Introduction
The majority of patients will experience significant improvement in their sinus symptoms after a sinus surgery. However, it takes time for the body to heal. While some patients may notice improvement immediately following surgery, others may take weeks before they feel a lot better. This depends on several factors including the type and extent of surgery and the patient’s personal experience. Remember, it takes time for the sinuses to fully heal after surgery.
Expectations
Packing
You may or may not have packing in your nose after surgery. If you have packing, it can come in two forms. One is absorbable and will dissolve on its own with time and regular saline irrigations. The other is not absorbable and will be removed by your doctor at a clinic appointment after surgery. Your doctor may also use stents or spacers with corticosteroids on them to help reduce inflammation and swelling after surgery (See Sinus Stents).
Irrigations
The most important thing you can do to help your recovery after surgery is to regularly irrigate your nose and sinuses with saline rinse after surgery (See Sinonasal Irrigations). Your doctor will show you how this works. S/he will also tell you when to start (usually within 1 to 2 days after surgery). Gently apply pressure on the rinse bottle while you lean over the sink or shower. You do NOT need to push hard.
Antibiotics
Infection is a common problem in patients with chronic sinusitis. It is also a risk of surgery. Your doctor may administer antibiotics during your surgery or prescribe antibiotics after surgery.
Steroids
One of the underlying causes of chronic sinusitis is inflammation and swelling. To improve healing and treat inflammation, your doctor may prescribe oral steroids, topical steroids or both. Topical steroids often come in the form of a spray or a medicine placed in saline irrigations.
Pain
Some patients experience minimal amounts of pain after surgery, while others may experience significant pain for several days. Your doctor will discuss an appropriate pain management regimen for after your surgery. S/he may give you a prescription for pain medication. Over-the-counter medications such as Tylenol may also be used.
Bleeding
It is common to see drops of blood or blood-tinged nasal secretions after surgery. Keep your head elevated. Avoid nose blowing. If you feel a sneeze or cough coming, open your mouth and let it out. Avoid lifting heavy objects and strenuous exercise for the first 2 weeks after surgery. Also avoid medications that can thin your blood such as aspirin and herbal medications until cleared by your doctor. It is NOT normal to have heavy amounts of bleeding after surgery. If you have bleeding that does not stop after holding nasal pressure for several minutes or you are concerned that you are bleeding too much, call your doctor’s office immediately or go to your local emergency department for further evaluation.
Nasal congestion/obstruction
Some patients may notice improvement in their nasal congestion immediately after surgery. Others may not notice improvement for several days to weeks. Both experiences are normal. After surgery, nasal congestion may be related to many factors including packing, crusting, and normal post-surgery swelling. Be patient, irrigate regularly, and follow up with your doctor. It should get better.
Fatigue
It is common to feel tired in the first days to weeks after surgery. Remember to take it easy while your body is recovering.
Clinic visits after surgery
It is important to see your doctor in clinic after surgery. S/he will look in your nose with an endoscope (See Nasal Endoscopy), remove any crusts that do not flush out with saline irrigations (you may hear this referred to as a “debridement”) and pull out any nonabsorbable packing. Additionally, s/he will make sure you are not scarring, that you are healing well and are on the road to recovery!
Return to work
Plan to take some time off after surgery. Some patients will be ready to go back to work in a matter of days while others will need 1-2 weeks to recover. This will depend on the extent of surgery, your recovery experience, and the nature of your work. If you have a desk job, you may be able to go back to work before the end of a week but expect to be tired and limit your work demands. If you have a job that demands strenuous labor, you may need to take as much as 2 weeks off until your body has time to heal. Be patient. If you push yourself too hard and too fast, you may risk slowing the healing process or experiencing bleeding. With time and good post-surgery care, the vast majority of patients experience significant long-term improvement!
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