What Patients Often Ask.

Fasting times will be provided for you in your information pack and by the hospital prior to arrival.

If you are unsure, then please contact our rooms for clarification.

If you have a morning surgery, then you will not be allowed to eat food after midnight and no water after 6am.

If you have an afternoon surgery, you may be able to eat a light breakfast prior to 7am and then water until 11am.

Clear fluids - fluids you can see through. Water, tea or black coffee with NO MILK, apple juice with no pulp, Gatorade/Powerade.

Fasting - means nothing into your mouth. No food, no chewing gum, no mints.

If you are unsure, then please contact our rooms for clarification.

You can take your normal medications on the morning of surgery with a glass of water. Your surgeon or anaesthetist may have requested that you stop particular medications leading up to surgery or to skip on the day of surgery. If you are unsure, then please contact our rooms leading up to the day of surgery to clarify.

Prior to elective surgery you may be required to stop blood thinning medications. This is to reduce your risk of bleeding.

After surgery you may be asked to start blood thinning medication to reduce your risk of blood clots. This is often for a 6-week duration.

Some immune modulators may need to be ceased before surgery to reduce your risk of infection. These can be discussed with your surgeon and rheumatologist or physician. Usually skipping 1 dosing cycle prior to surgery and recommencing 1 dosing cycle after surgery, or after the wounds have healed.

Surgical site infections are an unfortunate reality that can be minimised but not prevented entirely.

There are many factors that come into play, some are modifiable, and others are not. The best treatment is prevention, and elective surgery may be delayed or cancelled if the risk of infection is deemed to be too high.

Modifiable risk facts that can be corrected pre-operatively include, smoking cessation, diabetic glucose control, obesity and weight optimisation.

Infections can be a devastating complication. If you notice progressive redness, wound discharge, or increasing pain then you should notify our rooms.

Post operatively a sterile surgical dressing will be placed and often then covered with a bandage. You will be provided with specific instructions on whether you can remove the outer bandage, and when, or whether it should remain until our staff review you in clinic.

If it is a bandage that we allow you to remove, then underneath is usually a water-resistant dressing that will allow you to shower and then pat the dressing dry.

You should not submerge your surgical wound under water until it is completely sealed. This can take 3-4 weeks or longer in some circumstances.

This means no baths, no swimming, no sauna, no excessive sweating etc, until cleared by your surgeon.

Casts are temporary and need to be kept clean and dry. You should avoid going to the beach and getting sand in your cast.

If you get your cast wet inadvertently then you must notify our rooms as you may be required to come in and have your cast changed. Otherwise, it may lose function, or the skin or wounds may become soggy and compromised.

Do not attempt to scratch underneath your cast because the skin is often fragile, and you can breach the skin resulting in infections.

Swelling is normal following surgery. It is best to elevate the surgical site and maintain the compressive dressings. You can apply ice/cold compression to the region to help reduce swelling. It is important to keep the blood flowing through the area to help remove swelling. For example, in hip or knee surgery it is important to move your ankle up and down and wiggle your toes to contract your muscles to help keep the blood flowing through your leg. It can be normal for swelling to last for 3-12 months following lower limb surgery.

However, unusual swelling, redness and pain could be a sign of a blood clot. In this case contact our rooms and we can arrange for an ultrasound to assess the blood vessels.

Cold compression can be applied for 20 minutes every 2 hours. However, it is dependent on the size and location to be applied. The ice should not be applied directly to the skin, and it should not be painful to apply. For the first 48 hours regular ice can provide analgesic effects and reduce the post operative inflammatory reactions.

Following surgery there is a balance between mobilising the joint and protecting the bone and soft tissues. If you are placed in a cast or splint, then it is important to keep the joints that are not immobilised moving.

For example, if you have your wrist fracture fixed and are in a backslab and then wrist splint, it is important to keep your fingers moving and elbow/shoulder moving.

Following immobilisation of the joint there may be specific strategies required to get the joint moving again and a physiotherapist may be useful to help you through this process.

Long term opioid use is not recommended and ideally you should wean off any opioids prior to surgery.

Post operative pain relief can lead to constipation, often you will need to take laxatives while on these pain killers.

Prior to your surgery talk to the anaesthetist if you are prone to feeling sick, nausea and vomiting (N+V). There may be things that can be done to minimise the risk of N+V immediately post operatively.

At home the stronger pain killers and make you feel sick. There are medications that we can provide to help minimise this. Other strategies are to take the pain killers with food and to take smaller amounts more regularly rather than taking larger doses that can make you feel sick.

Constipation is a common side effect of strong pain killers. Laxatives are often required to maintain healthy bowel habits.

These can be ceased once you are off the strong pain killers or if your bowels are becoming loose.

Following surgery, you can usually return to many household activities within the constraints of your surgical dressings and pain limitations. It is important to give yourself the time you need to heal. Ideally the first 2 days following surgery you limit your activities to the necessities only.

If you are undergoing arthroplasty surgery, then it may pay to prepare some meals prior to your surgery that can be stored in your fridge/freezer for easy access. 

For detailed information on your rehabilitation program, please refer Your Rehabilitation page.

Yes. We recommend staying with your trusted physiotherapist. We can provide additional information on the specifics of your case and our preferences for your prehab or rehab if requested.

During your stay in hospital you will likely be reviewed by the physiotherapist on site to review your safety and get you started right from the day of surgery.

Dr George has a background in physiotherapy and a keen interest in research and optimising your outcomes. He may have a physio review you in his rooms to assist in preoperative and postoperative physical reviews and collecting specific data on the outcomes of your surgery.

There is also on-site gait analysis that may be utilised to maximise your preoperative and postoperative outcomes.

For guidance on when it is safe to drive or fly after your surgery, please refer to the Fitness to Drive / Fly page.

Returning to work is variable depending on your occupation and employer and the type of surgery you have had.

In principle you may be able to return to working from home after 2 days, return to light office duties from 2 weeks, and manual labour from 2 months.

An outline of your return-to-work plan can be provided in your planning consultation.

More detailed guidance is available on the Return to Work page.

Many high-performance athletes are keen to start rehabilitation straight away. There will be a tailored program for you to follow and can be adjusted depending on your progress.

It is important to allow your body to heal and depending on the surgery you have had there are things you will be allowed to do straight away. However, most surgical wounds and dressings don't like sweating, heat and humidity. So it is often prudent to allow your wounds to heal before you return to saunas or sweating.

We will help you 'focus on what you can do, not on what you can't do' so that you can maximise your recovery.

We acknowledge the mental anguish and difficulty that injuries can have to athletes, and it is important that you link in with your friends, family, sporting clubs, and seek out supports to help you through.

Your club doctor or GP is a great starting point, however, sometimes you may wish to utilise the services of a Sports Psychologist to help your recovery from the psychological impact of the injury and not just focus on the physical impact of the injury.

It is safe to resume sexual activities following your surgery once you are comfortable. There may be pain and stiffness at the surgical site and you should avoid positions that cause discomfort for up to 3 months.

Hip replacement surgery carries a risk of hip dislocation. This should be a consideration when positioning your legs to avoid extremes of movement especially with uncontrolled pressure from your partner.

Further information can be found on the Ortho Info website.

Maintaining a healthy diet leading up to your surgery and following surgery is important to facilitate healing and recovery.

Vitamin C assists in collagen cross bridging which is useful in wound healing. 500mg orally for 50 days following wrist fracture surgery has been shown to reduce the risk of chronic regional pain syndrome (CRPS).

Garlic oil has been suggested as a way of reducing skin infections prior to surgery and can be continued following surgery to minimise risk of infection.

Scarring following surgery is a normal process. It is important to keep your scar out of direct sunlight until it has matured, and then sunscreen to prevent increased pigmentation of the scar.

Once the scar is maturing it is then time to massage your scar to help break down the scar tissue and help free up the underlying soft tissues.

Sometimes the scar tissue can grow larger than expected, called a hypertrophic scar.

Some patients and populations are at risk of Keloid scars, which are larger and darker and more difficult to treat.

More information can be found on the DermNetNZ website.

In most instances the metalwork placed under your skin is safe to be left in place. On some occasions it is temporary, and we will plan to remove it at a second surgery.

The surgical stainless steel or titanium is inert in the body. Meaning that it does not cause an immune reaction and can be left permanently.

On rare occasions some patients may have allergies to some of the metal components in the implants, this can detract from the potential surgical success and may require investigation. It is usually a diagnosis of exclusion after other causes have been excluded, and referral to metal allergy testing may be undertaken [JACI In Practice, 2024].

Some implants, especially those used for trauma and fractures can occasionally be prominent or cause irritation to the soft tissues. Once the bones have healed, we can consider taking these out. However, in the large majority of cases it is preferable to leave the implants in place.