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Care of the post-operative tonsillectomy patient

January 11, 2018

 

 

 

 

Thank you for choosing to have your surgery with Dr. Kortbus and Hudson ENT!

 

  • The Day of Surgery

 

After you wake up [from anesthesia], you will be in the "PACU" (post-anesthesia care unit, aka recovery room) for an hour or so.  For kids, parents may be invited: some kids get a "little loopy" from the anesthesia and some get disoriented: this is normal!

 

 When the anesthesia personnel and nurses find you to be ready, you'll leave the PACU for the ambulatory bed you started at earlier in the morning, have some food and drink, then be allowed to go home if you and the ambulatory nurses feel you "are ready".

 

  • After Surgery

After the procedure, there are some VERY important tips.

 

- Do not have Pizza, bagels or chips!

 

- Basically any carbohydrate that is put in an oven will be risky to have. AVOID THESE!

 

 

- Above is a picture of baked ziti, which should be avoided like most carbs that go in an oven.

 

- Please do avoid anticoagulant medicine, https://goo.gl/C5UEAV  The list is long, but we do not prefer the patient to have any motrin, ibuprofen, advil, midol, celebrex, naprosyn, toradol, or aspirin, among many other anti-coagulant medicines.

 

- These medicines increase bleeding risk.

 

- You may bathe

 

- You should not lift anything more than ten pounds (10#), including children, TV sets, trays of food and such.

 

- You can take acetaminophen (Tylenol) for pain, or the stronger medicine I have prescribed. 

 

- If you are constipated, do not force yourself, but take a stool softener.  Bearing down (aka Valsalva maneuver) leads to markedly increased nasal pressure, and could create a hemorrhage.

 

- If you have a serious, profuse, red bleeding please call  911 immediately!

 

- You should not leave the general Hudson Valley area without discussing with the office [before surgery] until further notice, but typically for the first two weeks after surgery.

 

- For kids, no "PE" (phys. ed., physical education, gym, recess that includes running, jumping and such exercise) for two weeks minimum.

 

- The nose and throat may feel more clogged after surgery than it was before.  This is normal, expected, and temporary.  

 

- You might want to sleep on a recliner (e.g. LazyBoy), or use pillows.  A humidifier in the room on the night stand next to your head could help keep moisture.

 

DAYS LATER

 

FIVE DAYS LATER:

 

Since Dr. Kortbus tends to operate on Thursdays', the Tuesday and or Wednesday after tends to be sometimes more painful than the weekend / than the first few days.  In other words, it might feel "not too bad", then get worse!

 

This picture is probably the main reason I wanted to write this blog

 

 

This shows how a normal throat looks after tonsillectomy.  It may also have pink or black spots. This is not thrush, not infection and does not need antibiotics.

 

This is not pus or purulence.  This is called FIBRINOUS EXUDATE, and everybody's mucous membrane tends to heal with this yellow status.

 

Signs of infection would be warmth, fever, and purulence.  As always, call the office at 845-758-1456 for any question!  All questions are GOOD questions :-)

 

Here is another very important point: STAY HYDRATED!

 

Drinking is critical

 

Water is good, water with some sugar and salt (eg Pedialyte, Gatorade) are good.

 

Vitamin drinks and energy drinks and such are NOT recommended, as they have blood thinners in some versions, and might de-hydrate.

 

Some people (kids and adults) simply can not swallow: this definitely does require a trip to the emergency room or urgent care.  Here, an IV for fluid, pain and swelling control are helpful.

 

This is not a defeat in any way: almost all people find themselves feeling so, so much better after this move.  It is not common, but not rare to have this after tonsillectomy.  Naturally, let Dr. Kortbus know if you need this, and he can /will guide you.

 

TWO WEEKS LATER:

 

By now, you should be mostly healed, but might have some have pain through this time.

 

THREE WEEKS LATER:

 

The majority of people are doing very well by now, and feel just about back to normal.

 

THREE MONTHS LATER:

 

Dr. Kortbus should be seen to check on the healing after 90 days.  Please schedule this appointment!

 

Thank you again for having hudsonENT care for you and your loved ones, and for your trust in Dr. Kortbus!

 

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