330 Arkansas St. Suite 202
Phone: (785) 505-2200
PLEASE REVIEW THESE INSTRUCTIONS THOROUGHLY BEFORE SURGERY
ARRIVAL:
The day of surgery you should plan to report to the Registration desk at Lawrence Memorial
Hospital at the Maine Street Entrance at _______ on ________. Due to emergency circumstances, this time may change.
FOOD AND DRINK:
NOTHING SOLID TO EAT AFTER MIDNIGHT THE NIGHT BEFORE SURGERY
CLEAR LIQUIDS ONLY FROM MIDNIGHT TO 6:00 am.
OR
NOTHING TO DRINK AFTER MIDNIGHT THE NIGHT BEFORE SURGERY.
THIS INCLUDES WATER, ICE, COFFEE, TEA, ETC. You may brush your teeth with a sip of water. Do not chew gum or use cough drops, throat lozenges, etc after midnight the night before surgery.
SPECIAL INSTRUCTIONS :
Expect a call from the Preadmit (Same Day Surgery) nurse to review health status and confirm instructions.
Stop Aspirin ______ unless otherwise directed.
Medications the morning of surgery: The Preadmit nurse will review these with you at your phone call and give you specific instructions.
_____________________________________________________________________
Lab work needs to be done at: _____ _
* Additional information is available in the Surgery brochure.
LMH SURGERY DEPARTMENT WILL CALL YOU THE NIGHT BEFORE TO CONFIRM
YOUR TIME OF ARRIVAL
The nursing staff will get you checked in to the unit. You will talk with anesthesia. They will start an IV and take you to the operating room. You will wake up in the recovery room to be released when you have recovered. Or, you will be sent to the third floor to spend the night. A nurse from same day surgery will call you later that evening if you go home.
YOU WILL NEED A RESPONSIBLE ADULT TO DRIVE YOU HOME.
WE HAVE DISCUSSED WHAT YOU SHOULD EXPECT WHEN YOU ARRIVE HOME.

YOUR POST-OP APPOINTMENT WAS MADE TODAY. WE HAVE GIVEN YOU
INSTRUCTIONS SPECIFIC TO YOUR SURGERY. IF REQUIRED BY YOUR INSURANCE
COMPANY, WE WILL NOTIFY THEM.
NEXT APPOINTMENT: Call at your first opportunity to arrange an appointment for 7-14 days from surgery if not already scheduled.
Post Operative Appointment Time/Date:__________________
If you notice any signs of infection: wound redness, increasing pain, or marked swelling. Call if you have a fever over 101 degrees. Call at your first opportunity to arrange an appointment for 7-14 days from surgery if not already scheduled.
OPERATIVE SITE:
If topical skin adhesive is used to seal the incisions, no bandage is needed unless the incision starts draining or oozing. Do not use ointment on the medical glue. You may shower the same day but do not soak the incision areas for 1-2 weeks.
If steristrips are used, keep the dressing in place for 24-48 hours, unless draining or tape irritation necessitates change. DO NOT remove the steri-strip tapes from the incision. Keep the wound dry for 24 hours; then you may shower, but do not soak the incision areas for 1-2 weeks.
Use a band aid or dressing to cover any drainage from incisions. Call the office if you notice spreading redness around the incision, increasing pain, or thick odorous drainage.
ACTIVITY:
Avoid strenuous activity for the next four weeks. Do not lift more than 30 pounds for the next four weeks. Avoid repetitive bending, stooping, and straining; no pushing or pulling for next four weeks. You may resume driving when you are no longer taking prescription pain medications and when you feel you can do so safely. Climbing stairs is permissible. Sexual activity is permitted when comfort allows. Return to work is permitted as soon as you can perform your job activities without causing pain, usually light duty after the first week and manual labor in one month.
PAIN:
Ibuprofen (Advil, Motrin, Nuprin) 400-600mg three to four times daily may adequately control your pain. If not, take the prescription medication provided in addition to the Ibuprofen. Do not take Ibuprofen while taking Toradol (Ketorolac). Do not take these medications on an empty stomach, as they can cause nausea. Do not drink alcohol or drive while taking the prescription medication. Do not take Tylenol while using other medications which also contain Tylenol
(Acetaminophen) - (i.e.: Lortab, Percocet).

DIET:
You will eventually be able to resume your normal diet, but for the first three weeks post operatively you will need to follow a mechanical diet which provides foods that are easier to swallow. It is important to take small bites and chew foods thoroughly before swallowing. Please refer to the Mechanical Diet handout for recommended foods.
WHAT TO EXPECT:
You may have upper abdominal fullness and discomfort into the back and shoulder area for a few days. There may be some bruising and a small amount of drainage for several days, especially at the umbilical incision site. You may have a tender lump at each incision site, this will resolve over 4-6 weeks. Call your doctor if redness or swelling develops or if you experience increasing pain at any of the incision sites. Vomiting or belching is often difficult or even impossible after a nissen fundoplication.
RESUME YOUR USUAL MEDICATIONS:
If gas pains or constipation occur you may use a Dulcolax suppository or a laxative; these may be bought over the counter without a prescription. Please note that a side-effect of prescription narcotics is constipation.
THANK YOU FOR CHOOSING THE PHYSICIANS OF LAWRENCE GENERAL
SURGERY at LAWRENCE MEMORIAL HOSPITAL
Please let us know if there is anything else we can do.
We are here for you during your surgical experience!
Patient Portal: Communicate your questions via secure email - access Instructions, FMLA or
Return to Work forms, Visit Summaries, and some test results - schedule appointments and receive reminder emails. Sign up in person at any LMH physician practice or department. rev. Aug2014

PURPOSE:
To provide foods that are easy to swallow (for approximately 3 weeks post op).
DIET PRINCIPLES:
This is a well-balanced diet modified to provide foods easier to swallow. It is important to take small bites and chew foods thoroughly before swallowing.
Moisten foods if necessary.
FOOD GROUPS RECOMMENDED
Milk, Yogurt &
Cheese
NOT RECOMMENDED
Meat, Poultry, Fish,
Dry Beans, Eggs and
Nuts *
2-3 servings.
EGGS: Chopped
MEAT: Ground and moistened
COMBINATION DISHES:
Casseroles and stews in which meats and ingredients are chopped and diced prior to cooking, i.e. beef hash.
FISH: Finely flaked or ground with sauce.
Raw eggs, whole meats, nuts, and crunchy peanut butter
Any None
Bread, Cereal, Rice
& Pasta
Fruit**
6-11 servings.
Cereals: Cooked or ready-to- eat cereals,
Cereal Products: Rice, noodles, macaroni, spaghetti, crackers.
Breads — All kinds of rolls, muffins, biscuits, popcorn, cereals with seeds or nuts, french toast, pancakes or waffles with syrup.
2-4 servings. All fruit juices, canned fruit. Ripe fresh fruit prepared as tolerated with peel and membranes removed— chopped or sliced.
Uncooked dried fruit seeds.
Vegetable** 3-5 servings. All tender or well cooked, finely chopped or shredded, fresh vegetables as tolerated.
Potatoes: Boiled, mashed, baked without skins.
Any raw or cooked vegetables difficult to chew. Potato skins.
Hard fried potatoes.

Fats & Oils
Other
Use sparingly. Margarine, butter, crisp diced bacon, cream, shortening, salad oil, gravy.
Hard fried foods.
Moderate amounts not to exceed caloric requirement. Includes ice cream without nuts or seeds, sherbets, gelatins, puddings, cakes, cookie, pies. Flaked coconut in baked products as tolerated.
Whole or chopped nuts, dried or candied fruit, hard icings, popcorn, potato chips, corn chips.
Beverages & Fluids As desired, at least 6-8 (eight ounce) servings per day.
None
Miscellaneous As desired. Condiments, chopped pickles or pitted olives, spices, vinegar as tolerated.
Whole pickles or olives. All foods listed above.
**Should include 1 Vitamin C source daily and 1 Vitamin A source 3-4 times weekly from fruit and/or vegetable groups .