Each surgery has specific instructions, which we will review with you at the time of your procedure. However, there are some general questions which are asked frequently.
Q: When can I shower?
A: After most surgeries, you can shower immediately. You will be told if it is not OK for you to shower after your procedure. In general, let the soap and water run over the incision and then pat the incision dry. No not rub the incision and do not soak in a bathtub or hottub or submerge in a swimming pool until the wound is completely healed (2 weeks). We frequently use a “wound glue” called Dermabond on the incision, which may feel slightly gummy. Leave it alone; don’t pick at it. If your incision is in the groin, endeavor to keep this area as dry as possible between showers, but do not use any powder on the area. If you have a dialysis catheter or a drain hanging out of your skin, you cannot get this area wet; you must sponge bath.
Q: When can I exercise?
A: In general, there is no bed rest after any procedure. We want you to be active. Being sedentary increases risk of complications like blood clots and bed sores. We advise walking activity and stretching exercises starting immediately. Walking up stairs is absolutely fine. Wait at least 2 weeks before resuming strenuous activity (running, spin class, skiing, tennis). No swimming until the wounds are completely healed (usually 2 weeks). People who have a groin or abdominal incision should wait at least 1 month before resuming weight lifting, sit ups, or abdominal crunches. When you resume strenuous activity, it is a good rule of thumb to start out doing 1/2 the intensity and 1/2 the duration you’d normally do, and then ramp up from there. Listen to your body, and if it seems like too much, back off, wait a few days, and then try again.
Q: When can I fly, travel long distance, or go to high elevation?
A: We usually advise you wait at least 2 weeks after surgery before traveling. This actually has little to do with altitude and more to do with the normal process of healing after surgery. It is much safer if you have resumed your regular level of activity after surgery before taking a long car ride or plane ride.
Q: When can I return to work?
A: This has a lot to do with the type of surgery you are undergoing and the type of work you do. Most people feel that they are ready to return to work 2-3 days after varicose vein surgery. If you have a job that involves a lot of heavy lifting, it may be more like a week. If you have a job where you can work from home, you could probably start work the next day. In general, you need to be off pain medications and able to do your regular activities around the house before returning to work. We can help provide you letters to your employer explaining your absence from work, if needed.
Q: What should I look out for? How do I know if something is wrong?
A: After most surgeries, it is typical to feel somewhat sore around the surgical area. If you feel new and severe pain in an area not related to the surgery, please call. Bruising is very typical. The bruising may be more intense a few days after surgery than it seemed originally. It may also travel downward from the original area around the wound. A few dots of blood on the bandage is fine, but if you experience significant bleeding out of the wound or from somewhere else (persistent nosebleeds or dark tarry stools), please call. It is normal to have a lump underneath the incision. It may start to feel hard and more prominent several days after the operation. This is a normal part of wound healing. Call, however, if you feel that the lump is steadily expanding or is very painful. A mild amount of swelling in the operated arm or leg is normal after surgery. This should improve with elevating the extremity and should improve after the first 7-14 days. If you have persistent or extreme swelling in your operated arm or leg, please call. Fiery red appearance to the skin, fever, drainage from the wound or separation of the wound may indicate infection and should merit a call. If you have had carotid surgery and you have persistent headache associated with hypertension or if you develop stroke like symptoms or difficulty breathing or swallowing, you must be evaluated in the emergency room. As after any surgical procedure, if you develop chest pain, sudden shortness of breath, severe pain, fever over 104.5F or 38.5C, or collapse, you should also be evaluated by a physician.
Q: When should I resume my blood thinner?
A: After most surgeries, we ask you to resume your regular dose of your blood thinner the night after surgery. You will be given instructions about this on your discharge paperwork. If you are on warfarin, you should plan on having a repeat protime checked about a week after your surgery.
Q: Before my other surgery, they told me to stop aspirin. Should I stop aspirin before this procedure?
A: Because we are operating on blood vessels, we typically ask people to continue aspirin– Do NOT discontinue prior to the procedure. If you are taking other medications that are blood thinners (warfarin, Plavix, Aggrenox, Xarelto, Pradaxa, Pletal) you will be given instructions about when to stop these medications. If you are taking herbal medications that have effects on bleeding or clotting (ginkgo biloba, tumeric, ginger, garlic, ginseng, evening primrose, feverfew, omega 3, vitamin C and E , St John’s wort, milk thistle, grapeseed extract) do not take them for a week prior to surgery.
Q: Will there be stitches to take out after surgery?
A: In most cases, no. Most often we use absorbable sutures on the skin. If we do use sutures that need to be removed later, you will be advised. Typically those sutures would stay in for 2-3 weeks after surgery and would be removed in the office. If you are having abdominal surgery, you may have staples on the skin. These are usually removed 7-10 days after surgery.
Q: Can I drive myself home from surgery?
A: No. For any surgical procedure, even office based vein ablation, you are receiving a sedative. It is not OK to drive until your sensorium is completely clear— we generally recommend waiting at least 24 hours after vein surgery. See answer to #10 below, for more. Sclerotherapy does not require a sedative; it is OK to drive yourself home after sclerotherapy treatments.
Q: When can I resume driving?
A: As a rule, you need to be off pain medication and be walking well before you operate a motor vehicle. You need to have the ability to sit for more than 15 minutes and to turn your head easily and be able to perform an emergency stop. After carotid surgery, you must wait 2 weeks to drive. This advised based on legal recommendations.