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22510 SE 64th Pl, Issaquah, WA 98027
(425) 358-4707
The Foot and Ankle Center of Issaquah

Surgery Protocols

If you are undergoing foot & ankle surgery at The Foot and Ankle Center of Kirkland and Issaquah, you may have some questions about the surgical process. In order to help you prepare and make the necessary accommodations after surgery, Doctors have compiled this surgical guide to address your concerns and answer some of the most frequently asked questions.

Frequently Asked Questions on Surgical Preparations:

How can I prepare for surgery?

You will need to start preparing for your surgery up to a month before your actual surgery date. These long-term preparations are a necessary part of the surgical process and must be completed prior to you undergoing surgery:

  • 30 days before the surgery: within 30 days, you will need to have your primary care physician perform a preoperative physical and order lab work. These results will need to be sent to our office.
  • Start thinking about possible questions you have and write them down.
  • NOTE: Depending on your individual surgical procedure, a period of non weight bearing may be required for proper healing. If this is the case, this will be discussed at the time you schedule your surgery and reinforced in the post op instructions given to you from our office.
  • Obtain your assistive device to use after surgery.
  • 1-2 weeks before surgery: You will attend a pre-operative appointment. During this appointment, you will complete the necessary paperwork, get your post-operative prescriptions, discuss your questions, and receive instructions on the time and place of your surgery.
  • After your appointment, you will need to get your prescriptions filled immediately. Because of drug enforcement laws and regulations, these prescriptions cannot be called in once they expire.

The night before your surgery, you will also have some short-term preparations to complete:

  • No eating or drinking after midnight. Eating or drinking after midnight will result in the cancellation of your surgical procedure.
  • Do NOT swallow water when brushing your teeth.
  • Do NOT drink alcohol, smoke, or use recreational drugs.
  • Find someone over the age of 18 to drive you home and monitor you for at least 24 hours following surgery.
  • Pack 3-4 pillows in your care for elevating your foot after surgery.
  • Pack your assistive device for use after surgery.
  • If specified at your pre-op appointment, use the provided scrub brush to gently scrub from your knee down to your toes and in between them as well.

What is an assistive device and why do I need it?

After surgery, you will not be able to bear weight on your foot varying anywhere from a day to several weeks. This means your foot CANNOT touch the floor, even if you are wearing a splint or boot. Assistive devices are used to ensure you can still remain mobile after surgery without putting weight on your foot. Examples of assistive devices include: crutches, walkers, wheelchairs, rolling knee scooters, or walking knee crutches.

Will my insurance cover assistive devices?

In most cases, your insurance company will offer coverage for crutches, walkers, or wheelchairs, however a prescription may be required. If needed, a prescription can be given before your surgery. Most insurance companies do not cover rolling knee scooters (KneeRover Scooter/Drive Medical DV8) or walking knee crutches (iWalk 2.0), but they are available on Amazon for approximately $150. In addition, most insurance companies will only provide coverage for a single device, so any additional devices will most likely need to be paid out of pocket.

What do I need to do the day of my surgery?

The day of your surgery, you will want to dress in loose, comfortable clothing that can easily fit over bulky dressing. You will also want to make sure you arrive early enough to find parking and complete the registration process. Be sure to review your instruction sheet given to you at your pre-op appointment for timing guidelines. You will need to bring a photo ID, your insurance card, and your prescription card for surgery check in, as well as a list of your current medications and drug/food allergies.

What do I need to do the day of my surgery?

The day of your surgery, you will want to dress in loose, comfortable clothing that can easily fit over bulky dressing. You will also want to make sure you arrive early enough to find parking and complete the registration process. Be sure to review your instruction sheet given to you at your pre-op appointment for timing guidelines. You will need to bring a photo ID, your insurance card, and your prescription card for surgery check in, as well as a list of your current medications and drug or food allergies list.

Surgery Day Checklist:

Do:
__Loose comfortable clothing
__Bring pre-op instruction sheet
__Bring photo ID
__Bring insurance card
__Bring prescription card
__Bring list of current medications & food/drug allergies

Don't:
__Wear jeans
__Wear contact lenses, barrettes, hair pins, or hair pieces
__No makeup, artificial fingernails, nail polish, jewelry, or watches

Frequently Asked Questions on Surgical Recovery:

What can I expect directly after surgery?

After your surgery, you will wake up in the recovery room where nurses will be keeping a close eye on your vital signs. As the anesthesia wears off and you start to regain consciousness, you will most likely experience sensitivity to light, noise, and temperature. You may also experience possible side effects of nausea, shivering, sore throat or headaches from the anesthesia. Please notify your nurse so they can help alleviate these symptoms.

During surgery, Doctor will perform a nerve block that will cause you to lose feeling in your foot and ankle. Generally, this loss of sensation will last for about 8-10 hours, however, it has the potential to last up to 36 hours. Don’t be alarmed if you cannot feel your foot or ankle after surgery.

Once you are alert enough, you will either be able to move to your hospital room or return home. Your post surgical arrangements should be made ahead of time and you should know whether to expect a hospital stay or not. Whenever you prepare to leave the hospital, you will be given discharge instructions.

What will I need to do after arriving home from surgery?

The day you come from surgery, you will want to rest and elevate your foot using approximately 4-5 pillows. Elevation will alleviate some of the swelling and pain, and is advised for the first 5-7 days following surgery. During this time, you will also want to avoid standing for extended periods of time, and limit your walking. Excessive throbbing, aching, or thumping is an indication that your foot needs to be elevated.

You will also want to start taking your pain medication a couple hours following surgery to make sure it gets in your system before your nerve block wears off. You may also need to take anti-nausea medication if your nausea continues. This will be prescribed ahead of time and can be used as needed.

In addition, if surgery was performed on your toes, you will need to frequently check your circulation. To do this, carefully press on your toe until it pales and then make sure it quickly returns to its pink color. If your toes stay pale or appear dusky, or blue contact our office.

How can I manage my pain?

Doctor will prescribe you pain medication to take after your surgery. Usually, you will start this regime a couple hours after surgery and then continue to take it every 4 hours for the next 24-48 hours. To avoid an upset stomach, do not take these medications on an empty stomach. You can gradually wean yourself off pain medications once you feel your pain levels have decreased. You can also use over the counter extra strength Tylenol to manage pain if you don’t have liver problems.

If you require refills on your pain medication, please notify our office 3-4 days before you run out. Because of federal drug enforcement laws, these prescriptions can only be picked up at our office or mailed directly to you. Be prepared to tell our staff your name, what procedure you had, and your surgery date.

Keep in mind that you CANNOT take any nonsteroidal/anti-inflammatory medications (unless directed by Dr.) because they can inhibit bone healing. These include:

  • Celebrex
  • Vioxx
  • Bextra
  • Naprosyn/Aleve
  • Ibuprofen/Motrin/Advil
  • Mobic
  • Relafen
  • Lodine
  • Voltren
  • Diclofenac

Will the pain medication cause any side effects?

One of the most common side effects to occur with your prescription pain medication is constipation. To alleviate this, be sure to drink plenty of fluids and eating fruits and vegetables. You can also use Senokot-S or Colace, which are both available over the counter.

What if I have drainage or bleeding?

After surgery, you may notice drainage or bleeding on your dressing or splint. This is completely normal. You can add more gauze over the affected area, but not remove the dressing. Depending on what kind of surgery you have, you may have different types of dressing. Special instructions about your dressing will be given to you on the day of your surgery. If you only need a splint, you will not need to do anything.

Drainage or bleeding is only considered to be a problem if the drainage does not stop and causes the dressing to become saturated with wet blood once the first 24 hours have passed. If this happens, please call our office for further instructions.

Can I shower?

Yes, but you will need to keep the affected leg dry. You CANNOT get the bandages wet because this can cause infection. In the case that your bandage gets wet, you will need to immediately calls us or visit an urgent care center or emergency room to have your bandaged checked and possibly changed.To prevent your bandage from getting wet, place a clean, dry washcloth over the top of your bandage, then wrap two small trash bags or one medium trash bag around your leg. Be sure to make the open ends watertight before taping them. You will need to shower or bathe with the affected leg outside of the tub/shower.

How soon can I drive after surgery?

If you are having surgery on your right side, you will not be able to drive until gaining clearance from your doctor. Not only is this because your right foot will be in a splint, boot, surgical shoe, or cast, but because research has proven there to be an unsafe braking response time in feet or ankles that have recently undergone surgery. In addition, the pressure from braking could cause damage to your surgical site and cause complications.If you must drive, you will need to obtain temporary hand conversion controls for your car (QuicStick & FreedomStaff). These are available on Amazon for approximately $200. Be advised that most insurance companies will not provide coverage for this.

The Foot and Ankle Center of Kirkland and Issaquah practices excellence in treating all of your foot and ankle needs, from minimally invasive surgery to complicated reconstructions for foot and ankle problems. Take a step in the right direction and schedule your consultation today!

22510 SE 64th Pl, Issaquah, WA 98027