Some basic information that may be helpful for all surgical patients:
Low grade temperatures (99-100.5 degrees) are common in the first 2-3 days after surgery, especially if you have had general anesthesia. The best treatment is coughing, deep breathing, and use of the incentive spirometer from the hospital (if you were given one). Higher or persistent temperatures warrant notification of our office.
Bowel movements are commonly altered after surgery. If you received even one dose of antibiotics, you may develop several days of diarrhea after surgery. If so, eating yogurt may help this condition. If the diarrhea is foul-smelling, very frequent, or associated with fever, please notify our office. More often, the combination of anesthesia and pain medication (especially after bowel surgery) can cause severe constipation for up to a week. This may be treated with Metamucil each day, plus Milk of Magnesia if needed. Stubborn cases may benefit from Citrate of Magnesia or Fleets enemas. If you have had intestinal surgery, do not use an enema without clearance from your surgeon. Call the office if you have exhausted all of these methods.
Surgery hurts! The bigger the operation, the more it hurts. One of the reasons for the hospital stay in larger operations is for pain control with IV medications. In smaller operations, or after several days in the hospital, the pain can usually be well controlled with oral medications. Narcotics such as Percocet, Vicodin, and Tylenol #3 are fairly powerful medications that usually control pain very effectively. However, they have frequent side effects such as dizziness, nausea, and constipation. We recommend treating your postoperative pain initially with Ibuprofen (such as Motrin, Advil, or generic) 600-800 mg with food 3 times a day. Take this medication until your pain subsides to the point that you don’t need medication any more.
In addition to the Ibuprofen, take your prescription medication as directed for the first few days if needed. Do not take Ibuprofen if you are allergic to that family of drugs, if you take blood thinners, or if you have had stomach ulcers or gastric surgery. Do not drive if you are taking narcotics. Do not mix alcohol with narcotics.
Surgical incisions usually require little care. Inpatient surgical incisions are often closed with staples or external sutures. These are usually removed after 5-10 days, often in the office. You will be told in the hospital when you can get the incision wet. Typically showers are allowed after 3 days and tub baths after the sutures are removed. Outpatient or overnight-stay surgical incisions are often closed with dissolving sutures. Steri-strips are then applied to the skin. These may be exposed to the shower the next day, but tub bathing and scrubbing should be avoided for a week. Pinkish or clear discharge is common for 2-3 days after surgery. Thick yellow or foul-smelling discharge, or frank bleeding, should prompt a call to the office. Dissolving sutures typically take 3 weeks to disappear. If they protrude from the skin they may itch, and you may call the office for an appointment to have them trimmed. In a few cases, a blood collection in the wound (hematoma) or a wound infection may cause the edges of the wound to separate. This is usually a simple problem to deal with in the office; call for an appointment if this happens. In some situations wounds are not completely closed. These will be managed by dressing changes several times a day (visiting nurses may be arranged in complex cases), often for several weeks.
Band aids may be applied to small incisions. They should be removed the next day or changed as desired. If there are small white tapes on the incision under the band aids (steri-strips or “butterfly” bandages), these should be left on until they begin to fall off in 7-10 days. They may get wet 24 hours after surgery. Larger incisions may have gauze taped over them. This can usually be removed 48 hours after surgery. All wounds may be covered with clean bandages (changed daily) if they are tender or chafed by clothes.
You will be seen in our office 7 to 10 days after your surgery and again in several weeks. Prior to surgery, you should have made an appointment for your first post-operative visit. If for some reason that appointment was not scheduled, please call our office at (703) 359-8640 as soon as your return home to schedule your appointment.
You may have trouble belching or vomiting for several weeks after surgery. This will subside as your body adjusts to the operation. Please call our office immediately if you develop any of the following; chest pain, excessive drainage, fever over 100 F, persistent nausea or vomiting, or difficulty with urination. Please call us if other problems or questions arise. We can be reached any time, including evenings and weekends, by calling our office number(703) 359-8640.
Quitting smoking now improves your health and reduces your risk of heart disease, cancer, lung disease, and other smoking-related illnesses. If applicable, please visit the link below for information on quitting smoking. http://betobaccofree.hhs.gov/
Please also find educational material on our website at www.vasurgery.com.
If you are having an inguinal or ventral hernia repair:
To consistently provide top quality, innovative care for patients suffering from hernias, you may receive a post-surgery survey 6 months as well as 1 year after your hernia surgery via email in which provides outcome data to our practice. Your feedback assists us in tailoring our surgical techniques to provide minimally invasive surgeries as well as the most up to date care for sufferers of hernia related diseases.
Do You Have Sleep Apnea?
Obstructive Sleep Apnea (OSA) is a condition where your breathing becomes blocked by the soft tissues in your upper airway. This can become most obvious while you are sedated or undergoing anesthesia. Often patients will have OSA and not even know it. It is important for us to identify those patients who may have OSA, before surgery, as it can lead to some post operative complications. These complications, however, can be avoided with the right precautions.
Some common symptoms of OSA include snoring, restless and/or interrupted sleep as well as excessive fatigue during the day. Additionally, someone may tell you that you seem to stop breathing while you are sleeping (apnea). IF you experience any, or all, of these symptoms we encourage you to see your PCP so that they can evaluate you for this condition. In addition to post op complications, OSA can lead to other medical conditions like hypertension, acid reflux, heart disease, lung disease and stroke. It is important for your overall health to have these symptoms evaluated and treated when necessary.
If you have Obstructive Sleep Apnea (OSA) or you have the symptoms outlined above (Presumptive Sleep Apnea, PSA) we would encourage you to follow the Sleep Apnea Post op Precautions that we have outlined for you on our website at www.vasurgery.com. Our goal is for you to have both a safe surgery as well as a safe post op recovery when you return home.
The communication of your care plan is coordinated between your VSA Surgeon and your Primary Care Physician (PCP)/Referring Physician. Your office notes as well as applicable operative and pathology reports are sent by VSA to your PCP and/or Referring Physician.
When do I transition back to my Primary Care Physician (PCP)?
Patients are evaluated and treated by a VSA Provider and, when appropriate, they are then transitioned back to their Primary Care Physician (PCP) for management of their full health care.
PCP’s provide frontline care to patients by diagnosing and treating common illnesses and identifying minor health issues before they become acute. They provide whole-person, comprehensive care while also coordinating across other health services and specialties. PCP’s ensure patients get the appropriate care, in the correct setting, by the most suitable practitioner, and in a manner consistent with the patient’s values and desires. Without regular screenings, a controllable condition can eventually become critical without proper care. At Virginia Surgery Associates, our Providers and Staff encourage patients to continue to follow up with their PCP.
What if I do not have a Primary Care Physician (PCP)?
If you do not have a PCP, please visit http://health.usnews.com/doctors to search for a PCP near you. We also encourage you to contact your insurance company. Your health insurance company may be able to provide you a listing of PCP’s in their network, within your community, accepting new patients.