Name:__________________________________________Procedure:______________________________________ProcedureDate:__________________________________ProcedureLocation:_______________________________PatientSignature:_________________________________*Ihavereadandunderstandthesesurgeryguidelines*
PAROTIDSURGERYGUIDELINES
FOURWEEKSPRIOR&FOURWEEKSFOLLOWINGSURGERYo Pre-optestingmustbecompleted.Youwillneedtohavethefollowingtests:Chem7,CBC,
PT,PTT,EKG,Chestx-ray(age45andabove,acceptedupto6monthspriortosurgery)o Nodentalwork(includingdentalcleanings)4weekspriortoand4weeksfollowingsurgery.o Nolaserorchemicalpeeltreatments4weekspriortosurgery,andreceiveclearancefrom
Dr.Larian/Dr.Azizzadehforanylaserorchemicaltreatmentspost-surgery.o Donotdyeyourhairfor4weeksfollowingsurgery.Priortosurgery,youcandyeyourhair.
TWOWEEKSPRIOR&TWOWEEKSFOLLOWINGSURGERY
o Avoidallproductsthatmayinterferewithbloodclotting.Examples:aspirin,ibuprofen,oraspirinbasedproducts,NSAIDS(non-steroidanti-inflammatorydrugs),vitaminEandsupplements,garlicextract,alcohol(includingwineandbeer),herbalproducts,fishoilandfish.
o Avoidallsmokingornicotineproductsincludingnicotinegumandpatch.o Avoidallmedicationsunlessclearedthroughouroffice.Contactprescribingdoctorfor
alternativemedicationifnecessaryandforthemanagementofmedicationsduringyoursurgicalprocedureandrecovery.PleaseNOTIFYUSOFANYMEDICATIONSyouaretaking.Thisincludesoverthecounter,non-prescriptiondrugs.
o Tylenol(acetaminophen)isallowedpre-opandpost-opforpainand/orfever.o Purchase:hydrogenperoxide,Q-tipsandbabyshampoofromalocalpharmacy.o Discontinuealldietpillsorsupplements2weekspriortosurgery.o Avoidadietthatisrichinseafood.
DAY/NIGHTBEFORESURGERY
o Washfaceandshampoohairusingbabyshampooandgentlesoap.o DONOTeatordrinkanythingaftermidnightexceptasdirectedbydoctororstaff.o Youcanhaveclearliquidsupto8hoursbeforesurgery.o Youmaytakeyourusualasthma,heart,bloodpressureorseizuremedicationwithasmall
sipofwaterinthemorning,unlessotherwiseadvised.o Fillandpickupallpost-opprescriptions.o Confirmalltravelcompanionarrangementsareinorderfortransportationtothesurgery
andpickupafter.Thiscompanionshouldremainwithyoufor24hoursfollowingsurgery.YOUWILLNOTBEALLOWEDTOPROCEEDWITHSURGERYUNLESSTHESEARRANGEMENTSAREINORDER.YOUWILLNOTBEALLOWEDTOLEAVETHESURGERYCENTERWITHOUTYOURTRAVELCOMPANION.
DAYOFSURGERY
o Takeanypre-opmedicationasinstructedbydoctororstaff,onlyifpre-approved.o Removecontactlenses.o Removealljewelryandpiercings.o Leavevaluablesathomeorwithfamilymembers.o BringaformofID,insurancecardifnecessary,andmannerinwhichtopayforsurgerycenter,ifapplicable.
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o Wearloosecomfortableclothingandsensibleshoes.Bringwarmsocks,asitmaygetcoldinthesurgerysuite.
o Donotsignanypapers,makeappointmentsorimportantdecisionsfor24hoursaftersurgery.Thepost-opmedicationsmayalteryourjudgment.
AFTERSURGERY
PAROTIDSURGERYBecauseofourminimallyinvasiveapproachtoparotidsurgery,recoveryistypicallyquickandeasy.Infact,almosteverypatienttellsustheycannotbelievehoweasytheoverallrecoveryprocesswasforthem.Youshouldfeelimprovementeverydayaftersurgery.Wehaveputtogethersomepost-parotidectomycareguidelinessoyouknowwhattoexpectfollowingyoursurgery.However,keepinmindthateverypatienthealsdifferently,sothesearemerelygeneralguidelines.DayofSurgery
o Whenyouwakeupfromsurgery,youwillhaveaheaddressingandaplasticdrainagetube.
o Youwillspendafewhoursrecoveringatthesurgerycenter,andwillthenbedischargedtogohomewithyourcompanionortoanaftercarefacility.
o Itisimportantforthefirst24hoursyouhavesomeoneyoucancountontohelptakecareofyou.
o Thedrainshouldbeemptiedatleasttwiceadayandtheamountrecorded.Thisrecordshouldbebroughttoyourfirstpost-opappointment.
POST-OPAPPOINTMENTSPost-OpAppointment#1Yourfirstpost-opappointmentwillbethedayfollowingyoursurgery.AtthisappointmentDr.LarianandDr.Azizzadehwilltakealookatyourincisions,surgicalareaanddraintomakesureeverythingisbeginningtohealproperly.Post-OpAppointment#2Yoursecondpost-opappointmentisgenerally3–4daysfollowingyoursurgery.Atthisappointment,yourdrainwillmostlikelyberemoved.Oncethereislessthan25ccoffluidinthedrainovera24-hourperioditisusuallyreadytocomeout.Removingthedrainisprettypainlessasthetubeisverysmall.Post-OpAppointment#3
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Yourthird,andusuallyfinal,post-opappointmentisgenerally5–8daysfollowingyoursurgery.Atthisappointmentwewillremoveyourstitchesanddoafinalcheckonyourhealingprocess.Ifyourstitchesarenotreadytocomeoutandyouareanoutoftownpatient,wewillhelpyouplananappointmentwithaphysicianinyourhometowntoremovethem.Afterthethirdpost-opappointmentouroutoftownpatientsarereadytoflybackhomeandgetbacktotheirnormallives.Sinceeverypatienthealsdifferently,wealwaysrecommendouroutoftownpatientspurchaseanopen-endedplanetickettobesafe.Ournumberonepriorityismakingsureyourbodyhealsproperlyafteryourparotidectomyandwehavefoundthatourhands-onpost-opappointmentswithDr.LarianandDr.Azizzadehensurethissuccess.While,itispossibletoflyhomesoonerafterthesurgery,westronglyencourageourpatientstoattendall3post-opappointmentsattheCENTERforAdvancedParotidSurgery.AtHomeCareIncision
o Beforeyoutouchyourfaceorcleanyourincisions,washyourhandswithsoapandwarmwater.
o Cleantheincisionsinfrontoftheeargentlywithaq-tipandhydrogenperoxideonceaday.
o Antibioticointment(Neosporin,Polysporin,Bacitarcin)purchasedoverthecounter,shouldbeputontheincisiontwiceadayforthefirst10days,followedbyvitaminEointmentorbioCorneumforthenext2months.
o Crushediceinrubbergloves,coldcompressesorfrozenpeasshouldbeusedfor72hoursonanhourlybasiswhenawake.After72hours,usewarmcompressesinareasofbruising.
o Youmightnoticebruising,swellingandhardnessaroundyourincision.Thishardnesswillpeakatabout3weeksandwilldisappearoverthenext2to3months.Firmmassagingofthescarstarting2weeksaftersurgerywillhelp.
Drain
o Thedrainshouldbeemptiedatleasttwiceadayandtheamountrecorded.Thisrecordshouldbebroughttoyourfirstappointment.
Dressing
o Thesurgicaldressingwrapshouldberemovedatyourfirstpost-opappointment.o AnAceWrapshouldthenbewrappedaroundtheheadtightlytohelpreduce
swelling,especiallyatnights,for2weeks.Theswellingintheareaofsurgerywillincreasethefirstseveraldaysandmayhaveadonutshapetoit.
o Swellingwilllast2-3weeks.AdditionalAtHomeCareInstructions
o KEEPHEADELEVATEDWHILERESTING,RELAXING,ORSLEEPINGFORATLEAST1-2WEEKSFOLLOWINGSURGERY.SLEEPONYOURBACKONLY.Sleepisvery
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importantsolaydownatanelevatedanglethatallowsyoutosleep.o Youmayshowerwithlukewarmwaterthedayafteryourdrainhasbeenremoved.
Whendryingoff,delicatelypatdry.Donotsoakinabathtuborspendaprolongedtimeintheshower.
o Noheavyexerciseoryogafor3weeksfollowingsurgery.o Keepallincisionsprotectedfromsunexposurefor3monthsfollowingsurgery.
POST-OPERATIVEDIETSUGGESTIONS
o DRINKPLENTYOFLIQUIDS:Pleasedrinkasmuchwateraspossible,inadditiontootherliquids,suchasGatorade.Avoidsodasandcaffeinateddrinkforthefirstcoupledays.Citrus-basedjuicesmayirritateyourstomach.
o Good,nutritiousfoodonthefirst2-3daysareveryimportantinthehealingprocessandwillhelpyoufeelstrongersooner.Startwithsoftfoods.Herearesomesoftfoodsuggestions:mashedpotatoes,warmsoups,cooked/boiledvegetables,cannedfruit,oatmeal,creamofwheat,babyfood,yogurt,bananas,applesauce,JELLO,pudding,fruitsmoothies.
o NOSMOKINGo NOALCOHOLo NOdietfoods.NOdietdrinks.Yourbodyneedsthecaloriesforproperhealing.o NOaspirinoraspirinbasedproducts(seeattachedlist).o NOsaltyorspicyfoods.o NOgreasyfood.o NOhottemperaturefoods(warmispreferred)asitmaycausebleeding.o NOheavyorbigmeals.Startsmallandlight,thenslowlyincreaseastolerated.
Ifyouhavequestionsrelatingtoyoursurgeryoutsideofourregularofficehours,pleasecallusdirectlyat310.461.0300.
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SUGGESTIONSTOMINIMIZESWELLING,BRUISING&SCARRING
ArnikaForteisourpreferredtreatmentforswellingandbruising.ItistheonlycombinedArnicaMontanaandBromelaincapsuleonthemarketandcanonlybepurchasedfromaphysician.Treatmentstartsthemorningofsurgery/treatmentandcontinuesfor6daysafter:take2tabletsatatimeeachday,foratotalof7daysuntilallcapsulesarecompleted.
UsingbioCorneum(BC+),aself-adheringsiliconegelwithSPF30,willprovidethebestenvironmentforascartohealandwillhelpspeedupthehealingprocess.Threedaysaftersutureremoval,startapplyingBC+twiceaday,verysparingly,toyourscarfor12weeks,oruntilyoustopseeingnoticeableresults.Onedropisenoughtocovera3-inchscar.Ifyouhaveatendencytoformhypertrophicorkeloidscars,youmaywanttouseitfor6monthstoayear.BC+shoulddryrightawayandwithinafewminutesformaslicksurfaceoveryourscar.BC+willgraduallywearoffthroughouttheday,whichiswhyyouhavetoreapplyitagainatnighttomakesureyouaregettingasolid24-hourperdayexposuretothesilicone.
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ASPIRINCONTAININGCOMPOUNDS&MEDICATIONS
***IMPORTANTINSTRUCTIONS***Aspirinandaspirin-relateddrugs(includingarthritisandcoldmedications)causeprolongedandexcessivebleedinginnormalindividualsduringsurgery.Therefore,youmustnottaketheseproductsfor2weeksbeforeand2weeksafteryoursurgery.ThefollowingisapartiallistofmedicationscontainingAspirinthataretobeavoided:
*IBUPROFENISALSOKNOWNTOCAUSEPROLONGEDBLEEDING&SHOULDBEAVOIDED*Ifyoumusttakesomethingforreliefofheadache,menstrualcramps,backache,etc.,pleasetakeTYLENOL(asdirected)forthe2weeksbeforeand2weeksafteryoursurgery.Tylenolshouldnotbecombinedwithprescriptionpainmedications.PLEASECHECKALLMEDICATIONSYOUARETAKINGFORASPIRINCONTENT.IfyouaretakingamedicationnotlistedaboveyoumaycalltheofficetochecktheAspirin/Ibuprofencontentoryoucancontactyourpharmacist.Allherbalmedicines,vitaminsanddietary/nutritionalsupplementsneedtobestopped2weekspriortosurgerybyweaningover3days.
A.P.C.AdvilAleveAlka-SeltzerAnacinAnaproxArthritisPainFormulaAscodeen-30AscriptinAspirinSuppositories(allbrands)AspirinBayerAspirinBuff-a-CompBuffadyneBufferinButalbitalCarnaArthritisPainRelieverCarna-InlayTabsCheracolCapsulesCongespirinCopeCoricidinCoricidinDarvonCompoundDristanDoan’sPillsDuragesicEcotrinEmpirinEmprazilEquagesic
ExcedrinFiorinolFour-WayColdTabletsIndocinMeasurinMidolMonacetwithCodeineMotrinNaprosynNorgesicNuprinOs-Cal-GonePamprinPamprin(Buffered)PanalgesicPepto-BismolPercodanPersistinPropoxypheneRobaxisalSine-OffStendinStero-DarvonwithA.S.A.SupacSynalgosSynalgos-DCTolectinTraminicinVanquishVoltaren
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