Post-Operation Instructions



Instructions for ADENOIDECTOMY and PE TUBES

General Instructions

  • Ear Discharge:

    • We place medication in the ear, so it would be normal to see some discharge ( even bloody ) the first day. Beyond the first day this is no longer normal. If it occurs, please call us.

  • Pain:

    • It is normal to have some ear or throat pain the first two days.

  • Temperature:

    • A mild temperature elevation ( 99-100 ) is not uncommon for the first 24-36 hours. For higher or persistent temperatures you should call us.

  • Bleeding:

    • If it takes place, please call us.

  • Diet:

    • Begin a regular one as soon as tolerated.


    For after hours or weekend emergencies, you can reach the doctor on call by calling the answering service at: 443-481-3024.

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Instructions for TONSILLECTOMY

  • Call us at any time if there is mouth/nose bleeding. If calling after normal business hours or on the weekend, the doctor on call can be reached through the answering service at 443-481-3024.
  • Avoid coughing and clearing of throat. Call if the cough is persistent.
  • Drinking the proper amount of fluids is very important. A DRY THROAT WILL EVENTUALLY BLEED. Your child should drink enough fluids that when he/she voids the color of the urine will be pale yellow. Also, the night of surgery someone should wake him/her every couple of hours and have him/her drink some fluids.
  • All liquids are allowed except tomato and citrus juices. The best temperature is room temperature. Hot liquids should be avoided for the first five days.
  • All foodstuffs are allowed except potato chips, crackers, pretzels, etc. which should not be ingested until 17 days after surgery. Do not be concerned if the child will not eat for 2-3 days following surgery.
  • ACTIVITIES

    • It is best to be in a cool place and not to exert yourself in the first five days following surgery. If possible, remain in bed the first day at home. Stay in the area for two weeks. No physical activities for ten days ( sports). Do not leave the house if you are still taking prescription pain medication.

  • EXPECT
    • Earaches. This has nothing to do with the ears. It is simply referred pain from the throat.
    • Slight temperature ( up to 101 degrees ). This is normal for the first couple of days and secondary to mild dehydration and/or post-anesthesia effect.
    • The tongue may hurt or feel nimb for a few days. This is due to pressure from the mouth gag during surgery. Do not be concerned. It will go away within 3 days or so.
  • A yellow shaggy membrane will be seen where the tonsils were. This does not mean that there is an infection. It is simply “ old tissue” which will fall out. It will be replaced by normal healthy tissue.
  • Expect an increase in discomfort by days 6 – 8 . This does not mean that you are getting worse, but is a consequence of developing scar tissue.
  • FOR PAIN CONTROL:

    • Use the prescribed analgesic. For the first 2 days use it every 4 hours “ round the clock”. Do not wait until the patient is experiencing pain or asks for the medicine. After the first 2 days, use it as needed.

    Also:

    • Drink the proper amount of fluids.
    • Chew gum between meals during the first five days.
    • Do not use aspirin or nonsteroidal anti-inflammatory agents ( like Advil, Ibuprofen, etc.)
  • Finally, if there are any questions/doubts, please call us at any time. (410-266-3900 daytime 443-481-3024 evening)
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Instructions for SINUS SURGERY

  • General
    • Do not blow your nose, nor sniff forcefully until told that you may do so safely.
    • When sneezing, please do not try to prevent doing so, rather allow the sneeze to proceed unhindered through your open mouth.
    • DO NOT bend at the waist to pick up heavy objects, children, etc.
    • DO NOT engage in strenuous physical activities (sports, aerobics, jogging, bowling, bike riding, etc.) for 2 weeks.
    • For after hours or weekend emergencies, you can reach the doctor on call through the answering service at 443-481-3024.
  • Specifics

    • Day of Surgery:

    • Go home to rest. Lie down with head elevated (3 pillows). A reclining chair is ideal.
    • Use ice pack on and off throughout the day.
    • Expect some bleeding: your gauze drip pad will have to be changed 8-10 times.
    • Continue taking antibiotics (as prior to surgery) through the third day following surgery unless instructed otherwise.
    • If you notice any swelling, puffiness or discoloration around the eye, please notify us (by calling the office) immediately. Likewise, if you feel that the expected nosebleed, rather than a frequent drip, is in “gushes”.

    First Day After Surgery:

    • If you have a “pack” inside your nose, you should be seen today or as per your written instructions given after surgery.
    • You do not need to stay in bed, but remain at home. Please do not try to do “housework”, rather spend the day in sedentary pursuits.
    • There is no need to continue using the ice pack unless you find it soothing.
    • Expect having to change the drip pad 4 to 5 times.
    • Begin using the nasal saline mist as often as feasible. This is for soothing purposes (by moisturizing and cleansing of the nasal membranes).

    Third Day After Surgery:

    • Begin nasal irrigation with salt solutions: see attached instructions.

    Fourth Day After Surgery:

    • If you had been using a prescription nasal spray prior to surgery, resume using it as before. Make certain you use it following the nasal rinse started yesterday.

    After 10-14 days you will occasionally feel pressure-like discomfort in your sinuses. This should be relieved by gentle nose blowing (which is facilitated by steam inhalation for 3 to 5 minutes). Normally you will feel “something give” and a “clump” of mucus/old blood will be expelled. If this does not work, DO NOT blow forcefully, rather call us.


    Last but not least, there is always an ENT specialist available in the evenings and on the weekends. Feel free to call day or night if you feel that you are not recovering as expected. To reach the doctor on call in the evenings or weekends, call 443-481-3024.

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Instructions for SALINE SOLUTION

Mix together 1 pint of boiled water, ½ tsp sea salt or Kosher salt and ¼ tsp baking soda. Heat the solution to dissolve the salt. Keep in clean covered container.
Obtain a nasal aspirator syringe, see instructions below:

  • Nasal aspirator syringe (rubber bulb with small nozzle, may be purchased in any drugstore).
  • While tilting the head down over a sink, squeeze rubber bulb with moderate pressure. Irrigating should be forceful but should not hurt. Sometimes the solution return will be accompanied by small blood clots, mucus, etc. When inserting the nozzle in the nose, aim as if you wanted to shoot a spot between the nose and corner of the eye. Do this 4 times a day.