POST OP INSTRUCTIONS FOLLOWING NASAL AND SINUS SURGERY (ABBREVIATED)

- Elevate the head at all times. Head elevation reduces bleeding and swelling.

- Avoid strenuous activity or heavy lifting for a minimum of 2 week following surgery. 

- Do not blow your nose for at least 2 weeks after surgery.  If you have to sneeze or cough, do it with your mouth open.

- Do not remove packing or splints if present. You may have to breathe from your mouth if the splints get occluded with mucous or clots.

- Do not take Aspirin, Aleve, Motrin or other products that increase your risk for bleeding.  Do not smoke for a minimum of 3 weeks after surgery.

- A small amount of bleeding is expected for two to three days after surgery. Just change the drip pad as needed and keep the nostril clean.  If you have a brisk bleed that does not stop, present to the nearest emergency room.

- If you experience any changes in vision, pain with eye movements, rapid increase in swelling around your eyes present to the nearest emergency department without delay.

1. -Any fever over 101 F (38C) occurring before your scheduled follow up office visit should be reported to the office.
   

POST OP INSTRUCTIONS FOLLOWING NASAL AND SINUS SURGERY (EXTENDED)

DIET:

- Patients who have received general anesthesia may experience some nausea and occasionally, vomiting.  It is therefore preferable to eat a bland light meal or a liquid diet on the first day after the surgery.  Regular diet may be resumed the next day.

WOUND CARE AND RELATED INFORMATION:

1. Elevate the head at all times. Sit in a recliner or use two or three pillows when sleeping. Head elevation reduces bleeding and swelling.

2. Take the pain killers with some food or a piece of toast. This reduces nausea.

3. You may take a shower with lukewarm (not hot) water. Make sure you have someone with you in the house in case you feel drowsy or light headed from taking pain killers.

4. Do not remove packing or splints if present. You may have to breathe from your mouth if the splints get occluded with mucous or clots. This may cause a dry mouth. It is therefore very important to drink a lot and maintain adequate hydration.

5. Bleeding is expected for two to three days after surgery. Just change the drip pad as needed and keep the nostril clean. GENTLY clean the dried blood and secretions from the outer rim of the nostrils with hydrogen peroxide 3% and Q-tips.

6. Keep teeth clean. You may use mouthwash.

7. Avoid strenuous activity or heavy lifting for a minimum of 2 week following surgery.

CARE AFTER REMOVAL OF PACKS OR SPLINTS:

1. Do not blow your nose for at least 10 days from the day of surgery. Avoid heavy lifting or straining (nothing greater than 8lbs, approximately the weight of a gallon of milk).  Do not strain at the toilet. Use gentle laxatives as needed.  These activities will increase the likelihood of nasal bleeding.

2. If you have to sneeze or cough, please do it with your mouth open. This prevents excessive pressure build-up and bleeding from the nose.

3. Do not take Aspirin, Aleve, Motrin or other products that increase your risk for bleeding.  Do not smoke for a minimum of 3 weeks after surgery as this will cause irritation leading to bleeding and poor wound healing. 

4. For 3 days after the removal of the nasal splints or packs, use over-the-counter Afrin 0.05% ( or generic Oxymetazoline 0.05%), two to three times daily, in both nostrils.  Do not use longer than 3 days.  After three days, use saline spray (Ocean Spray, Ayr, NaSal, Sea Mist, generic normal saline) 6 to 8 times daily to keep the mucosa moist and to help loosen the crusts.

5. If excessive bleeding occurs, try spraying the nose with Afrin spray to constrict the vessels.

6. If you have an external nasal splint, keep it dry.

MEDICATIONS:

- An antibiotic may be prescribed for 7-10 days following the surgery. You may also receive a prescription for painkillers in the form of codeine or hydrocodone. These products cause somnolence, drowsiness and constipation. Do not take these medications before driving or operating heavy machinery.

WHAT TO EXPECT FOLLOWING SURGERY:

- For the first week after surgery, your head may feel stuffy due to swelling of the mucous membranes in your nose. The stuffiness will gradually decrease over the next few weeks. After this, you should notice that it is easier to breathe through your nose.

- Following surgery, you will have drainage from your nose. At first, there may be a small amount of bright red bleeding. This is normal and may continue through the first week. A gauze dressing may be used under your nose to absorb this drainage.

- It may be necessary to change the dressing several times on the day of your surgery. Old blood from the surgery is dark reddish brown and will drain for a week or more. The drainage may be thicker and pale-yellow in color. This is also normal after septoplasty and is not a sign of infection.

WHAT ARE SOME REASONS TO CONTACT OUR ENT SERVICE AFTER SURGERY?

- Any bright red bleeding that lasts more than 10 minutes, or is excessive, should be reported to our ENT service immediately.  If this occurs after normal business hours, present to the nearest emergency department emergently.  Swallowed blood may cause black, tarry stools, nausea, and vomiting. The black stools may last several weeks.

- Pain not relieved by Tylenol or other prescribed pain relievers

- Because the sinuses are located near the eyes, some puffiness may be seen; however, if the swelling of the face or eyes increases, or if bruising occurs, notify the office immediately.

- Any change in vision should be reported to our office immediately.

- Headache complaints are normal the day of surgery and may be present for 1 to 2 days after. If the headache continues, please call the office.

- Any fever over 101 F (38C) occurring before your scheduled follow up office visit should be reported to the office.