Surgical FAQ
Frequently asked questions about scheduling, preparing for surgery and after your surgery.
Preparing for Surgery
Following these steps will ensure you are prepared the day of surgery. if you have any questions about your pre-operative care, you are encouraged to contact your surgeon's office for direction.
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● We strongly suggest you stop smoking
● Do not have any alcohol, marijuana or non prescription drugs 24 hours before surgery
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● Thoroughly shower or bathe using soap (you do not need to shave body hair) ;
● UNLESS YOUR PHYSICIAN HAS ORDERED OTHERWISE, you can eat and drink normally until MIDNIGHT
● DO NOT have any solid food, dairy products diet drinks or juice with pulp after midnight
● You can have clear fluids (including water, apple juice, clear tea, black coffee) until 5 hours before your surgery.
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● Remove all jewelry including piercings and body jewelry
● Do NOT wear lotion, makeup, lipstick, nail polish, perfume, cologne , hairspray, contact lenses or aftershave:
● Stop drinking 3 hours before your surgery ( example: if your procedure is at 11 AM stop drinking at 8AM)
● If your doctor gave you instructions to complete a specific preparation (bowel prep), make sure you've completed everything according to their instructions:
● If you will be given sedation or put to sleep, make sure you have a friend or family member available to drive you home after the procedure
● You should have a responsible adult prepared to stay with you overnight after surgery.
After Surgery
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Pain Medication: You may experience pain and discomfort. Take your prescribed pain medication as directed. Do not wait until the pain becomes severe before taking your medication.
Ice Application: If you have a soft dressing on the you may Apply ice packs to the surgical area for 20 minutes every hour while awake. If your ankle is immobilized in a half cast you can try putting the ice over the front where there is no plaster.
Medications:
You will be given a prescription for
Percocet- this is a narcotic pain killer. We recommend that you take this regularly for the 1st 24-48 hours after surgery however after that use only as needed
Celebrex -this is an anti-inflammatory this is meant to be taken regularly for 48 hours
Keflex- this is an antibiotic this is meant to be taken regularly for 2 weeks . Some patients are unable to tolerate this due to gastrointestinal effects, if this is the case then you can stop using the medication: .
Vitamin C- this is meant to be taking regularly for 2 weeks as there is some evidence that it can help prevent complex regional pain syndrome (a rare condition in which there is ongoing pain even after the patient has recover from surgery)
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Elevation: Keep your foot elevated above the level of your heart as much as possible. This helps reduce swelling and pain.
Rest: Limit your activities and rest as much as possible. Avoid putting weight on the affected foot unless instructed otherwise .
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Bandages: Keep the surgical bandages clean and dry. Do not remove them unless instructed by your surgeon.
Wound Care: Do not touch or scratch the surgical area. If you notice any signs of infection (redness, warmth, increased pain, or discharge), contact our office.
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Dr. Manjoo will advise you as to whether you can weight bear normally, on your heel, or to avoid weight-bearing altogether after surgery
Bathroom Safety: Use a shower chair or a handheld showerhead to avoid standing in the shower. Keep the surgical area dry.
Diet and Hydration
Diet: Eat light meals and avoid greasy or spicy foods. Start with clear liquids and gradually progress to your regular diet as tolerated.
Hydration: Drink plenty of fluids to stay hydrated, especially if you are taking pain medications that can cause constipation.
Sleeping Arrangements
Positioning: Sleep with your foot elevated on pillows. This helps reduce swelling.
Comfort: Ensure your sleeping area is comfortable and easily accessible. Keep necessary items within reach.
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Increased Pain: Pain that is not relieved by medication or that suddenly worsens.
Swelling and Redness: Excessive swelling, redness, or warmth around the surgical site.
Fever: A fever higher than 100.4°F (38°C) that lasts for more than a few hours.
Numbness or Tingling: Persistent numbness or tingling in your foot or toes.
If you have concerns following your surgery you can contact Dr. Manjoo’s office during working hours (9:00 a.m. to 4:00 p.m. ) . Outside of these hours call 911, or proceed to your nearest emergency department or walk-in clinic.
Follow up appointment:
Please call the fracture clinic at Joseph Brant hospital (phone number 905-632-3737 extension 5842) to arrange a follow-up visit. Please note that Dr.Manjoo’s office is not able to arrange fracture clinic appointments for patients, this needs to be done by the patient themselves.
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Two weeks off work is recommended for initial recovery
If you are able to get to work safely, and will be seated for the majority of the day, you may return to work a couple days after surgery. This is assuming you are not taking narcotic pain medication.
From 2-8 weeks sedentary duties is recommended
By 8 weeks you can gradually return to full duties
If your job is physically demanding, return to full duties is usually possible around 12 weeks post operativel
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For right foot surgery you are not permitted to drive until you have completely weaned off the boot
For left foot surgery, please contact your insurance company to see if you are permitted to drive
Driving is not permitted while on narcotics
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1. Follow Medical Advice:
· Adhere to your doctor's instructions regarding immobilization, weight-bearing, and medication.
2. Maintain a Healthy Diet:
· Calcium and Vitamin D: Essential for bone health. Include dairy products, leafy greens, and fortified foods in your diet.
· Protein: Supports tissue repair. Incorporate lean meats, fish, beans, and nuts.
· Other Nutrients: Vitamins C and K, magnesium, and zinc aid in healing. Eat a balanced diet with fruits, vegetables, and whole grains.
3. Avoid Smoking and Alcohol:
· Smoking and excessive alcohol intake can delay bone healing. Quit smoking and limit alcohol consumption.
4. Stay Hydrated:
· Drink plenty of water to support overall health and the healing process.
5. Manage Pain and Swelling:
· Use ice, elevation, and prescribed pain medications to reduce discomfort and inflammation.
6. Use a Bone Growth Stimulator:
· Bone Growth Stimulators: These devices use electrical, ultrasound, or magnetic signals to stimulate bone healing. They can be external (worn over the fracture site) or internal (implanted during surgery). Discuss with your doctor if a bone growth stimulator is appropriate for your specific fracture.
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7. Exercise and Physical Therapy:
· Follow a physical therapy plan to regain strength and mobility. Start with gentle exercises as recommended by your healthcare provider.
8. Ensure Proper Immobilization:
· Keep casts, splints, or braces in place as directed to maintain bone alignment and stability.
9. Follow-Up Appointments:
· Attend all scheduled check-ups to monitor progress and address any complications promptly.
10. Avoid Re-Injury:
· Protect the affected area from further injury by using supportive devices and being cautious with activities.
11. Consider Supplements:
· If dietary intake is insufficient, consider supplements for calcium, vitamin D, and other essential nutrients after consulting your doctor.
We recommend Proven Therapeutic supplements: https://proventherapeutics.com/
By following these guidelines, including the potential use of a bone growth stimulator, you can enhance your body's natural healing process and promote a faster, more complete recovery from a fracture.
Scheduling & Booking
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If you need to cancel or reschedule your surgery, please do so at least 6 weeks in advance to accommodate other patients and manage schedules effectively.
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If you are a fracture clinic patient and need to book a follow-up, please contact the fracture clinic directly. Note that the office does not have your file for 2 weeks post-surgery.
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Dr. Manjoo will prescribe an appropriate amount of pain medication after your surgery. If you need a refill, please contact your GP or take Tylenol Extra Strength as an alternative.
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You need to book a follow-up appointment at the fracture clinic 2 weeks after your surgery. When showering, place a bag over the incision to keep it dry. Do not remove your wrap or dressing yourself; the fracture clinic or Dr. Manjoo will do this at your 2-week appointment and provide you with a boot.
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Our office does not provide medical reports directly. Copies of your reports are sent to your GP. You can obtain them from your GP or contact JBH Health Records to request them.
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If you have forms that need to be filled out, please complete the necessary portions/details and email them to our office. It takes 10-12 working days to process these forms. Note that there is a fee for this service. Please do not contact our office for updates on the forms. Once completed, they will be emailed back to you.
Non-operative Options
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What is Platelet-Rich Plasma (PRP)?
Platelet-Rich Plasma (PRP) therapy is a treatment that uses your body’s own blood to promote healing. PRP is made by taking a small sample of your blood, processing it to concentrate the platelets, and then injecting it back into the injured or damaged area. Platelets contain growth factors and proteins that help repair tissues and reduce inflammation.
PRP therapy is commonly used for conditions such as joint pain, tendon injuries, and osteoarthritis.
How Does PRP Work?
Platelets in your blood are responsible for clotting and healing injuries. When concentrated in PRP, they release growth factors that help accelerate tissue repair and reduce inflammation. By injecting PRP directly into the affected area, your body’s natural healing process is enhanced.
What Conditions Can PRP Treat?
PRP therapy can be used for a variety of conditions, including:
Tendon Injuries: PRP is commonly used for conditions like tennis elbow, Achilles tendinitis, or rotator cuff injuries.
Osteoarthritis: PRP can be injected into joints, such as the knee, to reduce pain and improve function.
Muscle Injuries: PRP may help speed up the recovery from muscle strains or tears.
Ligament Injuries: PRP can be used to treat sprains or partial ligament tears.
Post-Surgical Healing: In some cases, PRP may be used after surgery to promote faster healing.
What to Expect During PRP Therapy
Blood Draw: A small amount of your blood is drawn, similar to a standard blood test.
Processing: The blood is placed in a centrifuge to separate and concentrate the platelets.
Injection: The PRP is then injected into the injured area using ultrasound guidance to ensure accuracy.
The entire process usually takes about 10-15 minutes, and patients can typically go home the same day.
Is PRP Therapy Painful?
There may be some discomfort during the injection, similar to any other shot. After the procedure, you may experience mild pain or soreness at the injection site for a few days. This is a normal part of the healing process.
How Effective is PRP?
Many patients experience reduced pain and improved function after PRP therapy, but results can vary depending on the condition being treated, the severity of the injury, and the individual’s healing response. PRP is considered a promising option for those who have not found relief with other treatments like physical therapy or medication.
How Many Treatments Will I Need?
The number of PRP treatments varies depending on the condition and your response to therapy. Some patients may need just one injection, while others may require a series of treatments spaced a few weeks apart. Your doctor will develop a treatment plan tailored to your needs.
Are There Any Risks or Side Effects?
Since PRP is made from your own blood, the risk of an allergic reaction or infection is very low. However, some potential side effects include:
Temporary pain or soreness at the injection site
Mild swelling or bruising
Stiffness in the treated area
These side effects are usually short-term and resolve within a few days.
Who Should Avoid PRP Therapy?
PRP may not be recommended for individuals with certain conditions, including:
Bleeding disorders
Blood cancers
Infections in the treatment area
Pregnancy
Your healthcare provider will evaluate your medical history to determine if PRP is right for you.
Benefits of PRP Therapy
Natural Treatment: Uses your own blood to promote healing, reducing the need for medications or surgery.
Non-Surgical Option: PRP is a minimally invasive procedure that can provide relief without the need for surgery.
Long-Term Relief: Some patients experience long-lasting pain relief and improved function after PRP therapy.
What to Expect After PRP Therapy
After the procedure, it’s normal to experience some soreness or mild discomfort. You may be advised to avoid strenuous activity for a few days. Over time, you should notice improvements in pain and function as the tissue heals.
Follow-Up Care:
You may need to avoid anti-inflammatory medications (e.g., ibuprofen) for a period after PRP, as these can interfere with the healing process.
Physical therapy may be recommended to support your recovery and improve results.
Your doctor will schedule follow-up appointments to monitor your progress.
Is PRP Covered by Insurance?
In most cases, PRP therapy is not covered by insurance, as it is considered an experimental or elective treatment. Costs can vary, so it’s important to discuss payment options with your provider.
Conclusion
Platelet-Rich Plasma (PRP) therapy is a promising treatment option for many musculoskeletal conditions. By using your body’s own platelets to promote healing, PRP offers a natural, minimally invasive way to manage pain and improve function.
If you’re interested in learning more about PRP therapy or finding out if it’s right for you, speak with your healthcare provider.
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What are Viscosupplementation Injections?
Viscosupplementation is a medical treatment used to relieve joint pain caused by osteoarthritis (OA), especially in the knees. This therapy involves injecting hyaluronic acid, a natural substance found in the joint fluid, directly into the affected joint. Hyaluronic acid helps lubricate and cushion the joint, reducing pain and improving mobility.
How Do Viscosupplementation Injections Work?
In osteoarthritis, the natural hyaluronic acid in the joint may break down or become less effective, leading to pain and stiffness. By supplementing the joint with hyaluronic acid, viscosupplementation:
Improves joint lubrication.
Acts as a shock absorber for the joint.
Reduces inflammation and pain.
Enhances mobility and quality of life.
Who Can Benefit from Viscosupplementation?
Viscosupplementation may be recommended if:
You have mild to moderate osteoarthritis.
Other treatments, such as pain relievers, physical therapy, or lifestyle changes, have not provided sufficient relief.
You are not a candidate for or wish to delay knee replacement surgery.
What to Expect During the Procedure
Preparation: The area around the joint is cleaned, and a local anesthetic may be applied.
Joint Aspiration (if needed): Excess fluid may be removed from the joint before the injection.
Injection: The hyaluronic acid is injected into the joint using a fine needle.
The procedure takes about 5-10 minutes.
Most patients can go home immediately afterward.
How Effective is Viscosupplementation?
Relief may take several weeks to become noticeable.
Benefits can last from 6 months to a year, depending on the severity of your arthritis and individual response.
Some patients may require repeated treatments for sustained relief.
Potential Side Effects
Viscosupplementation is generally safe, but possible side effects include:
Mild pain, swelling, or stiffness at the injection site.
Warmth or redness in the joint.
Rarely, infection or allergic reactions.
If you experience severe pain, swelling, or fever, contact your healthcare provider immediately.
Aftercare Instructions
Avoid strenuous activities, such as running or heavy lifting, for 48 hours.
Apply ice to the injection site to reduce swelling, if needed.
Take over-the-counter pain relievers (e.g., acetaminophen) as directed, if necessary.
Follow up with your provider for evaluation and additional treatment if needed.
Who Should Avoid Viscosupplementation?
Viscosupplementation may not be recommended for individuals who:
Are allergic to hyaluronic acid or its components.
Have an infection in or near the affected joint.
Are pregnant or breastfeeding (consult your provider).
Have severe advanced arthritis or significant joint damage.
FAQs
1. Does the injection hurt?
Most patients experience minimal discomfort, similar to a typical injection. A local anesthetic can help reduce any pain.2. Can I receive injections in both knees?
Yes, if both knees are affected, your doctor can treat both joints, often during the same visit.3. Is this treatment covered by insurance?
Many insurance plans cover viscosupplementation, but coverage may vary. Check with your insurance provider for specific details