Frequently Asked Questions

How do I manage my wound after surgery? When can I shower after my surgery?

How do I manage my wound after surgery? When can I shower after my surgery?

The surgical incision will be closed with sutures or staples. We recommend that you do not get the wound wet for 2 weeks. When showering it is recommended that you place a bag over the ankle to just below the knee and secure it with tape to your leg.

If you have a dressing, wrap or cast DO NOT remove the dressing yourself. Dr. Marsh will remove your dressing at your 1st follow-up appointment, approximately 2-3 weeks after surgery.

The sutures/staples will be removed at your 2 week appointment. After the sutures/staples are removed, you may shower if Dr. Marsh has instructed that it is ok. DO NOT immerse your foot/ankle in water (bath, hot tub, pool or lake) for 4 weeks. We recommend that you do not apply any creams or ointments to your incision for 6 weeks unless instructed to do so by Dr. Marsh.

What do I do if I get my bandage or cast wet after surgery? What do I do if my bandage soaks through after surgery?

What do I do if I get my bandage or cast wet after surgery? What do I do if my bandage soaks through after surgery?

If the entire cast or dressing gets wet or the bandage is completely saturated, the surgical site and incision may be affected. Please call the fracture clinic at (416) 242-1000 ext 23005 to book an appointment to see Dr. Marsh to look at your incision and have your cast changed.

Can I get a refill of my pain medication after surgery?

Can I get a refill of my pain medication after surgery?

Dr. Marsh DOES NOT send refills for narcotic medications under any circumstances. You will be prescribed the appropriate amount of narcotics for your operation post-operatively. Once these are complete we recommend extra-strength Tylenol or seeing your family physician.

How do I best control my pain after surgery?

How do I best control my pain after surgery?

Dr. Marsh will prescribe you a regimen of narcotic and non-narcotic medication for post-operative pain control. The medications prescribed will be appropriate for the amount of pain expected based on your operation. There will be NO renewal or narcotics prescriptions after surgery.

We recommend avoiding alcohol consumption while on narcotics. You are NOT permitted to drive while on narcotics.

We recommend that you consume plenty of water to prevent constipation while on narcotics. A stool softener may be prescribed if prolonged narcotic requirement is expected.

Although not required a cryocuff / Game Ready unit may help control local pain and swelling after surgery. If interested please contact Dr. Marsh’s office at (416) 479-3580.

Keep your foot elevated as much as possible for the first 2 weeks after surgery to minimize swelling. The more the foot is down the more swollen and painful the foot/ankle will be.

What symptoms are normal after surgery?

What symptoms are normal after surgery?

It is normal to experience mild to moderate pain, numbness and tingling for the first 2 weeks following surgery. If you are experiencing severe pain please present to the emergency department for assessment.

Swelling is normal after surgery. It often remains for 6-9 months depending on the nature of your surgery.

Numbness throughout the foot is normal within the first 24-48 hours after surgery. It is also normal to have persistent numbness around the incision post-operatively. In the vast majority of cases the numbers is self-limited and resolves. Please inform Dr. Marsh of any numbness in the foot or ankle at your first follow-up visit.

It is normal for the toes to get discoloured when hanging/dangling the leg after surgery, this is due to a normal vasomotor post-operative reaction.

After surgery what should make me return urgently to the hospital?

After surgery what should make me return urgently to the hospital?

- Excessive bleeding that is not controlled with 15 minutes of applied pressure
- Fever greater than 38 degrees
- Intractable pain in conjunction with excessive swelling

What mobility aids will be required after surgery?

What mobility aids will be required after surgery?

Your mobility needs will be assessed by Dr. Marsh pre-operatively. Most foot and ankle surgeries require a period of partial or no weight bearing on the operated leg. Based on your mobility needs you may require crutches, walker or other mobility aids.

When do I follow up after my surgery?

When do I follow up after my surgery?

All surgeries require a 2-3 week follow-up visit with Dr. Marsh. Follow-up visits will occur at Humber River Hospital Fracture Clinic.

What does Non-Weight Bearing mean?

What does Non-Weight Bearing mean?

If you are instructed to be non-weight bearing that means you should be applying NO WEIGHT to your operated limb at all times

What does Weight Bearing as Tolerated (WBAT) mean?

What does Weight Bearing as Tolerated (WBAT) mean?

If you are instructed to be weight bearing as tolerated (WBAT), it means that you can put as much weight as tolerated through your operated limb. Discomfort and stiffness is expected after a period of non-weight bearing, it is important to work through discomfort but not push through pain.

When can I start driving after my surgery?

When can I start driving after my surgery?

After having right foot or ankle surgery you CANNOT drive for at least 6 weeks. For left foot or ankle surgery, please contact your insurance company to see if you are permitted to drive. Narcotics can impair your ability to drive or operate any machinery. Please avoid any driving or operating any machinery while taking narcotics.

How soon can I fly after surgery?

How soon can I fly after surgery?

Flying too soon after surgery can increase your risk of blood clots (Deep Vein Thrombosis - DVT) in the leg and can progress to blood clots (Pulmonary Embolism – PE) in the lungs which can be life threatening.

There are no guidelines for when you can fly after surgery. Dr. Marsh recommends waiting at least 6 weeks after toe surgery and 3 months after any other procedure.

It is also recommend that if flying post-operatively that a double dose of baby aspirin (162 mg) be taken the day prior, the day of and the day after flying to help decrease the risk of blood clots.

When can I return to normal shoe wear?

When can I return to normal shoe wear?

Dr. Marsh will inform you when you can discontinue your post-operative immobilization and return to normal shoe wear. Please do not return to normal shoe wear until instructed to do so by Dr. Marsh. The biggest impediment to return to normal shoe wear is swelling. The usual time frame to return to normal shoe wear is 6-12 weeks depending on the type of surgery performed.

What can I do to minimize foot and ankle stiffness post-operatively?

What can I do to minimize foot and ankle stiffness post-operatively?

Stiffness is a usual consequence of surgery/immobilization. Once able, based on your surgery, Dr. Marsh will instruct you to start gentle range of motion exercises of the foot/ankle. If stiffness persists physiotherapy can be prescribed to help improve range of motion.

How do I get copies of my medical records including x-rays?

How do I get copies of my medical records including x-rays?

Dr. Marsh’s office DOES NOT provide medical records. Humber River Hospital allows you to access your own medical records, including consultation notes, follow-up notes, and imaging reports. Medical records at Humber River Hospital can be reached at (416) 242-1000 ext. 82300. You may also access your records at http://myhumberhealth.ca/ (If you do not have an account, click on “sign up”)

What if I need forms filled by Dr. Marsh?

What if I need forms filled by Dr. Marsh?

Please fax all forms to Dr. Marsh’s office at (416) 479-3656 or drop them off at the office at 3695 Keele Street, 2nd floor.

The forms will take at least ONE week to complete. There are charges for filling out forms. Please do not call the office for forms, the office will contact you once the forms are completed and ready for pick up.

When can I return to work?

When can I return to work?

After any foot and ankle operation, Dr. Marsh recommends taking at least 2 weeks fully off to recover from the anesthetics, acute pain after surgery, etc. After 2 weeks, you should be able to sit at desk and perform sedentary duties; you should avoid standing, walking and prolong leg dangling. Please note that the longer the foot is dangling the more swollen and painful your foot will become, we recommend accommodations to allow your foot to be raised.  If your job/occupation cannot accommodate these restrictions/limitations then you CANNOT return to work and must remain off until full duties are possible. Dr. Marsh will NOT provide you a note suggesting you cannot work, a note will be provided for these restrictions/limitations. For manual / labouring workers you can expect to be off work for anywhere from 8-16 weeks.