Post Operative Instructions for Dr. Bregman Foot-Ankle & Nerve Center

1) Medications – Take all medications unless you have a reaction or None of the medications are mandatory but if you do have a problem such as allergy or bad reaction, please contact Dr. Bregman by email or call the office.

2) You will be prescribed Gabapentin which is only medication taken prior to surgery.  Antibiotic and Pain medication.

  a. Gabapentin will be 600mg twice a day this is to help to increase your pain threshold try to take a loading dose of 2 tablets at once 2-10 hours before surgery. If you cannot tolerate it then you can stop.  Depending on how long you take it you will need to wean off of it.  When you have about 7 pills left it will need to be refilled or taper down by cutting dosage in half every 4 days till down to 300 mgs then stop.

  b. Keflex OR Cephalexin (not both) is antibiotic take 6-8 hours after surgery as directed, usually 1 pill 3 times per day. Stop if having bad side effects.  Clindamycin is another antibiotic for people who are allergic to penicillin.  Start 6-8 hours after 1 pill 3 times per day.

  c. Narcotic medication for pain-Take if pain level hits 4-5/10. If one pill is not working, take 2 tablets if this is not working, please inform Dr. Bregman by Email. Take 2 Extra Strength Tylenol once a day starting 4 hours after your surgery for baseline pain management for at least.  We are also using a new pain med called Seglentis it requires a coupon.

  d. Take 1000mg of Vitamin C daily for 30 days

  e. Sometimes you may be prescribed a bone supplement if having bone surgery which you need to start prior to surgery and for 3-4 months after.

  f. DO NOT EAT OR DRINK ANYTHING (OTHER THAN SMALL WATER FOR MEDS) 12 HOURS BEFORE THE SURGERY

3) Elevate and ice non-stop for the first 48 hours. Use a big bag of frozen corn; get four bags and rotate them. Put on the area where the surgery was done and wrap with ACE wrap if possible. Keep the leg elevated toes above nose, even when sleeping; use 2-3 pillows. You should only get up to go to the bathroom or get something to eat. Wiggle your toes and move your leg while resting.

4) Check your temperature twice a day; if over 102.5 degrees, call the doctor. If you get chills or night sweats, call the doctor.  Blood clots are rare but if having calf pain email or call us.

5) Keep your dressing DRY.  Do NOT shower unless you are told that you can. The dressing you left the hospital/surgery center with is not to be undone unless you are told otherwise. Also, some bleeding through the dressing is normal but if it is still dripping the next day, please call the office.

6) It is normal to have numbness for up to two days after surgery. Check your circulation, touch the tips of the toes and make sure they blanch and return to pink color. If they turn blue or purple or white, call the doctor immediately.  Keep in mind it takes a year to fully recover from most surgeries.

7) Weight Bearing Status:  Please use crutches/walker/scooter and remain off the foot 100% unless you are released to bear weight.  If you fall, try to land on the other side or on your buttock.  Physical therapy may or may not be prescribed.

8) Laser treatments: It is highly recommended that you have laser treatments after surgery to dramatically reduce pain and swelling and speed your recovery.

9) Post Op Appointment:  Make it today for 3-5 days after your surgery unless from out of state in which case you need to set up a telemedicine consult

10) Under no circumstances should you be using any nicotine/tobacco products before, during, or after your surgery. Must quit 6 weeks prior to surgery.

11)  If you have any problems or concerns that are not an emergency, please call the office and leave a message, or you can email the doctor at DrBregman@BregmanFance.com 

If you have an emergency situation, call the office and ask for the doctor. If a doctor is unavailable, please go to the emergency room or call 911.

**Note, surgical scheduler will provide arrival time which can change the DAY BEFORE.