Most popular right now:. Communication Skills Ability to communicate effectively with a wide range of people including patients, medical staff and the general public. Fitness The condition of being physically fit and healthy. Writing Skills Excellent writing skills to write clear and concise medical reports. Demonstration Skills Having strong presentation and demonstrating skills.
Related Resources. Physiotherapist Cover Letter. Write a Cover letter Cover letter writing guide Cover letter tips Cover letter salary expectations. Formal Patient Registration Form Paediatric Patient Registration Form Template New Patient Registration Form Example Patient Registration Form Sample Private Patient Registration Form Template New Patient Registration Form Sample We first developed these guidelines in the mids.
We continue to revise them every few years to provide updated advice on clear communication. When we first wrote the guidelines, we were primarily interested in regulations. If you have any feedback or questions about these guidelines, please contact us. We also offer free half-day training sessions for federal agencies in the Washington, DC area.
Within a day or so oral pain medications such as hydrocodone or Tylenol with codeine are usually sufficient. Initially pain medication is administered usually intravenously or intramuscularly. Sometimes patient controlled analgesia PCA is used to allow the patient to administer the medication as needed. Hydrocodone or Tylenol with codeine are taken by mouth. Intravenous pain medications are usually needed only for the first day or two after the procedure. Oral pain medications are usually needed only for the first two weeks after the procedure.
Pain medications can be very powerful and effective. Their proper use lies in the balancing of their pain relieving effect and their other less desirable effects. Good pain control is an important part of the postoperative management. Pain medications can cause drowsiness slowness of breathing difficulties in emptying the bladder and bowel nausea vomiting and allergic reactions.
Patients who have taken substantial narcotic medications in the recent past may find that usual doses of pain medication are less effective. For some patients balancing the benefit and the side effects of pain medication is challenging. Patients should notify their surgeon if they have had previous difficulties with pain medication or pain control.
After surgery the patient spends an hour or so in the recovery room. A drainage tube is sometimes used to remove excess fluid from the surgical area.
The drain is usually removed on the second day after surgery. Bandages cover the incision. They are usually changed the second day after surgery. Shoulder motion soon after rotator cuff surgery helps achieve best possible shoulder function. Shoulders with cuff disease may have substantial scarring and may be stiff.
One of the major goals of rotator cuff surgery is to relieve any stiffness. However after surgery scar tissue will tend to recur and limit movement unless motion is started immediately. This early motion is facilitated by the complete surgical removal of the scar tissues so that after surgery the patient needs only to maintain the range of motion achieved at the operation.
A continuous passive motion CPM machine is often used to gently move the shoulder in the recovery room immediately after surgery. The CPM shown in figure 15 above and in the video clip below is continued for the first few days after surgery whenever the patient is in bed.
During the hospitalization the patient learns a simple rehabilitation program that will be used to maintain the range of motion at home after discharge. Figure 16 below shows the exercises used to maintain elevation and rotation of the arm. On the day of surgery or on the day after the physical therapist teaches the patient gentle range of motion exercises.
Usually the patient is shown how to stretch the shoulder forward and out to the side preventing stiffness and adhesions. Walking and use of the arm with the elbow at the side for gentle activities are encouraged soon after surgery. If a cuff repair has been performed the arm must be used only with the elbow at the side and only for very gentle activities so that the repair is protected.
These precautions remain in place for three months until the initial healing of the cuff repair is complete. The patient's specific limitations can be specified only by the surgeon who performed the procedure. It is important that the repaired tendons not be challenged until they have had a chance to heal. Usually the patient is asked to lift nothing heavier than a cup of coffee with the elbow at the side for the first three months after the surgery. Management of these limitations requires advance planning to accomplish the activities of daily living during the period of recovery.
Patients usually require some assistance with self-care activities of daily living shopping and driving for approximately three months after surgery. Patients usually go home after this surgery especially if there are people at home who can provide the necessary assistance or if such help can be arranged through an agency.
In the absence of home support a convalescent facility may provide a safe environment for recovery. Recovery of comfort and function after rotator cuff surgery continues for many months after the surgery. Improvement in some activities may be evident as early as three months.
With persistent effort patients make progress for as long as a year after surgery. The healing after rotator cuff surgery can be compromised by smoking, poor nutrition, and medications such as cortisone.
Diabetes can cause additional scar tissue. Heart and lung disease, as long as they are well managed, do not seem to have an effect. Shoulders with rotator cuff disease may be stiff. One of the major goals of rotator cuff surgery is to relieve much of this stiffness. This early motion is facilitated by the complete surgical removal of the scar tissue so that after surgery the patient needs only to maintain the range of motion achieved at the operation.
Later on once the shoulder is comfortable and flexible and after the cuff repair has healed usually three months after surgery strengthening exercises and additional activities are started.
It is often most effective for the patient to carry out their own exercises so that they are done frequently effectively and comfortably. Usually a physical therapist or the surgeon instructs the patient in the exercise program and advances it at a rate that is comfortable for the patient.
In general the exercises are best performed by the patient at home. Occasional visits to the surgeon or therapist may be useful to check the progress and to review the program. Patients are almost always satisfied with the increases in range of motion comfort and function that they achieve with the exercise program.
If the exercises are uncomfortable difficult or painful the patient should contact the surgeon promptly. For the first twelve weeks after surgery emphasis is placed on optimizing the flexibility and range of motion of the shoulder through gentle stretching exercises. After three months these stretching exercises are continued and strengthening exercises are added see movies Once the range of motion and strength goals are achieved the exercise program can be cut back to a minimal level.
However gentle stretching is recommended on an ongoing basis. The video box below is a playlist of 4 shoulder exercise videos. Watch the videos below or on our youtube channel. In general patients are able to perform gentle activities of daily living with the operated arm at the side starting two to six weeks after surgery. Walking with the arm protected is strongly encouraged. Driving should wait until the patient can perform the necessary functions comfortably and confidently.
Recovery may take three months if the surgery has been performed on the right shoulder because of the increased demands on the right shoulder for shifting gears.
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