Hand and Arm Surgery in San Diego, CA

Common Surgery Questions
Some important things to know before surgery
Postoperative Instructions

Common Surgery Questions

Q: WHEN CAN I SCHEDULE MY SURGERY?
A: Doctor Balourdas has time set aside for surgery every Tuesday so surgery can usually be scheduled with only 1 or 2 weeks prior notice. It may take longer if your insurance requires prior authorization or if we need to make special arrangements regarding the day of week, time of day, or surgical facility we use. Urgent or emergency surgery is scheduled accordingly.

Q: IS DR. BALOURDAS THE DOCTOR THAT WILL PERFORM MY SURGERY?
A: Yes.

Q: WHERE WILL I HAVE MY SURGERY?
A: COAST Surgery Center in Kearny Mesa is our main facility for outpatient surgery. On occasion we use Sharp Memorial Hospital Outpatient Pavilion.

Q: WILL I GO HOME THE SAME DAY?
A: Yes, unless you are told specifically otherwise. Fortunately most hand and upper extremity surgery can be performed “out patient”, which means you get to go home one to two hours after your surgery. However, you will need a ride home by a “responsible adult” AND someone to stay home with you for the rest of the day and over night, OR for 24 hours if possible.

Q: WILL I BE AWAKE DURING MY SURGERY?
A: Probably not, most of the time we use general anesthesia during hand or arm surgery. Not always though, this depends on many factors. You and your anesthesiologist will make the final determination on the day of surgery. If you have special concerns regarding anesthesia a meeting can usually be arranged ahead of time to discuss these issues.

Q: WILL MY INSURANCE COMPANY PAY FOR MY SURGERY?
A: Most medical insurance companies pay for a percentage or portion of the amount billed, and the patient also pays a percentage or portion of the amount billed, however, this is not always the case some insurance companies pay 100%. Insurance benefits vary greatly depending on the plan, if you are not sure what your benefits are it is recommended that you contact your insurance company for that information. In most cases we will bill your insurance company for the services provided and then send you a statement for the balance due, if there is one. If you have a co-pay, or a deductible that has not been met, this amount, or a portion of it, may be due prior to your surgery.

Q: WILL I NEED PHYSICAL/OCCUPATIONAL THERAPY AFTER SURGERY?
A: Often times patients do need to attend occupational therapy after surgery to aid in the rehabilitative process. When you will start therapy, how often and for how long you go, is different for each patient.

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Some Important Things to Know Before Surgery

1. If you are taking any anti-inflammatory type medicine i.e.: Ibuprofen, Advil, Aleve, Naprosyn, or Aspirin you will need to stop taking them prior to your surgery date.
2. If you are taking any other medications, vitamins or supplements (including herbal supplements) please notify Dr. Balourdas as some of these also need to be stopped prior to surgery.
3. Please notify Dr. Balourdas if you are under ongoing treatment by another doctor for a medical condition, or if you have a medical condition that does not require ongoing treatment, but may require periodic monitoring. Sometimes we need to contact your doctor prior to surgery to discuss any potential surgical risks. Even if you are healthy but you are over 50 years of age it is likely you will need an EKG (a simple test for your heart) prior to surgery.
4. If you are planning to have surgery, it is important you call our office immediately if you develop any cold or flu-like symptoms, or any other illnesses. Ideally you should be symptom free at the time of surgery.
5. Be careful to avoid any cuts, scratches, or injuries to the involved hand or arm. It is important that you report any such injuries to our office immediately, especially if they occur within one week of your surgery date.

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Postoperative Instructions

1. For the first 72 hours after surgery keep your hand/arm elevated above your heart at all times. If your hand is kept elevated while sitting and standing you will avoid throbbing and swelling, improve your rate of healing and avoid the need for pain medicine. When lying down, rest your hand/arm on one or two pillows at your side or on your chest or abdomen. (Be careful to avoid leaning your elbow on hard surfaces).
2. With the anesthesia you have received, your pain should be well controlled. Take your medications as directed on the labels.
3. Your hand is likely to be numb or asleep after the surgery. (This sometimes lasts for several hours, possibly until the next morning, this is normal). As it awakens, you will have a tingling sensation and you may notice the onset of some discomfort. If after the sensation returns to your hand, your hand falls asleep again, or becomes cold, pale, or swollen, elevate your hand (above the heart). If these symptoms continue, please call Dr. Balourdas.
4. Once your hand is awake and the numbness and tingling has worn off, you should stop using your sling if one was given to you at the surgery center. It is o.k. to use your sling if you are going out for a little while, or have a long arm splint (above the elbow) and need it occasionally for support, or if you have been instructed otherwise by Dr. Balourdas. If you have questions about this please call our office.
5. If your dressing feels uncomfortably tight and you have been keeping your hand elevated, please call Dr. Balourdas. Keep your dressing clean and dry. Do not change your dressing unless instructed.
6. A rash or general itching may indicate a reaction to pain medication, please call Dr. Balourdas if this occurs.
7. Signs of infection are fever, drainage, redness around the incision, red streaks up your arm and increasing pain. Please call Dr. Balourdas if these symptoms develop.
8. You may be sleepy or dizzy for several hours after surgery; this is a normal reaction. Please do not drive, make important decisions or use any dangerous tools until directed.
9. Do not drink alcoholic beverages while you are taking pain medications.
10. Do not take aspirin or other anti-inflammatory medications for at least 72 hours after your surgery, or until instructed by the Doctor.
11. If your surgery involved any TENDONS, do not attempt to move your fingers / hand.

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If you have questions that are not answered here please feel free to call me at 619-291-2430, just ask for Christina. As part of our commitment to assure that you are fully informed, and in accordance with the office of the Inspector General for the Department of Health &Human Services, we are required to inform you that Dr. Balourdas maintains an investment in the Coast Surgery Center Facility.