office.
10. Following neck surgery it is normal to have soreness of the throat and muscles of the neck.  This should begin to slowly subside in a few days.  Eating soft foods, drinking a lot of fluid, and wearing a soft collar help to relieve these symptoms.
11. For spine surgery patients: As discussed prior to surgery, the purpose of the operation was to prevent worsening of neurological symptoms, with the hopes of improving the pain in your arm or leg if you had pain prior to surgery.  Arm or leg pain may persist after surgery due to the nerve damage done to the previously compressed nerve roots.  If your extremity pain improves after surgery, it is not uncommon to occasionally feel a little “reminder” of the pain from time to time.  Usually rest and pain medication should improve these symptoms.  If you are unable to get up and move around due to the pain, please call us.