w  e  l  c  o  m  e

The Rhyneer Caylor Clinic was established with two core tenets in mind.

  1. We will work unremittingly to obtain the truest orthopedic diagnosis. We will provide you with all of the applicable treatment options available based upon your diagnosis.
  2. We will strive to keep our patients priorities as our top priority. We exist to help you do the things in life that bring you pleasure, with as much comfort as possible.

The Rhyneer Caylor Clinic engages patients completely in their own health and recovery. After thorough research and analysis, we discuss your options candidly. Are there alternatives that could forestall or avoid surgery? You are central to that conversation. You make that decision with our guidance.

Dr. Rhyneer opened this clinic in 2007 because he wanted a small practice known for personal attention, outstanding orthopedic care, good advice, the most modern technology, and staff members who exude warmth, professionalism and compassion.

When you need a partner to help you restore orthopedic health, remember the Rhyneer Caylor Clinic.

Are you a new patient?

If so, please visit the two links below. Want to eliminate the hassle of filling out a clipboard full of paperwork in the waiting room? Click the link below to download our New Patient Registration Packet. You will need to print it off and fill it out. Also the Online Health History link will take you to our secure server to complete a history of present illness and past medical history. This information gives our providers some sense of your current problem and pertinent history prior to your visit.

f r e q u e n t l y   a s k e d   q u e s t i o n s

Browse the tabs below for some helpful answers to commonly asked questions. If you have a question or concern that wasn’t addressed here, don’t hesitate to contact us for more information.

Our office is open Monday through Friday 8 AM – 5 PM. We are closed for lunch between 12-1 PM. We commonly have at least one provider in the office each day, though this ultimately depends on the surgical schedule.

We are located at 4100 Lake Otis Pkwy, Anchorage, AK 99508. Our office suite is #308, on the third floor. Upon exiting the main stairwell or elevator turn left. You will see our office down the hall on the left-hand side.

(Regarding dressings, showers, driving and returning to work)

1- When should I change my dressings?

Leave dressing applied at the time of surgery on until your first post-op visit, about one week after surgery.  A clean dressing will be applied at that time if still needed.

2- When can I shower?

After surgery, the incision needs to be kept clean and dry to prevent infection.  After your first post-op visit when either sutures are removed or steri-strips are changed, you may then shower and allow the water to run over the incision.  (No tub baths or hot tub use until approved by the doctor).

3- When can I drive?

  • If you are taking narcotic pain medications you should not drive since these medications can make you drowsy and possibly impair judgment.
  • If you have had surgery or injury to your left leg, you may drive when you feel comfortable.
  • If you have had surgery or an injury to your right leg, the driving restriction will vary on the type of procedure done.  For uncomplicated procedures or fractures it may be possible to drive three to four weeks after surgery if you are comfortable and feel safe.  For total joint replacements, ACL reconstruction, cartilage transplant, etc, and more complicated fractures, driving may be permitted after 6-8 weeks.  Decisions will be made regarding driving restrictions on a case by case basis.
  • Shoulder surgery- due to restrictions on movement and use of the arm, driving may be allowed 2-6 weeks post-op depending on strength and range of motion.
  • While in a cast on either arm, you should not drive if you do cannot maintain full control of the wheel.
  • The above listings are guidelines; the doctor will impose restrictions as necessary with each patient for their recovery and safety.

4- When can I return to work?

Work restrictions vary with the type of job and how your medical problem is affected by the specific work that you do.  Many times the patient is able to go back to work on “light duty”.  This may be shorter work hours or less days a week, sedentary work instead of a physically demanding job, restrictions on length of time on your feet or limited lifting amounts, etc.  Some employers do not offer “light duty”.

It is important to keep the cast clean and dry.

  • When showering, cover the cast with one or two plastic bags or trash bags, use a washcloth or hand towel at the top of the cast to absorb any water leaking in, and secure the plastic bag with tape or rubber bands. (There are cast covers available to purchase at some pharmacies or medical supply stores costing about $20.00)
  • If the cast does get wet, try drying it with a hair dryer on cool setting. The padding under the fiberglass is very difficult to dry completely. Skin under the cast can be easily irritated and may even develop a fungal infection if continually wet or damp.
  • Do not use or place any foreign objects under the cast such as pens, rulers, sticks, money (this is not the place to store your coins!) Your skin can be easily scratched or irritated leading to infection.

Swelling

It is normal to have swelling in the injured arm or leg even after the cast is applied. Wiggle fingers or toes periodically to stimulate circulation in the injured arm or leg.

Keep the casted body part elevated as much as possible. The injured area should be elevated in such a way that it is higher than the level of your heart.

For arm injuries take arm out of the sling and prop it up on pillows.

For leg injuries, when able, lay on a couch or bed and prop the leg up with pillows so that the injured area is higher than the level of your heart.

Cast Shoe

If you are permitted to bear weight on your leg, always wear the boot/cast shoe you are given when up and around. It will protect the bottom of the cast and prevent slipping on a wood or tile floor.

Driving

For your safety and the safety of others, it is not recommended that you drive with a cast on your hand or arm and your right leg. (This includes the left leg if using a clutch)

Pain

It is normal to experience discomfort in the area of the injury even after casting. Take prescription pain medications as ordered or over the counter Tylenol or Ibuprofen if there are no contraindications such as allergy, gastrointestinal problems/ulcers. Elevating the arm or leg may also help.

Devices such as canes, walkers, crutches, wheelchairs, braces, and supports are sometimes needed after orthopedic injuries or surgery.  These can be purchased locally or rented (as with a wheelchair) at:

Bernies Pharmacy
(907) 562-2138
4100 Lake Otis Parkway

Lake Otis Pharmacy
(907) 563-7878
4201 Lake Otis Parkway

Geneva Woods  
1) Anchorage-    (907) 565-6100
501 W. International Airport Rd.- Suite 1A

2) Wasilla-   (907) 376-8200
3674 E. Country Field Circle

Northern Orthopedics
For off the shelf braces, custom braces, orthotics, heel lifts

1) Anchorage   (907) 561-1777
4200 Lake Otis Parkway

2) Wasilla   (907) 357-3737
3719 E. Meridian Loop- Suite H

Medication Refills

Please call before 4PM to request a refill on your medication.  Please allow at least 24 hours for the refill.  It will be called to your pharmacy as soon as possible after approval from your provider.

Pain Medicines

1.  Some prescriptions cannot be called in or faxed to a pharmacy by law.  These are the controlled substances (Schedule II) narcotics which include:

  • Oxycodone and all derivatives. Oxycontin, Percocet, Percodan, Endocet, Endodan, Roxicet.
  • Dilaudid (Hydromorphone)
  • Vicodin (Hydrocodone)
  • Norco (Hydrocodone)

 The above medications must be on a written prescription, signed by the provider, and hand carried to the pharmacy.

2.  Pain medications that may be called in or faxed include:

  • Ultram (Tramadol)
  • Tylenol with Codeine

Antibiotic Prophylaxis for Invasive Procedures following Total or Partial Joint Replacement

We follow the guidelines issued by the American Academy of Orthopaedic Surgeons and the American Dental Association.  It is recommended that for 2 years following total or partial joint replacement that the patient be pre-medicated with a dose of antibiotics one hour prior to a dental procedure or any invasive type procedure.

Recommended medications

Those not allergic to penicillin:
Cephalexin, Cephradine, or Amoxicillin- 2 grams by mouth, 1 hour prior to procedure.

Those who are allergic to penicillin:
Clindamycin- 600 milligrams by mouth, 1 hour prior to procedure.

Medications

You will be given a prescription for pain medication either prior to surgery or at discharge.  Take medication as directed.  It may make you drowsy.  Do not drive when taking pain medications.  These medications are to keep you as comfortable as possible, but they may not completely eliminate discomfort.

Nerve Blocks

For some procedures, your surgeon may order a nerve block. These are administered by the anesthesiologist before or after surgery.  An anesthetic is applied around the appropriate nerve to block pain in the surgical area.  This often is a single shot, though sometimes patients are sent home with a catheter attached to a small pump which delivers a dose of numbing medication at precise intervals directly to the nerve.  When used, these remain in place for 2-3 days. Nerve blocks help with pain control and decreases the amount of oral narcotics needed for those first few days after surgery.  Nerve blocks are used with some shoulder, knee, or leg surgeries.

ICE

Ice is very important after almost all surgeries to help decrease pain and swelling. With some shoulder or knee surgeries, you may be sent home with a CryoCuff or Ice Man system surrounding your operative joint.  This machine provides chilled water to the area to decrease swelling, inflammation, and pain. Whether or not an ice system is used, you are encouraged to apply ice for at least a week after surgery.  After that, use as needed to help with pain control or swelling.

Continuous Passive Motion Machines (CPM)

These are infrequently used with some knee surgeries. The motorized device gradually moves the joint. If appropriate, your surgeon will discuss and order this machine prior to surgery.

Aspirin needs to be stopped one week prior to surgery since it affects the clotting time of the blood.

The following herbal medications should not be taken two weeks prior to surgery, as they have been linked to adverse reactions with anesthesia:
St. Johns Wort                                     Kava or Kava Kava
Ephedra                                                Ma Huang
Echinacea                                             Valerian
Garlic (in food ok)                              Herbal Phen Fen
Gingko                                                  Herbal Phentermine
Ginseng

Ask if you are on another herbal supplement not listed and unsure.  Drugs such as heroine, cocaine, etc., can alter the effects of anesthesia and can be fatal if used prior to surgery.  This can include alcohol.  (For safety reasons, please inform your doctor if you have used any of these within the past month.)

The following prescription medications should not be taken prior to the times noted under each medication: PLAVIX, COUMADIN, WARFARIN should be discontinued 10 days before surgery.

Xenical (generic name Orlistat), Meridia (generic name Sibutramine) should be discontinued at least 3 days before surgery. Phentermine (brand names Adipex, Fastin, Tora, Wilpowr, Zantryl)and Redux should be discontinued 2 weeks before surgery.

You will need to arrive at the facility for your surgery (2) hours prior to the scheduled surgery time.  This is to allow time to prepare you for surgery, start intravenous fluids, and if ordered, a nerve block for pain control which is put in place by an anesthesiologist.

If you are having day surgery, you must have someone drive you home (no taxies by yourself or public transportation are allowed- the facility will cancel your surgery if this is not arranged).  Someone should be available to stay with you for the first night after your surgery.   YOU ARE NOT TO DRIVE THE DAY OF SURGERY.

Anti-inflammatory medications such as Ibuprofen, Naprosyn (Naproxen) and Relafen (Nabumetone) also need to be stopped 4 days prior to surgery.

Nothing to eat or drink after midnight the night before surgery.  If your surgery is scheduled for 1pm or later, you may have clear liquids prior to 8am the morning of surgery.  (i.e. water, apple juice, broth)  No coffee, milk, or orange juice.

*Any blood pressure or heart medications may be taken early in the morning with a sip of water.

You should expect 3 to 4 surgery bills.  These include: [1] Your surgeon, [2] Our physician assistant (if present for the case), [3] The facility, and [4.] Your anesthesiologist.

We will see you in the office for a pre-operative visit within 2 weeks of surgery. This visit will include discussion and questions about the surgery, a limited history and physical exam, signing the operative consent and any last minute instructions.

If you have any pre-existing medical problems you may need to get medical clearance prior to surgery from the physician who is treating you for those medical issues.

Please notify us if you are taking any anti-coagulants (blood thinners) such as PLAVIX, COUMADIN, HEPARIN, LOVENOX, and XARELTO. These medications need to be stopped prior to surgery.

Some medications and Herbal supplements need to be stopped prior to surgery.

If your surgery is at Providence or Alaska Regional, you will be given an envelope with the operative consent, pre op orders and the history and physical paperwork. This envelope needs to be taken to “pre-admissions” at the appropriate hospital the same day or at least 1 day prior to surgery.

If your surgery is being done at the Alaska Surgery Center, you do not need to go to the surgery center prior to the day of surgery. The appropriate paperwork will be faxed to the Alaska Surgery Center. You will need to arrive about 2 hours prior to surgery, any studies that need to be done pre-operatively will be done at that time.

Our team operates at the following locations:

  • Alaska Surgery Center (same day surgery only)
    4100 Lake Otis Parkway (907) 550-6100
  • Providence Hospital (same day and in-patient surgeries)
    3200 Providence Drive (907) 562-2211
  • Alaska Regional Hospital (same day and in-patient surgeries)
    2801 DeBarr Road (907) 276-1131

Surgery Schedule

  • Our surgeons generally have set block times at each location. Certain times are dedicated for inpatient procedures, while other block times are set aside for same day surgeries.
  • Our clinic does require a surgery deposit of $500.00 prior to your procedure. This will of course be applied to your coinsurance/deductible. If your insurance company pays at 100%, your deposit will be refunded once payment is received from your insurance company.

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