Your doctor has recommended that you have endoscopic sinus surgery. This procedure will reduce that occurrence and severity of chronic sinus infections. It may relieve symptoms, such as, headaches, difficulty breathing, facial tenderness and sleeping problems. Using an instrument called an endoscope (a very thin telescope); the doctor will examine the nasal and sinus areas. Surgical instruments will be inserted alongside the telescope to allow the doctor to treat the problems inside your sinuses. These procedures are generally performed in a Same Day Surgery Center under general anesthesia. You will be able to go home 1-2 hours after surgery.
The following BEFORE and AFTER instructions can help you obtain the best possible results from your surgery. If you have any questions, please call one of the nurses. Make sure all of your questions are answered before surgery!
1. Tell your doctor all the medications and herbal supplements you are taking. This includes both prescription and over the counter medications.
2. DO NOT take any aspirin containing products for ____ weeks before and ____ weeks after surgery. Some arthritis medication and drugs like Advil, Motrin, Ibuprofen and Aleve act like aspirin and should NOT be taken. These medications may cause increased bleeding during and after surgery. It is okay to take Tylenol during this time period.
If you are taking Aspirin, Coumadin or Plavix special instructions as noted below will apply:
You will need to stop your Aspirin _____ days before surgery or on _____ and resume your Aspirin ____ days after surgery or _____.
You will need to stop your Plavix _____ days before surgery or on _____ and resume your Plavix ____ days after surgery or _____.
You will need to stop your Coumadin _____ days before surgery or on _____ and resume your Coumadin ____ days after surgery or _____.
3. If you develop a cold or any other infection during the two days prior to surgery, please notify our office immediately. The doctor may of may not prescribe an antibiotic instead of postponing your surgery.
4. Plan to spend 7 days away from work or school after surgery. This time frame is provided as a guideline since each individual’s recovery time will vary. Please postpone out of town plans for two weeks after surgery.
NIGHT BEFORE SURGERY
1. DO NOT EAT ANYTHING AFTER MIDNIGHT UNLESS INTRUCTED TO DO SO. IF YOU EAT OR DRINK AFTER MIDNIGHT YOUR SURGERY MAY BE CANCELLED!!
Continue to drink fluids (clear liquids only) up until ____ am/pm. Clear liquids consist of: water, apple or cranberry juice (no orange juice), Gatorade, Chicken Broth, Coffee or tea but no cream or sugar, popsicles and jello. You will feel much better on the day of surgery if you drink clear liquids up until the 4 hours before your scheduled surgery time. Then nothing to drink after ____ am/pm.
2. OK to take important medications with a small amount of water the morning of surgery.
3. Remove all nail polish and make-up. Get a good night’s rest.
4. Wear loose comfortable clothing (button down shirt and sweatpants).
Arrange to have someone drive you to the surgery center and stay with you at home on the night of your surgery. That individual should be available near the waiting room until you have been discharged back to them. (You are NOT allowed to drive yourself home)
Dissolvable packing may/may not have been inserted into your nose. It may create pressure and discomfort. About 4-5 hours after surgery when the numbing medication is wearing off, bleeding from the nose may increase. As the local anesthetic wears off, there may be a burning sensation in your nose. It is not uncommon for the roof of your mouth or your upper teeth to feel sore following surgery. This may last for two weeks. Follow the instructions below to relieve symptoms and optimize healing.
Dressing Care: Change the dressing under your nose as necessary. If you need to change the dressing every 15 minutes or less 4-5 times in a row because it is saturated please call our office. The dressing should stay in place as long as you are having drainage. The drainage usually lasts 2-3 days.
Nasal Saline Spray/Sinus Rinses: It is very important to use a salt water nasal spray to keep your nose clean and moist following your surgery. Before surgery purchase a bottle of Ocean Spray or generic Nasal Saline (Salt) Solution. This product is available over the counter without a prescription. Start nasal irrigations using the saline solution the morning following surgery.
Tip your chin down and insert two sprays in each nostril every two hours while awake. If you choose to use it more frequently, it is okay. Please continue the saline irrigations every two hours until your first postoperative visit. After this visit you will be instructed to continue saline nasal irrigations several times per day until your second visit. You may save the container and mix your own solution using 1-2 tsp of salt per quart of distilled or boiled water (cooled). Remove the top of the spray bottle and refill using this solution or you may purchase a new bottle.
1. ANTIBIOTICS: Your physician may or may not prescribe an antibiotic. If you are given a prescription, please take it a directed until you finish the supply. This is important in wound healing and in preventing infection. You will NOT need a refill.
2. PAIN MEDICATION: The pain medication that is prescribed is usually Tylenol based with a narcotic, so you may experience some drowsiness. You should NOT go to work of school, nor drive a car as long as you are taking the pain medication. Your pain medication should be taken as directed, but DO NOT exceed the prescribed dose. Watch for constipation. If severe pain persists, please call the office.
YOU MAY WISH TO EAT A LITTLE SOMETHING BEFORE YOU TAKE YOUR PAIN MEDICATION, IF NOT YOU MAY DEVELOP AN UPSET STOMACH. Suggestions: Yogurt, Applesauce, Saltine Crackers.
1. ANTI-NAUSEA MEDICATION: You may or may not have been given a prescription for suppositories to alleviate the nausea. If you were not given a prescription and you experience nausea and/or vomiting, please call the office.
2. Avoid alcoholic beverages as long as you are taking prescription medications.
3. DO NOT take Aspirin, Motrin, Advil, Ibuprofen or Aleve for ____ weeks after surgery. These products can thin the blood and may cause bleeding.
4. Refills must be approved by your doctor. Plan ahead and allow the office 48 hours to refill your prescription. Be sure to mention any drug allergies, as well as the name and location of the pharmacy at the time of your refill request.
5. The morning following surgery it is important to start salt-water spray irrigations to keep your nose clean and moist on the inside. Follow instructions on the previous page.
ACTIVITIES AND COMFORT MEASURES:
1. Rest day and at night with head slightly elevated on 2-3 pillows for the first few days.
2. Apply ice to nasal/facial area as tolerated while awake 15-20 minutes on/off for the first few days.
3. You may take a bath or shower at any time.
4. During the first week, quiet indoor activities are recommended.
5. NO heavy lifting, straining, athletic activities or sports for 2 weeks. DO NOT stay bent over for prolonged periods.
6. You may use a humidifier at night while you are sleeping.
7. A low grade fever of 99.9-100.9F is common. To help control your fever, drink plenty of fluids. If the fever exceeds 101.7, call the office.
8. Avoid blowing your nose for 48 hours.
9. If you must sneeze, sneeze with your mouth open to avoid air being forced through your nose.
1. Slowly progress to a regular diet as tolerated. Start off with something light and progress to your usual diet. As long as your stomach is feeling well, you can eat as you like.
2. You may want to keep a drink at your bedside to help clear your mouth. Using a straw is okay if you like.
1. You may or may not have a prescription for steroids usually to be started 4 days prior to your surgery date.
FOLLOW UP APPOINTMENT:
The doctor will want to see you 7-10 days after surgery. Your follow up appointment will be made before you are discharged home on the day of surgery. If an appointment was not made of if you need to reschedule, please call our office.
REASONS TO CALL YOUR DOCTOR AFTER HOURS:
1. Fever of 101.7 degrees or greater. (only call during office hours)
2. Increased bleeding or drainage from the nose or mouth.
3. Severe pain not relieved by medication.
4. Vomiting 2 or more times in one day, after the first 24 hours.
5. Difficulty breathing or swallowing.
6. Welts, Hives or Rashes that appear after taking prescription medication(s).
*If you need to reach the Doctor after hours for an urgent medical issue please call our office number (385-7272). Select option #7 to reach the on call doctor.
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