1. When you are discharged from the hospital, you should have received a discharge instructions form. The nurse in the hospital will have gone over this with you. It contains the information on your instructions for wound care, activity, medicines, and follow-up with Dr. Gross. This information is given to the nurse by Dr. Gross. Sometimes, Dr. Gross will give you specific information regarding your post-operative care. These direct instructions supersede the standard nursing instructions unless the discharging nurse has spoken with Dr. Gross directly and has informed you of such confirmation.

2. Wounds closed with stitches or staples should be kept dry for one week after surgery. You can shower if the wound can be covered with a water-resistant barrier, such as saran wrap, or a plastic medical dressing. Wounds closed with glue can get wet the day after surgery. All wounds should not be scrubbed, and only be blotted dry. All drainage from wounds should be reported immediately to Dr. Gross' office.

3. Please contact Dr. Gross' office to make an appointment for your post-operative visit. This varies depending on your surgery, but can typically be in 1—2 weeks. Stitches or staples may be removed at that time. This is usually a brief visit to check the wound and confirm the post-operative instructions, as well as to check the progress of your recovery. Please inform the office staff that you have had surgery, so they can squeeze you into the schedule.

4. You will be given prescriptions for any medications you will require at the time of discharge, unless you already have them. Typically, narcotics used for the control of post-operative pain are only needed for 1—2 weeks, depending on the type of surgery. Dr. Gross may modify this if you have a pre-existing narcotic dependence. It is important to remember that these medications are now used to treat incisional pain, and not the reason for having the surgery. Note: non-steroidal anti-inflammatory medications, and steroids (unless otherwise instructed) should not be used in patients who have had bone grafting (fusions). These medications have been shown to inhibit fusions and could slow your healing in the initial post-surgical phase. Some of these include: Advil, ibuprofen, Mediprin, Nuprin, Naproxen, Alleve, Naprosyn, Toradol, and others. Tylenol is usually acceptable, unless you have liver damage. Also, you should not take Tylenol and Vicodin together, as they both contain Tylenol, and too much can be damaging.

5. All refills for medications should be renewed by having your pharmacy fax our office at 949-364-6333. This is the best way for Dr. Gross to renew your prescription and keep track of your medicine refills. Please plan ahead by having your pharmacy fax us at least 2 days before your prescription will run out. We do not fill prescriptions at night, or over the weekends. Simply contact your pharmacy to let them know you would like a renewal, and they will fax our office.

6. If you are given steroid medications, you should be given instructions on how to take them. Either you will be on a constant dose, or if you are going to be stopping them, you will typically need to "taper" them off. It can be medically dangerous to stop steroid medications abruptly. Additionally, if you are on steroids, you are at higher risk for developing a stomach or intestinal ulcer, and should consider the use of a medication to reduce your acid production. If you have not been given one, please contact Dr. Gross' office.

7. If you have been given medicine to prevent seizures, steroids, or medicine for blood pressure, you must NEVER miss a dose.

8. Dr. Gross recommends that you take a stool softener if your activity is reduced, if you are on narcotic pain relievers (like Vicodin), or if you have had recent spine or brain surgery. This medicine is gentle and will help prevent straining. Additionally, narcotic medications can cause significant constipation.

9. Driving is not recommended until you are safe to drive. This means, you have to be able to turn and look over your shoulder, react quickly without pain, and be able to apply the usual skills of driving. Dr. Gross does not assess you for these skills. You are best able to assess them yourself, or with someone close to you. If desired, a formal driver's evaluation can be performed by an occupational therapist and can be arranged for you.