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Post Op Nasal / Sinus Surgery - overview, instructions, what to do, what not to do

hi I'm dr. Arthur woo myself and my

partners are diesel and sinus specialist

here in Los Angeles we're here today to

talk about post-operative instructions

after nasal and sinus surgery this

includes septoplasty inferior turbinate

reduction and endoscopic sinus surgery

it does not include rhinoplasty or a

nose job for instructions after a nose

job please refer to your plastic surgeon

please note that while we recommend

certain medications and practices after

surgery you should always check with

your specific surgeon regarding their

recommendations please make sure to have

the following medications and supplies

ready at home for your recovery first

you'll need tylenol and ibuprofen for

pain you can either take these staggered

every three hours or together every six

hours for mild to moderate pain your

surgeon likely prescribed you a narcotic

pain medication like Norco or vicodin

for a moderate to a more severe pain

these are usually also taken every six

hours but please refer to your

prescription for more specific

instructions if your narcotic pain

medication contains Tylenol don't take

additional over-the-counter Tylenol on

top of it second please have a free

nasal spray on hand for you at home in

case you encounter excessive bleeding we

will go into the management of bleeding

in the bleeding section of this video

third you should have a neo med sinus

rinse bottle and plenty of salt packets

for your post-operative nasal rinses now

after surgery you're going to have lots

of blood and mucus in your nose we

expect you to have a nasal congestion

but instead of blowing your nose

we want you to rinse your nose there is

no maximum number two the amount of

rinses that you can do after surgery

however at the very minimum we want you

to rinse at least three to four times a

day we usually want you to start rinsing

the day after surgery

taken yo med sinus roots bottle and in

salt packet undo the top and place the

packet inside fill it to the dotted line

with barely warm water shake it about

with your finger on top to mix it and

place it just into your nostril

gently squeeze this is a high volume low

pressure rinse switching between the

sides until the entire bottle is gone

you're gonna see lots of blood yucky

stuff mucus coming out into the sink

that's normal remember we want you to

rinse a lot at least three to four times

a day there are a couple of activity

restrictions after nasal and sinus

surgery that are important to remind you

about activities that could raise your

blood pressure like jogging Pilates yoga

or even sex are dangerous because they

could cause you to have excessive nasal

bleeding so please refrain from these

type of activities for about a week

however it's totally fine for you to

walk around go to a movie or go to a

restaurant we don't expect you to be in

bed all day in fact being in bed all day

actually can put you at risk for blood

clots in your legs typically you can

expect to take one to three days off of

work after surgery however if your work

entails strenuous activity please refer

to the previous instructions a few other

things that we don't want people to do

after surgery is to get on an airplane

going up and down with the altitude and

pressure changes to be dramatically

uncomfortable during the healing process

while all of the tissues inside the nose

and sinuses are so swollen we generally

recommend not flying for about a week to

a week and a half we also don't

recommend that people go swimming or get

water into the nose other than the sinus

rinses getting water in here nose pool

water bath water can burn can irritate

as things are trying to heal it is also

very common to have a stuffy nose after

surgery keeping your head a bit elevated

will be helpful putting ice over the

nose or

here and sometimes even ice in the mouth

can help with the swelling don't take a

lot of sudafed oral decongestants to try

to get rid of the swelling those can't

increase the blood pressure and increase

the risk of bleeding many patients want

to blow their nose after sinus surgery

so let's be clear about what type of

nose blowing is okay and when it's

potentially dangerous it's okay to sniff

and snort and very gently blow your nose

such as something like that will do you

no harm

I would avoid blowing your nose very

forcefully until your surgeon tells you

this is okay

many people blow their nose and you can

hear them from across the room and this

could potentially be dangerous this

could blow air into the eye socket or

into the cranial cabin and cause you

harm

for one to two days after sinus surgery

you should expect that your nose will be

a little bloody and may require a

moustache dressing or a piece of gauze

that you tape underneath your nose that

you can change if it becomes saturated

when you get up and walk around or

otherwise exert yourself you may have a

small nosebleed this should resolve with

sitting down relaxing putting an ice

pack on your face or pinching your nose

shut for a few minutes like so if you

feel that you are bleeding too much

which generally means you see bright red

blood steadily running out of your

nostrils spray a generous amount of

Afrin nasal spray into the side of your

nose that is bleeding it takes about ten

minutes to work this is a nasal

decongestant that you buy over the

counter that constricts the blood

vessels in your nose after you put it in

again squeeze your nostrils shut for ten

minutes without checking if you feel

you're bleeding too much in the advice I

just gave you doesn't work you should

notify your surgeon's office immediately

in rare cases you may need to go to the

nearest emergency department after sinus

surgery you should not expect to have

any bruising or swelling on your face if

you see any of these signs you should

call your surgeon immediately

also you should not have any double

vision or blurred vision or loss of

vision after sinus surgery and these are

warning signs that you should notify

your surgeon of immediately I hope this

video was helpful if you have any

additional questions please leave it in

the comments below