15 W. Dry Creek Circle                                                                                           6169 S. Balsam Way; Suite 290
         Littleton, CO  80120-4427                                                                                                                                   Littleton, Colorado  80123
     Phone: (303)  798-1309                                                                                                                                        Fax: (303) 798-2319
Ear, Nose & Throat Center
Specialists of the Ear, Nose and Throat   /  Head and Neck Surgery  /  Facial Plastic Surgery
Evaluation  of  Dizziness  &  Vestibular Disorders

For more information see us at our web site !      http://www.ENT Center.Net
   

PREOPERATIVE  SUPPLY  CHECK  LIST for Uvulopalatoplasty (UPP)

The following supplies most probably will be needed after the surgery for the following surgeries:  septoplasties, rhinoplasties, submucosal resections of turbinates (SMR), functional endoscopic sinus surgeries.

1.     4 x 4 gauze's - approximately 20 each.

2.     Humidifier or small steam vaporizer ( Steam preferred for winter & cool mist for
          summer ).

3.     Bulb syringe (baby bulb). It should be relatively small.

Ocean spray / nasal saline, can be purchased over the counter by the name of Ayr, NaSal or Ocean   
      spray.  Start using every hour that you are awake as soon as the packing is removed.

5.     Bottle of Alkalol concentrate - optional ( It is strongly aromatic and not everyone    
       can tolerate it's smell ) .  Ask our office nurse to give you a small sniff to try it   
       before the surgery.

6.     Bacitracin, Neosporin, Polysporin or Triple Antibiotic ointment, all of which need   
       to be ointment based, not cream based.

7.     Guafenesin ( Liquibid 1200,Duratuss G, Humabid LA, Fenesin, etc. ).  Begin this         
       medication as soon as the packing is removed.

8.     Have these at home PRIOR to your surgery so they are waiting for you when you  
       come home from the hospital.

9.     Begin bulb or water pic sea salt solution ( saline ) or Alkalol ( diluted half - half
       with water ) irrigations 3 to 4 days after packing removal.

10.   No aspirin should be taken.  Tylenol, Advil, Motrin, Aleve are okay.

11.   Plan on at least one week off work.  You may  need pain medications for 10 to 14 days after surgery.

12.  Diet: May consist of popsicles, milk shakes ( or milk shake like products such as Slim Fast, Ensure, protein drinks, Carnation Instant drinks, etc. ),
        eggs, apple sauce, pastas, soups  (warm, NOT HOT ), mashed potatoes, juice pops, mac & cheese, or pureed ice drinks ( Slurpees, Icee's, etc.).

You will need a driver for your first postoperative appointment (packing removal). This is because you cannot drive while taking narcotic pain medications.

Post op Recommendations after a Uvulopalatoplasty (UPP)
1st Day Diet:
The patient needs to maintain a good fluid intake in the first two days after his tonsillectomy.  Although swallowing may initially be painful, the patient must be coaxed or even "pushed" to drink an ample volume of fluids such as: water,  cool aid, popsicles, soft drinks, Jell-O, tea, soups, ice cream and milk shakes.  A mild elevation of temperature following  surgery usually means inadequate fluid intake.  Avoid citrus juices (orange & grapefruit) or other acidic or spicy liquids  or foods.

2nd -  10th Day Following Surgery:
Gradually add soft easy-to-chew foods such as soft cereals (oatmeal, etc.), scrambled eggs, chopped meats, rice, macaroni, or mashed potatoes.  Avoid "highly" seasoned foods or foods which require a great deal of chewing before swallowing.

After the 10th Day:   Resume a normal diet gradually.

Activity:
The patient does not need strict bedrest after their UPP but "quiet activities" are recommended.  The patient SHOULD NOT PARTICIPATE IN ANY STRENUOUS PHYSICAL EXERCISES OR PLAY FOR TWO WEEKS FOLLOWING THE UPP.  Exercise will increase blood pressure and could cause bleeding.

Work:
  Work can generally be started after 7 to 10 days.  Strenuous work cannot be resumed for 2 weeks.

Pain:
A sore throat, which can sometimes be considerable, is to be expected following UPP.  Drinking enough  fluids after the UPP will lessen the painful swallowing.  Earache will frequently follow UPP.  This earache is not an ear infection but originates from the sore throat as a type of phantom pain.  The earache may be treated with a heating pad or hot water bottle applied to the ear and with pain medication.  A prescription for tylenol with codeine will be given to you after surgery for pain relief.  Follow the prescription's instructions on dosage.

Bleeding:
Any fresh bleeding is not normal and you should call my office without delay if it occurs.  Old dark clots may be coughed up in the first day.  They represent blood from the operation and are not of any worry.  If they continue to occur frequently or 24 hours after the UPP call me promptly.

Follow up Appointment:  Approximately two weeks following surgery.

Other Information:
   - Gargling is not recommended.
   - The Patient may brush their teeth if they are not in pain.
   - After the tonsillectomy a whitish-gray shaggy scab covers the tonsillar area until healed.
   -Aspirin or aspirin containing products should not be used for two weeks before and after the tonsillectomy.
   - Call my office at 798-1309 if you child experiences repeated vomiting, persistent cough, or a fever of greater than 101.5 degrees. If it is after hours the paging service will page me without delay.