POST-OPERATIVE INSTRUCTIONS
ADENOIDECTOMY
DIET
BLEEDING
A common side effect from the anesthesia is mild nausea and
vomiting. Until this resolves, the patient should have clear
liquids in small amounts. After they are feeling better, they may
advance to a regular diet.
Bleeding is an uncommon complication of this surgery. Any
bright red blood measuring greater than 2 tablespoons should be
reported to the office.
ACTIVITY
Avoid strenuous activity for the first 24 hours; after that, the
patient may resume their normal activity.
HEALING
Occasionally, the patient will have a blocked-up sensation in
their nose for up to 2 weeks while their adenoid bed is healing. If
this continues beyond this time, please let us know.
FEVER/PAIN
FOLLOW UP
Occasionally, a temperature may be present for the first few days
after surgery. If this happens I recommend taking Tylenol. If the
temperature continues for more than 48 hours, and is greater than
101.5, please call the office for instructions. For pain control,
Tylenol should be used.
Your post-operative appointment should be made for
approximately 2 weeks after your surgery. Please call the office
if you have any questions or problems
POST-OPERATIVE INSTRUCTIONS
TONSILLECTOMY AND ADENOIDECTOMY
DIET
A common side effect from the anesthesia is mild nausea and
Vomiting. Until this resolves, the patient should have clear liquids in small
amounts. After they are feeling better, they may advance to a regular diet.
Not wanting to eat for the first several days is not unusual but ITIS VERY
IMPORTANT
TO
DRINK
PLENTY
OF
FLUIDS.
These fluids may be in any of the following forms: popsicles, tea, apple and
grape juice, soups, jello, pudding, ice cream, milk shakes, custard, and so on.
I suggest that you avoid highly seasoned, salted, or sharp foods such as
potato chips or breadsticks. Also, avoid acidic foods such as oranges or
tomatoes as they burn. However, beginning the first day, a patient may eat a
diet as tolerated. After 2-3 days, it is important to keep the pharyngeal
muscles in motion. To do this, I would suggest that the patient start chewing
gum on the 2nd day through the 10th day after surgery. This usually decreases
the muscle spasms of the pharyngeal muscles and will decrease the pain.
ACTIVITY
Avoid strenuous activity during the recovery period. Children do not
need to stay in the bed, but to remain relatively quiet for the first
couple of days. Their activity should be gradually increased over the
next several days. Children should not return until they have been
without a temperature for 24 hours and have adequate fluid intake.
They may go back to school as soon as 72 hours after the surgery,
but it is usually 5-7 days before they are ready to return to school.
NO PHYSICAL EDUCATION OR SPORTS FOR 2 FULL WEEKS!
Adults should avoid strenuous activity, exercise or heavy lifting for 2
Weeks and may return to work when they feel able. An ice pack
should be placed around the neck for the first 24 hours as this will help
decrease the swelling. Avoid strenuous activity for the first 24 hours;
after that, the patient may resume their normal activity.
FEVER/PAIN
Occasionally, a temperature may be present for the first few days
after surgery. If this happens I recommend taking Tylenol. If the
temperature continues for more than 48 hours, and is greater than 101.5,
please call the office for instructions. DO NOT TAKE ASPIRIN OR
ASPIRIN PRODUCTS AS THEY MAY CAUSE BLEEDING.
A sore throat may persist for up to 2 weeks. In children, the pain is
usually easily controlled with Tylenol. A prescription for stronger medicine
may be given in older children or adults. Usually in 5-7 days the pain is
residing. However, on occasion, especially if the patient has not taken
enough fluids, the pain may be increased or associated with earaches. These
earaches are not usually related to an ear infection, but are related to the
healing process of the tonsil. If pain is not controlled by the pain medicine
you are given, please call the office.
BLEEDING
An uncommon complication of this type of surgery is bleeding. Blood
streaks in the saliva may occur for the first 2 days. Bright blood, measuring
more than 2 tablespoons SHOULD BE REPORTED TO THE OFFICE. It is
usually easily controlled by having the patient rest quietly and by applying an
ice collar to the neck. If the patient is old enough to gargle, ice water may be
used to gargle and this may be helpful. Bleeding may occur at 7-10 days
when the scabs are coming off the tonsils. This usually has happened when
the patient has been involved in strenuous activity. This type of bleeding is
rarely a problem and will stop with the above measures. Coughing or
clearing the throat should be avoided as much as possible during the recovery
period. Bleeding is an uncommon complication of this surgery. Any bright
red blood measuring greater than 2 tablespoons should be reported to the
office.
OTHER SYMPTOMS
Bad breath and an unpleasant taste are not unusual. The tongue is often
coated and the tonsils may have a white appearance. This is part of the
healing process and does not mean that they are infected. To decrease the bad
breath and unpleasant taste, we recommend brushing your teeth several times
a day, and you may use a warm salt water gargle, teaspoon of salt and a large
glass of water.
FOLLOW UP
Your post-operative appointment should be made for approximately 2 weeks
after your surgery. Please call the office if you have any questions or
problems.
MYRINGOTOMY AND TUBES
POST-OPERATIVE INSTRUCTIONS
DIET
WHAT DOES THE SURGERY INVOLVE?
A myringotomy is an opening that is surgically created in the eardrum to allow the
removal of fluid and entrance of air into the middle ear. This is usually done when
the ears are repeatedly infected and do not respond to antibiotics. The most common
secondary cause is chronic fluid, which remains behind the eardrum for around 8-12
weeks in spite of adequate medical therapy. Occasionally, if the eardrum is retracted
(sucked in), a tube will be placed in an effort to restore it back to normal position.
The tube is placed after the hole in the eardrum is made in to prevent the opening
from closing. Chronic ear problems can result from allergies, sinusitis, tonsil and
adenoid enlargement, or infections.
WHAT IS THE PURPOSE OF TUBES?
The function of the ventilation tube is to allow the exchange of air between the
middle ear and external environment. This, hopefully, will allow the return of normal
middle ear function over a period of time. The tube takes over the function of the
patient's own Eustachian tube. It allows drainage outward to relieve pressure should
an ear infection occur. Its main advantage, however, is to prevent serious
complications that occurred in the past, such as mastoid infections, disruption of
hearing bones, hearing loss, or meningitis.
HOW LONG DOES THE TUBE STAY IN THE EAR?
The tube usually remains in the eardrum for eight to twelve months. It will
occasionally come out in a few days or a few weeks if a severe ear infection occurs.
It is very important that you see a physician within 24 hours if you notice any
drainage from the ear which is indicative of an infection. This will lessen the
chances of the tube falling out prematurely. When the tube comes out, the slit in the
eardrum usually closes by itself. However, on rare occasions, it will not close
spontaneously and may need to be closed surgically. You may not see the tube when
it comes out because of its small size. Occasionally, if the tube stays in longer than 3
years, it will be necessary to have it removed surgically.
WILL TUBES BE NEEDED AGAIN?
Over 80% of the time only one set of tubes will be needed for the
initial problem to resolve. However, on occasion, a tube will come out
too early or after it comes out, the fluid reoccurs and persist
necessitating a second set of tubes. When it does, this may be quite
silent and, if left unattended, may result in a significant problem. This is
why it is very important to have your child checked by their primary care physician
every 4 to 6 months to make sure that the tubes are functioning properly. If it is
necessary to replace the tubes, we usually remove the adenoids the second time this
procedure is performed.
Occasionally, there may be nausea and vomiting so we recommend starting with
clear liquids an switching to a regular diet as tolerated.
PAIN
Generally, this procedure causes no pain, but Tylenol may be given as needed. The
child may complain of a popping sensation in his ear until the Eustachian tube
function returns to normal. Occasionally, a young child will continue to pull at
his ears out of habit.
ACTIVITY
The child may resume his normal activity the evening of surgery.
EAR DRAINAG
This is not an emergency; however, the child should be checked within 24 hours to
see if a medicine needs to be prescribed. Ear drainage for the first 2-3 days following
surgery is not uncommon and need not be worried about. However, after 3 days, we
ask that you notify us for advice as to what you should do. After the routine post-op
visit, we recommend that you contact your primary care provider for this problem.
Often the drainage may be bloody if there is an infection present, and this should be
treated in the same manner as if there is pus draining from the ear.
EAR PROTECTION
Your child's ears should be kept as dry. It is okay to wash the ears normally with a
cloth, but keep water out of the ears. Usually the easiest way to do this is to place a
small piece of cotton, with the outside greased with Vaseline, in the ear. This will
form a watertight seal and allow you to wash your child's hair. Other mechanisms to
keep water out of your child's ear include: over-the-counter earplugs or custom ear
molds. The custom ear molds are available in our office. I feel very strongly that
anyone with a tube in place has to be careful about keeping water out of their ears
and should swim with earplugs. Swimming should take place only in chlorinated
water. Submersing the head under the surface is okay as long as it is not deeper than
one foot below the surface.
EAR DROPS
Post-operatively, you will be given eardrops, which help keep the tube open and heal
the middle ear. The patient must remain still for a few minutes when the drops are
placed in the ear. Keep the extra drops handy in case of any drainage in the future.
Most times the eardrops do not burn; if they do we may prescribe eye drops instead.
The best way to instill the drops is to first wipe away any visible drainage to allow
the drops to get down in the ear. Then shake and warm the container of drops in the
hand. Instill the drops into the ear canal then gently massage in front of the ear to
allow drops to run down into ear canal.
POST-OPERATIVE INSTRUCTIONS
SEPTOPLASTY
DIET
You may resume your normal eating habits immediately after your
surgery. There are no restrictions on your diet. If nauseous stick with
clear liquids for a few hours to see if it resolves
ACTIVITY
For the first two weeks after your surgery You SHOULD NOT do any
heavy lifting, straining or vigorous activities. The risk of postoperative bleeding is greater in patients who do not avoid these types
of activities. During the first 3-5 post-operative days it may be more
comfortable for you to sit in an upright position and even sleep in a
reclining chair. Most people can return to their normal activities,
including their jobs within 7-14 days, as long as they avoid the
activities mentioned above.
DO NOT try to blow your nose after surgery until the packing is
removed. If you need to sneeze, SNEEZE WITH YOUR MOUTH
OPEN. If you try to suppress a sneeze, the pressure may disrupt the
surgery results.
HEALING
We strongly suggest that you obtain a cool mist vaporizer and run this
at night, as this will loosen the nasal secretions and lessen your nasal
congestion. Following surgery, most of your discomfort will be
secondary to congestion from swelling of the membranes of the nose.
If a nasal splint is used this will be removed in the office in 3-5 days.
AS SOON AS THE SPLINT IS REMOVED, YOU MAY GENTLY
BLOW YOUR NOSE. The first few days following surgery, a small
amount of bleeding may occur. You may contain this bleeding by
placing small 2x2 gauze across your nostrils and taping with 1-inch
tape to the cheek area. You may change this gauze as needed. After the
first post-operative visit, you will be given instructions for mixing and
using salt-water nose drops. THE USE OF THESE DROPS IS
VERY IMPORTANT TO YOUR HEALING PROCESS, SO
PLEASE FOLLOW THE INSTRUCTIONS CAREFULLY.
You will have stitches inside your nose. These stitches are dissolvable
and do not need to be removed. Occasionally, a stitch will come loose
and it will feel like a long thread. This should be cut rather than pulled
out as it may affect your surgical result. On rare occasions, it may be
necessary to place splints inside your nose. If this is done, they will be
removed in the office following the surgery. Occasionally, the cut
surface of your nose will be raw. If this is a troublesome area, apply
Bacitracin ointment, which can be obtained over-the-counter, 3 or 4
times a day. You may use q-tips soaked in peroxide to remove the
dried blood at the tip of your nostrils.
PAIN
The post-operative pain associated with nasal surgery is usually
moderate to minimal. You have been given a prescription for pain
medicine that you may take as necessary. You also may take regular
Tylenol, but we ask that you stay away from aspirin or aspirin
products as they may cause bleeding. The pain medicine should only
be taken as needed and is best taken with meals or food to prevent
nausea
ANTIBIOTICS
Following surgery, you will receive a prescription for an
antibiotic, and it is very important that you take all of the doses
as directed. This will decrease the chances of the nasal mucosal
lining becoming infected after surgery.
.
FOLLOWING SURGERY, YOU WILL NOT BE ABLE TO
BREATH OUT OF YOUR NOSE VERY WELL. DO NOT become
discouraged. As the healing process begins and you begin to use the
salt-water nose drops, you will feel the improvement. I currently
recommend using Ocean Spray or Saline 3 or 4 times a day, to
moisturize your nose and speed healing. It is EXTREMELY
IMPORTANT that you use the nose drops as your healing may be
delayed if you do not. IF YOU HAVE ANY QUESTIONS ABOUT
THE DROPS OR SPRAY, please do not hesitate to call.
IF YOU HAVE ANY PROBLEMS/QUESTIONS PLEASE CALL
POST-OPERATIVE INSTRUCTIONS
FOLLOWING SINUS SURGERY
DIET
Following sinus surgery there are no restrictions on your diet.
You may resume your normal eating habits immediately after
your surgery.
ACTIVITY
For the first two weeks after your surgery You SHOULD NOT
do any heavy lifting, straining or vigorous activities. The risk of
post-operative bleeding is greater in patients who do not avoid
these types of activities. During the first 3-5 post-operative days
it may be more comfortable for you to sit in an upright position
and even sleep in a reclining chair. Most people can return to
their normal activities, including their jobs within 7-14 days, as
long as they avoid the activities mentioned above.
PAIN
The post-operative pain associated with sinus surgery is usually
minimal. You have been given a prescription for pain medicine
that you may take as necessary. You also may take regular
Tylenol, but we ask that you stay away from aspirin or aspirin
products as they may cause bleeding.
ANTIBIOTICS
Following surgery, you will receive a prescription for an
antibiotic, and it is very important that you take all of the doses
as directed. This will decrease the chances of the nasal and sinus
mucosal lining becoming infected after surgery.
HEALING
We strongly suggest that you obtain a cool mist vaporizer and
run this at night, as this will loosen the nasal secretions and
lessen your nasal congestion. Following surgery, most of your
discomfort will be secondary to congestion from swelling of the
membranes of the nose. Packing which is placed in your nose is
usually removed within the first 24 to 48 hours. If a nasal splint
is used this will be removed in the office in 3-5 days. AS SOON
AS THE PACKING IS REMOVED, YOU MAY GENTLY
BLOW YOUR NOSE. The first few days following surgery, a
small amount of bleeding may occur. You may contain this
bleeding by placing small 2x2 gauze across your nostrils and
taping with 1-inch tape to the cheek area. You may change this
gauze as needed. The majority of crusting that is present will be
removed in the first several post-operative visits. These visits to
the office involve spraying
your nose with a
numbing/decongestant spray, which involves between 20 and 30
minutes in the office. Please allow this in your schedule. After
the first post-operative visit, you will be given instructions for
mixing and using salt-water nose drops. THE USE OF THESE
DROPS IS VERY IMPORTANT TO YOUR HEALING
PROCESS, SO PLEASE FOLLOW THE INSTRUCTIONS
CAREFULLY.
FOLLOW-UP
A follow-up visit will be scheduled for you to have your packing
removed and nose cleaned out. It is VERY IMPORTANT that
you keep your appointments post-operatively to make sure that
you are healing in an appropriate manner. Even one missed postoperative visit can result in an infection or scarring, significantly
decreasing the effect of your surgery. IF YOU HAVE ANY
QUESTIONS OR PROBLEMS, PLEASE CALL OUR
OFFICE AT 704 544-6533 / 803 328-3686.
POST-OPERATIVE INSTRUCTIONS
Tonsillectomy/Uvulopalatopharyngoplasty
DIET
A common side effect from the anesthesia is mild nausea and
Vomiting. Until this resolves, the patient should have clear liquids in small
amounts. After they are feeling better, they may advance to a regular diet.
Not wanting to eat for the first several days is not unusual but IT IS VERY
IMPORTANT
TO
DRINK
PLENTY
OF
FLUIDS.
These fluids may be in any of the following forms: popsicles, tea, apple and
grape juice, soups, jello, pudding, ice cream, milk shakes, custard, and so on.
I suggest that you avoid highly seasoned, salted, or sharp foods such as
potato chips or breadsticks. Also, avoid acidic foods such as oranges or
tomatoes as they burn. However, beginning the first day, a patient may eat a
diet as tolerated. After 2-3 days, it is important to keep the pharyngeal
muscles in motion. To do this, I would suggest that the patient start chewing
gum on the 2nd day through the 10th day after surgery. This usually decreases
the muscle spasms of the pharyngeal muscles and will decrease the pain.
ACTIVITY
Avoid strenuous activity during the recovery period. Children do not
need to stay in the bed, but to remain relatively quiet for the first
couple of days. Their activity should be gradually increased over the
next several days. Children should not return until they have been
without a temperature for 24 hours and have adequate fluid intake.
They may go back to school as soon as 72 hours after the surgery,
but it is usually 5-7 days before they are ready to return to school.
NO PHYSICAL EDUCATION OR SPORTS FOR 2 FULL WEEKS!
Adults should avoid strenuous activity, exercise or heavy lifting for 2
Weeks and may return to work when they feel able. An ice pack
should be placed around the neck for the first 24 hours as this will help
decrease the swelling. Avoid strenuous activity for the first 24 hours;
after that, the patient may resume their normal activity.
FEVER/PAIN
Occasionally, a temperature may be present for the first few days
after surgery. If this happens I recommend taking Tylenol. If the
temperature continues for more than 48 hours, and is greater than 101.5,
please call the office for instructions. DO NOT TAKE ASPIRIN OR
ASPIRIN PRODUCTS AS THEY MAY CAUSE BLEEDING.
A sore throat may persist for up to 2 weeks. In children, the pain is
usually easily controlled with Tylenol. A prescription for stronger medicine
may be given in older children or adults. Usually in 5-7 days the pain is
residing. However, on occasion, especially if the patient has not taken
enough fluids, the pain may be increased or associated with earaches. These
earaches are not usually related to an ear infection, but are related to the
healing process of the tonsil. If pain is not controlled by the pain medicine
you are given, please call the office.
BLEEDING
An uncommon complication of this type of surgery is bleeding. Blood
streaks in the saliva may occur for the first 2 days. Bright blood, measuring
more than 2 tablespoons SHOULD BE REPORTED TO THE OFFICE. It is
usually easily controlled by having the patient rest quietly and by applying an
ice collar to the neck. If the patient is old enough to gargle, ice water may be
used to gargle and this may be helpful. Bleeding may occur at 7-10 days
when the scabs are coming off the tonsils. This usually has happened when
the patient has been involved in strenuous activity. This type of bleeding is
rarely a problem and will stop with the above measures. Coughing or
clearing the throat should be avoided as much as possible during the recovery
period. Bleeding is an uncommon complication of this surgery. Any bright
red blood measuring greater than 2 tablespoons should be reported to the
office.
OTHER SYMPTOMS
Bad breath and an unpleasant taste are not unusual. The tongue is often
coated and the throat may have a white appearance. This is part of the
healing process and does not mean that they are infected. To decrease the bad
breath and unpleasant taste, we recommend brushing your teeth several times
a day, and you may use a warm salt water gargle, teaspoon of salt and a large
glass of water.
FOLLOW UP
Your post-operative appointment should be made for approximately 3-5 days
after your surgery for splint removal. Please call the office if you have any
questions or problems.