Frequently Asked Questions

The anesthesia team manages pain before, during, and after the surgery.

Anesthesia Consultation: A preoperative anesthesia consultation is necessary. During the consultation, an anesthesiologist will inform you about the type of anesthesia to be used, and a general checkup will be conducted.

If necessary, A call to your general practitioner will be made to complete any necessary additional examinations. The purpose of the consultation is to identify the risk factors for each patient and minimize potential complications. It is, therefore, a necessary step in the treatment process.

Few tips before your stay at the clinic:

• Be present at the preoperative anesthesia consultation about 10 days before the operation.
• Inform your family and friends about the surgery to optimize assistance with daily activities (grocery shopping, cleaning, etc.) and certain ergonomic aspects of life (placement of heavy everyday objects, potential clutter in the house, etc.).
• Prepare comfortable clothing.
• Organize your toiletries.
• Avoid bringing valuables to the hospital, as the hospital does not take responsibility for loss.
• If you have allergies, bring the card with the list of allergies to the anesthesia consultation and to the hospital on the day of the operation.
• The medications you usually take should be discussed with the anesthesiologist during the consultation, and the list of these medications should be brought on the day of admission to the clinic.

There is no need to stop cardio aspirin. Regarding Plavix®, any modification of this treatment is discussed with your general practitioner and adjusted according to the type of surgery. In the case of anticoagulant treatment (Sintrom®, Xarelto®, Eliquis®), a switch to another anticoagulant will be planned in discussion with your general practitioner a few days before surgery to reduce the risk of bleeding. Each case is unique and should be discussed with the surgeon and the prescribing physician.

Hair removal before surgery is not recommended. Any skin injury can compromise the sterility of the operation and may mean that the surgery date needs to be postponed.

Contact your physiotherapist as soon as possible, even before the operation, so that sessions can begin once you are back home. Generally, two sessions per week are recommended during the first 6 weeks after surgery.

You must fast from midnight the night before your operation (unless otherwise instructed by the anesthesia team), which means ‘do not eat, drink, or smoke.’

Upon your arrival, you will be greeted by the healthcare staff who will settle you into your room. They will also explain the course of your stay and perform preoperative preparations, including ‘marking the side to be operated on.’

On the day of the operation, you will be transferred to the operating room and taken care of by the team responsible for your surgery in the operating theater. The operation usually lasts between 1 hour and 3 hours, depending on the type of surgery. After the operation and upon waking up, you will be taken to the ‘recovery room’ or monitored for a few hours before returning to your room.

The surgeon typically conducts the first visit in the late afternoon on the day of the procedure.

The hospitalization usually lasts 2 to 3 nights. The duration will be discussed with the surgeon during the informed consent process but may change based on events occurring during or after the operation. Ultimately, the healthcare team will decide the ideal time for the patient’s discharge.

You will receive physiotherapy during the hospital stay to start early rehabilitation. It is important to carefully follow the postoperative limitations indicated by the surgeon, which may vary depending on the operation and perioperative aspects. If in doubt, do not hesitate to ask questions to the physiotherapist and the surgeon.

The physiotherapist also plays an important role in ergonomic aspects during daily activities, providing techniques and advice on how to perform movements such as dressing, washing, getting in and out of bed, and moving in familiar environments like the kitchen. Similarly, they will teach you self-mobilization exercises for the operated limb to be done daily.

DAILY EXERCISES FROM THE FIRST DAY AFTER SURGERY:

Elbow: bend and extend the forearm while assisting with the other hand. Wrists: make small circles clockwise and counterclockwise. Fingers: gently squeeze a ball, open and close the hand, spread the fingers. Neck: tilt your head to the right and left.

In general, hospitalization lasts 2 or 3 days, but certain conditions must be met: optimal pain management; good scar evolution; understanding of the rules for mobilization and manipulation of the splint. The physiotherapist and the doctor confirm these points before discharge.

You will be provided with these documents upon leaving the clinic (adapted according to the type of surgery):

• The date of your next visit to your surgeon.
• A prescription for pain medication.
• A prescription for outpatient physiotherapy.
• A medical certificate of incapacity for work (if indicated).

The type of immobilization (orthosis, also called a splint) varies depending on the type of surgical intervention. The orthosis is applied in the operating room and is typically worn for a period of 6 weeks. Depending on the type of surgery, the splint may need to be worn 24/7 (except during physiotherapy sessions, home exercises, and during hygiene routines) or for comfort purposes (i.e., during outdoor activities, in risky environments with many people or children around, and at night).

Even in the early postoperative phases, the elbow and hand can perform active movements without bearing weight. If the orthosis is not well positioned or causes pressure points on the skin, it is necessary to visit the physiotherapist or doctor to optimize ergonomics.

After shoulder or elbow surgery, it is normal to experience pain. Hematoma and swelling may also occur postoperatively. To alleviate these effects:

• Medications will be prescribed. It is important to follow the prescription in the first few days after surgery and then adjust the medication quantity based on the intensity of pain.
• Ice can be applied. To optimize the effect, apply ice every two hours for 15-20 minutes. It is important not to place the ice directly on your skin: put the ice in a plastic bag and wrap it in a cloth.

Particularly during the first 2-3 weeks, a pain reliever is important to make the pain bearable for daily activities and to facilitate the quick mobilization of the operated limb.

Here are the signs to monitor after surgery:

• Fever higher than 38.5°C.
• Pain becomes more intense despite taking the prescribed medication (according to the maximum allowed dose).
• Drainage of pus from the incision.
• Persistent numbness and/or loss of sensation in the arm or fingers that does not improve by changing position.

If you experience any of these signs, contact the surgeon, your primary care physician, or go to the emergency room immediately.

The duration for which the dressing will remain in place will be specified when you leave the hospital. Scars are generally protected during the first 2 postoperative weeks.

The scar(s) should not be exposed to water to reduce the risk of infection. Baths are not allowed until the scar is completely closed. It is also important not to apply cream to the scar during the first 2 weeks.

If the dressing is accidentally wet, it is imperative to quickly change the dressing to reduce the risk of infection. To clean the armpit on the surgical side, lean forward gently so that gravity moves the elbow away from the rest of the body. Thoroughly dry to avoid skin irritation.

Always put on the sleeve on the operated side first. Lean forward or toward the operated side to slightly move your elbow away from your body. Generally, elbow and hand movements without any load are allowed from the first few days.

Undressing: Remove the sleeve on the NON-operated side first, then the sleeve on the operated side last.

For sleeping: on the non-operated side or on the back with a pillow under the operated arm for better comfort. In the case of shoulder surgery, a semi-seated position may be the most comfortable. Do not sleep on the operated side.

Prohibition of driving, carrying a load, pushing/pulling with the arm, putting the hand behind the back, leaning on the arm for at least 6 weeks (these instructions are adapted according to the type of surgery).

The answer depends on the type of surgery and whether the surgery involves the shoulder or the elbow. Generally, most surgical interventions entail a prohibition on driving for approximately six weeks. In any case, it is forbidden to drive a car while wearing a splint.

If the patient cannot go home immediately after the operation due to reasons related to the inability to meet their daily needs or the necessity of intensive rehabilitation, several solutions are possible. These will be discussed with the patient’s office, which is responsible for organizing rehabilitation, care, or temporary stays in a nursing home, as needed. Home assistance from a socio-medical center for various activities can often be a good solution, tailored to each patient.