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Pre-Operative investigations you have to undergo before you go ahead with nose and sinus surgery
If your doctor has recommended you a sinus surgery, you might be having lots of questions running through your mind like what are the Pre and Post Sinus Surgery Instructions, How long does sinus surgery takes. Is sinus surgery painful? or How to sleep after sinus surgery? Here in this article Let us begin by understanding what to expect after sinus surgery, if your sinus doctor recommended you a sinus surgery.
Firstly, you’ll have to undergo a series of blood and urine investigations as part of the major surgical profile. The reports take anywhere between a few hours to a day to reach you. Once you get these major surgical profile reports you’ll be visiting a cardiologist.
The cardiologist will take your detailed history, will examine you, and to assess your cardiac fitness will perform an ECG and 2D echo. Sometimes he may ask for a Treadmill Cardiac Stress Test. Based on your history, the findings, and the investigation reports, he will give cardiac fitness for you. With all these reports you’ll be visiting your anesthesiologist for the pre-anesthetic checkup or PAC. If you have any medical conditions like diabetes, hypertension, hypothyroidism, other heart, kidney, or other ailments, you’ll have to take the reports, investigations, and the medications you consume daily along with you to the anaesthesiologist.
If you have undergone any surgeries in the past and if the discharge summaries are available with you it’ll be really helpful for the anesthesiologist to have a review of them. So the anesthesiologist will examine your medical reports, and surgical reports, and based on the findings will give fitness for the anesthesia. If the anesthesiologist finds that any of their findings or your investigation reports are not in line, they may seek further clearance from other doctors like a gastroenterologist, pulmonologist, or an endocrinologist.
If they give fitness for surgery for you they may suggest what medications you have to take, what medications you should not take in the days leading to the surgery, and also will give you other instructions you have to follow before coming to further surgery.
What are the Pre-Operative instructions to follow on the day of surgery? How to prepare for sinus surgery
If you have a habit of smoking you have to stop smoking at least three weeks to a month before your surgery, because smoking will cause scarring in the nose and also will hamper with the healing after the nose and sinus surgery.
If you take any herbal medicines like Ginseng, Ginkgo Biloba, or Ginger Extracts you have to stop taking these medications at least two weeks before the surgery, because these will cause a lot of bleeding during the surgery.
If you’re a cardiac patient who’s taking blood thinners like Clopidogrel or Aspirin you have to stop taking these medications at least 72 hours before going ahead with the nose and sinus surgery. Again, because these medications will cause increased bleeding during the surgery.
You should not consume any food or liquids at least six hours before the beginning of your surgery.
This protocol should be strictly followed and the anaesthesiologist may postpone your surgery. if you do not follow this. If you are a hypertensive or hypothyroid patient you should take your medication as usual with small sips of water.
If you are a diabetic, however, you should refrain from taking your medication on the day of surgery. You have to carry all the medications which you take daily along with you. If you’re an asthmatic who uses inhalers you should carry the inhalers also along with you. You have to make arrangements so that a friend or a family member can stay with you during your entire admission to the hospital, which is usually not for more than one night. You should also make arrangements for someone to drive you to the hospital and from the hospital after the surgery.
Sometimes if the anesthesiologist feels that your anxiety is causing fluctuations in the blood pressure they may suggest an anxiolytic-like Alprazolam. Alprazolam tablet should be taken on the night before the surgery, and on the day of surgery with small sips of water. This medication can cause sedation for you. Once the admission and consent formalities are completed you’ll be shifted to the pre-operative ward. In the pre-operative ward, the anesthesiologist will again do a review pre-anesthetic checkup and give fitness for your surgery. They’ll place an IV cannula in your vein.
In the pre-operative ward, the anesthesiologist will again do a review pre-anesthetic checkup and give fitness for your surgery. They’ll place an IV cannula in your vein. Once you are shifted to the preoperative ward they will give test doses for the anesthetic solution and the antibiotic solution and see how you are responding to these particular medications.
What to expect during Sinus Surgery?
So how long does sinus surgery take? Once you are ready for surgery you’ll be shifted to the operating room. Usually, the nose and sinus surgery is done under general anaesthesia, that is you’ll be asleep during the entire nose and sinus surgery procedure.
Sometimes in some patients who are unfit for general anesthesia because of their medical conditions, the surgery may be done under local anesthesia, that is with you partially awake, your nose will be numb to pain and touch and the surgery will be performed. The nose and sinus surgery lasts anywhere between one to three hours based on the kind of procedure which is being done for you.
After your surgery, you’ll be transferred to the step-down unit. For the first four to six hours you’ll be feeling groggy, drowsy. Your vitals, that is the pulse rate, blood pressure, and oxygenation levels will be monitored in the step-down unit. Your friends and family members will be allowed to have a short visit to check on you in the step-down unit. After six hours, once your surgery is completed you’ll be allowed to have clear fluids and some light food. You’ll be shifted to the inpatient room where you’ll be resting along with your family and friends.
Your nose will be packed, you’ll feel nasal congestion, and you should not blow your nose or pull back your nose because both these things will not only help you to breathe better but will cause severe nose bleeding.
In most of the institutions all over India and the world, once the nose surgery is completed, the nose is packed. Once the nose is packed, you cannot breathe through the nose. You’ll have to breathe through the mouth. Although it is a little uncomfortable, it is not intolerable. In my institute where I operate regularly, we do not pack the nose. And when we have to pack the nose we use balloons in place of regular nose packs.
Although these are very much comfortable, they were a little expensive. You will have blood-stained nasal discharge coming from the front of your nose. We place a small mustache dressing to soak up this nasal discharge. Similarly, a blood-stained nasal discharge can keep dripping from the back of the nose into the throat. And when you spit out, you may see some bloodstains in the spit also.
This is much more in the first 48 hours. After that, you’ll be seeing small blood stains now and then in the coming 30 to 45 days after your nose and sinus surgery. You’ll be sleeping with your head elevated a little up, that is your head will be at a little upper position than your legs. This is to reduce the pressure on your head. Also, you’ll be discharged usually about eight to 18 hours after your surgical procedure. When you’ll get discharged depends upon the kind of surgical procedure done on you. And also it varies from surgical centre to another.
When you’ve discharged your operating surgeon or his team will visit you and your fitness for discharge. Somebody has to drive you from the hospital to your home.
Post-Sinus Surgery Instructions
Dos
- You’ll be prescribed some medications like antibiotics, painkillers, nasal washes, and nasal sprays, all these medications should be mentioned in your discharge summary. And the schedule you have to follow also will be mentioned. You have to follow these medications as per the schedule given by your operating surgeon. 24 hours after you’re discharged you can resume your daily activities.
- You can do your office work, you can do your desk work, you can do household chores. The only thing is it is advisable not to bend down as much as possible. There are no food restrictions, you can consume all kinds of food, which are cooked at home. You shouldn’t have anything too hot or cold.
- If you have noticed that you’re allergic to certain kinds of foods before the surgery you shouldn’t have such kinds of foods after the surgery.
- You can have your regular bathing, you can clean your nose without putting much pressure on it. The only restriction you have to follow is you should not allow the water to enter your nose. You have to consume plenty of fluids, that is plenty of water.
- Water not only thins down the mucus in the nose and makes you feel more comfortable but also helps in faster healing. You can sleep in your regular position. Make sure that you don’t put much pressure on your nose. You should sleep with your head a little elevated when compared to your legs, this will reduce pressure in the head and make it much more comfortable for you. If you get a sneeze or a cough, it is advisable to open the mouth and then produce sneezing or coughing.
- If you are a diabetic, hypertensive, or hypothyroid patient, you can take your daily medications as usual, as used to follow before surgery.
Don'ts
- You should not blow your nose, You’ll experience a nose block but, you should not blow your nose, you should not keep sniffing back as you told you before. Both these will not only not help relieve your nose block but will cause severe nose bleeding.
- You should not put your finger in your nose, you should not do nose speaking. The inside of the nose is very sacred, and especially after surgery is very sensitive. It not only will hamper the healing, but it can cause nose bleeding.
- Avoid strenuous activities like doing cardio, doing weight training, at least for one month after the nose and sinus surgery. You should also avoid flying, and swimming, at least for 20 days after the nose and sinus surgery.
- High-pressure activities like scuba diving should be avoided at least for one month after your nose and sinus surgery. If you are a cardiac patient who takes blood thinners like Clopidogrel or Aspirin, you should get clearance from an anaesthesiologist or your regular doctor before starting this medication.
- If you are experiencing constipation please call your operating surgeon, please do not strain, he may advise some stool softeners for you. It is also advisable that you do not consume any alcohol or get back to your habit of smoking after surgery. This is to be avoided at least for one month after your nose and sinus surgery.
When to Call Your Doctor
If you are experiencing a fever of more than 101 degrees Fahrenheit. If you have altered vision that is blurred vision or double vision. If you have severe pain in the head and the nose region, and you’re not getting good relief with the pain medications you’re normally using.
If you have uncontrollable bleeding from the front of the nose or the back of the nose, you have to call your operating surgeon or his team immediately.
Review Visits
10 days after your nose and sinus surgery we’ll perform an Endoscopy and Nose Cleaning. This is usually done in the operating theatre. Your nose will be numb to pain and touch, and we’ll remove the crust in the scar tissue during this endoscopy nose cleaning.
The procedure lasts anywhere between 10 to 20 minutes and you’ll be discharged within a few hours after your procedure. You’ll have to come for review visits on the 20th day, and the 40th day, after your nose and sinus surgery. During these visits, we’ll be examining your nose and sinus and if necessary we’ll perform the endoscopy nose cleaning again. We’ll be also writing some medications for you, which you’ll have to regularly follow.
Please remember that there may be slight variations from one surgical center to another and your operating surgeon is the best person to let you know what to do and what not to do.
Hope we could explain in detail about Pre and Post Sinus Surgery Instructions and how long sinus surgery recovery takes. To know more about sinus surgery in India, Get an appointment with best sinus doctor in India, Dr G V K Chaitanya Rao.
- You should not blow your nose
- You should not put your finger in your nose
- You should not do nose speaking
- Avoid strenuous activities like doing cardio, doing weight training, at least for one month after the nose and sinus surgery.
- avoid flying, and swimming, at least for 20 days after the nose and sinus surgery.
- High-pressure activities like scuba diving should be avoided at least for one month after your nose and sinus surgery.
- If you are a cardiac patient who takes blood thinners like Clopidogrel or Aspirin, you should get clearance from an anesthesiologist or your regular doctor before starting this medication.
You’ll be sleeping with your head elevated a little up, that is your head will be at a little upper position than your legs. This is to reduce the pressure on your head.
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- Stop smoking at least three weeks to a month before your surgery.
- If you take any herbal medicines like Ginseng, Ginkgo Biloba, or Ginger Extracts you have to stop taking these medications at least two weeks before the surgery.
- If you’re a cardiac patient who’s taking blood thinners like Clopidogrel or Aspirin you have to stop taking these medications at least 72 hours before going ahead with sinus surgery.
- You should not consume any food or liquids at least six hours before the beginning of your surgery.
- If you are a hypertensive or hypothyroid patient you should take your medication as usual with small sips of water.
This protocol should be strictly followed and the anaesthesiologist may postpone your surgery. if you do not follow this.
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If you have uncontrollable bleeding from the front of the nose or the back of the nose, you have to call your operating surgeon or his team immediately.
You’ll have to come for review visits on the 20th day, and the 40th day, after your nose and sinus surgery.
