Shoulder Arthroscopy Kevin P. Murphy, M.D.

1. Shoulder ArthroscopyKevin P. Murphy, M.D. Rotator Cuff Repair Labral / SLAP Repair Subacromial Decompression Distal Clavicle Excision Partial Synovectomy

2. General Information • I am honored that you have selected me as your surgeon, and I consider it a privilege to provide you with the highest level of surgical care. • Please read through this disc as it will explain the process you will go through before and after surgery. • Please contact me if you have any problems or questions.

3. Pre-operative Evaluation • You will be seen by my Physician Assistant pre-operatively • Your consent form will include rotator cuff repair, labral repair, decompression, and distal clavicle excision. This gives me your permission to fix any problem that I may find • The potential complications from surgery include, but are not limited to: infection, nerve injury, loss of motion, and possible failure of repair

4. Pre-operative Evaluation • You will receive prescriptions for post-op pain medication • Physical Therapy may be done at Center One or Riverside. If these locations are not convenient, you may obtain a prescription to take elsewhere • If you were given a form for medical clearance, this must be accomplished prior to surgery • You will be fit for your immobilizer that you will receive after your surgery • You will be notified by the surgery center for your time of arrival the day before your surgery

5. Surgery Day • Arrive at the surgery center at your scheduled time • You will speak with a representative of Pain Reduction Concepts Inc., and be given a TENS unit to help with post-op pain and swelling. • You will be seen by an anesthesiologist who will administer a nerve block, numbing your shoulder • You will be taken back to the OR and put to sleep • The procedure will generally take about an hour to an hour and a half • Upon completion of the procedure, you will be taken to the recovery room where you will remain for approximately 45min or until it is deemed safe for you to go home. • The TENS unit will be placed on and any further assistance or instruction regarding the device will be given at this time. • Dr.Murphy and/or his physician assistant will talk to your family members immediately following the procedure to explain what was done and answer any questions.

6. Post-Operative Your arm will be numb and painless for 12-24 hours If you have had no pain by bedtime-take a pain pill anyway to avoid pain in the middle of the night Start taking your anti-inflammatory medication right away-ensure you eat something prior to taking the medication; for pain that is not controlled by that medication, take the other pain medication you were prescribed. In addition to medication, use the prescribed TENS unit as directed. This is not a substitute for the pain medication, but will help to further reduce post-op pain and swelling. Apply Ice to the shoulder 20 min on / 20 min off during the day for 3 days. This can be done while using the TENS unit. Sleep with immobilizer on for 3 days

7. Post-Operative • Keep bandage dry for 2 days • You may shower, but keep bandage out of the direct flow of water for 2 days; you may find it helpful to wrap your shoulder with saran wrap to help keep it dry • Remove bandage on day 3, shower, place Band-Aids on incisions • No soaking shoulder in water for 3 weeks • Remove the immobilizer daily as your arm wakes up, and do small circles with the arm hanging • While sitting in a chair, you may remove your immobilizer

8. Post-Operative You may type, write, work below waist level Do not lift, carry, or power arm away from body Start Physical Therapy within one week Bring the TENS unit to your first Physical Therapy appointment so the Therapist can make any necessary changes.

9. 2 week Follow-up • You will be seen about 2 weeks from surgery by my Physician Assistant for suture removal • Please bring your pictures/disc for review if you would like an explanation of the procedure • Therapy should be ongoing • Continue to use the TENS unit as needed for pain, swelling, and/or muscle spasms. • You will be out of the immobilizer as of today if you are not already out of it • You will be returned to light duty at work • Please ask for Dr Murphy if you are having problems

10. 6 week Follow-up • You will be seen at 6 weeks by my Physician Assistant for re-check • If you are having pain that restricts motion, a cortisone injection will be offered • Therapy will continue with emphasis on strengthening and gaining full motion • You will be returned to limited duty at work • Please ask for Dr Murphy if you are having any problems

11. 12 week Follow-up • You will see Dr Murphy and/or his physician assistant at this visit • You should have near full motion and strength • Pain should be minimal • You will typically be directed to home exercises and will gain normal strength and function over the next 4-8 weeks • You should be at unrestricted work

12. Contact Numbers • Office – 904-634-0640 • Dr Murphy’s Medical Assistant- ext 1062 • Call for any problems during business hours • After hours / weekends- call office number – recording will give you pager for on call team • Pain Reduction Concepts Inc. • Adam Frisbie – 904-424-7020 • Steve Ross – 904-591-1974 • Roger Bowers – 904-610-1685 • If you have an emergency situation, call 911 • For more information, please visit:www.jaxsportsdoc.com