Post-Operative Care Instructions

Throat, Airway & Voice Procedures

• Tonsillectomy Hydration, scheduled pain control, and what to watch for after tonsil removal.
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  What to expect: A very sore throat and pain with swallowing; pain may worsen over the first few days. Ear pain is normal (referred from the throat, because the sensory nerves cross paths). Temporary tongue discomfort, numbness, or altered taste from the tongue retractor used during surgery. A fever up to 101° F may occur in the first couple of days. Bad breath for the first week or two. Nausea or decreased appetite for the first few days. Mild, temporary change in voice. White patches in the back of the throat are a normal part of healing.

  What to do: Staying hydrated is the most important thing: minimum 30–40 oz of water daily. Using a straw is fine. Eat soft foods for 2 weeks, even if you feel completely healed (the scab can come off early and cause bleeding). Schedule pain medication every 4–6 hours for the first few days so you don't fall behind on pain control. You can alternate Tylenol and ibuprofen per the bottle (for example, Tylenol, then ibuprofen 3 hours later, then Tylenol 3 hours later). In some cases you'll be specifically asked not to take ibuprofen and will be prescribed narcotic pain medication instead; we'll let you know if this applies to you.

  What not to do: No heavy lifting, strenuous exercise, or anything tiring for 2 weeks. Children should not do hard playing or get worn out for 2 weeks. For the first 48 hours, most time should be spent in bed or seated. Children returning to school after a week should skip recess and P.E. for 2 weeks. Do not travel for 2 weeks. Do not take aspirin or aspirin-containing products for 2 weeks.

  Call us if: Any bleeding from the mouth (if bleeding is severe, go immediately to the North Austin Medical Center ER). Persistent fever over 101° F. Unable to drink enough fluids to stay hydrated.

• Adenoidectomy What to expect for nasal congestion, snoring, diet, and warning signs after adenoid removal.
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  What to expect: A sore throat that usually resolves after a few days. Ear pain is common and is referred from the throat. Temporary tongue discomfort, numbness, or altered taste from the tongue retractor. Continued snoring and nasal congestion until swelling subsides (up to 2 weeks). A fever up to 101° F may occur in the first couple of days. Bad breath for about 2 weeks (extra tooth or tongue brushing does not help). Nausea or decreased appetite for the first few days. Mild nasal bleeding is possible. Mild, temporary voice change.

  What to do: Start with soft foods, then advance to a regular diet as tolerated. Pain is usually well controlled with over-the-counter Tylenol or Motrin.

  What not to do: Avoid traveling out of town or flying for 1 week in case of bleeding.

  Call us if: Severe or persistent bleeding from the nose or mouth, persistent fever over 101° F, inability to drink enough fluids to stay hydrated, or severe neck pain that doesn't respond to pain medication within 48 hours.

• Inspire Implant Wound care, neck rolls, activity limits, and what's normal in the first weeks after Inspire surgery.
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  What to expect: Pain and soreness around the incisions. Mild swelling around the incisions; the neck-incision swelling can be more significant due to temporary inflammation of the submandibular gland, which usually resolves within 2–3 weeks. Some mild oozing from around the incisions is normal. Your tongue will likely be sore for a few days after surgery.

  What to do: OK to shower 24 hours after surgery; you can let warm, soapy water run over the wound. Tylenol with ibuprofen or Aleve per the bottle is usually sufficient for pain. OK to eat a regular diet. Perform neck rolls: 10 clockwise and 10 counterclockwise, 3 times per day. Avoid exercises that involve lifting your arms above your head for 2 weeks.

  What not to do: Do not submerge wounds in water for 1 week. Do not scrub the wound while showering. No heavy lifting or intense exercise for 2 weeks. No flying or travel for 1 week.

  Call us if: Persistent fever over 101° F, severe or worsening pain, or persistent drainage from the wound or worsening redness around the wound.

• Vocal Fold Injection Augmentation Voice rest, hydration, and activity guidance to protect the injection site while it heals.
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  What to expect: Throat pain for a few days after the procedure. Some discomfort with swallowing initially. When you resume talking, your voice will likely feel strained and "tight" for 1–2 weeks, with some hoarseness for 1–3 weeks before gradually improving.

  What to do: Resume a normal diet and light activity. Drink plenty of water (about 60 oz per day). Continue your reflux medication if prescribed. Tylenol as needed for pain.

  What not to do: Do not speak (or whisper) at all for 48 hours after the procedure; this prevents the injection material from leaking out before it heals. Then keep voice use limited for 5 days (about 15 minutes of voice use per hour). Avoid coughing and throat clearing. No heavy lifting or intense exercise for 1 week. Do not smoke.

  Call us if: Persistent fever over 101° F, severe or worsening throat pain, or any difficulty breathing or swallowing.

Nose & Sinus Procedures

• Sinus Surgery (FESS) Saline rinses, activity limits, and warning signs after functional endoscopic sinus surgery.
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  What to expect: Some bleeding from the nose for the first few days is expected. Nasal pain, facial pressure, and congestion are normal; you may actually feel more congested than you did before surgery, due to swelling and crusting.

  What to do: Perform nasal saline irrigations at least 4 times per day until your first post-op visit. A sinus rinse kit (e.g., NeilMed) can be purchased at any drug store; use room-temperature distilled water. The more you irrigate, the less crusting that has to be removed in clinic, and the better you heal. You may use Afrin nasal spray as needed for bleeding and congestion for 3–5 days after surgery, then stop. Keep your head elevated while sleeping. Tape a piece of gauze under your nose for mild bleeding and change as needed. Take any prescribed antibiotics, steroids, or pain medication as directed. Tylenol with ibuprofen or Aleve per the bottle is usually adequate for pain.

  What not to do: No heavy lifting, strenuous exercise, or anything tiring for 2 weeks. Walking is fine and encouraged. Do not blow your nose for 2 weeks; sneeze with your mouth open. Do not travel for at least 1 week, or fly for 2 weeks.

  Call us if: Persistent fever over 101° F, changes in vision, eye swelling, worsening headache or nasal pain, neck stiffness, altered mental status (confusion), or persistent heavy bleeding from the nose.

• Balloon Sinuplasty Saline rinses, head elevation, and activity guidance after balloon sinus dilation.
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  What to expect: Some bleeding from the nose for the first few days is expected. Nasal pain, headaches, facial pressure, and congestion are normal; you may feel more congested than you did before, due to swelling and crusting.

  What to do: Perform nasal saline irrigations at least 3 times per day until your first post-op visit (a sinus rinse kit from any drug store, with room-temperature distilled water). The more you irrigate, the less crusting that has to be removed in clinic and the better you heal. You may use Afrin nasal spray as needed for bleeding and congestion for 3–5 days after surgery, then stop. Keep your head elevated while sleeping. Tape a piece of gauze under your nose for mild bleeding and change as needed. Tylenol with ibuprofen or Aleve per the bottle is usually adequate for pain.

  What not to do: No heavy lifting, strenuous exercise, or anything tiring for 1 week. Walking is fine and encouraged. Do not blow your nose for 2 weeks; sneeze with your mouth open. Do not travel or fly for 1–2 weeks.

  Call us if: Persistent fever over 101° F, changes in vision, eye swelling, worsening headache or nasal pain, neck stiffness, altered mental status (confusion), or persistent heavy bleeding from the nose.

• Septoplasty & Turbinate Reduction Splint care, nasal saline, and activity limits after septoplasty with turbinate reduction.
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  What to expect: Mild nasal bleeding for the first few days. You may have soft plastic nasal splints in your nose held in place by a suture; these are removed at your first post-op visit. Nasal pain and congestion are normal; you will likely feel more congested than before, due to swelling and the splints (if in place). Your upper front teeth may feel numb, which almost always resolves within a few weeks. Your nose is fragile for at least 6 weeks; avoid injury during this period.

  What to do: Use nasal saline spray every few hours while awake until follow up. You may use Afrin nasal spray as needed for bleeding and congestion for 3–5 days, then stop. Keep your head elevated while sleeping. Tape a piece of gauze under your nose for mild bleeding and change as needed. Tylenol with ibuprofen or Aleve per the bottle is usually adequate for pain.

  What not to do: No heavy lifting, strenuous exercise, or anything tiring for 2 weeks. Do not blow your nose for the first week; sneeze with your mouth open. Do not fly or travel for at least 1 week.

  Call us if: Persistent fever over 101° F, severe or worsening nasal pain, or persistent heavy bleeding from the nose.

• Inferior Turbinate Reduction Saline care, activity limits, and what's normal in the first week after turbinate reduction.
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  What to expect: Some bleeding from the nose for the first few days is expected and is usually mild. Nasal pain and congestion are normal; you will likely feel more congested than before, due to swelling. Some crusting and dried blood in the nose is normal.

  What to do: Use nasal saline spray every few hours while awake until follow up. You may use Afrin nasal spray as needed for bleeding and congestion for 3–5 days, then stop. Keep your head elevated while sleeping. Tape a piece of gauze under your nose for mild bleeding and change as needed. Tylenol with ibuprofen or Aleve per the bottle is usually adequate for pain.

  What not to do: Avoid heavy lifting, strenuous exercise, or anything tiring for 1 week. Do not blow your nose for the first week; sneeze with your mouth open. Avoid flying for 1 week.

  Call us if: Persistent fever over 101° F or persistent heavy bleeding from the nose.

• VivAer Nasal Airway Remodeling Nostril ointment, saline care, and what to expect as swelling resolves over 4–6 weeks.
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  What to expect: Mild bleeding for the first couple of days. Crusting in the nostrils for a few weeks. Nostril soreness for a couple of weeks, usually very mild. You will likely feel more congested than before the procedure due to swelling, which improves with time. Most patients achieve maximal benefit 4–6 weeks after the procedure.

  What to do: Use nasal saline spray every few hours while awake until follow up. Apply an over-the-counter triple antibiotic ointment to the inside of the nostrils twice a day for 1 month. You may use Afrin nasal spray as needed for bleeding and congestion for 3–5 days, then stop. Keep your head elevated while sleeping. Tape a piece of gauze under your nose for mild bleeding and change as needed. Tylenol with ibuprofen or Aleve per the bottle is usually adequate for pain.

  What not to do: Do not blow your nose for the first week. Do not pick at the crusting inside your nose. If turbinate reduction was also performed, avoid flying for 1 week.

  Call us if: Persistent fever over 101° F, severe or worsening nasal pain, or persistent bleeding from the nose.

• ClariFix Recovery expectations and the 2–6 week timeline for relief from chronic runny nose.
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  What to expect: Some bleeding from the nose for the first few days is expected and is usually mild. Nasal pain and congestion are normal; you may feel more congested than before, due to swelling associated with the procedure. Some crusting and dried blood in the nose is expected. Some patients experience a brief headache afterward that should resolve within a few hours. It typically takes 2–6 weeks to fully heal and achieve reduction in nasal symptoms.

  What to do: Use nasal saline spray every few hours while awake until follow up. You may use Afrin nasal spray as needed for bleeding and congestion for 3–5 days, then stop. Keep your head elevated while sleeping. Tape a piece of gauze under your nose for mild bleeding and change as needed. Tylenol with ibuprofen or Aleve per the bottle is usually adequate for pain.

  What not to do: Avoid heavy lifting, strenuous exercise, or anything tiring for 1 week. Do not blow your nose for the first week; sneeze with your mouth open. Avoid flying for 1 week.

  Call us if: Persistent fever over 101° F, persistent heavy bleeding from the nose, or persistent severe headache.

• Eustachian Tube Balloon Dilation Ear fullness, nasal care, and the 4–6 week timeline for full benefit after ET balloon dilation.
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  What to expect: A mild nosebleed for the first day. Some nasal congestion and soreness. Initially increased ear fullness from procedure-related swelling. Mild nausea or dizziness, which should resolve quickly. Most patients achieve maximal benefit 4–6 weeks after the procedure.

  What to do: Use nasal saline spray every few hours while awake until follow up. You may use Afrin nasal spray as needed for bleeding and congestion for 3–5 days, then stop. Keep your head elevated while sleeping for 72 hours. Tylenol with ibuprofen or Aleve per the bottle is usually adequate for pain. Continue your topical nasal steroid (e.g., Flonase) if you were previously using one.

  What not to do: Avoid blowing your nose and popping your ears for the first week. Avoid heavy lifting and intense exercise for 1 week. No flying for 1 week.

  Call us if: Persistent fever over 101° F, severe or worsening nasal or ear pain, persistent nausea or dizziness, or persistent bleeding from the nose.

• Closed Reduction of Nasal Fracture Splint care, nasal precautions, and the 6-week fragility window after broken-nose repair.
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  What to expect: Mild nasal bleeding for the first few days. You may have soft plastic nasal splints inside the nose held in place by a suture; these come out at your first post-op visit. You may also have an external splint on the nose held by tape and surgical glue, which also comes off at your first post-op visit. Nasal pain and congestion are normal; you may feel more congested than before, due to swelling and the splints. Your upper front teeth may feel numb; this almost always resolves within a few weeks. Your nose is fragile for at least 6 weeks after surgery; avoid injury during this period.

  What to do: Use nasal saline spray every few hours while awake until follow up. You may use Afrin nasal spray as needed for bleeding and congestion for 3–5 days, then stop. Keep your head elevated while sleeping. Tape a piece of gauze under your nose for mild bleeding and change as needed. Tylenol with ibuprofen or Aleve per the bottle is usually adequate for pain. If the external splint falls off early, gently place it back on your nose and secure with medical tape (available from any pharmacy).

  What not to do: No heavy lifting or strenuous exercise for 2 weeks. Light jogging is OK. Do not blow your nose for the first week; sneeze with your mouth open.

  Call us if: Persistent fever over 101° F, severe or worsening nasal pain, or persistent heavy bleeding from the nose.

Ear & Hearing Procedures

• Ear Tubes Ear drop schedule, water precautions, and when to call after tube placement.
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  What to expect: Ears may be sore for the first few days; children may pull at their ears. Mild ear drainage may occur for the first few days, sometimes longer. If surgery was done under general anesthesia, nausea and stomach discomfort may occur for the first couple of days; start with a clear liquid diet and advance to regular diet as tolerated.

  What to do: Tylenol per the bottle as needed for pain. OK to resume normal activity the evening after surgery. Use the prescribed ear drops, 4 drops in each ear twice a day for 7 days. Restart the ear drops if drainage returns. Most children can return to daycare or school the day after surgery.

  What not to do: Ear plugs are not required for clean water (bathing, showering, or swimming in clean pools). However, ear plugs should be worn for potentially dirty water like lakes, rivers, or oceans. It's fine to use ear plugs if water causes discomfort. OK to use a cloth to wipe the outside of the ear; do not use Q-tips to clean inside the ears.

  Call us if: Persistent or foul-smelling ear drainage, significant ear bleeding (mild blood-tinged drainage is normal), or persistent fever over 101° F.

• Tympanoplasty (Eardrum Repair) Keep-ear-dry precautions, packing care, and activity limits after eardrum reconstruction.
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  What to expect: The ear and incision will be sore for the first few days. Hearing will likely be worse initially; you may also have ear fullness and hear popping sounds, due to packing in the ear. Mild ear drainage may occur; a cotton ball can be placed to catch drainage as needed. Mild dizziness is normal for the first few days.

  What to do: Leave the ear shield in place for 24 hours. Acetaminophen and/or ibuprofen as needed for pain. OK to shower 24 hours after surgery. Keep the ear completely dry; when showering, place a cotton ball just outside the ear canal and coat the outside of the cotton ball with Vaseline as a water barrier. Apply antibiotic ointment (e.g., bacitracin) to the incision behind the ear twice a day.

  What not to do: Do not remove any ear-canal packing; be careful when removing the cotton ball. No swimming, bathing, or submerging your head in water until cleared by your surgeon. No heavy lifting (over 10 lb) or strenuous activity for 3 weeks. No air travel for 1 month. Do not blow your nose for 2 weeks; sneeze with your mouth open. Do not use Q-tips to clean the ear. Do not pick at the incision or remove any skin glue if present.

  Call us if: Persistent ear bleeding, persistent fever over 101° F, severe persistent dizziness or vertigo, or severe or worsening ear pain or headaches.

Head & Neck Surgery

• Parotidectomy Drain care, wound care, and what to expect for facial weakness and earlobe numbness.
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  What to expect: Pain and soreness around the incision and along the side of your face and neck. Mild oozing from around the incision is normal. You will go home with a drain, which is removed at your first post-op visit; the nurse will teach you how to empty the drain and record drain output before discharge. You may have weakness in all or part of your face on the surgery side. This almost always improves with time, but can take weeks to months. You will have numbness around the earlobe; this usually improves with time, but some degree of permanent numbness can occur.

  What to do: Remove the head-wrap dressing 24 hours after surgery. OK to shower 24 hours after surgery; warm, soapy water can run over the wound. Keep your head elevated while sleeping for 72 hours. Tylenol with ibuprofen or Aleve per the bottle is usually sufficient for pain; if narcotic pain medication was prescribed, use it for breakthrough pain. Empty the drain and record output every 8 hours.

  What not to do: Do not submerge the wound in water. Do not scrub the wound while showering. No heavy lifting or intense exercise for 2 weeks. No flying or travel for 1 week.

  Call us if: Persistent fever over 101° F, severe or worsening pain, or persistent wound drainage or worsening redness around the wound.

• Thyroglossal Duct Cyst Excision Wound care, drain management, and activity guidance after thyroglossal duct cyst removal.
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  What to expect: Pain and soreness around the incision and at the front of the neck. Mild oozing from around the incision is normal. You may go home with a drain, which is removed at your first post-op visit; if so, the nurse will teach you how to empty the drain and record drain output before discharge.

  What to do: Remove the gauze dressing 24 hours after surgery. OK to shower 24 hours after surgery; warm, soapy water can run over the wound. Keep your head elevated while sleeping for 72 hours. Tylenol with ibuprofen or Aleve per the bottle is usually sufficient for pain; if narcotic pain medication was prescribed, use it for breakthrough pain. If a drain was placed, empty it and record output every 8 hours.

  What not to do: Do not submerge the wound in water. Do not scrub the wound while showering. No heavy lifting or intense exercise for 2 weeks. No flying or travel for 1 week.

  Call us if: Persistent fever over 101° F, severe or worsening pain, or persistent wound drainage or worsening redness around the wound.

Allergy Procedures

• Allergy Testing & Treatment Shot schedules, reaction monitoring, and what to do between visits for allergy immunotherapy.
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  After each shot: Wait in the office for the required observation period (typically 20–30 minutes) after every injection. Do not skip this waiting period; most serious reactions occur within this window.

  Local reactions: A small, itchy bump at the injection site is normal and expected. Apply a cold pack and take an antihistamine if itching is bothersome. Do not scratch or rub the site.

  Systemic reactions: Symptoms such as widespread hives, throat tightening, wheezing, dizziness, or a feeling of impending doom require immediate treatment with epinephrine. Use your EpiPen and call 911 immediately. Then call our office.

  Schedule: Consistency is key to the effectiveness of immunotherapy. Missed or delayed shots may require a dosage adjustment. Always tell our staff if you have had any reactions since your last visit.

  EpiPen: Patients on immunotherapy should carry an epinephrine auto-injector at all times as directed by your physician. Make sure it is not expired and that you (and a family member) know how to use it.

• Allergy Pre-Testing Instructions Medication holds, food restrictions, and preparation checklist before your allergy skin test.
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  After each shot: Wait in the office for the required observation period (typically 20–30 minutes) after every injection. Do not skip this waiting period; most serious reactions occur within this window.

  Local reactions: A small, itchy bump at the injection site is normal and expected. Apply a cold pack and take an antihistamine if itching is bothersome. Do not scratch or rub the site.

  Systemic reactions: Symptoms such as widespread hives, throat tightening, wheezing, dizziness, or a feeling of impending doom require immediate treatment with epinephrine. Use your EpiPen and call 911 immediately. Then call our office.

  Schedule: Consistency is key to the effectiveness of immunotherapy. Missed or delayed shots may require a dosage adjustment. Always tell our staff if you have had any reactions since your last visit.

  EpiPen: Patients on immunotherapy should carry an epinephrine auto-injector at all times as directed by your physician. Make sure it is not expired and that you (and a family member) know how to use it.

• Allergy Skin Testing FAQ What to expect, how to read results, and next steps after allergy skin testing.
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  After each shot: Wait in the office for the required observation period (typically 20–30 minutes) after every injection. Do not skip this waiting period; most serious reactions occur within this window.

  Local reactions: A small, itchy bump at the injection site is normal and expected. Apply a cold pack and take an antihistamine if itching is bothersome. Do not scratch or rub the site.

  Systemic reactions: Symptoms such as widespread hives, throat tightening, wheezing, dizziness, or a feeling of impending doom require immediate treatment with epinephrine. Use your EpiPen and call 911 immediately. Then call our office.

  Schedule: Consistency is key to the effectiveness of immunotherapy. Missed or delayed shots may require a dosage adjustment. Always tell our staff if you have had any reactions since your last visit.

  EpiPen: Patients on immunotherapy should carry an epinephrine auto-injector at all times as directed by your physician. Make sure it is not expired and that you (and a family member) know how to use it.

• Agreement to Carry EpiPen Patient agreement for those prescribed an epinephrine auto-injector during allergy immunotherapy.
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  After each shot: Wait in the office for the required observation period (typically 20–30 minutes) after every injection. Do not skip this waiting period; most serious reactions occur within this window.

  Local reactions: A small, itchy bump at the injection site is normal and expected. Apply a cold pack and take an antihistamine if itching is bothersome. Do not scratch or rub the site.

  Systemic reactions: Symptoms such as widespread hives, throat tightening, wheezing, dizziness, or a feeling of impending doom require immediate treatment with epinephrine. Use your EpiPen and call 911 immediately. Then call our office.

  Schedule: Consistency is key to the effectiveness of immunotherapy. Missed or delayed shots may require a dosage adjustment. Always tell our staff if you have had any reactions since your last visit.

  EpiPen: Patients on immunotherapy should carry an epinephrine auto-injector at all times as directed by your physician. Make sure it is not expired and that you (and a family member) know how to use it.