Frequently Asked Questions

Where will my surgery be performed?

All surgeries and procedures are performed at the North Island Hospital Comox Valley (Comox Valley Hospital) located at 101 Lerwick Road in Courtenay, British Columbia.

Do I have to stay overnight in hospital after my surgery?

Not necessarily. This is dependent upon the type of surgery you are having. Total hip and total knee replacements typically require anywhere from 1 to 2 days in hospital depending on pain control, safe mobilization with physiotherapy, and other medical/surgical issues that may arise. Any other more complex or time-consuming procedures may require hospital admission on a case by case basis. Patients with complex comorbidities that require monitoring also may necessitate a stay in hospital.

Many procedures can be done as day surgery and you will return home approximately 2 to 3 hours after the surgery. Someone will need to be available to take you home. This includes smaller procedures such as arthroscopy of various joints, simple foot or ankle procedures, and ankle or wrist fractures, to name a few.

What type of anesthesia will I have for my surgery?

This is dependent upon multiple factors including your general health, the pain anticipated after surgery, and the length of the planned surgery. You will meet the anesthesiologist prior to your surgery and they will discuss the options with you such as a general anesthetic, spinal anesthetic, or local nerve block (freezing in the arm or leg). You will come to a decision together.

What can I do for pain control after surgery?

You will be provided with a prescription for pain medication by your surgeon, if necessary. The pain medication prescribed will be determined by the procedure you undergo and the anticipated pain afterwards, as well as a discussion between you and your surgeon. Occasionally this will include narcotic analgesia. These medications should only be taken as prescribed and stored appropriately. When the pain improves you can stop taking the narcotic and transition to regular or extra strength Tylenol/acetaminophen or Advil/ibuprofen as per the directions on the label.

Can I get a refill of pain medications after surgery?

In general, no. You will be given the appropriate amount by your surgeon based on the procedure and anticipated level of pain afterwards. Sometimes the prescription will include a refill, but narcotic analgesia prescriptions generally do not include the ability to have refills. Some patients have more difficulty controlling their pain than others and this can be discussed on a case by case basis with their surgeon. Once your initial narcotic prescription is completed you can transition to regular or extra strength Tylenol/acetaminophen or Advil/ibuprofen as per the directions on the label. Alternatively, you could see your family physician to discuss ongoing analgesia, especially if they are your primary narcotic prescriber if used before surgery for chronic pain/conditions.

What should I do to manage my wound/incision after surgery?

Your surgical wound will be closed with staples, sutures that require removal, or sutures that will dissolve on their own. Typically you should keep your dressings intact over the wound and keep everything dry for 2 weeks. If showering, the limb should be placed in a bag and sealed completely, or the limb excluded from the tub or shower. Do not remove the dressing by yourself. The dressing will be removed at your first follow up appointment which is typically 2 weeks after your procedure, or sooner at the discretion of your surgeon. The staples or sutures will be removed at that 2-week appointment as necessary. Typically, you can then shower 48 hours after suture/staple removal. Do not submerge the wound in a bath, hot tub, or pool for at least 4 weeks or longer until the wound is completed healed. Do not apply any lotions or creams over the wound unless directed by your surgeon, or until it is completely healed after approximately 6 weeks.

Can I get my cast/splint wet after surgery? What should I do if I get it wet by mistake?

No. The dressing and casting/splinting material used routinely is not waterproof so they must be kept dry. Place the limb into a bag and seal it well, or exclude it from the tub or shower to prevent it from getting wet. If it gets soaked or saturated (a few drops are likely okay) then the cast/splint may fail and the surgical wound may be compromised. Please call the office at 250-941-0080 to see if it’s necessary to book an appointment at the fracture clinic to be seen by your surgeon.

What symptoms should I expect after surgery? What symptoms are normal?

Pain is normal after surgery. It is generally mild to moderate, depending on what was done. The intensity of the pain may fluctuate depending on the time of day and how active you have been. If the pain is severe and unrelenting you may need to go to the emergency department. Numbness and tingling can be normal for 2 weeks or more after surgery, depending on what was done. Swelling is normal after surgery. Elevation of the extremity at or just above the level of the heart can help reduce swelling. If swelling is significant it can worsen pain. Swelling may persist for 6+ months after surgery, depending on what was done.

When can I start driving again after surgery?

While taking narcotics post-operatively your ability to drive is impaired and you should not be driving a motor vehicle or operating heavy machinery. After surgery involving the right lower extremity (ie. hip, knee, foot, or ankle) you should not drive for at least 6 weeks. After surgery involving the left lower extremity you may be able to drive an automatic vehicle before 6 weeks, depending on the circumstances. The same rules generally apply for upper extremity surgery also. You may also want to contact your insurance company to see if you would be allowed to drive.

When can I fly in an airplane after having surgery?

There are no specific guidelines regarding flying after surgery, but doing so too soon can increase your risk of developing a blood clot in the legs (deep vein thrombosis). This blood clot can travel to the lungs, called a pulmonary embolism, which can be deadly. You should wait at least 6 weeks after a smaller surgical procedure or 3 months after major surgery (ie. total hip or knee replacement) to fly in a plane. If you must fly sooner you should discuss with your surgeon or family physician regarding taking a blood thinner around the time of flying.

I need to get dental work done. How close before or after my joint replacement (hip/knee/shoulder) is it okay to have dental work? Do I need antibiotics for when I have dental work after a joint replacement?

The short answer is no. In general, one should be in optimal oral health prior to undergoing any total joint replacement (hip, knee, shoulder) and maintain good oral health both before and after surgery. If you have pending dental work ie. tooth extractions, crowns, route canals, etc. it is generally best to have them completed at minimum 6 weeks prior to your joint replacement, or wait at least 12 weeks after surgery is completed. There are no specific guidelines regarding this timing. In general, antibiotic prophylaxis is not required for routine cleaning and the majority of dental work. In patients whom are immunocompromised consideration may be given for antibiotic prophylaxis. If there is the possibility of significant dental bony work to be done prophylaxis may be warranted and can be discussed with your surgeon. If there is an active dental infection this should be treated appropriately by your dentist.

How do I obtain copies of my medical records/files?

The Comox Valley Orthopaedics office does not generally provide medical records. You are entitled to obtain or review your medical records under the Freedom of Information and Protection of Privacy Act (FIPPA), but a request must be made in writing. Please see the VIHA Accessing Information & Records website or this form for further information. You may also access your medical records, including lab results, via MyHealth.

How long will it be before I can return to work? How are the restrictions determined?

This is highly variable depending on what surgery you’ve had or the injury sustained. The limitations will generally be discussed with you by your surgeon and change on a case by case basis. For most lower extremity procedures, 2 to 3 weeks off is recommended to recover from the anesthetic, surgical pain, narcotics if used, and elevate the limb to minimize swelling and potential for wound compromise. Afterwards, office/desk work or seated, sedentary work may be possible. More physically demanding jobs may require longer periods off work. Upper extremity surgery may require less time off, depending on what was done. Hip and knee replacements routinely may take up to 3 months or more to recover from enough until you are able to return to work.

What should I do if I need notes or forms signed for work?

Please drop off or fax all forms to the office (250-941-0082). Do not bring the forms to the fracture clinic, as there is very rarely any time to complete the form sufficiently. Simple notes may often be accommodated. Please allow up to one week for completion. There is a charge for all forms completed (cash/card/cheque). The office will contact you when they are ready to be picked up.