Patrick J McGahan, MD Orthpaedic Surgen Specializing in Sprts Medicine/Shulder Recnstructin 2801 K St, Ste 330, Sacrament, CA, 95816 (p) 916-733-5049 (f) 916-733-8914 www.patrickmcgahanmd.cm Befre Surgery *** All PT prtcls can be fund at the website *** Medical Clearance If necessary, please see yur primary care physician, cardilgist, and/r specialist Have yur dctr(s) send, fax, r email my ffice a letter declaring that yu are ready and safe fr surgery EKG & Bld wrk If necessary, please make sure this is dne well in advance f yur surgery date and that ur ffice has received the result EKG s must be within 3 6 mnths f yur surgery depending n the facility where yur surgery is scheduled Any abnrmality requires clearance by a cardilgist Bld wrk needs t be recent, within ne week f yur surgery date If lder than 30 days, it must be repeated Medicatins Stp all bld thinners, aspirin, and anti-inflammatries (i.e. mtrin, ibuprfen, advil, naprsyn, aleve, excedrin, etc.) at least seven days befre surgery Please cnsult yur primary care physician if yu are unsure f yur medicatins Celebrex, tylenl, and narctics are generally k prir t surgery Ensure my ffice has a current list f yur medicatins, including dsage & frequency Fd & Drink Nthing t eat r drink after midnight prir t surgery If necessary, nrmal daily medicatins may be taken with a sip f water Pre-Operative Appintment Pre-perative appintments are 1-2 weeks prir t surgery We will discuss yur surgery and answer all f yur questins Yu are welcme t bring a family member with yu We will call in a prescriptin fr narctic and anti-inflammatry medicatins This shuld be picked up prir t surgery We will schedule yur pst-perative appintment fr 1-2 weeks fllwing surgery We will schedule yur physical therapy appintment fr 1-2 weeks fllwing surgery 1 Rev. 7-13
Patrick J McGahan, MD Orthpaedic Surgen Specializing in Sprts Medicine/Shulder Recnstructin 2801 K St, Ste 330, Sacrament, CA, 95816 (p) 916-733-5049 (f) 916-733-8914 www.patrickmcgahanmd.cm Physical Therapy Kyle Yamashir f Results Physical Therapy Results PT has 3 lcatins Ranch Crdva (916) 362-7962 Murieta (916) 354-0719 Carmichael (916) 562-9130 If yu already have a physical therapist, Kyle r his staff will be instructing yu regarding the specific therapy prtcl that I want yu t d with yur therapist Physical therapy prtcls may be dwnladed frm my website at This is strictly ptinal. I generally reccmended patients simply use ice as needed n tp f a twel t prtect the skin. Optinal Items Cld Therapy Unit Any questins r prblems must be addressed t Pacific Medical Inc. Chris Haas (916) 295-3688 / Main Office (916) 706-1520 Pacific Medical Inc. will cntact yu the week prir t surgery Yur insurance cmpany may r may nt authrize this prduct My ffice and staff des NOT prvide r supprt this item Yu are NOT required t purchase this ptinal prduct Sling r Braces Any questins r prblems must be addressed t Pacific Medical Inc. Chris Haas (916) 295-3688 / Main Office (916) 706-1520 2 Rev. 7-13
Day f Surgery *** All instructins & prtcls can be fund n my website *** Preparatin Nthing t eat r drink after midnight prir t surgery If necessary, nrmal daily medicatins can be taken with a sip f water Bring yur insurance card t yur surgery Be Available Arrive t the hspital 3 hurs prir t the time f scheduled surgery If yu are the first case, yu will arrive 1.5 2 hurs prir Scheduled surgery times are nly guaranteed fr the first case All ther cases are based n hw lng the earlier surgeries take and will begin immediately fllwing the end f an earlier case We ften run ahead f schedule, be available by telephne if we have t call yu in early Ensure we have a current and wrking cntact number fr yu If we cannt get a hld f yu, yu may miss yur surgery, which will then need t be rescheduled Illness If yu are feeling ill fr ANY reasn, yu must let us knw as sn as pssible Yur surgery may need t be rescheduled Discussin If a family member r significant ther is available immediately after surgery and if yu wish, I will talk t them regarding yur surgery and answer any questins they might have Mst patients have difficulty remembering infrmatin after anesthesia s I d NOT discuss the surgery with yu immediately after surgery I will talk t yu, answer questins, and shw yu the pictures during ur first pst-perative appintment Ging Hme Smene must be available t take yu hme Taking a taxi alne is NOT allwed 3 Rev. 7-13
After Surgery *** All instructins & prtcls can be fund n my website *** Pst-perative Appintment If yu have nt already made ne, call my ffice t schedule yur first appintment 1-2 weeks after surgery Pain Cntrl Pain medicatin will be called in at yur pre-perative appintment Narctics are used as needed Anti-inflammatries shuld be started directly after surgery, must be taken regularly, and must cntinue fr fur weeks after surgery Fr medicatin refills r changes, Fr refills f medicatins, call yur pharmacy r my ffice during ffice hurs Fr changes t medicatins, call my ffice during ffice hurs On-call physicians can NOT prescribe fr patients they have nt seen Ice the shulder 20 minutes per hur fr the first 72 hurs while awake Be very careful when applying cld directly t the skin in limiting hw much time it is used t avid cld burns If a cld therapy unit has been supplied, it is fr hme use. It will nt be placed n yu at the time f surgery. If there are any prblems r questins with the unit, please cntact Pacific Medical, Inc. After the first 72 hurs, ice the shulder at least 3 times a day and especially after physical therapy sessins It will wrk thrugh the dressings Swelling & Tingling It is nrmal t have sme mild swelling, tingling, r numbness after surgery Taking the arm ut f the sling and resting it n a pillw can help, if necessary Dressings Dressings can be taken ff 72 hurs after surgery The incisins will have small pieces f tape ver them called steri-strips. D nt remve the steri-strips cvering the small incisins The steri-strips fall ff after ne week r can be remved ten days after surgery Yu can replace the dressings with band-aids, if desired There may be drainage fr the first 48 72 hurs frm the incisins. This is nrmal Yu may take a shwer immediately but d NOT get the dressings wet Once the dressings are remved, yu can use sap and water n the wunds D NOT take a bath r swim as the incisins shuld nt be saked in water Keep the incisins clean and dry 4 Rev. 7-13
Physical Therapy Physical therapy usually begins 1-2 weeks after surgery If yu have nt already been given an appintment fr physical therapy after surgery, please cntact my ffice fr a referral My ffice will supply yu with a prescriptin fr yur therapist My physical therapy prtcl can be dwnladed frm my website If yu see a therapist besides Results Physical Therapy, please btain my written prtcl fr yur therapist A sling will be placed n yur arm at the hspital r surgery center D NOT use yur arm D NOT take ff the sling except t d therapy, shwer, r change clthes Therapy may have yu take ff sling ccasinally if swelling ccurs D NOT lift yur arm r use it t carry anything D NOT mve the arm ut frm yur side t write r use a muse D NOT guard the arm and keep the arm relaxed at yur side If we are ding surgery fr stiffness, physical therapy begins the day after surgery, and the sling is nly fr cmfrt What t Expect Surgery t repair a trn structure (i.e. rtatr cuff, labrum) r stabilize shulder Immbilized in a sling fr 4 weeks Sling can be remved 1-2 times per day t stretch yur elbw but NOT yur shulder If labrum r biceps repaired, then d nt actively flex the elbw Begin passive range f mtin exercises by 1st week (after surgery) unless therwise specified Take yur sling ff t d yur exercises but wear it at all ther times Remve the sling by the 6th week Begin active-assisted range f mtin exercises by 5-6th week. At this pint, yu are able t lift light bjects like a pen r paper ONLY Begin strengthening exercises by 12th week. Still NO heavy lifting Return t full sprts and activities by 4-6 mnths depending n prgress Surgery t shave bne (acrmiplasty) r clean ut (debridement) but NO repairs Sling immbilizatin fr 1st week. Remve sling by 1st week (after surgery) Active-assisted range f mtin allwed but fcus n passive range f mtin and pendulums. Prgressin as tlerated. Allwed t lift pen r paper bjects Return t full sprts and activities by 1-3 mnths depending n prgress 5 Rev. 7-13