Surgery Instructions

Preoperative instructions

  • Your Surgery will be scheduled by Mariana. Should you have questions regarding scheduling, Mariana can be reached at 713-486-1736, or emailed at
  • If you have clinical questions before or after surgery, please contact Mariana. 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 Herman Memorial City Hospital or West Houston Surgicare. Should you need to contact the hospital, the telephone numbers are as followes:
    Memorial Hermann Memorial City 713-242-3000
    West Houston Surgicare 713-461-3547
    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. If this is required, call 713-242-3880 to schedule this appointment. 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

  • Stop taking aspirin or any other anti-inflammatory medications such as Motrin (ibuprofen), Aleve (naproxen), Mobic (meloxicam), or herbal products such as St. John's Wort.
  • 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.

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.
  • Bathe or shower the night before, or morning of surgery to help minimize the risk of infection. We recommend purchasing a bottle of Hibiclens soap at your local drug store and using it to wash to surgical site.
  • 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 713-486-1736 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, and you have been prescribed a stool softener 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.


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.


A post-operative appointment will be scheduled once your surgery date is determined. If you have any questions, contact Mariana at 713-486-1736


You may resume your usual diet. 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.


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


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


As part of a post-operative pain management plan, you have been provided several prescription medications. This plan is customized based on each patient's individual needs. Generally, you are given a prescription for a narcotic pain medication (Norco, Oxycodone). 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 will be prescribed a stool softener (Colace or Senokot). Pain medication can make you constipated, and a stool softener will help relieve this discomfort. Additionally, eating fruits and vegetables may be helpful.

In certain circumstances, you may be prescribed an anti-inflammatory medication (Ibuprofen, Naproxen). These medications help with inflammation and swelling, but can cause side effects in your stomach of gastrointestinal tract. Take these medications with food. If you have a history of ulcers or GI bleeding, do not take 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 713-486-1736 to speak with Mariana, Dr. Gregory's medical assistant. After hours, please call 713-486-1700 or proceed to your local emergency department.

Contact Information

Mariana Trevino, MA
929B N. Gessner Road #100
Houston, TX 77024
Tel: 713-486-1736 Fax: 713-467-6775

Rose Garcia (Office Manager)
929B N. Gessner Road #100
Houston, TX 77024
Tel: 713-486-1700 Fax: 713-467-6682

Help Desk
Tel: 713-486-4848

Dr. James M. Gregory
929B N. Gessner Road #100
Houston, TX 77024
Tel: 713-486-1700 Fax: 713-467-775

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

Memorial Herman West Houston Surgicare
970 Campbell Road
Houston, TX 77024
Tel: 713-461-3547