Oscar Nicholson Jr.

Hiatal hernia repair can be performed laparoscopic or open. The preferred procedure is the laparoscopic approach. After surgery, patients are admitted to the hospital. Anti vomiting medicines are given to decrease the incidence of vomiting. Vomiting can cause disruption of the repair. On postoperative day one, a gastrograffin or barium swallow is performed to assess the repair. If the study is satisfactory a clear liquid diet is started. The diet is advanced as tolerated usually in 5-7 days to a full liquid diet, then a regular diet. The patient is discharged on post operative day 2 if no complications. An office visit is scheduled in 2 weeks post discharge. No lifting more than 15 pounds first 2 weeks post surgery, then no more than 30 pounds for the next 4 weeks. The total recovery time is about 4-6 weeks if everything goes well.

A hernia is a rupture of tissue causing an abnormal pertrusion of tissue. There are various areas in the body where a hernia can occur. The most common areas are the groin and the abdominal area. If the hernia is not repaired, complications can occur. The most serious complication is entrapment of tissue, requiring emergent intervention. Sometimes hernias can be observed if a patient is unable to tolerate a surgical procedure due to various medical problems. In the groin, a device called a truss can be used. If an abdominal hernia, an abdominal binder can be used. If at all possible, a groin and abdominal hernia should be repaired.

Post-operative things to remember after appendectomy are as follows:
1-no driving for at least one week
2-maintain an adequate diet
3-be careful taking narcotic pain medicine until return of bowel function
4-notify your physician if you have a fever, nausea, vomiting, redness around incision, drainage from incision, or incision swelling. Make sure you keep your follow-up appointment.

Tennis elbow, also known as Elbow Tendinopathy, is mostly a clinical diagnosis based on examination and possibly a musculoskeletal ultrasound for confirmation. If left untreated, elbow tendinopathy can persist for 6 months to 2 years. Conservative treatment alone may not lead to resolution of symptoms. Modification of activity, counterforce bracing, splints, and physical therapy are some of the initial management measures. You can add anti inflammatory medication and steroid injections. If no relief, some investigational treatment might have some benefit. Topical nitroglycerin, ultrasound guided needle tenotomy to break up calcifications are two of the treatments under investigation. If symptoms persist, elbow tendinopathy warrants surgical evaluation.

It is not normal to have pain months after hernia surgery, but it can occur. It depends on the location of the hernia repair and the procedure performed. The most common cause of pain after hernia repair is nerve entrapment or damage. This can be diagnosed with nerve conduction studies. If a nerve is transected (cut), it regenerates at a rate of 1 millimeter per day. If pain persists past 3 months, multimodal analgesia including nerve blocks can be performed. Patients with a positive response can be treated with weekly injections until pain relief is sustained. If more complicated and the pain persists, then a referral to a pain specialist is indicated.

Constipation is associated with hemorrhoids and is usually caused by anticipation of pain on deification. Some over-the-counter treatments can reduce constipation and pain on defecation. Stool softeners, hemorrhoidal creams, a high-fiber diet, and an adequate fluid intake. If pain persists, contact your physician. Most hemorrhoidal complications can be managed during an office visit.

Removal of the appendix can be done open or laparoscopic. Either choice is satisfactory. The operation usually takes about 1 hour if uncomplicated. The patient is usually discharged on the first postoperative day. Usually patients return to work in 1-2 weeks. Precautions are no driving for 1 week, no lifting more than 5 pounds for 4 weeks and maintain good wound care. Notify your surgeon if you develop redness, tenderness, drainage, or a fever. You can resume normal activity in 6 weeks after either procedure.

There are multiple bones that comprise the wrist. One of the most common fractures is a fracture of a bone called the scaphoid bone. It is located on the thumb side of the wrist. The bone can be repaired by the open method (surgical repair) and the closed method (immobilization). Each method is satisfactory for repair. The choice is between you and your surgeon. The healing time for an adult without complications of either procedure is 6-8 weeks.

After an uncomplicated appendectomy you should be able to walk after you recover from the anesthesia. Anesthesia recovery time is usually 1-3 hours post surgery. Most patients are able to walk to the bathroom and sit in a chair if they prefer.

The usual stay in the hospital after an uncomplicated appendectomy is 1-2 days at most. If the procedure is complicated, there can be a prolonged stay depending on the complication.

The anterior cruciate ligament is a stabilizing ligament of the knee. It is frequently injured by athletes and trauma victims. After examination by an orthopedic surgeon the diagnosis is confirmed by an MRI.After the decision is made for surgery and the operation is completed full range of motion should be started immediately following the ACL reconstruction.Lack of ability to regain normal knee motion is associated with an increase risk of osteoarthritis.Passive motion machines and knee braces have found to be of little benefit for rehabilitation after ACL surgery. So the answer is no you won’t need a cast after ACL surgery.

Usually, the return of bowel function after appendectomy is 1-3 days. If longer, adjust your pain medication and include a stool softener and/or a high-fiber diet. If constipation persists past 5-7 days, notify your surgeon.

After ankle surgery the most prescribed medications are opioids for acute postoperative pain. Opiate use for acute pain is also associated with increased risk of long term opioid use and abuse. Therefore the recommendations are short term opiate use. Short term opiate use is considered 5-7 days. After that a change to non steroidal ant -inflammatory medications is indicated. These are recommendations for most state based pharmaceutical groups and the CDC.