DR. WADEHRA’S

1. Keep foot/feet elevated approximately 6” above chest whenever possible.

2. Keep the bandage dry and intact unless otherwise instructed.

3. Follow your doctor’s instructions regarding walking/weight-bearing. If walking is allowed, wear your surgical shoe or boot as instructed. If no weight-bearing is allowed on the operated foot/ankle, use crutches, walker, knee scooter, or wheelchair as instructed. Follow activity limits specified by your doctor for your surgery. This will help for a more rapid, complete recovery.

4. Use Ice Packs or Cryo Cuff as often as possible, and change them as they become warm.

5. There may be some blood seen on your bandage. This is normal. If bleeding is noted, reduce activity, apply ice and elevate the foot. If bleeding persists, call your doctor.

6. Take the medication as prescribed. Do not drink alcohol before, during, or after taking pain medication. Take anti-inflammatories if instructed to reduce swelling. (i.e. Aleve OTC 2 tablets every 12 hours with food x 5 days)

7. Limit your walking. Most postoperative problems are a result of excessive walking. Do not push yourself in the beginning. Your ability to ambulate will gradually improve from day to day–please be patient. Remember after any activity, elevation and ice will help decrease pain and swelling.

8. Do not change the bandage unless otherwise instructed. All bandage changes will be performed in the office.

9. Perform knee flexion exercises to promote throughout the day to promote blood flow.

10. If you did not schedule your first postoperative before surgery, call the office when you get home to schedule your first postoperative appointment.

11. If you have any questions or concerns please feel free to call the office.

Nail Removal Instructions

1. You have had a minor surgical procedure to correct an ingrown toenail.

2. If you have any discomfort when the anesthetic wears off, you can take Tylenol, Advil, or Aleve, elevate your leg, and apply ice.
3. Keep the dressings on until the morning. You can take it off to take your shower. Then, dry the foot, apply antibiotic ointment, and apply another dressing.
4. You may see a spot of blood through the dressing. This is common and you should not be alarmed. If the dressing becomes wet with blood, you should remove the dressing, apply compression, and elevate your leg for 15 minutes. You can then apply another dressing.
5. If you have been instructed to soak your foot, use lukewarm water and Epsom salt. Soak 15 minutes as many times a day as recommended by Dr. Wadehra. Dry the foot, apply antibiotic ointment, and apply a new dressing.
6. Continued drainage is to be expected and normal. But, if you notice yellow or creamy drainage, increasing surrounding redness, fevers, or chills, notify the office immediately.
7. If you have any problems or questions, you may call the following numbers.

Dr. Sarmast

Dr. Sarmast Post-operative Instructions (Hand/Wrist/Elbow)

You have just undergone surgery and are now on your way to recovery! To minimize the pain and discomfort of surgery, please review the instructions listed below:
Swelling
Swelling is natural after surgery for the first few weeks. Reducing swelling helps speed recovery and will lessen your pain. Icing is very important in the initial post-operative period and should begin immediately after surgery.
Use icing machine continuously or ice packs (if machine not prescribed) for 30-45 minutes every 2 hours daily until your first post-operative visit Care should be taken with icing to avoid frostbite to the skin.
Elevate your arm above your heart. The best way to do this comfortably is to lie flat on your back with your hand resting on a few pillows. Elevate your hand for at least three days after surgery.
Wound Care
Your physician would have checked which direction to take for wound care. Be sure to follow the instructions that your care team selected for you.
____The postoperative dressing/splint should be left intact until you see your doctor. Loosening the ace bandage can sometimes help. Sponge bathing is ok but be sure not to get your dressing wet. Taping a plastic bag or garbage bag around your arm is advised or you may purchase cast protectors from your local pharmacy.
OR
____You may remove your dressing 3 days after surgery. You may apply a new dressing to the wound on the third day after surgery with dry gauze and tape. You may shower and let warm soapy water run over wound. Do not scrub wound. Be sure to pat dry and cover with dry gauze and tape. Do not use ointments or lotions at this time.
After removing your dressing, monitor for any signs of infection (excessive redness, warmth, pain out proportion) and let the office know if any of these signs or symptoms should develop.
Avoid direct exposure of the scar to sunlight for 1 year after surgery and use high SPF sunblock if necessary
Activities
Do not make important decisions in the next 24 hours while anesthesia continues to wear off.
If you were given a nerve block block, please wear a sling until you regain function of your elbow and hand. You may wear for general comfort postoperatively while outside of the home as well.
Do not engage in activities which increase pain/swelling.
Avoid long periods of sitting or long distance traveling for 2 weeks.
NO driving, operating machinery or alcohol consumption while taking narcotic pain medications. NO driving while still using sling.
May return to sedentary work ONLY or school 3-4 days after surgery, if pain is tolerable, unless otherwise discussed with Dr. Sarmast.
Some or all of your fingers may have been left free of your dressing so that you can move them. Finger movement, if allowed, can reduce stiffness and swelling.
Make frequent gentle fists, 10 times an hour while awake.
Start walking as soon as possible, as this helps decrease the chance of blood clots.
Medications
Pain medications have been prescribed. Please take them as directed. Pain medications can often cause nausea, constipation and itching. Do not drink alcohol, drive or make important decisions while taking narcotic pain medications. Please also follow the directions below, according to which directions were checked off on your packet.
____ Take over the counter tylenol (acetaminophen) as directed on packaging, unless you have pre-existing liver problems or allergy to this medication.
_____Take anti inflammatories as tolerated. over the counter Ibuprofen/motrin/NSAIDs unless you have history of stomach pain, ulcers, or GI bleeding. You may take 600 mg every 8 hours as needed for pain. (Do not use in case of broken bones/fractures). Do NOT take or combine these medications if Dr. Sarmast has already prescribed you an anti-inflammatory such as Naprosyn, Meloxicam, or Ibuprofen.
Pain medications may cause constipation. Please take stool softeners found over the counter as directed. These include Docusate/Colace, Miralax, and Senna. Ask your pharmacist for more information.
Diet
Begin with liquids and light foods, such as crackers and clear liquids. Advance to your normal diet once liquids and lighter foods are well tolerated.
Therapy
Dr. Sarmast will discuss physical therapy (PT) with you at your first postoperative visit, unless otherwise already discussed preoperatively.
Follow-up:
Please call Dr. Sarmast’s Office (313-749-0370) to schedule an appointment to be seen as indicated by Dr. Sarmast Post Operatively
If you have any fevers (temperature >100.5), yellow or greenish drainage, excessive warmth or pain, cool digits, numbness or tingling, uncontrolled continuous bleeding, please call the office immediately.

Dr. Sarmast Post-Operative Instructions (Knee Arthroscopy)

You have just undergone surgery and are now on your way to recovery! To minimize the pain and discomfort of surgery, please review the instructions listed below:
Swelling
Swelling is natural after surgery for the first few weeks. Reducing swelling helps speed recovery and will lessen your pain. Icing is very important in the initial post-operative period and should begin immediately after surgery.
Use icing machine continuously or ice packs (if machine not prescribed) for 30-45 minutes every 2 hours daily until your first post-operative visit
Care should be taken with icing to avoid frostbite to the skin.
Elevate your arm above your heart. The best way to do this comfortably is to lie flat on your back with your hand resting on a few pillows. Elevate your hand for at least three days after surgery.
Wound Care
Your physician would have checked which direction to take for wound care. Be sure to follow the instructions that your care team selected for you.
____The postoperative dressing/splint should be left intact until you see your doctor. Loosening the ace bandage can sometimes help. Sponge bathing is ok but be sure not to get your dressing wet. Taping a plastic bag or garbage bag around your arm is advised or you may purchase cast protectors from your local pharmacy.
OR
____You may remove your dressing 3 days after surgery. You may apply a new dressing to the wound on the third day after surgery with dry gauze and tape. You may shower and let warm soapy water run over wound. Do not scrub wound. Be sure to pat dry and cover with dry gauze and tape. Do not use ointments or lotions at this time.
After removing your dressing, monitor for any signs of infection (excessive redness, warmth, pain out proportion) and let the office know if any of these signs or symptoms should develop.
Avoid direct exposure of the scar to sunlight for 1 year after surgery and use high SPF sunblock if necessary
Activities
Do not make important decisions in the next 24 hours while anesthesia continues to wear off.
If you were given a nerve block block, please wear a sling until you regain function of your elbow and hand. You may wear for general comfort postoperatively while outside of the home as well.
Do not engage in activities which increase pain/swelling.
Avoid long periods of sitting or long distance traveling for 2 weeks.
NO driving, operating machinery or alcohol consumption while taking narcotic pain medications. NO driving while still using sling.
May return to sedentary work ONLY or school 3-4 days after surgery, if pain is tolerable, unless otherwise discussed with Dr. Sarmast.
Some or all of your fingers may have been left free of your dressing so that you can move them. Finger movement, if allowed, can reduce stiffness and swelling.
Make frequent gentle fists, 10 times an hour while awake.
Start walking as soon as possible, as this helps decrease the chance of blood clots.
Medications
Pain medications have been prescribed. Please take them as directed. Pain medications can often cause nausea, constipation and itching. Do not drink alcohol, drive or make important decisions while taking narcotic pain medications. Please also follow the directions below, according to which directions were checked off on your packet.
____ Take over the counter tylenol (acetaminophen) as directed on packaging, unless you have pre-existing liver problems or allergy to this medication.
_____Take anti inflammatories as tolerated. over the counter Ibuprofen/motrin/NSAIDs unless you have history of stomach pain, ulcers, or GI bleeding. You may take 600 mg every 8 hours as needed for pain. (Do not use in case of broken bones/fractures). Do NOT take or combine these medications if Dr. Sarmast has already prescribed you an anti-inflammatory such as Naprosyn, Meloxicam, or Ibuprofen.
Pain medications may cause constipation. Please take stool softeners found over the counter as directed. These include Docusate/Colace, Miralax, and Senna. Ask your pharmacist for more information.
Diet
Begin with liquids and light foods, such as crackers and clear liquids. Advance to your normal diet once liquids and lighter foods are well tolerated.
Therapy
Dr. Sarmast will discuss physical therapy (PT) with you at your first postoperative visit, unless otherwise already discussed preoperatively.
Follow-up:
Please call Dr. Sarmast’s Office (313-749-0370) to schedule an appointment to be seen as indicated by Dr. Sarmast Post Operatively
If you have any fevers (temperature >100.5), yellow or greenish drainage, excessive warmth or pain, cool digits, numbness or tingling, uncontrolled continuous bleeding, please call the office immediately.

Dr. Sarmast Post-Operative Instructions (Rotator Cuff Repair)

You have just undergone surgery and are now on your way to recovery! To minimize the pain and discomfort of surgery, please review the instructions listed below:
Swelling
Swelling is natural after surgery for the first few weeks. Reducing swelling helps speed recovery and will lessen your pain. Icing is very important in the initial post-operative period and should begin immediately after surgery.
Use icing machine continuously or ice packs (if machine not prescribed) for 30-45 minutes every 2 hours daily until your first post-operative visit
Care should be taken with icing to avoid frostbite to the skin.
Wound Care
The postoperative dressing/splint should be left intact until you see your doctor. Sponge bathing is ok but be sure not to get your dressing wet. Cover shoulder with Saran wrap or “Press ‘n Seal” while bathing. Do NOT soak incision/wound.
It is normal for the shoulder to bleed and swell following surgery. If blood soaks onto the bandage, do not become alarmed, reinforce with additional dressing.
Wait until your first post operative appointment to have Dr. Sarmast’s team remove the surgical dressing .
Please do not place any ointments lotions or creams directly over the incisions.
Once the sutures/staples are removed at least 10-14 days post operatively you can begin to get the incision wet in the shower (water and soap lightly run over the incision and pat dry)
NO immersion in a bath until given approval by our office.
Avoid direct exposure of the scar to sunlight for 1 year after surgery and use high SPF sunblock if necessary.
Activities
Do not make important decisions in the next 24 hours while anesthesia continues to wear off.
You are to wear the sling placed at surgery for at least 6 weeks. This includes sleeping and throughout the day. Removal for hygiene, dressing, and home exercise only.
When sleeping or resting, inclined positions (ie: reclining chair) and a pillow under the forearm and behind the elbow are recommended.
Do not engage in activities which increase pain/swelling. Unless otherwise instructed the arm should remain in the sling at all times.
Avoid long periods of sitting or long distance traveling for 2 weeks.
NO driving, operating machinery or alcohol consumption while taking narcotic pain medications. NO driving while still using sling.
May return to sedentary work ONLY or school 3-4 days after surgery, if pain is tolerable, unless otherwise discussed with Dr. Sarmast.
It is encouraged to move your hand, wrist, and elbow to increase circulation and prevent stiffness. Make frequent fists 10 x hr while awake for first week after surgery. No lifting is allowed.
Start walking as soon as possible, as this helps decrease the chance of blood clots.
Medications
Pain medications have been prescribed. Please take them as directed. Pain medications can often cause nausea, constipation and itching. Do not drink alcohol, drive or make important decisions while taking narcotic pain medications. Please also follow the directions below, according to which directions were checked off on your packet.
____ Take over the counter tylenol (acetaminophen) as directed on packaging, unless you have pre-existing liver problems or allergy to this medication.
_____Take anti inflammatories as tolerated. over the counter Ibuprofen/motrin/NSAIDs unless you have history of stomach pain, ulcers, or GI bleeding. You may take 600 mg every 8 hours as needed for pain. (Do not use in case of broken bones/fractures). Do NOT take or combine these medications if Dr. Sarmast has already prescribed you an anti-inflammatory such as Naprosyn, Meloxicam, or Ibuprofen.
Pain medications may cause constipation. Please take stool softeners found over the counter as directed. These include Docusate/Colace, Miralax, and Senna. Ask your pharmacist for more information.
Diet
Begin with liquids and light foods, such as crackers and clear liquids. Advance to your normal diet once liquids and lighter foods are well tolerated.
Therapy
Dr. Sarmast will discuss physical therapy (PT) with you at your first postoperative visit. No motion of the operative shoulder until that time.
Follow-up:
Please call Dr. Sarmast’s Office (313-749-0370) to schedule an appointment to be seen as indicated by Dr. Sarmast Post Operatively
If you have any fevers (temperature >100.5), yellow or greenish drainage, excessive warmth or pain, cool digits, numbness or tingling, uncontrolled continuous bleeding, please call the office immediately.

Dr. Sarmast Post-Operative Instructions (Shoulder Arthroscopy W/O RCR)

You have just undergone surgery and are now on your way to recovery! To minimize the pain and discomfort of surgery, please review the instructions listed below:
Swelling
Swelling is natural after surgery for the first few weeks. Reducing swelling helps speed recovery and will lessen your pain. Icing is very important in the initial post-operative period and should begin immediately after surgery.
Use icing machine continuously or ice packs (if machine not prescribed) for 30-45 minutes every 2 hours daily until your first post-operative visit
Care should be taken with icing to avoid frostbite to the skin.
Wound Care
The postoperative dressing/splint should be left intact until you see your doctor. Sponge bathing is ok but be sure not to get your dressing wet. Cover shoulder with Saran wrap or “Press ‘n Seal” while bathing. Do NOT soak incision/wound.
It is normal for the shoulder to bleed and swell following surgery. If blood soaks onto the bandage, do not become alarmed, reinforce with additional dressing.
Wait until your first post operative appointment to have Dr. Sarmast’s team remove the surgical dressing .
Please do not place any ointments lotions or creams directly over the incisions.
Once the sutures/staples are removed at least 10-14 days post-operatively you can begin to get the incision wet in the shower (water and soap lightly run over the incision and pat dry)
NO immersion in a bath until given approval by our office.
Avoid direct exposure of the scar to sunlight for 1 year after surgery and use high SPF sunblock if necessary.
Activities
Do not make important decisions in the next 24 hours while anesthesia continues to wear off.
You are to wear the sling placed at surgery for comfort.
When sleeping or resting, inclined positions (ie: reclining chair) and a pillow under the forearm and behind the elbow are recommended for first 1-2 weeks postoperatively.
Do not engage in activities which increase pain/swelling.
Avoid long periods of sitting or long distance traveling for 2 weeks.
NO driving, operating machinery or alcohol consumption while taking narcotic pain medications. NO driving while still using sling.
May return to sedentary work ONLY or school 3-4 days after surgery, if pain is tolerable, unless otherwise discussed with Dr. Sarmast.
It is encouraged to move your hand, wrist, and elbow to increase circulation and prevent stiffness. Make frequent fists 10 x hr while awake for first week after surgery. Avoid lifting greater than a gallon of milk for first 2 weeks.
Start walking as soon as possible, as this helps decrease the chance of blood clots.
Medications
Pain medications have been prescribed. Please take them as directed. Pain medications can often cause nausea, constipation and itching. Do not drink alcohol, drive or make important decisions while taking narcotic pain medications. Please also follow the directions below, according to which directions were checked off on your packet.
____ Take over the counter tylenol (acetaminophen) as directed on packaging, unless you have pre-existing liver problems or allergy to this medication.
_____Take anti inflammatories as tolerated. over the counter Ibuprofen/motrin/NSAIDs unless you have history of stomach pain, ulcers, or GI bleeding. You may take 600 mg every 8 hours as needed for pain. (Do not use in case of broken bones/fractures). Do NOT take or combine these medications if Dr. Sarmast has already prescribed you an anti-inflammatory such as Naprosyn, Meloxicam, or Ibuprofen.
Pain medications may cause constipation. Please take stool softeners found over the counter as directed. These include Docusate/Colace, Miralax, and Senna. Ask your pharmacist for more information.
Diet
Begin with liquids and light foods, such as crackers and clear liquids. Advance to your normal diet once liquids and lighter foods are well tolerated.
Therapy
Dr. Sarmast will discuss physical therapy (PT) with you at your first postoperative visit. You may use your shoulder for gentle range of motion as tolerated.
Follow-up:
Please call Dr. Sarmast’s Office (313-749-0370) to schedule an appointment to be seen as indicated by Dr. Sarmast Post Operatively
If you have any fevers (temperature >100.5), yellow or greenish drainage, excessive warmth or pain, cool digits, numbness or tingling, uncontrolled continuous bleeding, please call the office immediately.