Returning Patients

After your initial consultation with the doctor, you may be scheduled for therapy, further diagnostic testing, and/or conservative treatment i.e. splinting, injection, taping, casting, or surgery. Therapy can be scheduled at any of our clinic locations. Diagnostic testing may be scheduled at a hospital or another specialist’s office. Further testing may be necessary for your physician to make an accurate diagnosis. If surgery is needed, it can usually be scheduled on an outpatient (day surgery) basis. Minor surgical care can also be done right in our clinics.

X-Rays

Repeat X-rays may be ordered by your doctor to check for healing, alignment of a fracture or any changes that may have occurred. If x-rays are required, they can be performed in our office. Please understand that this will add some time on to the length of your appointment.

Injections

Everyone reacts differently following an injection. Some patients feel some minor discomfort, while others experience an increase in pain for the first 48 hours. This is normal. Applying ice to the area, elevating and taking over-the-counter pain relief will help with this discomfort. It can take up to three weeks to experience the full affect from the injection. If you develop increasing redness, swelling or pain, or have other concerns, please contact your doctor.

Work Status

It is your responsibility, as the patient, to keep your employer informed of your work status following injury or surgery. It is also important that we keep records of your work status in order to be able to answer questions your insurance company may ask. Please request a WORK STATUS REPORT, at each visit. Make sure that you give a copy of this form to your employer after each visit.

Cast Care

A hard permanent cast is usually changed every 2-3 weeks. While wearing a cast, we ask that you make every effort to keep it dry while bathing, swimming or washing dishes. Frequest cast changes can result in changes to a fracture and may increase your expenses. Although it may be tempting, avoid poking sharp objects into the cast to alleviate an itch. This can injure your skin and cause further complications.

Splint Care

Velcro splint: can be laundered or hand washed in mild detergent. Air dry. DO NOT dry in dryer.

• Orthoplast splint (Hard molded white plastic with Velcro straps):
  Your splint is custom molded out of low temperature plastic material. It will melt in warm water or if left near any heat source (i.e. in the car on a warm day, sunny day, near a heat vent, or in any direct sunlight, etc.).

To clean your splint, wipe it down on the inside with rubbing alcohol or a wet towel with mild soap. DO NOT put it in the washing machine, dryer or dishwasher. The stockinette, which is worn to provide protection between your skin and the splint, can be washed in warm soapy water and air dried.

Preparing for Surgery

Surgery is usually scheduled as an outpatient, at a hospital or an outpatient surgical facility. You will be asked to schedule an appointment with your 
primary care physician, within the 10 day period of time before your surgery, for a health physical, testing and surgical clearance. The requirements vary depending on your age and physical health. You will be asked to stop aspirin and/or anti-inflammatory medications 10 days before surgery. If you are on Coumadin or Plavix, you need to check with your Primary Care Physician to get his or her recommendation for continuing or discontinuing this medication prior to surgery. Most patients are required to fast prior to the surgery. (See fasting requirements.) Please arrange to have a family member or friend drive you home.

Fasting Requirements

Fasting prior to surgery is important for your safety. We understand that this can be difficult for some people, but it is of utmost importance that your stomach be empty while under anesthesia. There is the potential for a surgery to be cancelled, if these guidelines are not followed. The requirements for fasting include:

• NPO after midnight – nothing by mouth including food, coffee, gum and water.
  Medications necessary to keep your body functions running normally can be taken with a SMALL SIP of WATER the morning of surgery i.e. blood pressure medication. We make every effort to schedule diabetic patients scheduled early in the morning. Check with your Primary Care Physician regarding diabetes medication changes that may be needed on the day of surgery.

The pre-admission nurse and the anesthesiologist will review these requirements with you prior to your surgery.

Suture Care

We ask that you keep your stitches clean, dry and covered with the dressing your doctor recommends until removed. (Stitches are usually removed 7-14 days after surgery; your doctor will let you know when he wants you to come in for removal.)

Pin Care

Pins are placed during a surgical procedure to hold a tendon, ligament or bone in place while it heals. Pins can be underneath the skin or exposed above the skin. An exposed pin, should to be kept clean and dry. Your doctor will give you instructions on pin care. Notify our office if a pin that was buried under the skin becomes newly visible or if you have any drainage or redness around a pin.

Infection

The risk of infection following surgery is less than 1 percent. However, we take infection very serious. Please call our office if you suspect signs of infection. Some of the signs of infection may include but are not limited to; sudden swelling, pus or drainage, tight shiny skin, red streaking, or fever.

Occupational Hand Therapy

Some patients will require Occupational Hand Therapy for a variety of reasons. This could be a one time visit or a series of treatments over a duration of weeks. Your physician will complete a therapy order. Frequently, the physicians will request an initial evaluation to test strength, range of motion, dexterity, and sensation. Therapy may be ordered before or after surgery for strengthening, active and passive range of motion, desensitization, exercise and other tools used to facilitate healing.

A few splints are available over the counter, however, your physician may request a custom molded splint, which is designed and fabricated by our therapists.

Our therapists also provide services related to work injuries.

Perscription Refills

Prescription refill requests are welcome by phone between 9 a.m. and 4 p.m. Monday through Friday. Exceptions apply to some narcotics that cannot be refilled over the telephone. Please be aware of how many pain pills you have left so that you can call your doctor during the hours listed above. Prescription refill requests during nights and weekends will not be filled.

Medical Records

We would be glad to accommodate your request for a copy of your medical record. We must receive a signed medical records form in advance. Click on this link for a printable version of the medical records release form. Please allow 7-14 days for a mailed copy. There is no charge for these copies.

We are not able to release original copies of x-rays films that were obtained in our office. Because of the cost associated with obtaining a copy of the films, there is a charge of $5.81 (includes tax) for each sheet of x-ray film copied.

Disability Forms

Disability forms can be submitted to Hand Surgery Ltd. for completion. Please note that this is an additional service that is provided for our patients that does not impact your medical care. There is therefore a $5.00 fee for this service. The fee must accompany the form. Please allow 7-10 days for completion.