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Post-Operative Instructions

Preoperative Instructions   •   Post Operative Instructions

The following documents are for your review and download or printing. If at any time you have questions/concerns/issues please call Ear, Nose and Throat, Ltd. at 757-623-0526 during office hours. For life threatening emergencies, as always, call 911 or visit the closest emergency room. For non-life threatening emergencies with regard to your treatment at Ear, Nose and Throat, Ltd., call 757-623-0526.

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BMTT

HOME CARE INSTRUCTIONS: In BMTT, the “B” stands for bilateral which means “both sides.” The “M” stands for myringotomy, which is the incision in the eardrum. “TT” stands for tympanostomy tube, which is placed in the eardrum to allow air to enter the middle ear so that fluid will not collect. This reduces the frequency of infection.

AFTER SURGERY:
• Do not allow water to get in your child’s ears until allowed by the doctor.
• To keep ears dry while bathing, put Vaseline on a piece of cotton and place it snugly in your child’s ears.
• A small amount of drainage or blood is not unusual in the first 48 hours. It may be cleaned with a Q-tip. Do not put a cotton-tip applicator deep into your child’s ear.

WHEN TO CALL THE DOCTOR:
• If your child has persistent ear drainage after 48 hours.
• If you child’s temperature is 101.5° or more (slight fevers after surgery are normal)
• If you have any questions (please hold non-emergent questions for calls between 8:30 AM to 4:30 PM, Mon – Fri)

ACTIVITY:
• Normal activity, including school, may be resumed the following day.

FOLLOW-UP:
Call the office at 623-0526 on the day of discharge to set up a post op appointment. It is important to make this call as soon as possible, since the doctor’s schedule can fill up quickly. The Appointment Scheduler will know when your post op appointment is due depending on the type of surgery preformed, unless otherwise directed by your surgeon.

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NASAL, SINUS SURGERY

HOME CARE INSTRUCTIONS: Much nasal congestion and postnasal drainage is secondary to non -specific irritation and accumulation of mucus in the nose and high in the throat. This can be successfully decreased by cleansing the nose with a mild saltwater solution.

This maneuver accomplishes three (3) main things
1. The physical action of washing the nose out removes the small irritating particles and collections of mucus which cause a continuing cycle of irritation and congestion.
2. Saltwater is medicinal in decreasing irritation.
3. Saltwater decreases congestion.

DIRECTIONS FOR USE:
• Add one (1) teaspoonful of ordinary table salt and a pinch of baking soda to a drinking glass full of lukewarm water. The amount of salt may be increased or decreased to make the solution just strong enough to taste salt.

• This should then be placed in a small bowl, cupped hands, or may be used with a rubber bulb syringe. The “Birmingham Nasal Douche” device may be purchased at any drug store. Some find that this makes the sniffing easier.

• Place your nose in the liquid and sniff strongly so that the solution is carried completely through the nose into the back of the throat. This material may be expectorated. It should get into the back of the throat two or three times with each use.

• Coughing, gagging, and irritation may be experienced until this maneuver becomes familiar. Some patients feel it is helpful to gargle in the usual manner just prior to sniffing – this helps decrease the gagging.

• It is suggested this be done in the morning upon arising, before breakfast, and in the evening one-half hour before retiring.

• Initially, this should be done for 5 to 7 days and then decreased in frequency until only used intermittently, perhaps once or twice a week. If congestion persists, you should be re-evaluated by your physician.

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ADENOIDECTOMY

HOME CARE INSTRUCTIONS: The adenoids are found in the upper part of the throat, above the palate. Adenoidectomy is the operation to remove the adenoids.

WHAT TO EXPECT
• You can expect your child to complain of a sore throat. Swallowing is painful. Give your child the medicine for pain that your doctor ordered. Do not give aspirin or aspergum because it may increase the chance of bleeding. You may use an ice collar on the throat to help with the pain relief.

• Your child will have some ear pain for as long as two weeks after surgery. This pain is referred pain from the tonsillar area and does not mean that anything is wrong with ears.

• Frequently there will be a nasal quality in your child’s voice following the operation. This is a natural accompaniment of removal of bulky tonsils and/or adenoid tissue from the resonating cavities of the mouth and back of the nose. This may persist for several weeks until the muscles readjust. It may be helped somewhat by having the child say “kick” many times a day. This exercises his throat and mouth muscles.

• Your child will have bad breath, but this is normal and will go away.

DIET
• Your child needs to drink lots of fluids. This is very important. You want to avoid citrus juices such as orange or grapefruit juice because these juices may burn the throat. Eating and drinking helps healing and decreases pain because it exercises the sore muscles in the throat.

• The diet should be frequent liquids, especially for the first three (3) days. These may include milk, water, ginger ale, cola or other carbonated beverages, ice cream, popsicles or soups. Lack of proper fluid intake may cause high fever from dehydration! The second day milk, toast, Jello or any soft food may be added. Harsh, hard or rough foods may cause pain or bleeding from the throat. As soreness decreases, a normal diet may be resumed. As long as fluid intake is adequate, your child will resume eating solid food voluntarily as the discomfort subsides.

ACTIVITY
• Your child may be up and about but needs to be limited to quiet play. Your child should not take part in contact sports or strenuous play until instructed by your physician.
• Your child may return to school when instructed by your physician, usually 7 to 10 days. Physical education classes should not be attended for two weeks after surgery.

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SUTURE LINE CARE

HOME CARE INSTRUCTIONS
• Clean suture line twice (2) a day with a solution made up of one (1) part hydrogen peroxide and one (1) part saline or water
• Using a clean gauze or a Q-tip, gently moisten the sutures and immediate surrounding skin with the solution
• Apply either Polysporin / Neosporin / Bacitracin ointment to the suture line after each cleaning (twice a day)
• If redness, swelling or drainage develops, contact our office at 757-623-0526
• Suture lines may be exposed to water while bathing. Dry suture line by gently patting the area with a soft clean cloth or towel.

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NOSE BLEED

HOME CARE INSTRUCTIONS: Your doctor is treating you for nosebleeds. These are caused by superficial blood vessels near the front of the nose. The aim of treatment is to protect this area so the blood vessels can heal. This may require either chemical or electrical cautery within the nose. Occasionally, blood vessels have to be cut in the process of an operation. • Obtain a tube of either Bacitracin / Polysporin / Neosporin from the drug store (no prescription needed).

• Squirt this ointment up your affected nostril as directed by your doctor – this will be about ½ inch of ointment, or about ½ as much toothpaste as you would put on a toothbrush.
• Then take a piece of cotton, the size of the last joint of your finger, and put it in that side of the nose.
• Three (3) times daily, remove the cotton, squirt more ointment in your nose, and put a clean piece of cotton in – do this for as many days as your doctor prescribes.
• The next phase is to continue the ointment three (3) times daily, without cotton.
• If there should be bleeding, and there may be during the healing phase, blow out your nose, put ointment in the nose, and a large piece of cotton.
• Keep your head elevated rather than lying down.

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VESTIBULAR EXERCISES

HOME CARE INSTRUCTIONS: Exercises to be carried out for fifteen (15) minutes twice (2) a day, and increasing to thirty (30) minutes as your physical status permits.

EYE EXERCISES
• Looking up, then down – slowly at first, then quickly, 20 times
• Looking from one side to another – slowly at first, then quickly, 20 times.

HEAD EXERCISES
• Bend head forward then backward with eyes open – slowly, then quickly, 20 times
• Turn head from one side to another—slowly, then quickly 20 times
• As dizziness improves, these exercises should be done with eyes closed SITTING
• While sitting, shrug shoulders 20 times. Turn shoulders to right then to the left, 20 times. Bend forward and pick up objects from ground and sit up 20 times.

STANDING
• Change from sitting to standing and back again 20 times with eyes open. Repeat with eyes closed. Throw a small rubber ball from hand to hand under one knee.

MOVING ABOUT
• Walk across room with eyes open, then closed, 10 times.
• Walk up and down a slope with eyes open, then closed, 10 times.
• Walk up and down steps with eyes open, then closed 10 times.
• Any game involving stooping or turning is good.

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