Surgery Instructions

Preoperative instructions

  • Your surgery will be scheduled by Dr. Gregory's surgery scheduler. Should you have questions regarding scheduling, they can be reached at 713-486-1700, or emailed at magaly.e.deleon@uth.tmc.edu

  • If you have clinical questions before or after surgery, please contact Dr. Gregory's team. If you urgently need to contact us after hours, please call our main number, 713-486-1700 to have our answering service direct your call.

  • Surgeries are generally performed at Memorial Hermann Memorial City Hospital, Memorial Hermann Rockets Orthopedic Hospital, or Memorial Hermann Memorial Village Surgery Center. Should you need to contact the hospital, the telephone numbers are as followes:

    Memorial Hermann Memorial City 713-242-3000
    Memorial Hermann Rockets Orthopedic Hospital (MHROH) 713-314-4444
    Memorial Hermann Memorial Village Surgery Center 713-337-1111

    NOTE: Depending on the nature of your health insurance, you may be required to pay a deductible or a deposit prior to scheduling surgery. For question regarding hospital and anesthesia fees, please contact the hospital at the phone number listed above.

  • After you have a surgery date you may be asked to visit the Pre-Admit Testing Department for lab work, EKG, or X-rays. Plan to spend approximately 2-3 hours there, and bring a list of your current medications. If you have any specific pre-operative orders from Dr. Gregory, please bring them to this appointment, and they will be completed. If you have used an outside facility to obtain any pre-operative tests, then fax the results to 713-242-3964 prior to your visit.

  • If pre-admission testing is not needed, a phone interview will be conducted to obtain your medical history.

  • You will need a pre-operative history and physical examination prior to your surgery. This can be performed at our office or by your primary care physician. In some cases, cardiac clearance and/ or medical clearance may be necessary prior to surgery.

  • If you take a blood thinner such as Coumadin (warfarin), Xarelto (rivaroxaban), Lovenox (enoxaparin) or Plavix (clopidogrel), make sure you discuss when you should stop these medications with your cardiologist or primary care physician.

  • If you smoke, you should quit before and after surgery to improve the healing potential of your body.

Week before surgery

  • If you are taking narcotic medication (Vicodin, Norco, Oxycodone), please decrease or discontinue the use prior to surgery. We use these medications a for post-operative pain control.

Two days before surgery

  • Begin chlorohexadine showers as instruced on your pre-operative information sheet
  • If you are having shoulder surgery, apply benzoyl peroxide gel to your shoulder as diagrammed on your pre-operative information sheet

Night before surgery

  • Do not eat or drink anything after midnight, unless otherwise instructed by the anesthesia team. You may take certain heart or blood pressure medications the morning of surgery with a small sip of water.
  • If you are undergoing outpatient surgery: Arrange for a responsible adult over 18 years of age to drive you home and remain with you for the first 24 hours after surgery.
  • If you are unsure of the time of your surgery time, please call Dr. Gregory's office at 713-486-1700 to confirm.

Day of Surgery

  • Take medications as directed by your primary care physician, Dr. Gregory's staff, or anesthesia team.
  • Arrive at the hospital 2 hours prior to your surgery time. On occasion, your surgery may be delayed due to emergencies or operating room delays. Bringing something to read in case you have to wait may be helpful.

What to bring on the day of surgery

  • Photo ID and insurance card
  • Friend or family member
  • Any slings or braces prescribed by Dr. Gregory
  • Loose fitting shirt or blouse with front closure (buttons/zipper)
  • If you are scheduled for inpatient surgery, please bring any items that will make you comfortable during your brief hospital stay.
  • Please leave all jewelry and valuables at home.

Post-operative instructions

Pain management

If you are not currently being seen by a pain management physician, Dr. Gregory will provide a prescription for post-operative pain medication, which will be filled at your local pharmacy. Please be advised that not all pharmacies carry pain medication and it is the patients responsibility to find a pharmacy to fill their medications. Please only take the pain medications that Dr. Gregory has prescribed for you. Pain medication can often make you nauseated, and taking it with food can help this substantially. Additionally, pain medication can often make you constipated. A stool softener is recommended to help you feel more comfortable. If you have had regional anesthesia for your surgery, your arm may feel numb and painless after surgery. This is normal. Please begin the pain medication at the first sign of sensation returning, so that you can maintain good pain relief.

Ice

For the first 3 days, we recommend that you ice your shoulder or elbow three times a day for 15-20 minutes at a time. It is important to protect her skin with a towel or clothing, rather than placing the ice directly onto your skin. You can continue using ice after the 3-day mark to assist with pain control.

Follow-up

A post-operative appointment will be scheduled once your surgery date is determined. If you have any questions, contact Dr. Gregory's team at 713-486-1700.

Diet

You may resume your usual diet following surgery. It is normal to feel nauseated for the first 24-48 hours after surgery as a result of the anesthesia and pain medication. As a result, you may feel more comfortable avoiding heavy, greasy food during this time period.

Wound Care

Dr. Gregory will provide instructions about when you may shower. Generally, you may shower three days after surgery and let water run down the arm. Avoid scrubbing or washing the incision site directly. If you have a clear plastic dressing over your incision, leave this in place while you are showering. If you were placed into a hard splint following surgery, then this needs to be kept completely dry until you are instructed to remove it. You may cover your arm with a trash bag or opt to sponge bathe instead. If you have small battery-operated device coming out of your splint – this is most likely a wound vacuum dressing – please keep this dry and in place until your initial post-op visit.

Slings/braces

Please wear your sling or brace as instructed by Dr. Gregory. Please reference your discharge instructions for further guidance. Remove your sling three times a day to move your elbow, wrist, and hand. Avoid moving the shoulder unless instructed.

Driving

Please do not drive while on narcotic pain medication (Norco, Oxycodone, Tramadol).

Medications

As part of a post-operative pain management plan, you have been provided several prescription medications, as well as an informational handout on how to take the pain medications that were prescribed. This plan is customized based on each patient's individual needs. Generally, you are given a prescription for a narcotic pain medication (Norco, Oxycodone, Tramadol). This medication is effective for post-operative pain relief. Take it as directed. Taking it with food may help with nausea. Other side effects may include drowsiness. Do not drink alcohol while on narcotic pain medication.

Additionally, you were provided with a “shopping list” handout on a stool softener that you may purchase over the counter at the pharmacy (Colace or Senokot). Pain medication can make you constipated, and a stool softener will help relieve this discomfort. Eating fruits and vegetables may also be helpful.

In certain circumstances, you may be prescribed an anti-inflammatory medication (Ibuprofen, Meloxicam, Toradol). These medications help with inflammation and swelling, but can cause irritation to your stomach or GI tract. It is important to take these medications with food to help prevent this. If you have a history of ulcers or GI bleeding, do not take these medications. If you take a prescription blood thinner, you should also avoid these medications.

When to call Dr. Gregory

Please call if you have a fever greater than 101.5, chills, sweats, excessive bleeding requiring multiple dressing changes, foul-smelling drainage, or excruciating pain. During office hours, please call 713-486-1700 to speak with Dr. Gregory's medical assistant. After hours, please call 713-486-1700 or proceed to your local emergency department.

Contact Information

Neri Delgado (Medical Assistant)
10125 Katy Frwy #100
Houston, TX 77024
neri.delgado@uth.thc.edu
Tel: 713-486-1700 Fax: 713-467-6775

Magaly De Leon (Surgery Scheduler)
10125 Katy Frwy #100
Houston, TX 77024
magaly.e.deleon@uth.tmc.edu

Rose Garcia (Office Manager)
10125 Katy Frwy #100
Houston, TX 77024
rose.m.garcia@uth.tmc.edu
Tel: 713-486-1700 Fax: 713-467-6682

Nicola Amoruso, PA-C (Physician Assistant)
10125 Katy Frwy #100
Houston, TX 77024
Tel: 713-486-1700 Fax: 713-467-6775

Dr. James M. Gregory
10125 Katy Frwy #100
Houston, TX 77024
Tel: 713-486-1700 Fax: 713-467-6775

Memorial City Center for Advanced Orthopedics
929 Gessner 12th floor
Houston, TX 77024
Tel: 713-242-3000

Memorial Hermann Rockets Orthopedic Hospital (MHROH)
5410 W Loop S Bellaire, TX 77401 Tel: 713-314-4444

Memorial Hermann Memorial Village Surgery Center
1120 Business Center Dr., Suite 110 Houston, TX 77043 Tel: 713-337-1111