Post Operative Instructions

1. Begin with liquids and light foods (jello, soups, etc) Gradually resume a normal diet.
2. To aid in both surgical wound and bone healing here are several recommendations:
   • Eat 3 or more servings per day of foods high in Protein and Calories.
     • Examples include: fish, poultry, meat, pork, nuts, and dairy products
   • Take Calcium 1500 mg per day from a combination of dairy products and Calcium supplements
   • Take Vitamin C 500 mg 3 times per day (total of 1500 mg) or eat 5 servings of citrus fruits
   • Take Zinc 200 mg 2 times per day (total of 400 mg)
   • Take Betacarotene 25,000 IU each day
3. It is best not to smoke, use tobacco, or nicotine patches during your healing period.

For 24 Hours Following Foot or Ankle Surgery:

1. Be in the care of a responsible adult.
2. Do not drive or operate any machinery.
3. Do not make important personal or business decisions or sign legal documents.
4. Avoid alcoholic beverages.

Medications:

1. Strong oral pain medication has been prescribed for the first few days. Use only as directed.
2. Do not drink alcoholic beverages while using this medication.
3. When taking pain medication, be careful as you walk or climb stairs. Mild dizziness is not unusual.
4. Continue to take your routine medications as prescribed by your internist/family practitioner. Please ask if you are unsure about continuing these medications after surgery.
5. Do not take any medications that have not been prescribed by your physician.

Activities:

1. While seated or lying, keep the operated limb at the level of your heart, toes at the level of your nose, for 23 hours per day for three full days after surgery. This is the time when the most swelling occurs while the wound attempts to seal.
2. Over the next 10 days if the limb begins to throb, you may have been up for too long or been trying to do too much. Take a break and elevate your leg.
3. Place ice packs over the operative site on the cast or dressing. Use for 20 minutes every 2-3 hours while you are awake-it will help alleviate pain and swelling.
4. Return to work: timing depends on your type of employment.
5. Do these rehabilitation exercises at home to speed up your recovery.

Wound Care:

1. Unless you have been instructed by Dr. Silverman, do not remove your cast or dressings.
2. To help keep your dressing clean and dry use a waterproof cast sock (Dry-pro) or a plastic bag for bathing.
3. Do not place foreign objects into your cast or dressing even if you are itchy-they can get stuck and cause ulcers and infections. Use a hairdryer if skin becomes moist from sweat.

When To Call your Physician:

1. While a low-grade fever in the first 24-48 post-operative hours is not unusual, a temperature above 100.40F, an elevation in temperature more than 3 days after surgery, or associated with chills, merits evaluation.
2. Increasing or a change in type of pain, swelling, numbness, pain with constant toe stretching.
3. Continuous drainage or bleeding from the incision site. A small amount is expected.
4. Any other worrisome condition.