Pre-Procedure InstructionsListed below are instructions for Pre-Procedure Care. The doctor will review these instructions with you before your procedure. If you have any questions, please discuss them with your Doctor before your procedure.Nuclear Thyroid ScanTo best visualize the thyroid area, it is of the utmost importance that you follow the preparation as described below:1. One week prior to your scheduled appointment, DO NOT take any prescribed thyroid medication, hormones, antihistamines, aspirins, multivitamins or cough syrups. Also, DO NOT eat any seafood or salted foods. 2. DO NOT have anything to eat or drink after midnight the evening prior to your exam. Nuclear Medicine procedures are performed by a team of trained professionals that include the Nuclear Medicine technologists, physician, and physicist. Nuclear Medicine procedures use radioactive materials to assist in the diagnosis and treatment of a number of diseases and disorders. After receiving the radiopharmaceutical capsule, the technologist will inform you when to return for the imaging portion of the procedure. During the waiting period, you will be able to leave the department and return at the time the technologist has given you. Upon your return, the technologist will position you in front of the thyroid imaging equipment. The process will take approximately 45 minutes while the Nuclear Medicine equipment detects the emitted energy. A computer will analyze the energy to create an image. Sometimes it becomes necessary for the patient to return the following day for additional imaging. If this is so, the technologist will let you know. The technologist will be available at all times to assist you and keep you well informed. If you have any questions, please ask the technologist. Your scan images will be interpreted by the radiologist and a report will be mailed to your physician. If the findings are significant, your physician's office will be telephoned with the results and your physician will contact you. Sinus SurgeryFESS is a procedure most commonly used to help treat chronic sinusitis refractory to maximal medical therapy. By the time that you are considered for this surgery, you should have already been treated with various medicines and have found treatment thus far to be inadequate. A CT scan of your sinuses will be performed as well and should show anatomic changes and/or chronic changes in the lining of the sinuses that can be addressed at surgery.The goal of FESS is to enlarge the natural sinus drainage pathways so that your sinuses will be able to drain more effectively and remain ventilated. The surgery is performed with instruments designed to work inside of your nose without making any external incisions. Visualization is achieved through an endoscope like one you may have seen used in the office. The extent of FESS is variable depending upon the extent of your sinus problem. Sometimes only some of the sinuses need to be addressed. Sometimes all of the sinuses need to be addressed. In addition, if you have a deviated septum that may need to be straightened by a septoplasty at the same time. Your doctor will be able to give you an indication of the extent of the surgery that you will need during your preoperative visit. FESS is usually performed under general anesthesia as an outpatient procedure. After you are observed in the post-anesthesia care unit and in the recovery area, you will be discharged home the same day. You will be given postoperative instructions and prescriptions at discharge. Prescriptions may include pain medicine, antibiotics, and nasal sprays. Saline nasal spray or irrigation is usually prescribed and can be of great help to you during your recovery. Frequent liberal use of the saline will help flush out crusting and clotting from your nose as it heals and will help you to feel better faster. You should avoid heavy lifting, straining, and nose blowing for the first week after your surgery. You may return to light work sooner if you wish. You should not have a lot of pain after this type of surgery. On rare occasion you may have tooth pain or numbness over your cheek. You are more likely to experience the type of symptoms you get when your sinuses flare up such as nasal obstruction and facial pressure. These symptoms will gradually improve over the first week or two after surgery. You should not have any significant facial swelling or bruising after this type of surgery either. Your first postoperative appointment will be scheduled for approximately one week after surgery. At that time your nose will be checked to be sure that healing is beginning appropriately. If you have fever greater than 101.5 degrees, fresh bleeding, or any other problems, you should call the office to be checked sooner. The goal of sinus surgery is to improve your day-to-day sinus symptoms and reduce the frequency of your acute flare ups. You may be continued on some of the sinus medications you were using preoperatively to achieve the best result. With these goals in mind, FESS is about 85% successful in treating chronic sinusitis in properly selected patients. TonsillectomyTonsillectomy is not performed as routinely as it once was, but it is still a relatively common procedure.Today, most tonsillectomies are performed for either recurrent acute infections, chronic infections or tonsillar enlargement causing symptoms of nighttime airway obstruction. Often the adenoids are part of the same process and need to be removed at the same time. The tonsils and adenoids normally function as part of the immune system to help fight infection. When they become recurrently infected or too enlarged, they can no longer effectively serve this purpose and may need to be removed. As in all surgeries, you should have nothing to eat or drink after midnight the night before your tonsillectomy. Tonsillectomy and adenoidectomy are generally performed as outpatient surgeries. Under certain circumstances, however, your doctor may wish for you or your child to be observed in the hospital overnight following surgery. Your doctor will inform you if this is the case. Tonsillectomy and adenoidectomy are performed under general anesthesia. The surgery usually takes about 20-30 minutes to perform with additional time for anesthesia and recovery. Unless you are being observed in the hospital overnight, you will be discharged from recovery after a few hours. All surgery has some associated risks. The risks associated with tonsillectomy and adenoidectomy include bleeding and infection as well as possible unforeseen risks. Fortunately the incidence of these risks is quite low. POSTOPERATIVE INFORMATION: Tonsillectomy HURTS! You can expect to have a bad sore throat for about 1 week to 10 days following surgery. You may experience referred pain to your ear as well. This is normal; it is not an infection. You may advance your diet as tolerated following surgery. However, you should avoid crispy, crunchy foods and very hot foods initially. You should at least be sure to take plenty of liquids. You will be given a prescription for a liquid pain medicine to take as needed. You may also be given a prescription for a liquid antibiotic to take for 1 week. Some patients find that chewing bubble gum to help loosen the throat muscles reduces the pain more quickly. If you or your child are initially having too much pain to swallow the pain medicine, try using Tylenol suppositories available over the counter in any drug store. You will be given an appointment for a postoperative check 2-3 weeks after surgery. We prefer to see all of our patients for this visit, however, if there have been no postoperative problems and it is a hardship to make this visit, it can be cancelled. Call the office or come to be seen sooner if you develop fever higher than 101 degrees, bleeding or any other problems. Tympanostomy TubesYou or your child are being scheduled for placement of middle ear ventilation tubes called tympanostomy tubes. Tympanostomy tubes usually are placed for either recurrent acute middle ear infections, otitis media, or for chronic failure to reabsorb middle ear fluid after acute ear infections.Otitis media is common in children. Studies show that 70% of children have at least one episode of otitis media by the time they are three years old. Otitis media sometimes can resolve on its own but is usually treated with antibiotics. When a child with acute otitis media is treated, the infection usually resolves rapidly but the middle ear fluid may take longer to clear. When middle ear fluid does not clear and persists for a long time, it results in an associated conductive hearing loss. Studies show that children with chronic and/or recurrent otitis media with conductive hearing loss can have problems with speech and language development. When treated effectively, however, hearing can almost always be restored to normal. Placing tympanostomy tubes is a minor surgical procedure done as an out-patient. In children the procedure is performed under general anesthesia and takes about 10-15 minutes. In adults tubes may be placed under local anesthesia. The tubes are placed in the eardrum using a microscope after first making a tiny incision and suctioning out any middle ear fluid. There is no discomfort after tympanostomy tubes are placed. Your child would be able to resume normal activities after the anesthesia wears off. You may be asked to use ear drops for a few days after the tubes are placed. The tubes that are most commonly used stay in place for an average of 8-12 months before extruding on their own. While the tubes are in place, you should avoid getting water in the ear. This can be accomplished by using a cotton ball coated with Vaseline or ear plugs when bathing and swimming. Immersing the head in water and diving are not recommended. You should have routine appointments to see the ear doctor to have your ears checked every 4-6 months while the tubes are in place. If any ear problems or ear drainage occurs while the tubes are in place, you should make an appointment to be seen sooner. All surgical procedures have associated risks. The risks associated with tympanostomy tube placement are minor and uncommon but include, minor bleeding, infection, and persistent perforation of the eardrum after tube extrusion. In addition, about 10-15% of children who require tympanostomy tube placement at a young age will develop recurrent ear infections again after the tubes extrude and will require a second set of tympanostomy tubes. |
