Wound Care

• You have been placed in a splint with a sling. Please keep this in place until follow up.
• Keep clean and dry.
• Showering is fine; be sure to keep splint/brace clean and dry.

Sling & Weight bearing status

• With a Distal Biceps Tendon Repair, you will be placed in a splint or hinged elbow brace.
• If you are in a splint, you will be changed to a hinged elbow brace at your first post-operative visit (about 1 week after surgery).
• You should not bear weight with your arm or use your arm to lift anything until 3 months after surgery.

Physical Therapy

• Formal physical therapy will be ordered by your orthopedic surgeon in the form of a written prescription upon discharge from surgery. You will also receive a therapy protocol form. Following a Distal Biceps Tendon Repair, you should start formal physical therapy about 2 weeks after your surgery. The prescription and protocol should be given to a physical therapist of your choice so you can begin your program as directed under close supervision of your surgeon.

Pain Control and Medications

You have been given a regional anesthetic block prior to your operation. This will wear off in the evening following your surgery. You may find it beneficial to sleep in a recliner after surgery.

1. Pain Medication: Tylenol 1000mg every 8 hours and, unless discussed otherwise, you have been prescribed a narcotic pain medication (Oxycodone 5mg) to take every 4-6 hours as needed.
• DO NOT drive/use any heavy machinery, drink alcohol, make any life-changing or legal decisions (i.e. sign a will), or participate in activities that require a lot of physical skill, as narcotics may change your mental acuity. On rare occasions they may cause confusion or disorientation, we advise you to discontinue this medication should that occur.
• Narcotics can be addictive. Dispose of any excess medication at a police/fire station.
• Take a stool softener (e.g. Colace) while taking narcotic medication, as narcotics may cause constipation.  If this does not help alleviate your constipation, you can try adding miralax or milk of magnesia. Please call our office if this regimen does not alleviate your constipation.
• If you have any questions or concerns about narcotic strength medications, please contact us.
• Journavx (suzetrigine): If Journavx has been prescribed, take it in place of the Oxycodone. Start with a loading dose of 100 mg (two 50 mg tablets), then take one 50 mg tablet twice a day (every 12 hours) for two weeks. If you are not getting adequate pain control with Journavx, you may take Oxycodone instead. Do not take Journavx and Oxycodone at the same time, and avoid grapefruit while taking Journavx.
2. Anti-nausea: Zofran (Ondansetron): Take as prescribed if needed for nausea, esp. with narcotics.
3. Anti-Inflammatory: Unless contraindicated due to other health reasons, you have been prescribed a non-steroidal anti-inflammatory drug (Ibuprofen 800mg) for use postoperatively. If you have no personal history of adverse response to anti-inflammatories (NSAIDs), take as prescribed every 8 hours with food to help reduce swelling and pain. Do not take other NSAIDs (Advil, Aleve, etc) with Ibuprofen.
4. Muscle Relaxer: Cyclobenzaprine (Flexeril) will be prescribed for patients <70yo for muscle spasms as needed. You may take 5-10mg of Flexeril every 8 hours for muscle spasm as needed.

Tylenol and Ibuprofen are the foundation for your pain control regimen

Example dosing: 1000mg Tylenol then 4 hours later 800mg Ibuprofen then 4 hours later repeat- every 4 hours alternate between Tylenol and Ibuprofen. Oxycodone as needed for breakthrough pain.

*You should not exceed 3,000mg of Tylenol or 3,200mg of Ibuprofen in 24 hours.

Driving

• Driving may resume when you are 4 weeks post operatively, and able to remove your sling. You may not return to driving while still taking narcotics. You must feel safe to operate a vehicle. We recommend you practice driving in an open parking lot before returning to the road. If you have to drive for long periods of time within 2-4 weeks after surgery, we recommend taking frequent breaks to walk and stretch, to decrease the risk of a blood clot.

Return to Work

• You may return to work as soon as you are comfortable. This is dependent on your job type. You will not be able to return to work with heavy lifting until 4-6 months post-op. Return to work notes can be obtained at your first post-op appointment.

Follow-up Appointment

• Your first post-operative appointment will be scheduled 7-10 days following your surgical procedure. If you do not have a post-operative appointment scheduled when you leave following surgery, please call 513-441-5639 to make the appointment.

****Signs & Symptoms to Immediately Report****

• Call 911 and go to the nearest hospital if you are having chest pain or trouble breathing.