Recently I wrote a blog on pre-operative tips before having foot and ankle surgery, and I got many requests to write about what to do after foot surgery.  These are general tips, and different procedures may require more individualized instructions.  Make sure your podiatrist gives you instructions for your specific needs.  Your actions the first 48-72 hours after surgery are critical to your healing and comfort.

Medications:  Take all prescriptions as directed.  Do not use any other medications including aspirin, Tylenol, or Ibuprofen unless you have consulted your podiatrist first.  Most patients will be given pain medication and antibiotics to help prevent infection.  Pain medications may cause constipation and you may want to discuss taking a stool softener with your doctor.  Do not drive or use dangerous equipment while taking pain medication.  Finish all antibiotics given as directed.

Walking:  Depending on what procedure you have, your podiatrist will tell you to stay off your foot for at least 48-72 hours following surgery.  You should limit your walking to just the bathroom during this time.  Some procedures require you to be non-weight bearing on crutches.  This is extremely important and means no weight on the foot at all, sometimes not even resting the foot on the floor while not walking.

Elevation:  The more you keep your foot elevated the less pain and swelling you will have.  If not elevated, you may feel throbbing pain and the bandages may feel tight.  Elevation above the heart is key. While lying down place 2 pillows under the foot; this is usually enough to get the foot above the heart.  It is important to keep your foot or ankle elevated whenever you are not on it. If you can keep it elevated for more than 48-72 hours you should do so.

Post-Op Shoe/Boot:  Always wear the post-op shoe or boot that is dispensed to you whenever you are walking.  Walking without the shoe/boot will cause damage to the surgical site and will cause an increase in pain, and the procedure may not heal correctly.

Keep Bandages Clean and Dry:  The bandages are in place for a purpose and will help to hold the surgical correction in place so it can heal.  If you get the bandages wet, your infection chances increase.  To help keep the bandages dry, get a waterproof cast protector usually available from your podiatrist’s office.  If your podiatrist’s office does not carry them, any medical supply house will have them.  Trash bags with tape do not work, so please do not use them.  The cast protector will fit over your shoe or boot and should be used every time you bathe.  Never remove the bandage without contacting your doctor’s office.

Ice:  Ice should be used for 48-72 hours following your procedure.  If using re-usable ice packs have two so one can be freezing while the other is being used.  Ice should be place on the foot or ankle for 20-30 minutes per hour during waking hours only.  You do not have to use it during the middle of the night.  Some podiatry offices use cold machines which work on their own, and you will be shown how to use it prior to or directly after surgery.  Ice will help reduce pain and swelling.

Blood:  It is normal to notice some blood on the bandage, so do not become alarmed if you see a small amount.  Free-flowing blood is not normal, and you should contact your surgeon’s office immediately.

Feeling Dizzy:  It is normal to feel dizzy or lightheaded the first few days following surgery.  If possible, use assistance when walking.  If you have been lying down, sit up slowly and remain sitting with your feet over the edge of the bed for at least one minute before standing.

Numbness:  The local anesthetic used during the surgery may last up to 48 hours.  This means you may not feel anything or be able to move your toes for this time period.  The numbness may make it hard to feel the effects of not following the directions.  If you have not elevated your foot above your heart, not walked only to the bathroom, not used cold to minimize swelling, or not taken your medication as prescribed, you may have more discomfort than anticipated once the anesthetic has worn off.

Swelling:  You will get a certain amount of swelling following any foot or ankle surgery.  Elevation above the heart will help reduce this.  If the bandage or cast feels too tight, touch the end of your toes to see if they blanch white then pink within a few seconds.  If so, then this is normal.  If it takes longer for the normal color to return or a blue color is noted, call your doctor’s office immediately.

Prevent Blood Clots:  Unless you are in a cast, it is good to move your foot at your ankle for a few minutes each hour.  If you feel severe pain to the back of the leg, knee, or upper leg with redness and heat call your surgeon’s office right away.

Fever:  It is normal to run a low-grade fever for up to 72 hours following surgery.  If the fever persists or exceeds 100 degrees, call your doctor’s office.

Keep all appointments:  It is essential to keep all follow up appointments with your podiatrist to ensure you are healing properly.  Redressing may be performed to your foot or ankle.

These are general tips to follow.  Your foot and ankle surgeon will likely give you his or her own written instructions.  If you have any questions at any time, you should contact your doctor.  As Dr. Bowman always tells his patients, “no question is too stupid to ask.”

Dr. Bowman at Houston Foot Specialists can be reached at www.houstonfootspecialists.com or by calling 713-467-8886

Having foot or ankle surgery is not as bad as some make it out to be if you are prepared.   In this blog, you will learn some tips from foot and ankle surgeon Dr. Jeffrey Bowman and Houston Foot Specialists.

First, and most important is to ask your podiatrist before the procedure any questions you may have.  If your podiatrist has written orders for lab work, X-rays, or MRI, have them done in advance so your foot and ankle surgeon is prepared -  and, yes, surgeons have to prepare just like the patient.

Tips for Before Surgery:

Have a cooler set up by the bed or couch with ice packs and food and drinks so you don’t have to get up and down.

Have a waterproof cast cover to keep your foot dry when you bathe.  Trash bags with tape do not work, and if your bandage gets wet your chance of infection increases.

If you are on blood thinners, aspirin, or ibuprofen, stop taking it at least 5 days prior to surgery unless your doctor specifically authorizes its use.

If your surgery requires crutches, get them in advance to practice using them.  Your podiatrist or staff can show you how to get used to them.

If given a post-op shoe or a walking boot, make sure you bring it with you to surgery.

Have all prescriptions filled before the surgery.

Remember, do not have anything to eat or drink after midnight the day before the surgery.

Tips the Day of Surgery:

It is normal to be nervous the day of surgery.  The surgery center or hospital will give you something to help with this.

Wear loose fitting clothing.

If advised, take any medications you normally take with just a sip of water.

Do not wear any jewelry, makeup, nail polish, body piercings, contacts leases, or dental appliances.

If you have any metal in your body, make sure you tell the pre-op nurse.

Leave all valuables at home.

Bring photo ID (such as your driver’s license) and health insurance card with you.

Bring your post-op shoe or walking boot if given one.  Some doctors have them at the surgery center or hospital for you.

Have a friend or family member with you to drive you home.

Most foot and ankle surgeons will have written post-operative instructions with do’s and don’ts.  Make sure to read these before your surgery and have them handy after.  If you follow the instructions carefully, you will have much less post-operative pain, swelling, and chance of complications.  Every patient is different, so your instructions may be tailor-made for you.

Your recovery will go more smoothly if you are prepared before surgery. If you have any questions, it is important to ask before surgery.   Dr. Bowman is available to answer any questions you may have.