Post
op instructions

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Tympanoplasty or Tympanomastoidectomy Stapedotomy

  • Take all prescribed medications as directed. Additionally, ear drops may be prescribed to moisten an ear wick inserted into your ear canal.
  • Avoid strenuous activity until after first postop visit; indoor activity only.
  • Avoid getting water into ear.
  • Avoid blowing nose for 2 weeks.
  • Avoid bending head downward.
  • May wash hair with assistance 4th postop day.
  • If you must sneeze, do so with the mouth open.
  • Regular diet.
  • Keep any visible incisions covered lightly with Bacitracin ointment to prevent crusting.
  • Remove any external dressing on 2nd postop day. Do not remove ear wick if one was inserted.
  • Expect mild drainage for 2 weeks; may lightly place cotton ball into ear canal opening.
  • Elevate head of bed 30° on 4-6" bed blocks or angle mattress 30° until first postop visit.
  • Check-ups: Return one week following surgery unless you are told differently.

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Tonsillectomy and Adenoidectomy

Day 1: (At Home)--Keep indoors.

DIET: Ices, soft drinks,carnation instant breakfast, smoothies, Pediasure, pedialyte, puddding, soft cereal, ice cream, and grape or apple juices. Encourage the child to frequently drink small amounts of fluids, as the more he swallows the less sore his throat will be.**NO POPCORN, FRIED FOODS, CRACKERS, POTATO CHIPS, FRENCH BREAD, OR ANY SOLIDS THAT MIGHT IRRITATE THE THROAT. AVOID ORANGE JUICE, GRAPEFRUIT JUICE, AND TOMATO JUICE FOR SEVERAL DAYS AS THEY WILL BURN THE THROAT.

Day 2: DIET:
As above; plus soft-boiled or scrambled eggs, well mashed potatoes, and warm soups. You may chew gum if old enough but make sure not to swallow it.
**NO HOT, HARD, SOUR, OR HIGHLY SPICED FOODS. **Chloraseptic or Spec T Lozenges 15 minutes before meals may help the pain.

Day 3:
You may go outside only if weather is nice. DO NOT GET OVER-HEATED FOR THREE FULL WEEKS FOLLOWING THE SURGERY. DIET: As above, plus start soft buttered noodles other soft meats (well chopped and blended), soft vegetables and bread WITHOUT crust.

Days 4,5,6:
Gradually add foods, including well cooked meat, and any foods which are soft.

Throat pain form a Tonsillectomy can range from mild to sever. Sometimes patients seem to do well and have mild pain the first couple days after surgery and the may complain that the pain gets worse at days 3-5. This is normal and is a part of the body's healing process. For pain relief, most importantly, use the prescribed pain medication and drink plenty of cool fluids. Additionally you may use maximum strength succretts or chloraseptic spray. In some cases when the pain is severe to cause dehydration you may need to report to OLOL Emergency room to be given stronger pain medications and fluids through an IV or injection
BOWEL MOVEMENTS: After surgery your child's bowel movements may become less frequent due tothe anesthesia, pain medications and less solid foods eaten. If the child complains of stomach pains due to possible constipation you can try milk of magnesia and/or glycerin suppositories(over the counter) miralax.

A low grade fever can be normal after surgery but can also be a sign of dehydration.
For fever over 101° you may give an additional does of plain Tylenol with the pain medication but only administer 1/2 the recommended dose on the Tylenol bottle. The pain medication prescribed has some Tylenol already in it. Increase cool fluids and monitor.

For fever greater than 102°, During Office Hours,come in to see your surgen.

For fever over 102°, After Office Hours, go to the Our Lady Of the Lake After Hours Clinic or Our Lady Of the Lake Emergency Room to be evaluated by a doctor.

BLEEDING: Rarely, but sometimes bleeding occurs after the patient has gone home or even up to three weeks after surgery. If the patient spits out only a few drops of blood, try ice water gargles for 10 minutes then lie down and then place an ice collar around the neck. If the bleeding does not stop,if the patient is spitting up a lot of blood, or if blood is flowing from the nose, CALL 225-767-7200 and proceed to the nearest Emergency Room!!!!.***PREFERABLY OLOL ON ESSEN IF ABLE TO MAKE IT THERE***


OFFICE FOLLOW UP: Follow up with your surgeon one week after surgery, call 225.767.7200 to schedule this "post operative" appointment.

JUST A FRIENDLY REMINDER: Please make sure that you have plenty of pain medication to get you through after the clinic closes and especially if a weekend or holiday is approaching. The on call surgeons DO NOT call out pain medications or antibiotics over the telephone! For safty reasons it is our office policy to only refill medications during office hours. Thank You!

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Tympanostomy Tube Insertion with or without Adenoidectomy

  • Avoid getting water or foreign debris into ears (use earplugs or cotton ball lightly coated with Vaseline jelly in ear canal opening when bathing).
  • Patient may resume usual activities 24 hours after surgery.
  • Use prescribed medications as directed.
  • Bedside humidifier may be used for nasal congestion if needed.
  • Mild discomfort sometimes occurs from adenoidectomy, use plain Tylenol; avoid aspirin.
  • Office follow-up in 3 weeks. Ear molds or ear plugs may be obtained at this time if desired.
  • Regular diet.

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Blepharoplasty

  • Remain quiet and relaxed at home.
  • Elevate head of bed 30°- 45° when sleeping and napping until first post-op visit; return to office four to five days post-op.
  • Ice soaked gauzes to eyes for 36 hours post-op (for 20 minutes every two hours).
  • Diet Regular as tolerated.
  • Avoid direct sunlight for four weeks; wear dark glasses and a hat.
  • Apply ointment (prescribed) gently to incisions three times a day.
  • Notify doctor if eyes swell closed or eye pain seems excessive.
  • May wear eye makeup on eighth post-op day.
  • Absolutely no smoking for two weeks post-op and preferably never thereafter.
  • Expect bruising and mild swelling of eyelids.
  • Take medicines as prescribed.
  • Don't use Aspirin products.
  • Don't pull eyebrows for two weeks.
  • Avoid bending over or strenuous activity for four weeks.
  • Hair may be washed after third post-op day.
  • Swelling and discoloration is temporary so don't become depressed about this.

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Facelift/Forehead Lift

  • Avoid turning head or bending neck.
  • Ice soaked gauzes or washcloths to jaws and neck for 20-30 minutes every 2-3 hours (may be placed in a plastic wrapper bag).
  • Return to the office one day after surgery for dressing removal—DON’T remove it yourself.
  • Elevate head of bed 30º– 45º during sleep for two weeks (use pillows under head of mattress).
  • Take all prescribed medicines as directed. These help minimize swelling.
  • Use a laxative if constipated.
  • Activity: Quiet indoor resting. Avoid bending over or lifting heavy things for one week.
  • Wear support sling as directed (constantly for 1-2 weeks after surgery then during sleep for one month).
  • Avoid excessive sun exposure of the face for six weeks.
  • May wash hair four days after surgery.
  • Cosmetics: May begin use after all sutures are removed (after 10-14 days postop).
  • Do not tweeze eyebrows for one week.
  • Soft diet: Avoid excessive chewing for one week.

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Facial Fractures

AFTER SURGERY:
Take medicine as prescribed after leaving the hospital. These will help dissipate the swelling.
Elevate head of bed 30° to 45° when sleeping and napping until first postop visit; return to office 4-5 days postop.
Ice soaked gauzes to eyes for 36 hours postop (for 20 minutes every 2 hours).
Keep incisions clean with peroxide and lightly covered with bacitracin eye ointment for 4-5 days.
Avoid sleeping or applying pressure against area of facial fracture.
Don't lift objects for 2 weeks; avoid bending head downward.
Don't keep looking into the mirror; bruising and swelling usually disappear in 2-3 weeks.
Don't use sun lamps or direct sun for one month as this can cause swelling.
Hair may be washed after the 4th postop day with assistance.
Check-ups: Return 1 week following surgery unless you are told differently.

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Laser Assisted Uvulopalatoplasty (laup)

Take antibiotics as prescribed.
Take pain medication as prescribed. Expect a moderate amount of pain for several days.
Gargle with warm salt water (1 tablespoon per 8 oz glass) twice a day for 2 weeks.
Soft diet for 1-2 days following the procedure. Avoid orange juice, grapefruit juice, and tomato juice for several days as they burn the throat. Avoid hot, hard, sour, or highly spiced foods for several days.
No aspirin, motrin, or any other medications containing NSAID’s.
Chloraseptic, Spec-T, Sucrets, or Cepacol lozenges every 2 hours as needed for several days.
Bleeding: Sometimes bleeding occurs after the patient has gone home. If you spit out only a few drops, don’t panic. Gargle gently with ice water until clear. IF BLEEDING A LOT OR THERE IS A STEADY BLOOD FLOW, CALL THE OFFICE AT 225.767.7200.

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Nasal Reconstruction

AFTER SURGERY:

  • Take medicine as prescribed after leaving the hospital. This will help dissipate the swelling.
  • Elevate head of bed 30° when sleeping or napping until first postop visit.
  • Ice soaked 4" X 4" or 2" X 2" gauzes to eyes for 36 hours (for 20 minutes every 2 hours); don't get nasal cast wet; don't use heavy ice bags.
  • Don't cover nose with bandages or dressings. Change dressing under nose as needed. Expect mild bloody mucous drainage within 48-72 hours.
  • Don't lift heavy weights for at least two weeks. Avoid bending head downward.
  • Irrigate nose gently six times daily with saline nose spray (Examples: Ocean or Ayr). Begin 1 day after surgery. 3-4 sprays each nostril every 4 hours when awake.
  • May gently clean nasal openings with cotton tip applicator soaked in hydrogen peroxide as needed.
  • Apply jelly bean size puddle of Bacitracin ointment to each nasal opening every 4 hours when awake.
  • During the first days any secretions from the nose should be blotted off with tissues and not wiped away. Avoid hard sniffing.
  • Don't wear regular glasses or sunglasses which can rest on the bridge of the nose for at least 6 weeks. If you must wear glasses, we will show you how they should be taped to the forehead. Contact lenses may be used within 2-3 days after surgery.
  • Don't strike or bump nose. Don't squeeze or move your nose.
  • Don't tweeze eyebrows for one week. Don't massage nose until told to do so.
  • Don't blow nose for the first 4 days. Following this, you may blow it with both sides open at first. After two weeks, you may blow the nose normally.
  • Don't wash nose with face cloth or hands--use cotton. Take tub baths for one week.
  • Brush teeth with soft toothbrush only.
  • DON'T WASH YOUR HAIR WHILE BANDAGES ARE ON NOSE.
  • Don't swim for one month. No diving for at least 2 months.
  • Don't eat coarse food or chew vigorously for one week. Soft diet. Drink liquids with a straw.
  • Don't use sun lamps or direct sun for one month as this can cause swelling.
  • Don't keep looking into the mirror.
  • Entire nose, upper lip and eyes may be somewhat swollen after bandages are removed.
  • Don't be disturbed. Swelling usually disappears in 2-3 weeks. However, it takes 6 months for the last 1% to 2% of the swelling to disappear. This does not detract from appearance of nose or bother patient.
  • The skin of the nose should be cleaned gently with any mild soap or cleansing cream as soon as the tape is removed.
  • You may start using make-up as soon as the tape is removed. To cover the discoloration, you may use clinque cover cream or other non-allergenic cover cream or lotion.
  • There is no danger in gently cleansing the outside of the nose or in the use of cosmetics.
  • Check-ups: We would like to see you in 1 week, 2 weeks, 1 month, 6 months, and 1 year following surgery.

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Otoplasty

  • Before and after surgery read these instructions several times.
  • Take medicine as prescribed after leaving the hospital. This will help dissipate swelling.
  • Elevate head of bed 20º – 30º when sleeping or napping (until first postop visit).
  • Don’t sleep directly on either ear.
  • Leave dressing intact until seen in the office—DON’T remove dressing yourself.
  • Return to the office the next day after surgery for the first dressing change.
  • Wear ear dressing daily. Make adjustments as needed if it slips off or becomes crooked.
  • Prior to applying each new dressing apply antibiotic ointment (i.e. Bacitracin or other if prescribed) to ear incisions with a cotton applicator.
  • Dried bloody crust may be removed from ears or incisions with cotton tip applicators soaked in hydrogen peroxide.
  • Return for office follow-up on first postop day, then at three days postop, one week postop, two weeks postop, then as directed.

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SMR/Septoplasty with or without Endoscopic Sinus Surgery

AFTER SURGERY:
Take medicine as prescribed after leaving the hospital. This will help dissipate the swelling.
Elevate head of bed 30° when sleeping or napping until first postop visit.
Don't cover nose with bandages or dressings. Change dressing under nose as needed. Expect mild bloody mucous drainage within 48-72 hours.
Don't lift heavy weights for at least two weeks. Avoid bending head downward.
Apply jelly bean size puddle of bacitracin ointment to each nasal opening 4 times daily; use finger or cotton tip applicator.
Irrigate nose gently six times daily with saline nose spray (Examples: Ocean or Ayr). 3-4 sprays each nostril every 4 hours when awake.
May gently clean nasal openings with cotton tip applicator soaked in hydrogen peroxide as needed.
During the first days any secretions from the nose should be blotted off with tissues and not wiped away. Avoid hard sniffing.
Don't strike or bump nose. Don't squeeze or move your nose.
Don't blow nose for the first four days. Following this, you may blow the nose gently with both sides open.
Don't keep looking into the mirror.
There is no danger of gently cleaning the outside of the nose or in the use of cosmetics.
Check-ups: We would like to see you in one week, two weeks, one month, and 6 months following the surgery.
After your surgery the first and second check-ups may require a special clean out procedure that will make you breathe easier. These procedures will be charged separately from the surgery.

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Thyroidectomy and Parotidectomy or other Head and Neck Procedures

  • Take all prescribed medications as directed.
  • Remove any external dressing on the 2nd postop day; replace new dressing if needed.
  • Keep any visible incisions covered lightly with Bacitracin ointment to prevent crusting, unless you are told differently. You may gently clean skin around incision with hydrogen peroxide prior to applying ointment.
  • Care for any drain as instructed. Measure, record, empty and restart any suction bulb drain every 8 hours until it is removed in the office.
  • Come to the office for drain removal on the 1st, 2nd, or 3rd postop day as directed.
  • Regular diet.
  • Avoid strenuous activity for one week.
  • Don't lift anything over 15 pounds for one week.
  • Expect mild skin swelling around incision.
  • Avoid sleeping against or applying pressure against area of surgery.
  • Elevate head of bed 30° when sleeping or napping to minimize swelling and discomfort. Plan this for 3 to 5 days.
  • Use mild laxative if constipated. Avoid straining.
  • Checkups: Return 2 to 3 days postop, then one week postop unless you are told differently.

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