Total / Revision Shoulder Replacement

Pre-Op Instructions for Shoulder Replacement Surgery

Items to bring to Surgery: Sling and Cold Therapy Cooler

• Give the above items to the nurse when you get to the bed.
• Once in bed, the anesthesiologist will offer you an interscalene nerve block. This block involves an injection of local anesthetic which will numb your shoulder and arm before surgery so that your brain will not receive any pain signals during or immediately after surgery.
• A block will numb your whole arm and will occasionally make your neck and the side of your face numb.
• The block will last from 6 to 24 hours from the time it is given.
• You will be given an IV pain pump in the hospital. When the block starts wearing off and you start to get feeling back in your arm, you will want to use your pain pump. If you do not have a pain pump, you will want to call the nurse so she can bring you some pain medication.

Recovery: The amount of time you will spend in the hospital depends on your blood count and your pain control. Normally there is not enough blood loss to warrant a blood transfusion with shoulder surgery, but if you need a blood transfusion, this will be discussed with you first and may extend your hospital stay. You will not be able to leave the hospital until your pain is controlled by oral pain medication. The average length of stay in the hospital is 2 nights.

When you awaken from surgery, you will have a thick dressing, a blue surgical towel, a cold therapy pad on your shoulder, and a sling on your surgical arm. Your arm will be numb. The sling will have a strap around your neck and your waist. The thick dressing will be replaced with an Island dressing before you leave the hospital. This dressing will remain in place until your follow-up visit with Dr Todd. This appointment will be approximately 15-16 days after surgery.

If the dressing becomes wet, soiled or comes loose, it will need to be changed. This dressing will be covering your incision line which is usually closed with staples. Half of the staples will be removed at your first post-op appointment. If the incision is well healed, all of the staples will be removed at this appointment. If it is not well healed, you will return the next week to have the remaining staples removed. Twenty-four hours after all the staples are removed, you may take a shower. Until that time you will need to take sponge baths.

Sleeping: Dr. Todd recommends sleeping in a recliner. If you do not have a recliner, you will need to make a “nest” in your bed. Most people do not feel comfortable sleeping in a flat position and use pillows for elevation. Always keep your pain medication and water close by for easy access.

Exercising: The Physical Therapists in the hospital will instruct you on how to do some exercises. You will need to set a timer on your stove or cell phone for 5 minutes. These exercises include hand, wrist, elbow and pendulum exercises. All of these exercises together should be done for 5 minutes, 3 times a day, and every day. You can do these exercises more than 3 times but not less than 3 times a day.

Cold Therapy: If you continue using the cold therapy, it is important to use a thick hand towel underneath it once the surgical dressing has been removed. Without proper protection, the cold therapy can damage your skin. You may use the cold therapy as often as you like. It can run 24 hours per day. Ice can be made at home by filling four (4) quart-size freezer bags with water. Freeze solid. Put two (2) bags in the cooler and swap them out as they thaw.

Dressing: When you are dressing, you can move your arm but not your shoulder. You can move it from mouth to zipper and with your arm bent at a 90 degree angle at the elbow from your side to across your abdomen. If you need to apply deodorant or wash under your arm, you will need to lean over like you are doing a pendulum exercise. You will be able to zip your pants, button a shirt, brush your teeth, but you won’t be able to wash your hair with your surgical arm.

Important Note: When your sling is removed, do not use your surgical arm to push yourself up or let yourself down into a chair. This can result in you dislocating your shoulder and the need for a second surgery.

Driving: Driving is an issue due to the taking of narcotic pain medications and the wearing of a sling

POST-OP: You will need to be in the sling for approximately one month. Your first post op appointment is usually 15-16 days after surgery to remove your staples. The second appointment is usually 2 weeks later. You will transition out of the sling over the next 7-10 days, will start outpatient physical therapy, and be able to drive.

Medications: This surgery will require you to take prophylactic antibiotics before having an invasive procedure, such as any dental procedures (including all cleanings). Inform your dentist that you have had a shoulder replacement. Some dentists will prescribe the antibiotics for you. If the dentist does not feel comfortable prescribing the antibiotics, please call the office so Dr. Todd can prescribe them for you.

Questions: Any questions may be addressed by calling the office at 251.625.2663, Monday to Friday, between the hours of 8 am – 4:30 pm.

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