Post Surgical Issues

Post-surgical issues that you might encounter after surgery depends on various factors, including the type of surgery performed. For patients who undergo surgical procedures on their feet, they may encounter typical discomforts which include:

Surgical procedures done in the feet and legs use general anesthesia to put you in a sleep-like state and numb you from pain. When the surgery is complete, the anesthesiologist reverses the medication to wake you up. A little confusion may be felt that would last from less than 10 minutes to a few hours. If your surgeon speaks to you immediately after surgery, you may have no recollection of the discussion made.
An anesthetic-related confusion is often due to anesthetic gases and narcotics that are given during the operation. You remain in this condition until these metabolites clear your system. Unfortunately, for overweight patients, there may be increased confusion since it may take longer for the fat-soluble anesthetics to clear their system.

General anesthesia relaxes the muscles in the digestive tract which slows down the motility of the bowel movement. Thus, constipation occurs. At the same time, the narcotic medication given to patients in controlling their post-operative pain can be a contributing factor in staying constipated that usually manifests for about 3 to 5 days.
Always follow your doctor’s instructions. Treatment includes a stool softener daily after the surgery. Laxatives can be added if stool softeners are seen ineffective.

Hiccups occur due to the irritation of the diaphragm, a muscular area that separates your lungs from the abdomen. The combination of taking medications and laying down (supine) can cause patients to develop hiccups that are self-limiting and will usually settle on their own.

Heel pain is a common complaint 6 to 12 weeks after a major foot and ankle surgery. The most common cause of heel pain is tissue irritation. The heel tissue gets irritated when a person begins to increase walking and general weight-bearing after being off their foot for an extended period of time, recovering from the surgery.
During the recovery or non-weight-bearing period, often 6 to 10 weeks, the heel becomes accustomed to not being walked on. The heel tissue atrophies a bit during this time and does not appreciate the relatively sudden increase in activity that occurs when the patient starts weight-bearing again. The solution in this instance is to slow down the recovery a bit and to realize that the heel symptoms will get better (usually in 3-6 weeks) – once the heel tissue toughens ups a bit.
The other potential cause of heel pain following surgery is pain from a prominent screw head. If this is the case, it can be padded using a heel gel pad that can be bought from a local drug store. But ultimately, the screw will need to be removed once the bone has healed.

A low-grade fever is surprisingly common after surgery. A patient following surgery can have a fever below 38.5 C (101.3 F) that occurs within 2 to 3 days.
It is commonly caused by atelectasis, a condition in which your lungs don’t fully expand causing its base to clump up a bit. This tends to occur in situations where a patient is lying down and not taking deep breaths – both common situations after foot surgery.

Treatment of atelectasis include:

  • Taking a full deep breath a couple of times every hour to help expand the lungs
  • Getting out of bed and sitting upright
  • It might be common for post-operative patients to acquire a fever, but you need to be more concerned if the fever:
  • Occurs more than three days after surgery
  • Is quite high – above 38.5 C (101.3 F)
  • Is associated with intense pain at the site of surgery
  • Is associated with other symptoms such as chest pain, abdominal pain, and urinary tract infections
  • These situations may be associated with an infection or other potentially serious medical problems.
  • After foot surgery, an initial pain can be felt that will make walking and moving around challenging. Depending on the type of operation that was done, the surgeon will allow patients one of the three limitations:

  • Weight-bearing as tolerated. It may be acceptable to bear full weight on the operated foot for surgeries that do not require major bone, tendon or ligament healing. However, it is still important to wear the appropriate footwear, limit the amount of time walking around and, as much as possible, elevate the affected foot.
  • Non-weight-bearing. Your surgeon will instruct you to be non-weight bearing following a surgery that requires healing of a major bone, tendon, or ligament. It can be made possible with the use of crutches, walkers, knee walker or wheelchair. It is critical that patients remain non-weight-bearing until their surgeon instructs them otherwise, since loading through a healing bone or ligament may cause inappropriate tissue healing or lead to non-unions of bones or fusions.
  • Partial weight-bearing. Some surgical procedures around the front and mid-part of the foot can be treated with partial weight-bearing. It can be done through the heel while using crutches or other devices that limit the weight through the foot. It may be important not to load through a part of the foot (ex. the front of the foot) as this may disrupt the healing process.
  • Unfortunately, nausea and vomiting are relatively common after surgery due to the reaction of the anesthetic agent and narcotic pain medications. The main treatment is to remove the cause if possible. For patients sensitive to narcotics, they may limit or switch to a less sensitive type available. Another option for treating nausea is to take an anti-nausea medication (antiemetic), such as diphenhydramine (Benadryl).

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