Postoperative Care And Instructions After Sleep Apnea Surgery
You are scheduled to undergo surgery for obstructive sleep apnea. It's normal to be apprehensive about any form of surgery. Hopefully, this sheet will help you to prepare for what's to come after the surgery. If you have any questions at any time, please do not hesitate to call Dr. Park.
For Uvulopalatopharyngoplasty only (with or without tonsillectomy):
The surgery will open your breathing passageways at the level of your soft palate and tonsils. It is performed through the mouth, similar to a tonsillectomy procedure. Usually, a high-tech cutting tool called a Coblator (using radiofrequency energy to generate a plasma field) is used to vaporize tissues at relatively low temperatures. This is in contrast to electrocautery which uses high currents at high temperatures, leading to more pain.
After waking up from anesthesia, you will be taken into the recovery room for 1-2 hours, after which you will be taken to your hospital room where you will stay overnight. You may be a little groggy after having anesthesia, but that will wear off within a few hours. Your throat will be sore, and if necessary you can ask for pain medications from the nursing staff. You will have two options: a milder, liquid form of a narcotic pain medication, or a stronger intramuscular shot. This can be given every four hours, as needed. You may also be prescribed a topical oral steroid/Benadryl gargle to soothe the wounds in your throat. You should be able to walk immediately after surgery. Your speech may be a little garbled for a few days, but this improves as well.
Try to swallow water or soft foods right away. It may be difficult, but most people (99%) are able to leave by the next morning. You will not be sent home until you are drinking an adequate amount of liquid so that you don't get dehydrated. Try to take pain medications just before trying to eat or swallow. Expect some degree of liquids or food regurgitating into the nose—this is an expected and temporary event. Usually, it goes away in a few days to weeks.
Pain medication and an antibiotic (liquid forms) will be given to you either before the surgery or on discharge. Pain and discomfort is different for everyone, but most people say that the pain was around a 3-5 (out of 10) for up to a week. Afterwards, you can expect slow gradual improvement. For the first few days, try eating very soft foods such as ice cream, Jello, milk shakes, Ensure, or nutritional drinks. You can also puree or blend whatever you like in mixer. Try to stay away from spicy, citrus or hot (temperature) foods. After about a week (or earlier), you will want to eat more solid foods. Some people have commented that they liked applesauce, or peach juice blended with other foods. Experiment, and try different foods. Obviously, don't eat a hamburger during the first week after the surgery. Be sure to drink plenty of fluids, as the one possible complication is dehydration. You can monitor yourself by how week you feel or by the lower volume and color or your urine (dark and in small amounts).
For up to 10 days, expect to see a white or gray patch in the throat which can taste bad or smell somewhat—this is the normal scab that appears. Eventually, it wil fall off. Remember that the wound healing phase occurs in the first 2-3 weeks. I will usually see patients in the office about 2 weeks after surgery. It takes another 4-6 months for the scarring and tightening phase to occur. This is why we wait 4-6 months after surgery before another sleep study is ordered. Some people may feel a lump in the throat for weeks or months after surgery, but this goes away as well with time.
Most patients are able to go back to work the following Monday after surgery (6 days later).
With Genioglossus Advancement & Hyoid Suspension:
These procedures address tongue base collapse that is responsible for many cases of obstructive sleep apnea.
If you are also undergoing these tongue base procedures, the same recommendations apply as for uvulopalatopharyngoplasty, but it may take a few days longer before you are discharged from the hospital. Most patients stay about 2-3 days in the hospital. Some go home the next day, and rarely others stay 5-6 days. How quickly you go home depends on how quickly you can swallow. The hard part is in learning how to swallow—it's difficult initially, but everyone gets it eventually. It's not so much pain with the tongue procedure, as it is difficulty with swallowing. We will do everything possible to keep you comfortable, as well as to encourage you to swallow so you can go home ASAP.
Most people can go back to work about 2 weeks after the surgery. Again, you won't see significant results until many months later. A sleep study is ordered at the 4-6 month mark.
For any of these procedures, it will be helpful if you can get a friend or family member to help with simple chores for a few days.
If you have any questions or concerns about your surgery, please contact Dr. Park. For scheduling and pre-authorization issues, contact Adrienne at 212-315-9058. We are here to help.
Preparing For Surgery
* WHAT TO BRING TO THE HOSPITAL or SURGERY CENTER. Wear loose, comfortable clothing. You will want to bring a few personal items such as a toothbrush, slippers and robe. Most patients find it easier to use the hospital gowns instead of their personal bed clothes. If you usually wear contact lenses, you will be more comfortable wearing your eyeglasses after surgery.
* BRING SPECIAL MEDICATIONS. Medication which you take on a regular basis should be brought with you.
* LEAVE VALUABLES AT HOME.
* ARRANGE YOUR TRANSPORTATION. You should arrange to have someone take you home.
* AVOID ASPIRIN. You must not take aspirin or aspirin products for two weeks before surgery. Tylenol is OK.
The Day Of Surgery
* ANESTHESIA. You will have a chance to discuss your anesthesia with a member of the anesthesia department before your procedure.
* PAIN. Your throat will be quite sore following surgery. Medication will be prescribed to help reduce swelling and to prevent post-operative infections.
* You will also have a prescription for pain or you may take acetaminophen (Tylenol) in tablet or liquid form as directed on the label.
* DO NOT TAKE ASPIRIN OR ASPIRIN PRODUCTS because they have a tendency to cause bleeding.
The First Several Weeks After Surgery
* THROAT CARE. Your throat may continue to be sore following surgery. It will hurt to swallow for up to two weeks. To help keep the back of the throat moist, use a room humidifier. You will have medicine for the pain to help reduce any swelling and to prevent infection.
* BREATHING. A stuffy nose is not uncommon. This is due to crusting and mucous accumulation. It will be cleaned out during your follow-up visit. You can take either Sudafed or Afrin for 2-3 days for temporary relief until your visit. Nasal saline sprays can be used frequently to loosen the secretions.
* BLEEDING. If excessive bleeding occurs, call the doctor's office or go to the nearest emergency room.
* FEVER. Mild fever is expected. Call the Dr. Park if you develop a high fever (greater than 101).
* ACTIVITY. You will feel a lack of energy for 1-2 weeks and will
need more rest than usual. Reduce your activity level to accommodate these needs. Heavy lifting or straining is not recommended.
* VOICE. You may notice your voice has an unusual sound quality. This is not uncommon and generally will return to normal as your throat heals.
* SWALLOWING. Your swallowing should slowly return to normal within 1-2 weeks, but everyone recovers at a different rate. The more extensive surgery you have, the longer it will take.
Remember, your recovery is a process, not an event.
Steven Y. Park, M.D.
Otolaryngology – Head & Neck Surgery
(212) 315-9058
