Preparing for Surgery & Procedure

• Dr. Lindsay's Pre-operative Shoulder Replacement Checklist
• Dr. Lindsay's Pre-operative Arthroscopic Shoulder Surgery Checklist
• Dr. Lindsay's Pre-operative Knee Surgery Checklist

Total Shoulder Replacement

Preparing for Surgery

Once you and your doctor decide that surgery will help you, you will need to learn what to expect from the surgery and how to actively participate in the treatment plan for the best results afterward.

Preparing mentally and physically for surgery is an important step toward a successful result. Understanding the process, and your role in it, will help you recover more quickly and have fewer problems.

Working with Your Doctor

Before surgery, your doctor will perform a complete physical examination to make sure you don’t have any conditions that could interfere with the surgery or the outcomes.

• Routine tests, such as blood tests and X-rays, are usually performed a week before any major surgery.
• Discuss any medications you are taking with your doctor and your family physician to see which ones you should stop taking before surgery.
• Discuss with your doctor about options for preparing for potential blood replacement, includes donating your own blood, medical interventions and other treatments, prior to surgery.
• If you are overweight, losing weight before surgery will help decrease the stress you place on your new joint. However, you should not diet during the month before your surgery.
• If you are taking aspirin or anti-inflammatory medications or any drugs that increase the risk of bleeding, you will need to stop taking them one week before surgery to minimize bleeding.
• If you smoke, you should stop or cut down to reduce your surgery risks and improve your recovery.
• Have any tooth, gum, bladder or bowel problems treated before surgery to reduce the risk of infection later.
• Eat a well-balanced diet, supplemented by a daily multivitamin with iron.
• Report any infections to your surgeon. Surgery cannot be performed until all infections have cleared up.
• Arrange for someone to help with everyday tasks like cooking, shopping and laundry.
• Put items that you use often within easy reach before surgery, so you won’t have to reach and bend as often.
• Remove all loose carpets and tape down electrical cords to avoid falls.
• Make sure you have a stable chair with a firm seat cushion, a firm back and two arms.

Preparing for Procedure

If you are having day surgery, remember the following:

• Have someone available to take you home, you will not be able to drive for at least 24 hours.
• Do not drink or eat anything in the car on the trip back home.
• The combination of anesthesia, food, and car motion can quite often cause nausea or vomiting. After arriving home, wait until you are hungry before trying to eat. Begin with a light meal and try to avoid greasy food for the first 24 hours.
• If you had surgery on an extremity (leg, knee, hand or elbow), keep that extremity elevated and use ice as directed. This will help decrease swelling and pain.
• Take your pain medicine as directed. Begin the pain medicine as you start getting uncomfortable, but before you are in severe pain. If you wait to take your pain medication until the pain is severe, you will have more difficulty in controlling the pain.

Pre-Operative Instructions

• How to use an Ice Machine or Cold Therapy Unit

• Shoulder Sling Instructions

Preparing well before surgery makes the entire experience smoother and safer. The goal is simple: arrive rested, organized, and medically optimized so you can focus on recovery. If anything here is unclear, contact our office — we would rather answer questions early than troubleshoot on surgery day.

2–4 Weeks Before Surgery

Medical clearance

If you have heart disease, lung disease, diabetes, sleep apnea, or are over 65, you may need clearance from your primary care doctor or cardiologist. Complete this early to avoid delays.

Medications

Bring a complete medication list to your pre-op visit. We will give you specific instructions, but common adjustments include:

• Blood thinners (Eliquis, Xarelto, warfarin, Plavix)
• Anti-inflammatories (ibuprofen, naproxen)
• Supplements that increase bleeding (fish oil, turmeric, vitamin E)

Do not stop prescription medications unless instructed.

Smoking and nicotine

Nicotine significantly impairs healing and increases infection risk. Stop all nicotine (including patches and vaping) at least 4 weeks before surgery.

Dental work

Avoid major dental procedures within 4 weeks of surgery.

1–2 Weeks Before Surgery

Illness check

If you develop a cold, flu, COVID, urinary infection, or skin infection, notify us immediately. Even minor illness can require rescheduling.

Home preparation

Set up your recovery space in advance:

• Comfortable chair or recliner
• Pillows for arm support
• Ice machine or cold packs
• Frequently used items at waist height

If you live alone, arrange help for the first few days.

Transportation

You must have a responsible adult drive you home and stay with you the first night.

The Day Before Surgery

Fasting instructions

Do not eat solid food after midnight unless anesthesia gives different instructions. Clear liquids may be allowed up to a few hours before surgery depending on your surgical center.

Skin preparation

Shower the night before with antibacterial soap (such as chlorhexidine if provided). Do not shave the surgical area.

Medications

Take only medications specifically approved by our team with a small sip of water.

Sleep

A normal night’s sleep is helpful, but don’t stress if you are anxious — this is common.

The Morning of Surgery

• Do not eat or drink unless instructed
• Wear loose, comfortable clothing (button-up shirts are ideal for shoulder surgery)
• Remove jewelry and leave valuables at home
• Bring your sling or brace if provided in advance
• Bring ID, insurance card, and medication list

Avoid lotions, cologne, or deodorant near the surgical area.

After Surgery: What to Expect

Most patients go home the same day. You will leave in a sling and may have a regional nerve block that keeps the arm numb for 12–24 hours.

Common early experiences:

• Arm heaviness or numbness from the nerve block
• Mild throat soreness from anesthesia
• Fatigue for several days

We will provide detailed post-operative instructions, including pain control, sling use, and therapy timing.

Pain Control Philosophy

We use a multimodal pain approach to minimize narcotics. This typically includes:

• Long-acting local anesthetic (nerve block)
• Scheduled non-opioid medications
• Short course of opioid medication if needed

Most patients taper off narcotics quickly.

When to Call Us Before Surgery

Contact the office promptly if you develop:

• Fever, cough, or flu-like symptoms
• Skin cuts or infections near the shoulder
• Dental infections
• New swelling in the legs
• Medication changes from another physician

Final Thoughts

Surgery should feel organized and predictable. Our goal is to make the process straightforward so you can focus on recovery and getting back to the activities you enjoy. If questions come up at any point, reach out — clear communication leads to better outcomes.