Nasal Surgery Preparation

expectations2 How do I prepare for this surgery?

Certain laboratory blood test, chest x-rays and EKG may be required before surgery.

Be sure to let us know of any medications that you are allergic to.

It is very important that you are at the place of surgery at the time the nurse gives you.

DO NOT take aspirin or related pills with Ibuprofen or Naproxen for ten days before surgery because they will make your blood thin and make you bleed.

DO NOT eat or drink anything after midnight the night before your surgery. If you have to take medicines every day, be sure to ask how you should take them on the day of surgery.

Some people need pills like antibiotics to fight infection or steroids to prepare them for the surgery. If these were given to you, please take them as directed.

Avoid smoking 2 weeks before and 3 weeks after your surgery to promote better healing.

Will I have stitches and dressings?

No cuts are made on the face or outside the nose. You will have a small “moustache dressing” (or nasal drip pad), a folded piece of gauze, placed under your nose to catch the nasal drainage. Change this for a new one as often as needed. At first you may have dripping from the front and back of your nose. It will be dark red or pink. It will slow over a few days to light pink or brown, and then stop. However, it is normal for nasal bleeding to increase for a short time just after any increased activities such as bending over, coughing, sneezing, vomiting, or laughing.

You will likely have some internal splints and maybe small spacers, which will be removed on the sixth to seventh day after surgery. The majority of advanced nasal and sinus surgeons in the country use these Doyle Splints. Dr. Seicshnaydre has found they absolutely lead to better long-term success, especially in narrow nasal cavities, people over weight, or in patients with allergies. Until your first post operative visit, do not blow your nose, but rather gently sniff secretions into the throat and expectorate. Avoid smoke and other substances, which might irritate the nose.

Will I have to take pills after the surgery?

DO NOT use aspirin or other related pills like Advil until two weeks after the surgery because they can make you bleed. Along with some pain pills you may have an antibiotic pill to take, usually for a period of ten to fourteen days after the surgery. Continue to use the medications you bring home from the surgical facility as directed until your supply runs out.

Will I have nausea? What can I eat after the surgery?

A few people feel sick in the stomach and vomit after the surgery. This may be from the anesthesia or because a small amount of blood from the nose gets into the stomach. A common cause of nausea is taking pain pills on an empty stomach. The stomach is usually normal by the day after surgery. In the first few hours after surgery, an upset stomach may be a side effect of the anesthesia.

If you are unable to eat, at least keep drinking water and other liquids. Try clear, mild liquids first, like juices, broth and Jell O. Then try mild foods like ice cream, yogurt, bananas, rice, applesauce and toast. When these are going down well, get back to your normal foods. Nutrition is necessary for normal body function, and healing after surgery. After the first 24-48 hours, your only limitation is excessively chewy foods like bagels or po-boy sandwiches.

Will my face be swollen and bruised?

Because all the work is done inside your nose and sinuses, it is not common to have swelling or bruising of your face. However, if reshaping of the outside of your nose is included with the sinus surgery, you may be swollen and bruised. Head elevation makes swelling and most nasal symptoms less likely. You may also use a cold washcloth across your cheeks and forehead. It is normal to have a feeling of fluid or congestion in the ear, your nose is supposed to be stuffy for a while.

What may I do after surgery? When may I return to work or school?

On the day of surgery, rest in an upright position and do quiet activities when you get home. It can take 24 hours for the anesthetic drugs to get out of your system. To be safe, DO NOT drive, run dangerous machines, or make important decisions for at least 24 hours after surgery. Stay sitting up. This is the most beneficial thing you can do to reduce swelling quickly, and experience less discomfort. Sleep with your head elevated 45 degrees. This can be done preferably in a recliner.

You may wash your face, hair and shower as usual. No swimming, gym or strenuous athletic activity until physician’s permission. Discuss your work activities with the surgeon, especially if your work involves significant exposure to dust, dirt, or chemical compounds. Most people take one week off from work or school, and schedule part time or light duty for the next week.

Will my symptoms improve right away? Will I be able to breathe through my nose?

You will probably feel the same or even a little congested during the first week after surgery. Your nose will be partly or totally blocked by dried blood and mucus (nasal crusting), swelling inside the nose, and the doyle splints in the nose, if used. All this can give you a feeling of pressure or headache, along with nasal blockage and a dry mouth. You also may be unable to smell, and foods may not taste normal. If you sneeze, keep your mouth open and don’t try to hold back the sneeze. Also, if you have any chronic lung problems, such as asthma or emphysema, it is common for the lungs to be worse when the nose is blocked. Make sure you have enough of your lung medicines from your primary care doctor during this time.

You may clean the front part of your nose only, with water and peroxide, gently, as directed, with a Q-Tip. DO NOT blow your nose for four weeks after the surgery. You will be tempted to blow your nose, but doing this too early could restart bleeding or change the long term result of your surgery. Rather, gently sniff secretions into the throat and gently expectorate.

Will this surgery cure my sinuses?

Any disease or blockage that was in your sinuses will be all cleaned out and corrected at the time of surgery. In the future, you may still get acute nasal and sinus infections just like anyone else. These may follow colds or excessive exposures.

Chronic sinus problems may develop again if acute infections or severe allergies are not treated, or if you keep getting exposures such as smoking cigarettes, or other exposures that helped it to develop in the first place.

REMEMBER:

It is normal to:
• have oozing of blood from the nose for a few days after surgery.
• have nasal blockage and be unable to smell for up to a week after surgery.
• have a mild headache or feeling of facial and ear pressure for up to 3 weeks after surgery.
• have a feeling of dryness and buildup of crusting in the nose for 1 to 2 months after surgery.

It is not normal to:
• have problems seeing after sinus surgery. Please report any blurring, double vision, loss of vision, black eyes, severe redness or bulging around the eyes right away.
• have clear nasal drainage from one side of the nose.
• have a severe headache or neck stiffness.
• have a persistent fever over 101 degrees.
• have a skin rash or peeling skin.
• feel dizzy when you stand up.

If any of these symptoms occur within two weeks of the surgery, report them to us right away!!!!!

How painful is this surgery?

You will have no pain during the surgery. Afterward, most people have mild to moderate pain, but mostly pressure and a sense of congestion. Some people do not need any pain pills at all; many need just plain or extra strength Tylenol; others need stronger pills with a narcotic. Maintaining head elevation at all times helps minimize the pressure or pain.

If you are given a strong painkiller (narcotic), do not drive, run dangerous machines, or make important decisions while under its effects. In general, you should eat prior to taking both pain and antibiotic medications. Doing so will to help avoid nausea and vomiting. Two to three cleanings of the sinus openings may be necessary in the office by your surgeon at approximately two-week intervals. This will provide you with the best possible result from your surgery.

You should have a follow up appointment about one week after surgery!! Please eat prior to follow up office visits. Please DO NOT take pain meds before follow up visits.